Subtract Before You Add: Toward the Development of a De-Implementation Approach in School-Based Speech Sound Therapy.
Purpose: It is often difficult for school-based speech-language pathologists (SLPs) to prioritize implementing new practices for children with speech sound disorders (SSDs), given burgeoning caseloads and the myriad of other workload tasks. We propose that de-implementation science is equally as imp...
| Published in: | Language, Speech & Hearing Services in Schools Vol. 54; no. 4; pp. 1052 - 1066 |
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| Main Authors: | , , , |
| Format: | case study research Journal Article |
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American Speech-Language-Hearing Association
Oct2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=172759386&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 172759386 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01611461 LSH jtl: Language, Speech & Hearing Services in Schools issn: 01611461 maglogo: N pubinfo: dt: Oct2023 vid: 54 iid: 4 pid: 42 pub: American Speech-Language-Hearing Association place: Rockville, Maryland artinfo: ui: 172759386 172759386 172759386 10.1044/2023_LSHSS-22-00176 172759386 ppf: 1052 ppct: 14 formats: tig: atl: Subtract Before You Add: Toward the Development of a De-Implementation Approach in School-Based Speech Sound Therapy. aug: au: Farquharson, Kelly Cabbage, Kathryn L. Reed, Anne C. Moody, Mary Allison affil: School of Communication Science and Disorders, Florida State University, Tallahassee sug: subj: Speech Therapy Methods Communicative Disorders Therapy Speech-Language Pathologists School Health Services Implementation Science Workload Human Male Female Child Speech Skill Acquisition Surveys Speech-Language Pathology Outcomes (Health Care) Professional Development Child: 6-12 years Male Female ab: Purpose: It is often difficult for school-based speech-language pathologists (SLPs) to prioritize implementing new practices for children with speech sound disorders (SSDs), given burgeoning caseloads and the myriad of other workload tasks. We propose that de-implementation science is equally as important as implementation science. De-implementation science is the recognition and identification of areas that are of "low-value and wasteful." Critically, the idea of deimplementation suggests that we first remove something from a clinician's workload before requesting that they learn and implement something new. Method: Situated within the Sustainability in Healthcare by Allocating Resources Effectively (SHARE) framework, we review de-implementation science and current speech sound therapy literature to understand the mechanisms behind continuous use of practices that are no longer supported by science or legislation. We use vignettes to highlight real-life examples that clinicians may be facing in school-based settings and to provide hypothetical solutions, resources, and/or next steps to these common challenges. Results: By focusing on Phase 1 of the SHARE framework, we identified four primary practices that can be de-implemented to make space for new evidence-based techniques and approaches. These four practices were determined based on an in-depth review of SLP-based survey research: (a) overreliance on speech sound norms for eligibility determinations, (b) the omission of phonological processing skills within evaluations, (c) homogeneity of service delivery factors, and (d) the use of only one treatment approach for all children with SSDs. Conclusions: De-implementation will take work and may lead to some difficult discussions. Implementing a framework, such as SHARE, can guide SLPs toward a reduction in workloads and improved outcomes for children with SSDs. pubtype: Academic Journal doctype: case study research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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