Using family paradigms to improve evidence-based practice

Mary Jo Cooley Hidecker, Rebecca S. Jones, David R. Imig, Francisco A. Villarruel

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose: Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP. Method: This article describes the family paradigms framework: 4 classic paradigms of "closed," "random," "open," and "synchronous." Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples. Results: A family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions. Conclusions: Family and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.

Original languageEnglish
Pages (from-to)212-221
Number of pages10
JournalAmerican Journal of Speech-Language Pathology
Issue number3
StatePublished - Aug 2009


  • Augmentative and alternative communication
  • Evidence-based practice
  • Family-centered practices

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Developmental and Educational Psychology
  • Linguistics and Language
  • Speech and Hearing


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