7 Points to Check Your Intervention

Penny Hamilton-Dick is a Speech and Language Therapist at I CAN’s Meath School in Surrey.  Here she presents some thoughts on her first time attending the NAPLIC (National Association of Professionals concerned with Language Impairment in Children) conference in Birmingham earlier this year.

In May, a small group of teachers and speech and language therapists from Meath School attended the NAPLIC conference in Birmingham. It was a fascinating day with opportunities to listen to new research, and share ideas with fellow teaching professionals. There were many thought provoking sessions throughout the day but we were particularly enthused by the presentation by Caroline Bowen and Pamela Snow who are ‘stirring the possum’ (defined in the English Oxford Dictionary as to ‘excite interest or controversy’) with their new book ‘Making Sense of Interventions for Children with Developmental Disorders.’ They have toiled so that we don’t have to, with their forensic examination of the evidence base for many popular and lesser known therapies.

We know there is a plethora of interventions offered on the internet, with varying degrees of evidence to support their effectiveness and validity. Caregivers can be vulnerable to the enticing possibilities, when the message and interventions delivered by the professionals are ‘in some way unsatisfactory.’ This book is aimed at both professionals and parents and is written in a very accessible manner. It examines different interventions and the evidence base for them; where this is lacking the authors helpfully suggest other interventions that have more evidence. As professionals, it provides a sound base from which to begin discussion with parents and carers about therapies, and why they may be suitable or unsuitable. The authors include a seven point safety-check for parents and therapists when thinking about different interventions:

  1. If something seems too good to be true, it probably is.
  2. If a link to ‘research’ leads only to unpublished, in-house reports, white papers, blog entries and magazine articles and not to peer-reviewed publications, be on the alert.
  3. Put your metaphorical sunglasses on so you are not blinded by the bright lights of (pseudo) neuroscience
  4. Many approaches work a little bit, or for a little while
  5. Use social media carefully
  6. Use Google Scholar to access information from the peer-reviewed literature
  7. Be wary of ‘flat – feet – to- halitosis’ claims i.e. any intervention that claims to remedy a range of difficulties is unlikely to be very effective and should be approached with caution. See point 1.

There are many challenges to the creation of quality research, from the stringent ethical criteria to the difficulties associated with finding the correct number of children to form a credible sample. The authors have compiled a section called ‘Could try harder’ which lists the approaches which have a ‘degree of face validity but that are not yet supported by sufficient quality evidence.’ The NAPLIC session and subsequently their book has encouraged us to think about our setting and some of the unique opportunities that it provides for contributing to research and furthering the evidence base.

Most practicioners try to employ evidence based therapies, but we know that with pressure on resources and time, it can be difficult to give this the due time and attention that it deserves. ‘Making sense of Interventions for Children with Developmental Disorders’ reminds us to evaluate the evidence base across a range of therapies, and ‘set the bar high’ when looking at the validity of studies. The content straddles multiple disciplines which enables professions to increase their knowledge in other areas. We found it helpful as a tool to aid dialogue, and to think constructively about some of the therapies that we use, and why.