title: How conceptual frameworks influence clinical practice: Evidence from the writings of John Thelwall, a 19th-century speech therapist.
abstract: BACKGROUND
  The impact of speech therapists' conceptual frameworks on their clinical methods tends to be ignored or taken for granted by today's practitioners. One way to show the importance of such frameworks is to study how they were used previously. John Thelwall, a 19th-century elocutionist, offers a rich source for studying the influence of conceptual frameworks in the past and provides needed distance for clinicians to discover how they frame their own practices.
  
  
  OBJECTIVE
  To discover how conceptual frameworks have influenced past and current speech-therapy practices.
  
  
  METHODS
  Content analyses of the writings of Thelwall were performed to discover his conceptual frameworks and how and when they were used. The results were then compared with frameworks in use today.
  
  
  RESULTS
  Four frameworks were found in Thelwall's writings: medical, linguistic, educational and political. All are still used, but each differs from Thelwall's in scope and detail. These comparisons have the potential for revealing the significance of conceptual frameworks in today's clinical practices.
  
  
  CONCLUSIONS
  The ways Thelwall wrote about his work early in the 19th century bear striking resemblances to today's construals of speech therapy practices. It is the scope and application of the frameworks that have changed with time. Both the similarities and differences between current practices and those of Thelwall offer instructive insights into about how frameworks can influence clinical choices and practices.
authors.affiliation: duchan@buffalo.edu
authors.forename: Judith F
authors.initials: JF
authors.lastname: Duchan
mesh_terms: D049672:History, 19th Century; D006801:Humans; D013070:Speech Therapy / Q000266:history*; D006113:United Kingdom