MA-thesis about stuttering guidelines

 

The EST-team is very glad to welcome MA-student Trude Beseth Nordeide to the project. Trude is presenting her project here - and would really appreciate feedback from you concerning existing guidelines.

My name is Trude Beseth Nordeide. I’m a master’s degree student at the speech language therapist study at the University of Oslo. This spring I will write my master’s thesis, and I will write my thesis in collaboration with the EST project.

Through my time at the master program at UiO I’ve got an increased interest for stuttering in preschool children and children in school age. Therefore, I decided to take a closer look at existing national clinical guidelines in other countries for stuttering treatment for these client groups for my master’s thesis.

Through ECSFs (by Mark Pertijs) presentation “Evidence-based Clinical Guidelines in Stuttering Therapy” from 2014 I did find an overview over European countries with national guidelines, and I have chosen to take account for that list http://www.ecsf.eu/userfiles/files/PDF%20M.Pertijs%2020014-03-27.pdf, see page 41). 

However, I have not been able to find an updated list of countries with national guidelines. Therefore, I recently sent out emails to 13 countries with both consensus-based and evidence-based national guidelines (most of them were at that time evidence-based, and some in process of changing from consensus-based to evidence-based). Furthermore, I chose to contact ASHA and the Australian association as well, since both the USA and Australia have been influencing European SLTs practice with their research and guidelines.

Method and analysis 

I will use Appraisal Guidelines Research and Evaluation (AGREE) for analysing the guidelines. AGREE can contribute in evaluating the clinical guidelines through giving rates in the following six domains.

 

1 Scope and purpose	addresses the overall goal with the guideline, specific help questions and the target population.
2 Stakeholder involvement	focuses on the extent to which the guideline has been developed by the appropriate stakeholders, and whether it represents the views of its intended users.
3 Thoroughness in development	deals with the process of collecting and synthesizing the evidence, the methods for formulating the recommendations and updating them.
4 Clarity in the presentation	deals with the language, structure and format of the practice guidelines.
5 Usability	looks at the different variants and facilities, strategies for increasing uptake and source usability for the use of the practice guidelines.
6 Editorial independence	deals with the fact that the recommendations are not exclusively biased with a form of competing interest.

    

                  

The questions and domains in AGREE can contribute to receiving important information on how the guidelines relate to evidence collection and how well they are transferred to clinical implications for the SLTs. 

What is my goal with the project?

The purpose of my master’s project is to address information about the following elements in the guidelines: 

• How evidence-based national guidelines apply holistic implications for clinicians based on the underlying research (e.g., to which degree does the case that a treatment is evidence-based mean that it will be adequate for SLP clients in their environment?)
• If I receive both consensus-based and evidence-based guidelines it would be interesting to discuss the eventual differences.
• Do the authors of the guidelines have any relations with how the implications are presented? (E.g., Ratner et al. (2005) expressed lack of more independent stakeholders in the research of the different stuttering treatments.)
• Do the guidelines implications work as strict procedures or more “loose indicatives” to the clinician’s practice?

If you have any information relevant to my master project, or maybe have any updated information about countries in Europe who are not represented in the mentioned overview from 2014, who do have national guidelines today, I would be very happy hearing from you! You can contact me on this email: trudebno@student.uv.uio.no   

Thank you!  

Kindly, Trude Beseth Nordeide

Half way there- thoughts from a midway assessment

 

The PhD candidate in the EST project, Åse, marked being half way in her PhD this fall. In this blogpost she shares her thoughts from her midway assessment:

The midway assessment in a PhD is a milestone for a PhD candidate, although it is carried out differently across universities and departments. At the Faculty of Educational Sciences here at the University of Oslo, the mid way evaluation is a 90 minutes seminar, often held as part of a research seminars the PhDs candidates partake in. Participants are the candidate, opponent (a senior researcher within the research field), supervisor, coordinator of the organized research seminar and other PhD students.

I had my midway assessment in the end of September with professor Scott Yaruss as the opponent. The seminar begun with a presentation of my work. I talked about the three studies that will be included in my thesis, about the progress I have made, and about how I plan to work the next two years in order to finish the project on time. I also accounted for the courses I have taken and plan to take. Preparing for the seminar really felt like taking a step back and looking at my work from a distance. So much of working with the PhD feels like being on a high-speed rail, and it felt good to pause for a minute and get an overview of the road I have already traveled: The first study, a systematic review and meta- analyses, has been submitted, and the second study of my PhD is currently being drafted. I have finished all courses and the teaching proportion of the job. When did this even happen? It feels like I just started!

Also, preparing the presentation forced me to think ahead. Although I do have a progress plan and a time frame it is nice with a reason to reassess the plans, check in with deadlines and make changes accordingly. Two years is still a long way to go, but at least now, I know more about where I am going.  

The presentation was followed by a discussion about the work, between professor Yaruss and I. We discussed questions such as: what are the mechanisms leading to improvement in children`s stuttering? What are implications of the individuality of programs for treating stuttering in children? Discussing treatment for stuttering in preschool aged children, and the studies included in the EST project and my thesis especially, was very motivating. The discussion illuminated some parts of the projects that wasn’t clear for me, and presented me with many new insights. Thanks for the discussion, Scott!

-Åse