Burn Your Text Books! Evidence-Based Practice in Stuttering Treatment
Barry Guitar University of Vermont, Burlington, VT 05401-0010
Stuttering treatment has had a colorful history. Methods of therapy have ranged from Demosthenes’ pebbles to Dieffenbach’s scalpel, from little gold forks in the mouth to little delayed feedback devices in the ear, from exhortations encouraging ﬂuency to admonitions advising more stuttering. Are any of these methods effective? And what do we mean by “effective?” How do we measure it? These are the questions that researchers in the field of stuttering management have been asking for decades. Now the questions should be asked by clinicians, as a habit of their practice. Evidence-based practice is essentially a set of principles for clinicians to use in evaluating and treating their clients. The definition given by one of its developers is that evidence—based practice is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” (Sackett et al., 1996, page 71) The term “current best evidence” includes the latest journal articles and on-line sources of scientiﬁcally sound information on evaluation and treatment techniques. Textbooks can be dangerously out of date, unless they are revised very frequently and teach the reader the latest tools for searching the literature. In this paper I will describe they why’s and Why-not’s of evidence—based practice and then make recommendations for clinicians who are interested in following the principles of this philosophy.