Attitudes & Utilization of Alternative Therapeutic Practices for Children With Disabilities: Parent & Practitioner Surveys

Abstract

BACKGROUND It is critical that speech-language pathologists engage in evidence-based practice (EBP). According to ASHA (2005), EBP integrates: 1. clinical expertise/expert opinion, 2. externalscientific evidence, and 3.the perspectives of clients/families to provide high-quality servicesthat reflect their needs, values, interests, and choices.Resonating with this third aim of EBP, Black and Wells (2007) define cultural competence as an attitude and practice in which the treating professional is knowledgeable about and sensitive to their clients’ beliefs and values and works with them to develop appropriate and meaningful treatment plans. Many individuals do not share information about their utilization of alternative practices and remedies with their health care professionals (Wong & Smith, 2006), potentially due to concerns with professionals’ lack of acceptance and cultural mismatches. SLPs may sense a dilemma. It is critical that SLPs provide treatments that are evidence-based and avoid promoting practices that are not, yet they must also display cultural competence and sensitivity to the values and choices of their clients and families. METHODS Participants: Parents/guardian participants were recruited via email and online community and parent groups. SLPs were recruited via email, ASHA Special Interest Groups, Multicultural Constituency groups, and online professional networks throughout the United States. Respondents included 105 parents/guardians of children with special needs in 24 U.S. states and 115 SLPs who serve children ages 0-18 in 29 states.Methods: Surveys were broadly distributed to encourage participation from demographically representative and culturally diverse samples. Participants completed online surveys that included both closed-and open-ended questions. The survey for parents/guardians included 26 specific questions about their views, use and experiences with alternative practices for their children with special needs and how comfortable they feel sharing such information with their SLPs. The survey for SLPs included 28 questions about their clients’ utilization of and their own experiences, education, and opinions on alternative therapeutic practices, also known as Complimentary Alternative medicine (CAM). DISCUSSION More than half (58%) of parents reported using complementary and alternative methods to treat their child’s disorder; in addition, 11% reported that physicians, 15% reported that SLPs, and 7% reported that other professionals have recommended CAM methods. Of SLP respondents, approximately one-third reported that their clients/families use CAM to address their child’s special needs prior to pursuing SLP services; additionally, 21% reported having recommended CAM to families, and 75% reported having used CAM personally. The majority of SLP respondents reported rarely or never discussing the use of alternative methods with parents/guardians. Overall, these research findings highlight the importance of continued investigation of the effectiveness of these methods, sensitivity to clients’ and families’ values and choices, increased education, and open communication between SLPs and the clients/families they serve.