Building good practice: Lessons from a multimethod study of speech and language therapy

This article examines data from a multimethod study of speech and language therapy for pre-school children. The study compares the impact of intervention offered immediately following assessment with a control condition of monitoring over a 12-month period. A randomized controlled trial, a survey and in-depth interviews with parents are used. Data from the component studies were reviewed in order to draw out implications for good practice. These cluster into four areas: caseload selection, eclecticism, targeting and acceptability of therapy. Therapists were found to individualize therapy for their heterogenous caseloads. Parents generally valued therapy but wanted more specific activities. The article concludes that the heterogeneity of therapists’ caseloads creates challenges for evidencebased practice. In order to increase therapists’ understanding of factors that are critical to success, therapy should be systematically varied within a well-documented hypothesis testing approach.