November 7, 2006
This is another in a series of occasional ASHA Executive Director updates. These updates are intended to provide ASHA members with a more in-depth view of various National Office teams and clusters, their key member services and the names and roles of ASHA staff in those units. Information about staff changes and ASHA National Office recognitions/awards is also included.
Many thanks to those of you who have provided feedback regarding the previous updates (posted on the ASHA Web site), or suggestions for future Executive Director updates. Hope to see you all at Convention in Miami next week.
Established in 2005, N-CEP coordinates the Association's activities in the areas of evidence-based practice (EBP) and treatment outcomes research. In addition to collaborative projects with staff units from across ASHA's National Office, N-CEP works with ASHA's Advisory Committee on Evidence-Based Practice to identify and meet the needs of ASHA members in these areas.
N-CEP's work in the area of EBP is organized along three themes: knowledge about EBP, development of the skills needed in order to incorporate EBP into everyday clinical practice, and ongoing support from ASHA.
Knowledge. Knowledge in this case sometimes involves de-bunking misinformation, along with helping members to learn more about EBP. EBP is sometimes misconstrued as "cookbook" clinical practice, where the expertise of individual clinicians is discarded in favor of a strict dependence on the external scientfic evidence. ASHA's view of EBP is the integration of clinical expertise, client values, and external scientific evidence into the clinical decisions that will best serve our clients. This is the message that N-CEP staff, Advisory Committee members, and volunteer leaders have tried to spread through the ASHA Convention, state association meetings, and articles in the Leader and other communication vehicles.
Skills. While most ASHA members seem to know what EBP is, many report feeling ill-prepared to deal with the realities of EBP. Of particular concern to many is the area of identifying and evaluating scientific evidence. N-CEP now has a professional librarian on staff, and she is available to give guidance to members in conducting searches to identify the scientific literature most relevant to their clinical question(s). The Advisory Committee and N-CEP have also developed a system of "levels of evidence" that apply to the specific nature of scientific studies in the area of communication sciences and disorders.
Support. In the summer of 2005, N-CEP conducted a survey of ASHA members to determine, among other issues, what members perceived as the biggest barriers to their ability to engage in evidence-based practice. Two issues dominated. One was the evidence itself. Many members felt that the available scientific evidence on many important topics was not always directly relevant to the realities of clinical practice, and often evidence just wasn't available at all. N-CEP has embarked upon a series of evidence-based systematic reviews on topics identified by the members as important. A review of the evidence on the intensity of aphasia treatment is almost complete, and a two-part review of the efficacy of oral-motor exercises (for articulation, and for swallowing) is about to get underway, with more reviews planned for 2007.
By far the most-frequently cited barrier, however, was time. Many members have expressed concern that the time demands of integrating scientific evidence into clinical decision-making creates unrealistic demands upon clinicians. One way in which N-CEP has tried to address this barrier is through the development of a Compendium of EBP Guidelines and Systematic Reviews on the N-CEP page of the ASHA web site. This compendium provides citations and direct links where available, to evidence-based practice guidelines and systematic reviews on speech-language pathology and audiology topics. The guidelines and reviews are from across the globe, and all have been reviewed for quality before inclusion.
Treatment Outcomes
N-CEP's work on treatment outcomes has focused on the National Outcomes Measurement System (NOMS). Established in 1998, NOMS collects data on three SLP client populations: Adults, Schools, and Pre-Kindergarten (which includes school and healthcare settings). Currently, the federal government's Center for Medicaid and Medicare Services is considering piloting the use of the Adult NOMS for data collection as a possible therapy cap alternative for Medicare Part B patients.
N-CEP Staff
Rob Mullen
Director, National Center for Evidence-Based Practice in Communication Disorders
rmullen@asha.org
Beverly Wang
Clinical Research Associate
bwang@asha.org
Iris Smorodinsky, Ph.D.
Librarian, National Center for Evidence-Based Practice (N-CEP)
ismorodinsky@asha.org
Floyd Roye
Outcomes Data Manager
froye@asha.org
Tracy Schooling, MA, CCC-SLP
Associate Director, (N-CEP)
tschooling@asha.org
Tobi Frymark, MA, CCC-SLP
Associate Director, (N-CEP)
tfrymark@asha.org
Floyd Roye
Outcomes Data Manager
froye@asha.org
National Office Staff Updates:
The following individuals are new to the ASHA staff since October 2006:
- Leticia Azoro, Account Manager for Membership Sales
- Andrea Ducker, Program Coordinator - Special Interest Divisions
- Steven Ritch, Manager, Higher Education Data System
- Svetlana Roudik, Programmer Analyst
The following individual has left ASHA to pursue other opportunities:
- Ilya Berdichevsky, Programmer/analyst
Next Executive Director Update – ASHA's Planning Activities
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