Integrate evidence with clinical judgment, patient values. Critically assess evidence, decide if it applies to patient. Find best evidence to answer the question. When such analysis is not available, other levels of evidence may be researched, based on credibility When engaging in EBP, many clinicians follow a five-step approach: Ask a straightforward question. Results from several studies are synthesized, providing optimum basis for treatment choice. Consists of more than one randomized controlled trial. Clinical decisions for patient care should be based on: Clinical expertise Patient values Best research evidence Not "This is what we've always done" Use well-documented research of outcomes The most compelling evidence for selecting services (Level 1) results from meta-analysis. ASHA encourages, whenever possible, that services should be provided based on EBP. In this age of managed care and accountability, aural rehabilitation plans need to be supported by empirical evidence. For children and teenagers, aural rehabilitation can include: Auditory and speechreading training. Some will need support from a speech and hearing professional to better manage relationship with affected friend/family member. Assertiveness training, psychosocial support, and counseling/instructions for family & colleagues. Family and Frequent Communication Partners Techniques are available for optimizing communication with those with hearing loss (i.e. For many, due to health advances, hearing loss is their only physical restriction. Many want to continue their careers, or desire to communicate with friends and family, and participate in community activities. Older persons Baby-boom generation has expanded demand for services. The passage of the Americans with Disabilities Act (ADA) reflects this reality. Services include: Educational planning Accommodation in the classroom with assistive tech Support in transition from elementary to secondary/postsecondary school settings Adults With appropriate aural rehabilitation services and support, adults can make contributions in workplace and communities. School-age children Communication with peer groups is a high priority. Through parental demands and public policy, there is a great emphasis on early identification, and service provision for young children with hearing loss. Infants and Children Higher survival rate of high-risk babies has lead to need for more services. There is currently a general shortage of speech and hearing professionals. By 2015, an expected 700 million people worldwide will suffer from hearing loss.
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