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School-Based Speech-Language Pathologists' Clinical Decision-Making Process in the State of California

Lei Sun and Pei-Fang Hung

Purpose: The purpose of this survey study was to examine the relationships between knowledge and training in evidence-based practice (EBP) and ethical decision-making processes among school based speech-language pathologists (SLPs) in the state of California, U.S.A. The possible factors that may prevent SLPs from making ethical clinical decision were also explored.
Method: An online survey collected demographic information as well as responses pertaining to school-based SLPs’ understanding and implementation of EBP and ASHA Code of Ethics, and perceptions of possible constraints to ethical decision-making.
Result: All demographic factors are not related to EBP implementation and ethical decision-making. Weak positive correlations were found between ethical decision-making and the use of research evidence as well as between EBP training and understanding the role of school-based SLPs. Factors that may have a notable impact on ethical decision-making include parent’s preference, school district policies, and lack of administrator’s support while caseload, workload, and service delivery model have relatively less impact.
Conclusion: School-based SLPs who had the EBP training more likely incorporated EBP components during their decision-making process. However, the lack of comprehensive understanding of EBP and explicit guidelines of applying EBP to clinical practice may limit the effective implementation of EBP.