MEASURING OUTCOMES IN APHASIA - BRIDGING THE GAP BETWEEN THEORY AND PRACTICE ... OR BURNING OUR BRIDGES

Economic forces have increased demands for efficacy research in the sp eech-language rehabilitation of aphasia that is more relevant to aphas ic individuals' ability to function as productive, or at least indepen dent, members of society. Siegel (1993) views efficacy research as 'a natural bridge between the requirements of careful research and the ne eds of clinical practice'; however, he acknowledges that the therapy n eeds of individual clients do not always mesh with the requirements fo r 'reliable and replicable data collection' (p. 37). How will outcome measures help to bridge these two goals of the discipline? It is a wid ely held belief that the renewed emphasis on measuring 'functional com munication' will bring theory and practice together, by focusing resea rch on intervention efforts directed at communicative skills required in daily life, and by involving clinicians in on-going, standardized e valuation of their own efforts. In the process the profession will be able to justify its efforts in both clinical and research domains. It is worthwhile examining the rocky shores upon which these claims are b ased, before diving headlong into the current of changing health-care policies.