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JCPSLP
Volume 15, Number 3 2013
Journal of Clinical Practice in Speech-Language Pathology
Table 3. Challenges and strategies for the foster carer (FC)
Challenges
Strategies
FC does not typically have information on child’s:
Speech pathologist accesses information from centralised medical systems
• prenatal history (e.g., alcohol exposure)
• developmental milestones
Consent from caseworker or non-government organisation (NGO) representative as
• related early developmental factors (e.g., feeding problems)
“parent of the child” to engage with other health/education professionals
• family history of speech and learning disorders
• medical history (e.g., ear infections)
Presume child likely has recognised risk factors
• maltreatment
FC may not be privy to information regarding the
Phone call follow-up with caseworker to discuss maltreatment, to ensure accuracy
maltreatment of, and the potential impact on, the child
and appropriateness of sharing this information
FC may not have had links to early intervention or support
Referral to relevant service (e.g., Early Childhood Information Team) to assist families
services (e.g., carer support, playgroups)
to access services
FC may be unaware of length of placement
Ongoing liaison with caseworkers
FC may have difficulties working with child who has concurrent Liaison with OOHC SP coordinator regarding referral to appropriate services to access
behavioural issues, i.e., separation anxiety, trauma, aggression other allied health/multidisciplinary teams
Table 4. Challenges and strategies for the caseworker
Challenges
Strategies
Caseworkers are increasingly situated in NGOs
Educate speech pathologists on caseworkers’ roles
The clinical pathway identifies when there is a need to contact caseworker
Caseworkers may have varying exposure or knowledge
Incidental education of the caseworkers surrounding specific clients
regarding speech pathology
Provision of generic information on identification of speech/language delays and
referral mechanisms (Lyddiard, 2012b)
Caseworkers’ contact with FC may vary
Ensure contact details of caseworkers are current
Provide regular feedback on intervention (e.g., through the development of family
services/support plans)
Table 2. Challenges and strategies regarding the child
Challenges
Strategies
Child may have had a previous SP referral, but poor
Child is not to be disadvantaged based on previous failures to attend service under differing
attendance or follow-up while in the care of their
circumstances
parents may have led to their discharge
Hunter New England Local Health District Clinical Priority Tool is applied to all referrals;
children in OOHC typically have multiple risk factors placing them at a higher priority
(HNELHD, 2012)
Work with OOHC health case manager to provide assistance regarding active follow up
Child may not have had previous access to toys/
HNELHD play therapist provided a training workshop to SP team regarding the importance of
books/age-appropriate items, impacting upon
play, play stages and skills and relationships between play, interaction and communication
development of play skills
Speech pathologists work with childcare providers
Child may have difficulties with trust, building
Initial appointment is an opportunity to gain trust and build rapport with the foster carer (FC)
relationships and rapport
and the child, rather than a formal SP assessment
Education provided to SP team (e.g., attachment, managing complex behaviours)
Child’s speech and language ability on initial placement
Detailed discussions occur with FC about the child’s communication skills, including child’s
may be not representative of abilities once they have
length of time with that foster family, the problems they were experiencing in speech/
settled into their foster family and are in a stimulating
language when they entered into their care, any changes they have noticed (i.e.,
environment
improvements) since coming into care
Monitoring the child’s communication development may be the most appropriate
intervention.
Child may not respond well to new environments
Visits may be conducted in familiar environments (e.g., preschool)
and people
Families are encouraged to bring some of the child’s familiar toys/ books to the appointment
Where possible child maintains the same speech pathologist through intake, screening,
assessment and intervention
Provide a calm environment, introducing one activity at a time