Reliability of speech and language therapists using therapy outcome measures

The Therapy Outcome Measure (TOM) aims to provide Speech and Language Therapists (SLT) with a practical tool to measure outcomes of care by providing a quick and simple measure which can be used over time with patients and clients in a routine clinical setting. The TOM allows therapists to reflect their clinical judgement on the dimensions of impairment, disability/activity, handicap/participation and well-being on an 11-point ordinal scale. The purpose of this paper is to examine the reliability and the influences on reliability of SLT using this measure. Three studies are presented and give information on 73 SLT using the measure with different client groups. Study one assesses the degree of reliability of six SLT using the TOM following training and practice. Reliability was studied on three occasions and the results demonstrate the influence of training and practice. Study two included 56 SLT to examine reliability over a broader range of client groups and to investigate the effect of the SLT specializing on rating patients from within or -out that specialism. Eleven therapists were included in the study, which examined the influence of a specific training approach. The participating SLT achieved a substantial-moderate level of reliability; this was established in all domains. The degree of reliability achieved on the TOM was affected by some, but not extensive, training and experience.