A Framework for Managing Controversial Practices

Every day, speech-language pathologists working in schools make difficult, life-impacting decisions regarding which assessment and intervention approaches to use with their clients. These decisions can become even more difficult when the approaches being considered for use are controversial. The risks involved in making choices about controversial practices are likely to have increased significance simply because the approach being considered is not widely accepted. The increased professional risk may cause decisions to be made based on risk avoidance rather than on a careful consideration of the pros and cons of the approach itself. This article offers a clinical practice framework for gathering information about controversial approaches and for implementing and monitoring their use. The framework will be illustrated using facilitated communication as an example of a controversial practice.