Date of this Version
Mount, A. L. (2019). Speech-language pathologists' assessment and treatment of dementia: A mixed methods study.
The intent of this research was to investigate how speech-language pathologists (SLPs) are assessing and treating people with dementia (PWD). To examine this the researcher first completed a literature review to determine prominent evaluation and treatment procedures for dementia. Then the researcher set out to identify whether there was a gap between the external evidence found in the literature and the practice patterns of SLPs, and subsequently attempt to delineate potential reasons for the differences.
Using a mixed-method design, the researcher conducted 10 phone interviews and 114 SLPs participated in an online survey. The researcher engaged in grounded theory coding procedures for the interviews. Survey data were analyzed based on demographic groups (e.g., rural versus urban) using non-parametric procedures. In general, the results suggested that SLPs are completing some of the assessment and treatment procedures identified in the literature. In regard to assessment, there was a departure from the literature in terms of the need to screen for vision/hearing and depression and engaging differential diagnosis to inform the evaluation. Both qualitative and quantitative results yielded a discrepancy in the use of vocabulary across participants. In fact, some SLPs reported engaging in procedures without having a name for them. SLPs with more years of experience and more dementia-related CEUs had higher confidence in completing several dementia-related procedures than those with fewer years/CEUs. Participants with fewer dementia-CEUs and a smaller caseload of PWD were less familiar with treatment approaches identified in the extant literature than those with more CEUs/higher caseloads. Participants with fewer dementia-CEUs reported using external memory aids less frequently than those with more CEUs; and, SLPs with fewer years of experience used errorless learning less frequently than those with more years of experience. Barriers that emerged that identify sources of gaps between the literature and clinical practice (i.e., implementation of EBP) included: lack of time, lack of carryover by caregivers, insurance barriers, lack of applicability of research, limited evidence, and lack of materials/resources.
Advisor: Kristy Weissling