Almost without exception, speech language pathologists are constantly looking for more numerical and better data. We want ways to measure aspects of our job and balance it against what is typical. We want to know how many kids we should be working with and how long it should take us to complete different testing and writing activities. But what if some of the numbers we get are deceiving? A bias called the anchoring effect explains how our reaction to some numbers can have unintended consequences.
The anchoring effect refers to our predisposition to be swayed by irrelevant numbers, often leading us to anchor our estimates and judgments to a reference point, regardless of its relevance.
In my time as an SLP this has come in the form of needlessly jumping into an evaluation because another professional (not testing communication) got a low score. Or how about accepting a job with a high caseload, simply because my last job had a high caseload? Or avoiding evaluations because “they take to long to write” because they did take too long to write, 10 years ago in grad school.
In this final of seven essays on bias, let’s learn about the anchoring effect, highlight how it rears it’s head in speech pathology, and borrow strategies from ambassadors and negotiators to avoid its negative influence.
Understanding the Influence of the Anchoring Effect
The anchoring effect introduces its influence through a simple yet profound mechanism: the introduction of a numerical reference point. By starting with a number, another person has subsequently shaped our judgments and estimates. Here is a simple yet funny experiment dealing with jelly beans that demonstrates the idea perfectly.
The Role the Anchoring Effect Plays on SLPs
In speech language pathology, the anchoring effect pops up all over the place. We deal with numbers related to the qualification of clients, how large our caseload is, and even how long it takes us to do the various tasks throughout the day. Sometimes these numbers serve as a helpful benchmark. But what if they are leading us to do work we might not need to do? What if they make us think that we are not performing well at our jobs?
Here are several ways that SLPs might be lead to an incorrect conclusion by hearing an anchored number.
Anchoring To a Score from Another Professional About Qualifications
Diagnosticians, psychologists, OTs, and even special education teachers run tests and come up with numbers. These colleagues of ours come to us, the communication experts, when there is a concern. That’s great and a fun way to collaborate. But should their test numbers have any bearing on our decisions?
School psychologists often come to me with low Oral Expression and Listening Comprehension scores. Tragically low, like in the 50s. I used to jump up and do these evaluations but stopped when I began disqualifying so many of them.
It dawned on me that when I had academic concerns about one of my students, they asked me to start the referral process for the academic concerns. When they had communication concerns about someone they were testing, they asked me to test. I now take a page out of their book and gather the needed referral information before saying I will test.
Anchoring To Caseload Size to Decide What Is an Acceptable Number of Children to Treat
When we receive new caseloads in the clinic, we often peg it against our peers to get a feeling about whether it is acceptable. Even with new jobs we will hear, “everyone in this district sees 60-65 children.” That might be true, but is it acceptable?
What if everyone is miserable? What if they are all experienced and you are a CF? What if they run groups and you do individual therapy? It might be true and acceptable, but you will see in the suggestions at the end that we probably need more information.
Anchoring To Caseload Size to Determine Workload Size
Something that has been proposed by ASHA is the idea of workload management rather than caseload management. In our current situation, appropriate work is anchored to a caseload number. You, dear SLP, are fulfilling your obligations if you see X# of students or clients.
Unfortunately this doesn’t account for working at multiple sites, more severe disorders, or bilingual children. A more fair (and hopefully forthcoming) assessment of effort would peg the SLP against workload, giving credit for serving multiple campuses, diverse children, and serving children with higher levels of severity. Basically, rewarding experience and the acceptance of challenging placements.
Anchoring To a Suggested Amount of Time to Complete a Report
Clinic personnel suffer under this one the most. Report writing time is anchored to billable minutes. You are “given” 90 minutes to write. However, is anyone actually completing the evals in that amount of time? What quality of report is it? And are Autism, Bilingual, and Articulation evaluations the same thing? No way.
