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From: John B. Ellis
Date: 03 Oct 2005
Time: 12:37:59 -0500
Remote Name: 128.138.218.19
Rosalee, Thanks for contributing to this year's Online Conference. I appreciate the well-documented information regarding your attempts to apply the Lidcombe Program to school-aged stutterers. I have a question regarding your definition of Evidence-Based Practice (EBP). In your paper, you quote Sackett's earlier definition of EBP from 1996: EBP is " the use of current best evidence in developing treatment programs for individual clients". In America, however, ASHA has currently defined EBP as consisting of the integration of (a) best research evidence with (b) clinical expertise and (c) patient values." (see Sackett et al., 2000). After reading your article, it is clear that your approach addresses all three components (e.g., "The child should be involved in all phases of treatment including setting all short term goals and activities, deciding the frequency and type of contingencies for stutter free and stuttered speech." or "All goals were set by the client, parent and clinician, and in the later stages of treatment Tom collected Severity Ratings (SR) at school to inform treatment progress and to help set the goals for maintenance.") These are clear examples that your conceptualization of EBP is broader than research data alone. So, I'm wondering if you could comment on what, in your opinion, constitutes "best evidence". Despite that your paper intended to concentrate "on the behavioral aspects of assessment and treatment", it appears to address additional EBP issues contained in Sackett et al.'s more recent definition.