Going the distanc: Providing Speech Pathology services ito schools in rural NSW
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Describes the development of the Specialist Integrated Community Engagement (SpICE) model of resourcing and supporting communication skill development in regional communities. Developed as partnership project between CSU Albury staff, Albury Community Health, NSW Education Dept. and Dept of Families, housing, Community Service and Indigenous Affairs.
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Going the distanc: Providing Speech Pathology services ito schools in rural NSW
- 1. SCHOOL OF COMMUNITY HEALTH Going the Distance: Providing speech pathology services to schools in rural NSW Libby Clark1 , Marijke Denton2 , Helen Evans2 , Jane McCormack1 , Kendall Clark3 1 Charles Sturt University 2 Albury Community Health Centre 3 Department of Families, Housing, Community Services and Indigenous Affairs Speech Pathology Australia National Conference, June 2012, Hobart
- 2. SCHOOL OF COMMUNITY HEALTH Background Speech/language impairments are high prevalence conditions (Law, Boyle, Harris, Harkness & Nye, 2000; McLeod & Harrison, 2009) Personal and societal costs associated with speech/language impairments are significant (McCormack, McLeod, McAllister & Harrison, 2009; Ruben, 2000) Speech/language impairments respond well to early intervention from speech pathologists (Almost & Rosenbaum, 1998, Hesketh, Dima & Nelson, 2007) Parents rely on teachers for information about communication development/difficulties and confirmation of concerns (McAllister et al., 2010)
- 3. SCHOOL OF COMMUNITY HEALTH There are barriers to accessing services when children with communication impairment have been identified • Child and family related barriers (e.g., child readiness for intervention, family capacity to engage in therapy, cost) • Service barriers (e.g., lack of positions, turn-over of staff, waiting times, travel distance, type of services provided) • Policy barriers (e.g., recognition of communication impairment, prioritisation, criteria for access and amount of services received) Service Delivery / Policies
- 4. SCHOOL OF COMMUNITY HEALTH Communication impairment and the ICF-CY
- 5. SCHOOL OF COMMUNITY HEALTH
- 6. SCHOOL OF COMMUNITY HEALTH Aim This paper describes community development projects that have been trialled by speech pathologists at ACHC in conjunction with CSU and FAHCSIA: • School’s Project • ‘SpeechSpace’ / ‘Connected Classrooms’ • SPiCE model
- 7. SCHOOL OF COMMUNITY HEALTH School’s Project / Speech Space / Connected Classrooms
- 8. SCHOOL OF COMMUNITY HEALTH What we’ve learnt...
- 9. SCHOOL OF COMMUNITY HEALTH
- 10. SCHOOL OF COMMUNITY HEALTH Applying the SPiCE model to speech pathology practice
- 11. SCHOOL OF COMMUNITY HEALTH Clinical Implications / Future Directions Change focus: Outcomes vs. Outputs Find “champions” – be connected Workforce preparation
- 12. SCHOOL OF COMMUNITY HEALTH Department of Education and Communities Acknowledgment
- 13. SCHOOL OF COMMUNITY HEALTH References Beecham, R. & Denton, M. (2010). Collaborative engagement in fieldwork education. In L. McAllister, M. Patterson, J. Higgs, & C. Bithell (Eds.). Innovations in Allied Health Fieldwork Education: A Critical Appraisal. Sense Publishers. Speech SPACE: Speech Pathology and Classroom Exchange http://csusap.csu.edu.au/~mdenton/pages
- 14. SCHOOL OF COMMUNITY HEALTH Going the Distance: Providing speech pathology services to schools in rural NSW Libby Clark eclark@csu.edu.au +61 2 6051 XXXX Jane McCormack jmccormack@csu.edu.au +61 2 6051 9224
Editor's Notes
- Prevalence: 25.2% of parents (n=4,983) identified concerns with child’s speech/language in early childhood (4-5 years) “Communication disorder” is the second most prevalent identified area of learning need, after specific learning needs, and is more prevalent than: behavioral/emotional difficulties physical/medical disabilities intellectual disabilities hearing or vision impairments (McLeod & McKinnon, 2007) Children may experience: Bullying (Knox & Conti-Ramsden, 2003) Withdrawal from peers (Fujiki, Brinton, Isaacson & Summers, 2001) Lower academic attainment and greater need for remedial help at school(Lewis, Freebairn & Taylor, 2000
- According to the ICF-CY (WHO, 2007), health and wellbeing result from the interaction between biology (Body Structures and Functions) and everyday life (Activities and Participation), which are influenced by Personal and Environmental Factors. Impairment results when there is a problem with a Body Structure or Function (such as the impaired ability to articulate sounds, or produce grammatical sentences), and the impact (or effect) of that impairment is seen by examining the way in which an individual’s ability to perform Activities has been limited, or their Participation has been restricted. The traditional assessment and management of speech impairment has focused on the impaired body function (typically, we evaluate articulation and provide intervention targeting the production of speech sounds). However, this is only one component of a holistic approach to clinical practice. We also need to consider the environmental context of the individual and work with significant others within the environment to deliver appropriate and sustainable intervention.
- The research reported in this paper explored the application of the Activities and Participation component of the ICF-CY as a framework for investigating difficulties associated with speech impairment in early childhood. The aim of the research was to examine the association between communication impairment in early childhood (at 4-5 years) and a range of Activities at school-age (7-9 years), as reported by children, parents and SLPs. This study is the fourth in a series of studies that have examined speech and language development of children within the Longitudinal Study of Australian Children (LSAC; Australian Institute of Family Studies, AIFS, 2009) Kindergarten cohort, recruited at age 4-5 years (Harrison & McLeod, 2010; Harrison et al., 2009; McLeod & Harrison, 2009). The LSAC data set documents the development of a large, nationally representative sample of Australian children and the contexts in which they are raised. Communication development is one of the many areas for which data are available for analysis, and these data have been accessed by McLeod, Harrison and colleagues to investigate the prevalence of communication impairment, risk factors and protective factors for communication impairment and academic progress of children identified with speech and language impairment at age 4-5 years when they were 6-7 years of age. The present study extended this work in three ways, by: (1) examining a further wave of longitudinal data, gathered four years after recruitment, at age 7-9 years; (2) examining the associations between communication impairment and a broad range of life Activities including, but also extending beyond, a focus on language and learning outcomes; and (3) drawing on multiple perspectives – reports from children, parents, and teachers, as well as direct assessment – to provide a more holistic examination of Activity limitations. The specific aim of this paper was to enable a better understanding of the dimensions of childhood communication impairment by investigating the longitudinal associations between communication (speech and language) impairment at age 4-5 years and five domains of life Activities, as defined by the ICF-CY (WHO, 2007), at age 7-9 years. A further aim was to examine the relative strength of these associations after accounting for the contribution of important child and family demographic characteristics to the outcomes.