The Key to Assessment and Services at RNBC: They are Evidence-Based
RNBC employs two main pathways to helping children and families. The first resource is through assessing the nature of children’s neurobehavioral challenges. The second area is through providing recommendations for or directly administering services to children. Making judgments about the best way to approach assessment and the best kinds of interventions to provide or recommend is central for each of the professionals from all disciplines here at the Center. As part of this process, parents also engage in similar decisions regarding what kind of assessment and treatment to pursue for their child. At RNBC we follow evidence-based practice. Likewise, as parents, it’s extremely important to understand how to gather evidence-based information.
What is the value of understanding evidence?
Understanding the evidence of what works is good practice for everyone. When professionals know how to weigh and judge evidence of what works, making well-informed decisions becomes easier. When parents know how to weigh and judge evidence or what works, they become better consumers of services and better advocates for their children. When practitioners and parents uncover and understand the evidence, the big winners are the children who get the best assessments and treatments.
What is good evidence?
In judging what works, there are many kinds of evidence available to practitioners and parents, including:
- Peer-reviewed scientific research on the effectiveness of assessment and treatment practices,
- Professional associations practice parameters outlining recommended assessment and treatment practices, and
- Professional word-of-mouth about what works.
Often, the children we see are more diagnostically complex or unclear than the children included in scientific studies. Nevertheless, in most cases, it is possible to apply general assessment and treatment principles, firmly rooted in scientific and professional evidence, to every individual child. As practitioners, we continually draw on these and other sources of evidence to decide how to proceed in each child’s best interest.
How do parents discuss the evidence with professionals?
When parents meet with a clinician, they should feel free to ask which proposed diagnostic and treatment strategies are evidence-based and what aspects of the recommended approaches have the strongest evidence of effectiveness.
Parents should expect open, clear explanations of the evidence on which a clinician is making recommendations and a candid assessment of both what is strongly supported by the evidence and what is less strongly supported. In general, parents should expect clinicians to engage in this conversation in a friendly and informative manner. Parents should walk away feeling confident in the clinician’s approach to decision-making.
How can parents make sense of anecdotal accounts?
Caveat emptor! With the vast amount of information available today via the Internet, passionate and heartfelt anecdotal parent accounts of what works abound. Some of these approaches may appeal mostly to fulfilling parents’ hopes, but are not supported by respectable research. Charismatic celebrities sometimes passionately champion unproven approaches. Weighing the quality of the available evidence can often be a difficult task, particularly when confronted with a passionate and persuasive alternative practice that sounds sensible.
It is understandable that parents might be persuaded to divert time and money to alternative treatments even when there is little hard evidence of their usefulness. Before choosing one of these less carefully evaluated assessments or treatments, parents should consult with trusted members of the professional community to help weigh the potential benefits and drawbacks of such a choice.
What other kinds of evidence should parents keep in mind?
There is another important kind of evidence in determining what works. All helping professionals engaged in treatment monitor the progress of their patients. When treatments are psychosocial, often this monitoring is informal, involving interviews with patients and parents. Sometimes, progress monitoring is more formal, consisting of periodic data collection to evaluate in a more “objective” way how children are responding to treatment over time and to determine whether the treatment needs to be modified to improve a child’s response. Parents should be informed about how professionals are monitoring their child’s response to treatment, and should feel confident that the progress monitoring procedures employed are providing adequate information to determine the level of success of the treatment and decide on next steps.
Who can parents turn to for help in weighing the evidence?
Professionals regularly turn to one another for consultation about evidence-based procedures. Similarly, parents of children with neurobehavioral disorders should identify professionals in their lives whom they feel comfortable consulting. Parent should seek this kind of help as they weigh the diagnostic and treatment options carefully to make the best evidence-based decisions possible for their child.
Clark McKown, Ph.D., Executive Director