Adopting Public Health Approaches to Communication Disability: Challenges for the Education of Speech-Language Pathologists

Abstract

Public health approaches to communication disability challenge the profession of speech-language pathology (SLP) to reconsider both frames of reference for practice and models of education. This paper reviews the impetus for public health approaches to communication disability and considers how public health is, and could be, incorporated into SLP education, both now and in the future. The paper describes tensions between clinical services, which have become increasingly specialized, and public health approaches that offer a broader view of communication disability and communication disability prevention. It presents a discussion of these tensions and asserts that public health approaches to communication are themselves a specialist field, requiring specific knowledge and skills. The authors suggest the use of the term ‘communication disability public health' to refer to this type of work and offer a preliminary definition in order to advance discussion. Examples from three countries are provided of how some SLP degree programmes are integrating public health into the SLP curriculum. Alternative models of training for communication disability public health that may be relevant in the future in different contexts and countries are presented, prompting the SLP profession to consider whether communication disability public health is a field of practice for speech-language pathologists or whether it has broader workforce implications. The paper concludes with some suggestions for the future which may advance thinking, research and practice in communication disability public health.

Speech, Language, and Communication in a Public Health Context: A UK Perspective with Potential Global Application – An Opinion Piece

“…They do this by working with a broad range of other disciplines including community workers, health visitors, teachers, psychologists, and other allied health professionals to improve identification and address communication needs in children, young people, and vulnerable adults whose interaction and/or swallowing difficulties reduce their life chances and can lead to secondary health problems as well as having social sequelae [7]. For example, approximately 6% of children have speech, language and/or communication difficulties, of which the majority will not have any other significant developmental problem.…”

“…Wylie et al [7] describe the tensions between clinical services, which have become increasingly specialised, and public health approaches that offer a broader view of communication disability and its prevention. These authors argue that speech-language pathology training programmes should integrate public health training into the curriculum and advocate the term “communication disability public health” to promote this broader contribution.…”

Stepping out of the shadows: Allied health student and academic perceptions of the impact of a service-learning experience on student's work-readiness and employability.

“…The program is underpinned by a cross-sector partnership between school education and health service stakeholders, the Broken Hill UDRH (BHUDRH) and The University of Sydney Faculty of Health Sciences. Program objectives include addressing unmet allied health needs of children, expansion of regional placement capacity through extension into nontraditional community settings, and exposure of students to alternative population health practices (Wylie, McAllister, Marshall, & Law, 2014), with intent to influence student place of practice post-graduation (Deaville & Grant, 2011).…”

“…Approximately 150 pupils access these services annually. Service delivery takes a population health approach (Kindig & Stoddart, 2003) in response to the needs of school children, parents, and teachers and includes individual, small group, and whole of class sessions (Wylie et al, 2014).…”

“…Relationship-centered care (RCC) is based on partnerships between individuals, communities and health care practitioners and includes an understanding that relationships occur at multiple levels, between different partners and are critical for effective health care delivery (Suchman et al, 2011). There are increasing calls for allied health professions to engage in population health approaches that are intrinsically linked to complex relationships (Miller & Gallicchio, 2007;Wylie et al, 2014). A lack of practice experiences within community-based organisations that provide exposure to these relationships has been identified as a constraint in the provision of RCC experiences (Suchman et al, 2011).…”