Practice-Based Research in Speech-Language Pathology

Practice-based research is an active and collaborative approach to clinical research that minimizes the research-practice gap. Practice-based research involves collecting data in practice to answer questions that arise from clinical practice. The findings from this research then inform future practices. Though over the past two decades there has been a significant increase in knowledge translation activities, especially the use of collaborative partnerships, the integration of these practices in speech-language pathology is in its infancy. In this thesis, I investigate the role of practice-based research in speech-language pathology. In Chapter 2, I first examine the current role of practice-based research in speech-language pathology through a scoping review. I present a practice-based research Co-Creation Model that characterizes the outcomes of partnerships, and I present the results of the scoping review. The Co-Creation Model outlines capturing practice, changing practice, and creating practice as three potential outcomes of these partnerships. In Chapter 3, I employ two aspects of the model, first capturing practice and then changing practice. In this chapter, I report on a practice-based research partnership between researchers and speech-language pathologists at a school board in Ontario. The clinicians at this school board designed a language and literacy tool and they were interested in determining the effectiveness of the tool. In study 1, we capture the current use of the tool and the results of this study led to a collaborative update of the tool. In study 2, additional data was collected to determine the effectiveness of the updated tool and determine the tool’s validity against standardized measures of language. The results of this study demonstrated that the update of the tool was successful. Chapter 4 aims to understand the experiences of researchers and clinicians engaged in a partnership and draws on qualitative data collected during the practice-based study reported in Chapter 3. Insight from their experiences provided knowledge of barriers and facilitators to partnership, and factors important for partnership initiation and maintenance. Chapter 5 summarizes the findings of these 3 chapters, discusses broader implications of this work, acknowledges limitations of the current work, and outlines considerations for future work in practice-based research

Exploring Practice-Based Clinical–Research Partnerships in Speech-Language Pathology: A Scoping Review

Collaborative partnerships between speech-language pathologists and researchers present an opportunity for practice-based research. For practice-based research to become more widely used in speech-language pathology, a crucial step is outlining the potential purposes and outcomes of these partnership projects. The current article is two-fold. First, we describe a model for practice-based partnerships between researchers and speech-language pathologists. The practice-based research cocreation model developed for this project includes three distinct partnership outcomes: (a) creating practice, (b) capturing current practice, and (c) changing practice. Then, informed by our model, we completed a scoping review to explore the extent and type of practice-based research in the field of speech-language pathology to date. A literature database search identified 3510 articles meeting our inclusion criteria. Two independent readers reviewed abstracts and titles to determine articles for further review. Fifty-three articles were reviewed in full and 18 of these were excluded. Data were extracted from the remaining 35 articles. Level of partnership (creating, capturing, or changing) and type of partnership (collaborative or consultative) were coded. A thematic analysis revealed that three of the 35 articles involved creating practice, 19 captured current practice, and 13 were aimed at changing practice. Of the 27 articles in which details were provided about the partnerships between researchers and clinicians, 18 partnerships were collaborative and 9 were consultative. This review offers an initial step in examining the use of practice-based research in speech-language pathology, thereby demonstrating to researchers and clinicians how they can support each other to cocreate clinically relevant researc

Evidence for complementary effects of code- and knowledge-focused reading instruction

There is growing recognition of the need to end the debate regarding reading instruction in favor of an approach that provides a solid foundation in phonics and other underlying language skills to become expert readers. We advance this agenda by providing evidence of specific effects of instruction focused primarily on the written code or on developing knowledge. In a grade 1 program evaluation study, an inclusive and comprehensive program with a greater code-based focus called Reading for All (RfA) was compared to a knowledge-focused program involving Dialogic Reading. Phonological awareness, letter word recognition, nonsense word decoding, listening comprehension, reading comprehension, written expression and vocabulary were measured at the beginning and end of the school year, and one year after in one school only. Results revealed improvements in all measures except listening comprehension and vocabulary for the RfA program at the end of the first school year. These gains were maintained for all measures one year later with the exception of an improvement in written expression. The Dialogic Reading group was associated with a specific improvement in vocabulary in schools from lower socioeconomic contexts. Higher scores were observed for RfA than Dialogic Reading groups at the end of the first year on nonsense word decoding, phonological awareness and written expression, with the differences in the latter two remaining significant one year later. The results provide evidence of the need for interventions to support both word recognition and linguistic comprehension to better reading comprehension

Comparing community-based reading interventions for middle school children with learning disabilities: possible order effects when emphasizing skills or reasoning

IntroductionThere is an abundance of community-based reading programs for school-age children who are struggling learners. The aim of this study was to compare two community-based programs (i.e., skill and reason-based programs) and to analyze any complementary benefits.MethodsIn this randomized cross-over study, 20 children completed two 8-week literacy intervention programs. The skills-based program, Leap to Literacy, focused on explicit teaching and repeated practice of the five key components of literacy instruction (phonemic awareness, phonics, fluency, vocabulary, comprehension). The reason-based program, Wise Words, focused on morphological knowledge, hypothesis testing, and critical thinking.ResultsResults revealed study-wide improvements in phonemic awareness, nonword reading, passage reading accuracy, spelling words and features, and affix identification. There were consistent program by program order effects with robust effects of completing the skills-based program first for phonemic awareness, the reason-based program first for passage reading accuracy, and both programs for affix identification. A significant increase in an oral language measure, recalling sentences, was observed for the group who completed the reason-based program first, although they also started off with a lower initial score.DiscussionFindings indicated improvements from participating in either program. The observed order effects suggest potential additive effects of combining reason- and skills-based approaches to intervention