From uwriise at uw.edu Thu Nov 2 15:02:34 2023 From: uwriise at uw.edu (UW SMART Center) Date: Mon Mar 18 22:27:31 2024 Subject: [RIISE] 2023 Fellow Publishes on De-Implementation Message-ID: Hello, We?re excited to share with you Kelly Farquharson?s (2023 Cohort) recent paper on de-implementation in speech therapy! Subtract Before You Add: Toward the Development of a De-Implementation Approach in School-Based Speech Sound Therapy. Authors: Kelly Farquharson, Kathryn L. Cabbage, Anne C. Reed, and Mary Allison Moody Purpose: It is often difficult for school-based speech-language pathologists(SLPs) to prioritize implementing new practices for children with speech sound disorders (SSDs), given burgeoning caseloads and the myriad of other workload tasks. We propose that de-implementation science is equally as important as implementation science. De-implementation science is the recognition and identification of areas that are of ?low-value and wasteful.? Critically, the idea of de-implementation suggests that we first remove something from a clinician?s workload before requesting that they learn and implement something new. Method: Situated within the Sustainability in Healthcare by Allocating Resources Effectively (SHARE) framework, we review de-implementation science and current speech sound therapy literature to understand the mechanisms behind continuous use of practices that are no longer supported by science or legislation. We use vignettes to highlight real-life examples that clinicians may be facing in school-based settings and to provide hypothetical solutions, resources, and/or next steps to these common challenges. Results: By focusing on Phase 1 of the SHARE framework, we identified four primary practices that can be de-implemented to make space for new evidence-based techniques and approaches. These four practices were determined based on an in-depth review of SLP-based survey research: (a) overreliance on speech sound norms for eligibility determinations, (b) the omission of phonological processing skills within evaluations, (c) homogeneity of service delivery factors, and (d) the use of only one treatment approach for all children with SSDs. Conclusions: De-implementation will take work and may lead to some difficult discussions. Implementing a framework, such as SHARE, can guide SLPs toward a reduction in workloads and improved outcomes for children with SSDs. [A picture containing shapeDescription automatically generated] Research Institute for Implementation Science in Education (RIISE) Funded by the Institute for Education Sciences E: uwriise@uw.edu Click here to join our RIISE mailing list! Psychiatry and Behavioral Sciences / UW School of Medicine 6200 NE 74th, Suite 110 Box 354920, Seattle, WA 98115-6560 [IMAGE DESCRIPTION: A light blue book lays open with a yellow and orange sun coming out from it. ?RIISE? lays on top of the sun in orange lettering with the two I?s in dark blue going up invisible steps. To the right in dark blue is ?Research Institute for Implementation Science in Education.?] [IMAGE DESCRIPTION: The SMART Center logo displays a golden apple composed of small squares with the acronym ?SMART? for School Mental Health Assessment, Research, & Training Center] [IMAGE DESCRIPTION: Gold circle with white Twitter bird in middle.] -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 5319 bytes Desc: image001.png URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 12826 bytes Desc: image002.png URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.png Type: image/png Size: 2450 bytes Desc: image003.png URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image004.jpg Type: image/jpeg Size: 1545 bytes Desc: image004.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Farquharson 2023 Deimplementation.pdf Type: application/pdf Size: 255544 bytes Desc: Farquharson 2023 Deimplementation.pdf URL: