INTERVENING FACTORS IN DECISION MAKING IN SPEECH AND LANGUAGE THERAPY: AN ORGANIZING RESOURCE

Abstract

Conducting a therapeutic approach in people with language and communication disorders involves sustained development over time where modifications of factors, evolutions, and relationships between them are witnessed. The speech and language therapist must repeatedly carry out multifactorial assessment procedures from which he decides the next step, having various indicators as a guide. These decisions result from the synthesis of theoretical, practical knowledge, observation of the patient's process, and his support group. The multitude of incident factors and the complexity they entail make it difficult to measure and define a rational and well-founded criterion in therapeutic decision-making. A resource that facilitates the organization of information and underpins decision-making in language and communication therapy must contain guidelines that include the various significant aspects at each moment of the process, without diverting attention on those that do not offer a greater impact.

This paper proposes an instrument that, predicated on assumptions regarding the individual, language, and speech therapy intervention, systematically collects and organizes information across three dimensions: Personal, Contextual, and Intervening Factors in Decision Making. Additionally, it considers the dynamic relationships manifested as Movements: Driver, Conflict, Causal Mechanism, and Resolutive Mechanism.

The application of this framework in a clinical case throughout the course of language therapy facilitated the consolidation of subdimensions and movements at different stages. Furthermore, its generalization to other clinical cases will demonstrate an algorithm for therapeutic decision-making in speech therapy.