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Professional culture in SLP: How trainees find their place

Patients’ perspective on their health, captured as ‘patient-reported outcomes (PROs)’, is a reasonable and important part of therapeutic practice in any field. In mainstream speech-language pathology, however, PROs play a relatively small role. A recent narrative review of the literature (Cohen ML, Hula WD. Patient-Reported Outcomes and Evidence-Based Practice in Speech-Language Pathology. Am J Speech Lang Pathol. 2020 Feb 7;29(1):357-370. doi: 10.1044/2019_AJSLP-19-00076) has observed this, and introduced terminology and applications that might be imported from other healthcare fields to help, and has even made suggestions for clinical administration, interpretation, and future research in practical application.

The basic need, judge the authors of this review, is for more routine measurement of subjective health constructs via patient-reported outcome measures (PROMs). These would quantify such variables as effort, participation, self-efficacy, and psychosocial functioning. Evidence-based medicine requires these at the very least. But which PROM instruments?

A companion article (Cohen ML, Lanzi AM, Boulton AJ. Clinical Use of PROMIS, Neuro-QoL, TBI-QoL, and Other Patient-Reported Outcome Measures for Individual Adult Clients with Cognitive and Language Disorders. Semin Speech Lang. 2021 Jun;42(3):192-210. doi: 10.1055/s-0041-1731365) examines this, focussing on the battery of tools created by the National Institutes of Health, comprising the PROMIS, Neuro-QoL, and TBI-QoL measurement systems. Some of these may be useful as primary or secondary outcome measures, or as contextual variables, for adults with language disorders. They have potential benefit in group and individual settings. For clinicians, the task will lie in obtaining, administering, scoring, and interpreting PROMs for individual clients. Nettlesome issues will be the type and extent of communication support that is appropriate, implications of likely large measurement error, and how to apply minimal detectable change values at a particular level of precision.

MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.

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