JCPSLP Vol 17 No 3 2015

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Fresh science and pioneering practice
JCPSLP Volume 17, Number 3 2015 151
Tara Shem (top),
Chris Brebner
(centre), and
Lilienne Coles
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
CHILD HEALTH
RECORDS
COMMUNICATION
DIFFICULTIES
EARLY CHILDHOOD
EDUCATION AND
CARE
EARLY CHILDHOOD
EDUCATORS
EARLY
IDENTIFICATION
Use of Child Health Records
to support referral for
speech-language pathology
services
Tara Shem, Chris Brebner, and Lilienne Coles
One area of child development outlined in CHRs is
communication. During the early years crucial communication
foundations which contribute to future outcomes are
developed (Speech Pathology Australia [SPA], 2014).
Unfortunately, developmental difficulties, including
communication impairments, are not being identified until
formal schooling for a significant proportion of Australian
children (Department of Education, 2013). Hence, developing
strategies to identify and act to remediate communication
difficulties early in children’s lives is a priority, especially for
speech-language pathologists who have the expertise to
provide appropriate assessment and intervention.
Recent inquiries have suggested that early identification
practices be supported by Early Childhood Education and
Care (ECEC) and ECEC staff (Oberklaid, Baird, Blair,
Melhuish, & Hall, 2013; SPA, 2014). In this context, “ECEC
staff” refers to educators working in ECEC facilities with a
minimum qualification of a diploma in children’s services,
and this term will be used in this context for the remainder
of this article. Educators have skills, knowledge, and
understanding of the children with whom they work which
could assist with developmental monitoring (Oberklaid et al.,
2013) and the process of identifying early communication
difficulties (Branson, Vigil, & Bingham, 2008).
The purpose of this research was to explore CHRs as
a tool to assist with the identification of communication
difficulties in the early years in South Australia. The research
question for this study was: Does the South Australia
CHR assist educators to discuss their concerns about
development of children in their care with the child’s
parents? A general view of “developmental concerns” was
sought for this study; however, the key focus of this study
was on communication concerns.
Method
A qualitative research design employing individual, face-to-
face semi-structured interviews with educators was adopted
to answer the research question. This approach is appropriate
for the exploration of educators’ perspectives (Creswell,
2014). Similar qualitative designs have been implemented in
previous research exploring educators’ perceptions on
language development (Marshall & Lewis, 2014) and
experiences with speech, language and communication
needs (Mroz & Letts, 2008). Ethical approval for the study
was obtained from the Social and Behavioural Research
Ethics Committee at Flinders University, South Australia.
Participants
Eight educators, working across four childcare centres in a
community organisation in metropolitan Adelaide, South
Child Health Records (CHRs) are used to
record developmental information which
could be useful in identifying communication
difficulties. It is critical to identify
communication difficulties promptly as early
experiences influence future outcomes. This
study explored the utility of the South
Australian CHR as a tool for early childhood
educators (educators) in conveying concerns
about development to parents of children
attending childcare services. Eight educators
discussed with parents their concerns about
the development (primarily of communication)
of children in their care, drawing on
information provided by families in their CHR.
Interviews with educators were conducted
following these interactions. The eight
educators found the CHR to be a valuable
support during conversations that they
described as challenging. Thus, CHRs could
be a useful tool for educators to support early
identification of communication difficulties.
Child health records (CHRs) are a parent-held
resource, provided to every Australian at birth, into
which developmental information can be recorded.
They contain immunisation records, growth charts, and
developmental information (e.g., communication/motor
milestones), and are used by health care professionals
to record such data (Department of Education and Early
Childhood Development [DEECD], 2010). The aim of CHRs
is to promote parent knowledge, to increase engagement
and communication with health professionals, to record
developmental information, and to improve health care
service utilisation (DEECD, 2010).
Hamilton and Wyver (2012) identified, through exploring
parents’ views of the New South Wales CHR, that mothers
found it to be a valuable resource to assist communication
of information about children’s health/development
between parents and professionals. Their interviews also
highlighted that professionals, such as teachers in childcare
settings, can support families in understanding information
in the CHR and identifying when to act upon concerns
(Hamilton & Wyver, 2012). These findings show that CHRs
can provide value for parents and that non-health care
professionals may have a role in conversations with parents
about their children’s development.