We benefit from continually looking for strategies to reduce writing time. However, this type of anchoring can make us feel like we are really incompetent when we are working just as quickly as everyone else. It’s made worse when a number is suggested but no training is suggested to close the gap between how much time they are suggesting and how much time it is taking us to write a report. It could just come down to experience.
Reeling in the Anchor: Strategies for Informed Decision-Making
Luckily, negotiators, business leaders, and ambassadors have been battling the anchoring effect for decades. They have plenty of suggestions for making decisions that are not based on irrelevant numbers and relieve us from feeling like we have to respond when we don’t have all the information we need.
Here are four strategies looked at through the lens of speech language pathology:
Avoid Leading with a Number
Like we saw in the video above, often times negotiators will immediately end a potential contract if someone leads with a number because they are aware of how powerful the anchoring effect really is. As an example, instead of a school psychologist saying “he scored 50 on oral expression” she might say, “we saw real communication concerns during our evaluation.”
In speech pathology, the numbers are often irrelevant.
- It should only take 3 hours to write a report. Really, is it a bilingual eval? How experienced are you?
- A caseload is 50+ kids. Really? What if I have 3 campuses? What if one has a life skills unit?
- All children get 30 minutes of therapy per week. Really, even with severe stuttering?
Probe
Challenge the number with questions. The great thing about numbers is they are completely defensible and shouldn’t just come out of thin air. If someone uses a number, follow up by repeating the number and probing with a question. These can look like:
- You said this caseload has 75 children. There are 38 SLPs working here, is everyone seeing this many children?
- You said he scored 50 on Oral Expression. What was the initial referral for?
I love the part of this suggestion about repeating the number back. If a number sounds ridiculous to you, chances are it might sound ridiculous to them too!
Push Pause
There is no harm caused by taking a day to think about something. Our default setting as healthcare workers and educators is to help. But what if saying yes to a request for an evaluation or expansion of your caseload is not in the best interests of anyone?
To make pushing pause not sound like a rejection, use this three-step process.
- Compliment: “You have obviously put a lot of thought into this and it must have been hard to ask to add this to my plate.”
- Thank: “Thank you for bringing this to my attention.”
- State a timeframe: “I have sessions and meetings straight through the afternoon. I will send you an email tomorrow.”
Survey
SLPs are really at a disadvantage when we work in sites where we are the only communication professional because we have no one to compare to. For example, if you think you are spending too much time writing up your evaluation, is it true?
With a survey we might find we are the norm and we also might find innovative solutions. For example, we surveyed our blog about how many hours it takes to write an evaluation. There was much similarities but then there were some individuals who produced drastically faster evaluations. By interviewing them, we found really unique strategies that influenced our development of Evalubox.
Overall, I think the data on the anchoring effect gives us permission to chill out! I can’t think of a situation where more data didn’t help me understand a situation better. We just have to understand that when our desire to help is coupled with an innate desire to glom onto the first number that is offered to us, we risk doing more or unneeded work. In the worse cases, we think we are not working hard enough, even after an intense full week. Don’t anchor yourself to someone else’s idea of productivity without the facts!
7 Types of Bias and How They Affect Speech Language Pathology
This is one of eight essays we wrote on bias, based on the work of Daniel Kahneman and the research we put together for the ASHA CEU course: How Ethics and Biases Shape Our Decisions: A Fun Look at Research on Heuristics. Start with the inspirational article on Daniel Kahneman and then work your way through seven ways our hidden biases can unknowingly influence our thinking.
- Navigating Fairness Bias in Our Role as SLPs
- Framing Effect: Shaping Perspectives with Words
- Understanding Availability Bias: Challenging Perceptions During Evaluations
- Deciphering the Conjunction Fallacy – Overlap or Isolation of Disorders?
- The Overconfidence Effect – Misperceptions About Amount of SLP Work and How Long it Takes
- Embracing Loss Aversion: Balancing Risk and Reward in Speech Pathology
- Freedom from the Anchoring Effect: When Numbers Work Against Us
