Knock…knock…knock…Hey there… Long time no see. I can’t believe anyone is still around; it has been forever since I’ve put words down here. Since moving to academia, I seem to struggle to find relevant topics for clinicians. I’m also struggling with finding the time (where is time going?) to truly write what I’m thinking…and let’s face it, sometimes what I’m thinking just shouldn’t be put into print.

Recently, someone who had come across the blog post in which I shared information from Gregg Lof about science vs. pseudoscience and the need for skepticism reached out to me. In responding to them, I was forced to consider why we, as a profession, struggle to keep pseudoscience at bay. I know research lags behind the need, but why are so many intelligent and caring SLPs throwing science to the wayside and treating with non-evidence-based practices?

Sadly, I don’t have a good answer. Heck, I don’t even have a bad answer. But, I do have some information that might shed some light and lead us to an answer…or maybe it just leads to weeds to get lost in, but I find it interesting.

How do we know what we know? More formally known as Charles Sanders Pierce’s Fixation of Belief. I’m going to be doing a lot of paraphrasing of this, because our friend Mr. Pierce wrote this in 1877 and … well.. it’s a bit … (ahem)… dry.

So…how do we know what we know? Basically, there are four methods. The Method of Tenacity, the Method of Authority, the Method of Intuition or a priori, and the Method of Science.

The most common way we know things is through the Method of Tenacity – we stick to the views we already hold, those we prefer, and those known to us by personal opinion. When we get stuck in this method, we’re not willing to consider whether or not we are correct, or if there’s a better way to do something… we’re going to stick to what we know already. Does this sound familiar? I promise I’m not pointing any fingers. Identifying our biases toward anything is critical. We need to be willing to consider different viewpoints, but we also need to look at the science behind those viewpoints.

The second most common way is the method of authority. In this method, people accept information from an individual (or a group of people) who have been designated as authoritative producers of knowledge. From the time we were little kids, we became conditioned to believe that those in position of authority (parents, teachers, etc.) knew things and were right. Think back to grad school – you accepted that your professors were right and didn’t question what they told you. I frequently tell my students to not take my word for it just because I happen to be the one standing in the front of the class. I am human and I don’t know everything…sometimes I’m even (gasp) wrong. Those social media influencers (SLPs in the know…or whatever you want to call them)…they too are human and they make mistakes (or make stuff up). Please don’t ever take the word of an instructor, professor, blogger, SLP Influencer, etc. as final. Do your own research to verify what they are saying. Yes…even this post should be vetted…maybe I made this stuff up!

I didn’t, but I could have.

The third way is the method of intuition. This method relies on reason based on prior assumption (or a priori) that are seen as self-evident. There’s no consideration given to the role of experience, it’s just “gut feelings.” When we do treatment because it “feels right to do it this way,” “it seems more humane” or some other statement that is not based on science, it is by intuition. Unfortunately, intuition by itself is dangerous. It’s not to say it doesn’t have a place – but that place should be second (or third) to the final method.  

The final method, and least used, is the method of science. This method bases belief on the reality of external evidence separate from fashion and preference and personal convictions. The method of science CAN endorse currently held beliefs, but it also calls those beliefs into question through critical investigation. 

Ideally, our treatment of anyone will be rooted in the method of science and flavored with intuition. Hopefully, we can identify the science behind our treament methods while using intution to be humane in our methodology.

Sometimes we mix methods together. I can think of times when I knew something because I just “knew” it and my gut backed me up. Sometimes it was even right (but not very often).

So… I encourage you to go and reflect on how you know what you know. What method do you most commonly use? Then consider it again and really be honest with yourself…When you’re considering treatment methods what method of knowing do YOU want to be known for? Then I challenge you to open your mind, consider all the methods, and embrace the science as well as the other methods. Remember, as Greg says, skepticism is not a bad thing.

I’d love to hear your thoughts. Until then…

Adventure on!

Mary