Evidence-based means that a treatment method has been studied and does what it claims to do. Not all evidence is the same. The type and strength of evidence that supports a treatment can vary from very weak to very strong. There is no requirement that treatments have evidence before they can be used, so it is up to therapists and even parents to evaluate the available evidence when deciding whether to use a treatment method.
Does evidence-based mean the treatment will improve my child’s communication?
Not necessarily. It is important to pay attention to what outcomes the study evaluated and who the study included. For example, it is now well established that practicing oral movements like blowing, chewing, or tongue movements, does not lead to direct changes in speech production for children with CAS. Secondly, it is important to consider the population studied in the research, such as the diagnosis and age of the child. Evidence that a treatment works for children with one type of speech sound disorder does not mean it will work for children with CAS.
Is all evidence the same?
No, it is very important to evaluate the quality and level of evidence the research provides. Publication of a study in a peer-reviewed journal indicates that the quality of the research design was solid. Research reported without peer review (i.e. in a paid advertisement or through social media) has not been critically reviewed.
Peer reviewed research that provides evidence that the treatment resulted in improvements that were maintained over time and generalized to items not directly practiced in the study are well accepted as the strongest evidence of a treatment’s effectiveness. That research is even stronger when multiple independent researchers reported consistent findings, and when the studies involve more than just a few children.
More information about evaluating a program and its evidence can be found here.
Questions to ask
Here are some questions to consider about any treatment method selected for a child with CAS:
How do I find out about the evidence that supports a CAS treatment method?
You can learn more about specific CAS treatment methods supported by research here. The American Speech-Language Hearing Association (ASHA) maintains Evidence Maps for a a variety of disorders, including CAS. You can visit the ASHA CAS evidence map here. You can also talk with your SLP about evidence that supports a CAS treatment method and share these resources.
What if my child is receiving a treatment approach not supported by evidence?
There are other CAS treatments that do not have the same level of evidence. Using a different method does not necessarily mean a child will not make progress, it just means that there is not sufficient evidence of effectiveness across different children. Thus, it is up to clinicians to carefully monitor the child’s response to treatment, including maintenance (skills learned persist over time) and generalization (skills transfer to things not directly practiced in therapy). If your child is using a therapy program not supported by evidence, ask the SLP about the research evidence that supports the program and the methods the SLP is using to evaluate the child’s response to the treatment.