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 speechlanguage rehabilitation of aphasia that is more relevant to aphasic individuals' ability to function as productive, or at least independent, members of society. Siegel (1993) views efficacy research as 'a natural bridge between the requirements of careful research and the needs of clinical practice'; however, he acknowledges that the therapy needs of individual clients do not always mesh with the requirements for 'reliable and replicable data collection' (p. 37). How will outcome measures help to bridge these two goals of the discipline? It is a widely held belief that the renewed emphasis on measuring 'functional communication' will bring theory and practice together, by focusing research on intervention efforts directed at communicative skills required in daily life, and by involving clinicians in on-going, standardized evaluation 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 based, before diving headlong into the current of changing health-care policies.