Clinical Problem Solving

Abstract

In the lead article of this forum, Ken Bleile explains his approach to the initial assessment of Bobby, a 4;3 (years; months) old child with suspected problems with articulation and phonology. Bleile argues that to meet the challenge of balancing thoroughness and efficiency under less than ideal conditions and time limitations, one must resist the temptation of following the lead of the referral source and instead, focus on determining the general nature of the problem. In contrast, this article will argue for the efficiency of focusing on the suspected problem. Although doing so involves some of the same tasks described by Bleile, philosophical differences lead to different conclusions and subsequently, a different approach to clinical treatment, particularly treatment target selection.