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ACQ Volume 13, Number 1 2011 43
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consider the principles of effectiveness, efficiency, and equity
in their decision making processes regarding assessment
practices and subsequent recommendations and service
delivery (McAllister et al., 2009). Kenny, Lincoln, Blyth, and
Balandin (2009) highlighted the tension between “quality”
and “quantity” in their study of ethical dilemmas related
to quality of care for new graduate speech pathologists.
Participants in this study perceived a number of ethical
dilemmas when they did not have adequate resources or
support to meet the needs of paediatric clients (i.e., time
pressure, long waiting lists for assessment, children with
complex medical and social histories). Limited time for
report writing and discussing complex cases with more
experienced colleagues impacts the speech pathologist’s
ability to offer competent, wholistic assessments. This
research highlights the tension between “quality” and
“quantity” in assessment loads and whether there are some
“duties to our profession and ourselves” at stake in models
of assessment delivery and how we value the “assessment”
component of our work.
From the discussion above, it is clear that there are many
complexities involved in decision making. These include the
identity of the “client”, the assessments to be undertaken,
and the format of reporting. Given these complexities,
taken together, the “Three Es – effectiveness, efficiency,
and equity”, and the importance of viewing the child as our
primary focus, may provide an enduring framework to guide
the practice of speech pathologists working with children
with language disorders.
Conclusion
The preceding discussion has raised several ethical issues
facing speech pathologists working with children with
language disorders. Many of these relate to the relationship
between assessment and educational funding. Some
guiding principles have been offered.
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Dr Nerina Scarinci is a lecturer in the Division of Speech
Pathology at the University of Queensland and is a member-elected
representative on the Speech Pathology Australia Ethics Board.
Nerina coordinates the final year speech pathology course on ethics
and has a special interest in family-centred practice. Dr Wendy
Arnott is a lecturer in the Division of Speech Pathology at the
University of Queensland. Wendy has a special interest in paediatric
language disorders and coordinates the speech pathology course
on: Language, literacy, and the school-aged child.Anne Hill is a
lecturer in the Division of Speech Pathology at the University of
Queensland. Anne is currently completing PhD studies investigating
student learning in simulated environments and teaches in the areas
of paediatric speech disorders and pre-clinical education.
Correspondence to:
Dr N. Scarinci