Speech and Language
|Posted on October 2, 2017 at 6:40 AM|
Is Melodic Based Communication Therapy Evidence Based Practice?
The most common definitions of Evidence-Based Practice (EBP) involve “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research” (Sackett et. al. 1996).
The American Psychological Association (APA) defines EBP as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences."
The American Speech-Language-Hearing Association (ASHA) uses the following definition of EBP: "the integration of research evidence with practitioner expertise and client preferences and values into the process of making clinical decisions. Note that although this is referred to as "evidence-based" practice, the roles of clinician expertise and client preferences and values are equally important. The notion that external research evidence somehow "trumps" all other considerations is one of the big myths surrounding EBP."
The American Medical Association defines evidence as "a provisional departure point in the consideration of whether or not a particular course of action is to be taken in any clinical context" (Virtual Mentor. January 2013, Volume 15, Number 1: 86-89).
What does this mean?
The goal of EBP is to combine clinical expertise/expert opinion, external scientific evidence, client/patient/caregiver perspectives to provide high quality services that reflect the specific needs, interests, and values of the population served.
M.B.C.T. was developed by a speech-language pathologist after years of working with nonverbal children with autism in the field. The approach is meant to combine clinical expertise/expert opinion, external scientific evidence from multiple fields of study, and the needs and interests of the child to facilitate verbal speech.
M.B.C.T. pulls scientific evidence from a variety of fields including speech-language pathology, neurology, behavioural science, music, and occupational therapy to address the multifaceted needs of the nonverbal child with autism. See our blog on evidence to read more on this.
The original study on M.B.C.T. was designed as a randomized controlled trial (RCT), which is generally considered to be "the design least susceptible to bias." Blocking was necessary prior to randomization to ensure both groups had an equal amount of 5, 6, and 7 year olds.
The original interdisciplinary research team, formed at Loma Linda University, consisted of speech-language pathologists, Dr. Karen Mainess and Dr. Givona Sandiford, pediatric neurologist, Dr. Sarah Roddy, neuroscientist Dr. Ernie Schwab, psychologist, Dr. Taryn Hudson, and statisticians, Dr. Noha Daher and Dr. Grenith Zimmerman. Speech-language pathology graduate students at Loma Linda University acted as clinicians and were given two full days of training in the approach. The results were first published in the Journal of Autism and Developmental Disorders under the editorship of Dr. Rhea Paul.
Though steps were standardized for the purposes of the research study, those trained in M.B.C.T. for clinical purposes are encouraged to make modifications based on their own clinical expertise and observations of the needs of the child.
Research on M.B.C.T. is ongoing. We have included several references on the evidence behind M.B.C.T. in this blog, however for more on this topic you may wish to attend one of our continuing education seminars at www.ciaoseminars.com.
Sources: Click on links in blog post to be directed to sources.