Organic SLP: An attitude or a science?

When you think of how SLP's work; where we do our work; and about the processes and the goals for our work - is organic SLP, science? Can the results of clinical practice that stresses communication for relationship-building, over drill work to increase component communication; the use of environmental structures and cues to make it easier for a person to function well;  the primacy of applying component skills for cognition, communication and swallowing, in the settings where they will be used; where rapid acquisition of goal targets is stressed; where customer satisfaction is accentuated through teaching and obtaining frequent feedback - be replicated across ages, disorder types and treatment settings?? Is organic SLP, science??

I would say, yes - that organic slp IS built upon a scientific framework, and that its principles can be upheld alongside the practice of what I have called "mechanistic SLP".The clinician who uses organic SLP principles has her/his roots in mechanistic SLP; namely, the tools for impairment-based evaluation and treatment can and should be used. There are scores, hundreds of incidences where a person with a cognition or communication problem would only begin to change when slow, methodical and segmental training of processes occurred. Impairment-based training is the core of our field, and the skill sets inherent in our clinical training will always be in that bag of tricks we scour before each encounter.

There does remain a need in SLP clinical practice, for a skill set that brings the person served from an entry point of dependence to that of relative independence as quickly as possible; that allows the SLP in an interdisciplinary practice setting (e.g. with physical and occupational therapy, or with education and psychology) to assert her/his expertise as vital to the successful outcome of the person served; that models for all the professionals involved with a person, superior customer service; that constructs a strategy system allowing the person to say: I can do this in real life when I - , and that treats communication processes largely where the processes will be used day-to-day. How can these additional be measured and evaluated, as having met the tests of scientific method?

The SLP clinician has the skill set to operationally define organic SLP processes, and to write targeted goals for treatment after baseline status is clearly described. For example, the person served may gain attention of a caregiver from across the room, using speech and gestures in a noisy setting, 25% of the time. Barriers to the person performing this function include the noise level ( TV on, dishes clattering, chatter within the room, PA system occasionally carrying announcements, person's weak voice and impaired hearing). Treatment includes identifying the components controlled, then controlling them as possible. It also includes compensating for the variables that cannot easily be controlled. How would you help the person increase her/his skill?