by Mary Huston, CCC-SLP

Unfortunately, I think the term fits many in our profession.
I didn’t just tick you off did I?
This morning I listened to a CEU seminar on speechpathology.com (SPC). It was titled  Evaluating Science and Pseudoscience in Speech-Language Pathology #5499 for those of you with SPC accounts (and for those of you that don’t have them…think about getting one. They are great – so many hundreds of sessions at your fingertips…ASHA CEUs just waiting to be taken. [But this is not a commercial for that site…no matter how good it is! Although if this post moves you to get an account – let me know and I’ll happily give you a code you can use so I get a referral credit toward my renewal…or if you know someone else using it, ask them for one so they get credit. We can all share the wealth, so to speak]).
Anyway! Back to the session.
The seminar basically was all about the difference between true science and pseudoscience and how we tend to get caught up in pseudoscience. The session was led by Dr. Gregg Lof, who I have tremendous respect for and have had for years. I love his series on Non-Speech Oral Motor Exercises (Oops, that’s a different subject!).
In the session, Dr. Lof talks about types of pseudoscience and why it happens. He states that because we WANT it to work we think it does. He also talked about how sometimes the people selling the product use theories or vocabulary that is close to what we already know, but in a slightly different way…Examples of his pseudoscience??? Glad you asked (and some of you are NOT going to like this!): Ear Candling (duh), Therapeutic Touch, Facilitated Communication (still popular in some of our areas), Right Brain Education, Brain Gym, Miracle Mineral Solution for Autism, NSOME, etc.  [I have a few I could add on my own, but I’m not going to.]
Now, some of the reasons that those practices (and the ones I’m thinking of as well) fall into the pseudoscience arena is because there is a decided lack of peer-reviewed research to back them up. I’ve had lots of conversation where SLPs say “there IS evidence, see”… and when I go look, it’s all written by the people that have a financial interest in the product…or they are case studies…or anecdotal evidence. None of which is “real” science.
Fad therapies  happen because we, like everyone else, want to fix the problem. When many of our solutions are hard-to-do and time-consuming, we don’t want to take them at face value. I totally get that and I’m guilty of it myself. In all honesty, who hasn’t? I mean, I get emails a lot from people who tried Cycles – for about 2 months and “didn’t see any change” so obviously it doesn’t work (not paying any attention to those of us who say it usually takes 3 complete cycles and here’s how you do them). So they went on to whatever other technique promised a prompt (ahem) result. Or, they have truly tried everything and nothing has worked so they resort to the $100 tool to help form an /r/….or whatever. Bottom line, we live in a “want it now society” and we want it now.
So…How do we know it’s pseudoscience?
1) don’t be guilty of confirmation bias (don’t believe it works b/c it fits your belief)
2) If the theories are ignored, re-interpreted, or misinterpreted
3) Beware the new terms and concepts that are not measurable (just how do we measure lip strength…I mean, really?)
4) Anecdotes and case studies are the evidence (read this in your best cheap bad movie accent: ‘evidence, we don’t need no stinking evidence – it works, I’ve proved it…’)
5) Inadequate evidence
6) Peer review??? Who needs Peer Review? (we do that’s who!)
7) Grandiose outcomes are proclaimed! (Drink this juice, it’ll solve dandruff, language delays, hearing problems, erectile dysfunction, and halitosis!) Uhm… no. Really…There is no cure-all for everything that ails us (except death – that’s a sure fire “fix”). If it’s too good to be true – it’s NOT true. period. End of story.
What are things we can do to make sure we’re not engaging in pseudoscience?
Great question…we can:
1) Be skeptic (not a cynic – a skeptic). Be skeptical of cure-alls, be skeptical of packaged materials and programs that are easy to purchase (and this includes *gasp* apps. Look at them – critically review them – look at the literature – is there evidence to suggest the theory behind the apps are sound [hint: there is in most smarty ears apps which is why I love them]),
2) Engage in science based practice
3) Critically consume the literature. Is it peer-reviewed? Is the “research” written by the “publisher or owner of the company” or is it written by someone not affiliated?
I really liked this part – Baloney Detection… we need to:
1) get independent confirmation,
2) encourage debate on the evidence (I get disgusted sometimes with the debate and throw my hands up in disgust and leave the conversation…I need to work on this)
3) believe data, not experts
4) spin more than one hypothesis – and look at ALL the hits/misses.
5) look at every link in the argument – they must all work.
and lastly, be wary of popular press…Just because it’s on the news doesn’t make it true. Just because it’s in a blog doesn’t make it real. And just because I said it, doesn’t make it accurate (although I try really hard to be accurate…still…I can’t walk on water and am fallible).
Oh, and as an aside…just because it has ASHA CEUs on it, or it’s a Continuing Ed Seminar by whichever company, or you paid $$$ for the product, does NOT make it EBP and is no guarantee that it is not pseudoscience.
So…out of curiosity… what current therapy technique have you done or considered that could be construed as pseudoscience? I know you have them…we all do. I’ll start…I think mine would have to be I recently bought a program that was “readily packaged” and all sorts of “anecdotal” evidence. Heck, I even asked for anecdotal evidence because I polled the SLPs on Facebook to see if I wanted it…did it “work?”  I haven’t started it yet – but now I find myself wondering if there’s evidence – true – evidence to back it up…and if not, what do I do? If I think it’s a good program, I’m going to have to do some scientific method stuff to get to the research behind it – and maybe create some practice based science to show that it does (or doesn’t) work. So…you’re turn!
Drop me a note and let me know…Or, if you’re worried about that…Tell me something you think could be construed as a pseudoscience – so we can discuss that… (I’ll start with that too…PROMPT…and Interactive Metronome…and…) you get the idea.
Until then….Adventure on!
 
Featured Contributor:   Mary Huston, MS., CCC-SLP
Mary Huston, MS, CCC-SLP is a school based SLP with James River Multidistrict Special Education Cooperative based in North Dakota. Mary has been using technology in therapy for years and has presented on the use of  iPads in speech-language therapy for multiple state associations. Recognizing a need for specific apps to use in schools, Mary authored the iPad applications Phono Learning Center, Categories Learning Center, co-authored the iPad app SLP Goal Bank, and currently has other apps in production. Mary is an active user of social media and collaborates with SLPs internationally on a variety of subjects via twitter (@mtmarySLP) and on her website at www.speechadventures.com. In addition to her own app work, Mary is on the Smarty Ears advisory board and routinely consults with CEO and Founder Barbara Fernandes.