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James Law Keynote Speech
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Bridging the gap between external evidence and service delivery for children with speech and language disorders

Professor James Law

Over the past decade there has been an increasing awareness of the need to consider evidence based practice as being built on three pillars, namely external evidence, patient choice and practitioner judgement, to which is sometimes added a fourth, namely the mechanisms by which services are funded (insurance, private, state etc.). At the same time we have come to better understand the role that intervention and how much of an effect we can anticipate in some areas of intervention - for example in parent/child book reading, parent/child interaction and some other areas. It other areas (for example receptive language and pragmatics) the evidence remains thin. From a recent survey of over 5000 practitioners across Europe and beyond carried out by members of Cost Action IS1406 we are also becoming more aware of what practitioners around Europe are doing with children with speech and language impairment. In this presentation I will try to reconcile what people do with what the evidence tells us works and raise the question of how much it matters from a social and indeed and ethical perspective.

The presentation will start by discussing the evidence based pillars and report on work for the Communication Trusts' "What works for SLCN" website and specifically the work on effect sizes. To this will be added evidence from recent systematic reviews related to children with language disorders ad the question of how much change we can reasonably expect from interventions in this field. I will then draw on the findings from our report to the Education Endowment Foundation in the UK looking to match up what we know from clinical evidence with what we know about educational interventions which include language as an outcome. Finally, I will turn to the Cost Action Survey and what it does and does not tell us about practice across Europe and ask why some evidence based interventions do not appear to be used at all and why the range of time spent giving interventions varies so much from one country to another. Clearly such discrepancies point towards a gap between evidence and practice which needs to be closed if progress is to be made.

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Last Updated: 24 November 2017

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