Dear SLPs, Evidence-Based Practice Is a Framework for Collaboration-Not Division
It’s disappointing to see conversations in our profession framed in ways that divide rather than unite. Open dialogue is how we grow, refine our work, and support the children and families we serve. When comment sections are turned off or conversations are shut down, we lose the very thing that evidence-based practice requires: respectful discussion, shared perspectives, and collective reflection.
Instead of responding with the same tone, I want to offer something different…
Education. Clarity. Collaboration.
Grounded in what the Evidence-Based Practice (EBP) model actually calls for.
What Evidence-Based Practice Really Means
The EBP triangle is clear. Ethical clinical decision-making requires the integration of three pillars:
External Scientific Evidence
Clinical Expertise
Client Preferences & Perspectives
All three are required. NOT just one, and certainly not “science versus feelings.” The model exists because children achieve the best outcomes when we combine research, professional judgment, and the lived experiences of the individuals we support.
This isn’t “wokeism.”
It’s our professional standard.
It’s the foundation of ethical care.
On Lived Experience & Neurodiversity
Dismissing lived experience as “propaganda” ignores an entire pillar of the EBP framework. Client and family perspectives are not optional add-ons; they are essential clinical data.
Understanding how identity, sensory regulation, safety, autonomy, trauma history, and communication preferences affect learning is not political, it is clinical competence.
Understanding a client is not abandoning science.
It is applying science skillfully.
On Research (and What It Can and Cannot Tell Us Yet)
High-quality research absolutely matters.
But so does acknowledging the complexities of human communication.
Autistic communication styles are still being actively researched.
Right now, ongoing studies are expanding what we know. As our understanding grows, our practice grows with it. When we know better, we do better.
RCTs (randomized control trials) have limitations with highly variable populations.
Autistic individuals present with a wide range of strengths, sensory profiles, communication styles, co-occurring conditions, and support needs. This variability makes it difficult to create the tightly controlled, homogenous groups required by randomized controlled trials. As a result, RCTs may miss meaningful differences or overlook the individualized, real-world progress clinicians see every day.
Many emerging practices begin with qualitative or observational evidence.
For autistic communicators, some of the most meaningful information comes from:
naturalistic observation
caregiver and client reports
relational interactions
patterns within authentic communication
These insights often guide researchers toward the very questions they later study formally. Qualitative work is not “less than”—it’s often the foundation for future research.
Neurodiversity-centered care is supported by decades of interdisciplinary research.
Trauma-informed, sensory-informed, and neurodevelopmental frameworks have deep roots in psychology, OT, mental health, and developmental science. To insist that only RCTs "count" is to overlook a vast and meaningful body of evidence.
On Questioning & Critique
Critical thinking is essential in our field.
But critique is only productive when it is:
rooted in accuracy
open to learning
free from inflammatory language
grounded in curiosity, not contempt
When the tone becomes hostile or accusatory, clinicians stop engaging; not because they cannot defend their work, but because no one learns in environments that feel unsafe.
This is true for SLPs just as much as it is for the children we support.
On Progress and What It Truly Means
Connection-centered, neurodivergent-affirming care does not lower expectations.
It refines them.
It asks us to identify what meaningful progress looks like for each individual child; especially those who are dysregulated, traumatized, or not well served by traditional compliance-based approaches.
Many autistic children do not thrive when forced into neurotypical communication molds. Honoring their communication style is not “making excuses.” It is aligning therapy with who they are and how they learn.
That is evidence-based practice.
A Path Forward
We can uplift our profession without attacking each other.
We can demand high-quality research and honor client perspectives.
We can challenge outdated frameworks and maintain rigorous clinical standards.
We can critique ideas without devaluing the people who use them.
Our profession will move forward not through fear-based rhetoric or name-calling, but through nuance, curiosity, and collaboration.
EBP was never intended to be a weapon.
It is a framework for integration and understanding.
And integration—not division—is how we best serve children and families.
♾️🫶🏻
#iykyk
