Like all professionals serving individuals with developmental disabilities, speech-language pathologists (SLPs) are called upon by consumers, insurance providers, and policy makers to justify their clinical practice through evidence-based outcome data. Yet Tharpe (1998, p. 180) has noted that “the field of communicative disorders sorely lacks systematic documentation of clinical outcomes” and that “much of our current practice is based on opinions, theories, and personal experiences.” We will examine this claim by describing (1) the Scope of Practice for SLP, (2) the nature of fads and controversial treatments within SLP, (3) treatment efficacy information in journals published by the American Speech-Language and Hearing Association (ASHA), and (4) factors that contribute to fads and controversial treatments. We conclude with our recommendations for future directions in SLP.