How can we get effective treatments into schools and clinics as quickly as possible?

In healthcare, it is estimated that it takes 17 years for effective treatments to move from research studies into clinical practice. It is further estimated that people only receive about 50% of recommended health care procedures. There is emerging evidence that the same problem exists in speech-language pathology, particularly in the treatment of children with speech sound disorders (SSD). Children with SSD are behind their peers in learning how to pronounce speech sounds but other areas of development are typical. A 2013 survey showed that speech-language pathologists were most familiar with older treatments for children with SSD and were least familiar with more recent treatments (i.e., those developed in the last 25 years). This means that children with SSD are not receiving the best available treatments, which could affect how long they are in treatment and whether other areas of their development are impacted by their SSD (e.g., reading, social interactions, self-esteem).

One barrier to getting effective treatments into schools and clinics is how the information is disseminated. Most practicing clinicians have high caseloads and have minimal time to read research. Moreover, research articles are not written in a way that makes it easy for clinicians to quickly apply the findings to their practice. Typically, speech-language pathologists must do a lot of extra work to go from reading a research article to implementing the findings. We engage in social media outreach to bring key research findings to clinicians so that they are aware of current clinical practice research that impacts their daily work. In addition,we write clinician friendly tutorials (Storkel, 2019; Storkel, 2018a; Storkel, 2018b) to explain research findings and demonstrate clinical application. These tutorials include clinical materials to facilitate clinical implementation. Two of these tutorials (Storkel, 2019; Storkel, 2018a) have over 15,000 downloads each (compared to the more typical several hundred to several thousand downloads), suggesting that people are accessing the information at higher levels than a typical research article.

A second key barrier is that most of the research on treatment of children with SSD has been done in research settings under conditions that are quite different from typical clinical practice. This has led to procedures that are not feasible in clinical practice (e.g., lengthy assessments to inform treatment goals; high intensity treatment that differs from that seen in typical clinical settings). Our group wants to work with clinicians to adapt a treatment that has a strong research base: the complexity approach. In the complexity approach, more advanced or difficult sounds are prioritized for treatment to spark broad learning of speech sounds with minimal treatment. While it is estimated that this approach has more research evidence than other SSD treatment approaches, it has not been widely adopted in clinical settings. Our goals are to better understand why this approach has not been adopted clinically, create a more clinically feasible version of the approach, and test the effectiveness of the adapted version.