ACQ Vol 10 No 2 2008

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ACQuiring knowledge in speech , language and hearing, Volume 10, Number 2 2008 45
Work– l i f e balance : preserv i ng your soul
In conjunction with my boss, the District Guidance Officer,
we tackled the issue of how to provide a service across the
entire district. Using the models described above, we would
seed services in the schools in larger country towns around
Cairns. When a service was up and running, it would be
withdrawn, citing distance, weather and road conditions as
barriers to sustaining it. (Occasionally this was true – I once
had two weeks “flood leave” when all roads out of my
northern beach home were cut by floods.) The power of rural
communities to influence government policy and spending
was considerable in Queensland in the 1970s, and repre­
sentations by schools and community members to relevant
parliamentarians would lead to creation of a new speech
therapy position. In just a few years, the service grew from
one (me) to five speech therapists in the district.
One aspect of service delivery in FNQ that gave me
particular pleasure was providing consultations over the
School of the Air radio from the Flying Doctor base in Cairns.
Teachers would occasionally ask me to “listen to this kid on
the radio and tell me if he needs speech therapy”. This was no
easy task given the static on the radio but a short conversation
with child and then parent could sometimes establish the
need for a referral to the Bush Children’s Health Scheme in
Townsville for assessment and intensive therapy, or a visit to
me next time they were in Cairns. Because I had grown up in
“the bush”, I had great sympathy for the isolation and
distance faced by these families and would happily come into
the clinic for an evening or weekend consultation if they
happened to come to Cairns at short notice for other reasons.
In recent years, this interest in equity of opportunity for
access to services has motivated my research with Telstra into
the use of low-tech telehealth, using the IT and computers
already available in the homes of many remote Australian
families (Wilson, McAllister, Atkinson & Sefton, 2006;
McAllister, Wilson & Atkinson, 2008).
Another strategy for providing services to large numbers of
children, teachers and schools was to involve as many speech
therapy students as I could in my work. I asked the University
of Queensland to send me students whenever they could,
particularly in the school holidays. If students came in term
time, they were exposed to the models of indirect service
delivery I described above. They found this a great challenge
as it was outside their experience to date. If the students came
during school holidays, we would run intensive one-to-one
and group therapy programs for children who needed direct
therapy. The students served not only as many extra pairs of
hands, but also as a lifeline for me to new ideas, resources,
journals, and so on. In essence, they were my professional
development program, and I remain gratefully in touch with
many of them to this day.
I had a wonderful five years in Cairns, interrupted by a
year at Western Michigan University to complete a Masters in
and all the children who potentially required a service. It
would have been easy to continue to do “the same old thing”
because expectations of me were low. Had I stayed in “my
clinic”, I might have been simply fulfilling the first two of
three prevailing views held by many teachers of the day: that
speech therapists “spent term 1 assessing, term 2 doing “a bit
of therapy”, and term 3 getting pregnant and leaving”.
However, I seized the opportunity to do things differently,
spent little time in the clinic, and almost serendipitously
found myself pioneering new ways of providing services
across large areas.
Through trial and error in the first year, I developed a plan
for rotating through schools on a term basis, typically 2–3
schools each term. Schools would be responsible for
identifying children of concern using a checklist I had
developed. There was excellent support from the local schools
for my work. At large seminars organised by the schools and
conducted at the local teachers’ resource centre, I regularly
explained how to use the checklist to identify, refer and work
with children with speech and language problems in the
classroom. At the start of a school’s target term, I would do
screening assessments of all referred children, and use carbon
paper to leave summary reports and suggested goals with the
school on the same day. I would return in the next few weeks
to run workshops on “how to help children with speech and
language problems” in staff meeting times, and to meet with
teachers about how we jointly could achieve these goals,
preferably in the classroom. This might involve developing a
program for the teacher, aide, parent or volunteer. If the
teacher was willing, I would come into the classroom and co-
teach an activity with in-built listening, and speech or language
goals which would benefit the whole class as well as the
target children. I would endeavour to see parents and explain
their children’s needs and programs, providing additional home
practice where possible. Once programs were running, I could
move onto the next school, returning to the previous school
on a fixed intermittent schedule to check on progress, adapt
programs and so on. A school could expect to see a lot of me one
term, less the next, and only once or twice for “check ups” in
the third term. I was always available to teachers and parents
by phone on the day a week I spent in the office.
The approach to service delivery I developed was a com­
bination of what we now refer to as block or cycle therapy,
collaborative consultation and co-teaching. These initiatives
were reported in more depth in McAllister (1985). I did also
provide more extensive assessments and traditional one-to-
one therapy for children who required this, for example those
with severe speech impairments (e.g., post-cleft palate sur­
gery, dyspraxia), and voice disorders. Children who stuttered
I took to the Education Department clinic in Townsville
during school holidays for an intensive program , and in later
years I ran intensive group therapy with my new speech
therapy colleague at the Cairns Base Hospital.
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