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136 JCPSLP Volume 15, Number 3 2013 Journal of Clinical Practice in Speech-Language Pathology
for comparison. Increased knowledge sharing across
speech pathology and other disciplines will benefit all key
stakeholders, but in particular maltreated children, through
improved service delivery, tailored to their individual needs
and circumstances.
Acknowledgements
The authors wish to thank the community-based services
speech pathology team and the HNELHD OOHC Health
services. The authors are happy to discuss service delivery
with interested speech pathologists.
References
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Child Family Community Australia (CFCA). (2012). What
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au/cfca/pubs/factsheets/a142091/index.html
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Inquiry: A positive revolution in change. San Francisco, CA:
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Retrieved from
documents/child_protection_framework.pdf
Couzos, S., Metcalf, S., & Murray, R. (2001). Systematic
review of exisiting evidence and primary care guidelines
Table 6. Challenges and strategies for the speech pathology service
Challenges Strategies
Children in OOHC need to be considered separately as a NSW Health, Kaleidoscope children services and SP team’s commitment to care
vulnerable group and this challenged the beliefs of some clinicians for these children as a vulnerable group
Speech pathologists have different knowledge and experience Education of the SP team regarding the social, emotional, physical and
regarding working with children who have suffered maltreatment behavioural implications of maltreatment
Consistency in the way in which SP services are provided across SP team developed and implemented OOHC clinical pathways to ensure
7 sites coordinated and supported access to services
Timely exchange of information between SP service and Developed links between SP service and key services within HNELHD, including
stakeholders OOHC clinics, child protection, and HNELHD health case managers
FC may change if child was in short-term or emergency care At referral or at the first appointment, the speech pathologist ensures they have
the correct contact details of the current FC and caseworker
HNELHD identification of the need for priority services to children in HNELHD district-wide clinical priority tool for paediatric community speech
OOHC, due to their high-risk situation and potential inability to pathology services acknowledges this as a discrete group and provides additional
access/complete services weighting for prioritisation
Ensure speech pathologists are aware of referral for child in OOHC Centralised intake sends an email alert to the SP team leader, which is forwarded
to the SP OOHC coordinator and entered onto database
Higher representation of Aboriginal children in OOHC HNELHD encourages identification of Aboriginality and has a commitment to
reducing health disadvantage (NSW Ministry of Health, 2012)
Information on the number of Aboriginal clients helps support the identification of
the need for culturally appropriate resources
Cultural awareness training available to all staff
Culturally appropriate resources are being purchased
Staff education provided regarding HNELHD commitment to reducing Aboriginal
disadvantage, and communicating effectively with Aboriginal clients
Liaise with available internal and external Aboriginal staff in local area in the
provision of services
Consistency and clinical support for less experienced clinicians or HNELHD clinical supervision policy requires monthly supervision which may
those with specific interest in working with vulnerable groups incorporate case management, review and discussion of children in OOHC
Child may not be ready for intervention when service identifies it is Flexibility to provide therapy when family situation is conducive to intervention –
their turn (i.e., child’s name at top of waiting list) FC may hold off therapy while other services are provided (e.g., psychology); child
is not disadvantaged if not accessing services at that time
Clients are put on hold and offered next available therapy appointment when they
are ready to access services
Many children in OOHC have been living in other geographical Implemented a referral transfer system that back dates referral from entry to
locations (outside of the referral area) and may have either been previous SP service; enables transfer at an equivalent level and eliminates multiple
on a speech pathology waiting list or accessing services elsewhere waits for service
Child may not fit into typical service parameters for session caps Increased flexibility in number of appointments available and cognizant that
greater time may be required to build trust and rapport