ACQ Vol 13 no 3 2011

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Cultural diversity
ACQ Volume 13, Number 3 2011 141
From top to
bottom: Andrea
Coleman, Tania
Porter, Ursula
Barber, Jillian
Scholes
Keywords
COMMUNI-
CATION
DEVELOPMENT
INDIGENOUS
SERVICE
DELIVERY
OTITIS MEDIA
conductive hearing loss that has the potential to adversely
affect speech and language and educational outcomes
(Williams & Jacobs, 2009). For this reason it is important
that approaches to the management of OM in children from
Indigenous communities encompass not only medical, but
also developmental and educational considerations.
Deadly Ears is a statewide (Queensland) Indigenous ear
health program. It is the core component of Deadly Ears
Deadly Kids Deadly Communities: 2009–2013 (Queensland
Health, 2009), a comprehensive inter-agency strategic
framework established to improve ear health in Indigenous
children. Following community invitation, the Deadly Ears
team works to develop sustainable solutions that improve
ear health related population outcomes. This requires a
diverse team that includes Community Engagement and
Development, Health Promotion, Workforce development,
Allied Health and an ENT outreach surgical team known as
“Hospital Walkin’ Country”. This paper focuses on the allied
health component of the program, which aims to reduce
the impact of OM in Indigenous communities.
Working closely with local service providers is essential
to create the positive environments necessary to optimise
communication and play development for all Indigenous
children. Indeed, formation of partnerships with community-
based organisations is considered essential for successful
delivery of health promotion and capacity building activities
in Indigenous communities (Pyett, Waples-Crow, & Sterren,
2008). While delivering sources to address the impacts of
OM in Woorabinda community in early 2010, the Deadly
Ears allied health team became aware that two other
service providers shared the same aim: to reduce the
impact of OM for 0- to 4-year-olds in a remote Indigenous
community by building the capacity of key stakeholders in
the early education setting. The first of these, Undoonoo
Day Care, is a Multifunctional Aboriginal Children’s Service
(MACS) long day-care in Woorabinda community, managed
by the Woorabinda Shire Council. The second, the Child
Services Skilling Plan (CSSP) (a Department of Education
and Training program) was working with Undoonoo to
deliver contextualised training to support the centre to
meet legislative requirements and to provide quality early
childhood services. Deciding that combining their efforts
may prove more efficient than working separately, the three
groups agreed to move forward in partnership to meet
their shared goals. This paper describes how the shared
journey evolved and offers a preliminary evaluation of its
effectiveness to date.
The discrepancy between the growing
demands for speech pathology services in
Australia and the size of the skilled workforce
calls for innovative solutions to meet
population health needs. This is perhaps
most apparent in rural and remote Aboriginal
and Torres Strait Islander communities where
the delivery of high-quality allied health
services (necessary to close the gap in health
inequality) is frequently challenged by an
underinvestment in the workforce. In
response, allied health clinicians are actively
seeking alternative models of care that utilise
a diverse range of resources to deliver the
service. The purpose of this clinical insight is
to share one such experience of service
adoption from the perspective of the allied
health team in the Deadly Ears program (Qld
Health Aboriginal & Torres Strait Islander Ear
Health Program). After outlining the
background of the partnership, the paper
highlights how the allied health team used
this model of service delivery to reduce the
impact of otitis media on communication
development for Indigenous children in the
context of the early childhood education
setting. The insight then draws on reported
benefits and areas for improvement with the
intent of sharing how this model of care can
effectively add to the scope of practice for
speech pathologists working in resource-
poor settings.
The prevalence of otitis media (OM), infection of
the middle ear, exists in much higher rates in the
Indigenous1 population than the non-Indigenous
population; it begins earlier and may extend into
adolescence and beyond (Couzos, Metcalf, & Murray,
2001). A prevalence of 91% has been reported in
Indigenous infants (Morris et al., 2005) compared with
30% among non-Aboriginal infants (Boswell & Nienhuys,
1995). OM often occurs with a fluctuating mild-moderate
Clinical insights
Partnerships: A service delivery option for speech
pathology in Indigenous communities
Andrea Coleman, Tania Porter, Ursula Barber, Jillian Scholes, and Helen Sargison