In Conclusion
Potential reasons why NSOME continue to be used (Lof, 2009):
The procedures can be followed in a step-by-step “cookbook” fashion; The exercises are tangible with the appearance that something therapeutic is being done; There is a lack of understanding the theoretical literature addressing the dis-similarities of speech-nonspeech movements; The techniques can be easily written out to produce; There are a wide variety of techniques and tools available for purchase that are attractively packaged; Many practicing clinicians do not read peer-reviewed articles but instead rely on unscientific writings; SLPs attend non-peer reviewed activities that encourage their use; Parents and therapists on multidisciplinary teams encourage using NSOME; Frequently other clinicians persuade their colleagues to use these techniques.
If clinicians want speech to improve, they must work on speech, and not on things that LOOK like they are working on speech.
Phonetic placement cues that have been used in traditional speech therapy are NOT the same as NSOME.
NSOME is a procedure not a goal.
The goal of speech therapy is NOT to produce a tongue wag, to have strong articulators, to puff out the cheeks, etc. Rather, the goal is to produce intelligible speech.
We have been burned before. In the 1990s many SLPs inappropriately embraced Facilitated Communication (FC) as a treatment approach because they thought they observed that it worked. Once it was tested using scientific methodology, it was found to not work. Pseudoscientific methodologies can persuade clinicians to provide the wrong treatment.
Following the guidelines of Evidence-Based Practice, evidence needs to guide treatment decisions. Parents need to be informed that NSOME have not been shown to be effective and their use must be considered experimental.
