A Comparative Overview of Evidence-Based Treatment of Stuttering in Bulgaria and in the USA and Canada

Abstract

Introduction: The move towards evidence-based practice (EBP) requires speech-language pathologists (logope-dists) to understand the types of studies that build an evidence base for the field as well as the standards for assessing the quality of evidence.

Objectives: This article discusses the conceptual and methodological issues associated with EBP in Bulgaria, the USA, and Canada related to clinical stuttering intervention. This article discusses how the movement towards the current high-level standards of practice established in North America may challenge some of the traditional Bul-garian beliefs regarding stuttering treatment.

Method: Theoretical overview and analysis of the existing literature data sources including systematic meta-analysis articles on EBP on stuttering.

Results: The study outlines the steps of EBP accepted in SLP. Thirteen systematic reviews and meta-analyses are discussed concerning the application of research evidence to clinical decision making. These issues remain prob-lematic for Bulgarian logopedists who received their training before or during the recent professional shift from a special education subspecialty to a health profession specialty as represented by speech-language pathology (SLP).

Conclusions: The professional bodies that govern clinical practice in the Bulgarian health fields are not currently guided by EBP concepts. In Bulgaria, there is no evidence-based framework for the prevention, diagnosis, and treatment of stuttering as there is in the USA and Canada. In Bulgaria EBP stands as a fundamental way to pro-mote changes appropriate for SLP as a health profession.