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JCPSLP
Volume 19, Number 1 2017
Journal of Clinical Practice in Speech-Language Pathology
Caregiver skill acquisition
Caregivers also reported the benefits of learning new skills
themselves: “It’s shown me how I can do different sounds
with my son” (8); “We play the games at home and we both
enjoy them” (3).
Theme 2: Impact of the health service
(individual clinician and
organisational factors)
The participants mostly spoke about their experiences with
the SLP service, but also made comments relating to
Aboriginal-specific health services they had attended.
Flexibility
Some participants identified that the service flexibility
facilitated them to attend SLP: “It’s been pretty good
working around our schedule. I don’t work Fridays, so we
can normally get an appointment on Fridays” (1).
Being able to bring siblings to their child’s SLP
appointment was seen as positive by participants: “I’m able
to take my baby as well and [
speech-language pathologist
]
doesn’t mind” (5).
Relationship
Positive aspects of the relationship between the speech-
language pathologist and both the caregivers, and the
child, were directly referenced by many: “[The speech-
language pathologist] is friendly and welcoming” (3);
“Seeing the same person and having continuity of care. I
feel comfortable” (4).
Expectations of service
Participants spoke about their experiences with SLP
services, expressing some uncertainties initially about what
therapy would entail:
It was a lot different to what I expected. I was
expecting it to be, not exactly boring, but not as
enthusiastic as it is. (8)
They [other Aboriginal people] probably don’t get
to experience what speech therapy is like. So many
questions are asked in the first appointment. (10)
Commitment of caregiver
One theme that emerged strongly was that of caregiver
commitment and motivation. A number of participants
emphasised their commitment to their children’s care, and
wanting the best outcomes for their children: “We both put
ourselves on the backburner and do everything we can for
the kids” (3); “It’s going to improve his future” (2).
Child and caregiver experience with
speech therapy
It was important for caregivers that their children liked the
speech-language pathologist: “He’s excited to go there” (2).
Child’s receipt of attention
It was also important for caregivers that their children
received individual attention: “The work is directed
especially at her, as her own person, and L loves the
individual attention she gets from [the speech-language
pathologist]” (3).
Table 3. Potential strategies to facilitate Aboriginal families’ engagement with SLP services
Theme
Subtheme
Possible strategies
Client and
caregiver
Awareness of
service
Hold community education sessions
Encourage clients to share their positive SLP experiences with family and community
Hold drop-in clinics in familiar locations (e.g., Aboriginal Medical Service)
Changes
to child’s
communication
Inform caregivers that improvements in a child’s communication can lead to improvements in
behaviour, confidence, and education
Encourage caregivers to seek feedback from stakeholders (e.g. preschool) about improvements in their
child’s communication
Expectations of
service
Hold a separate session before assessment, to gather case history from caregiver
Enforce positives that caregivers are doing (e.g., bringing their child to the appointment), and things
that they have picked up on (e.g., practising speech sounds at home)
Inform caregivers:
• What SLP services entail (e.g., assessment followed by therapy)
• That therapy will be practical, relevant and enjoyable
• About strategies they will learn for themselves to use with their children at home
• About expectations and requirements of therapy, (e.g., number of sessions, homework)
• That personal and health questions will be asked
Impact of the
health service
(individual
clinician and
organisational
factors)
Location and
physical access
Identify site that is most easily accessible for public transport
Flexibility
Talk to caregivers about what would be a good time for them to attend (e.g., fitting in with other
commitments) and arrange appointments at these times
Relationship
Spend the first session getting to know the family
Maintain same clinician throughout service provision (if not possible conduct a handover appointment
where new speech-language pathologist attends session)
Community and
Aboriginal culture
Aboriginal culture Treat each caregiver as an individual
Ensure Aboriginal-specific SLP resources (e.g., dolls, books) are available
Consider including Aboriginal languages in therapy
Aboriginal staff to support clinical staff to engage with Aboriginal families