JCPSLP Vol 17 No 3 2015

Fresh science and pioneering practice

Use of Child Health Records to support referral for speech-language pathology services Tara Shem, Chris Brebner, and Lilienne Coles

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. C hild 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.

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

THIS ARTICLE HAS BEEN PEER- REVIEWED EARLY CHILDHOOD EDUCATION AND CARE EARLY CHILDHOOD EDUCATORS EARLY IDENTIFICATION KEYWORDS CHILD HEALTH RECORDS COMMUNICATION DIFFICULTIES

Tara Shem (top), Chris Brebner (centre), and Lilienne Coles

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JCPSLP Volume 17, Number 3 2015

www.speechpathologyaustralia.org.au

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