Barriers to accessing rural paediatric speech pathology services: Health care consumers’ perspectives

O'Callaghan, A. M.; McAllister, Lindy; Wilson, Lindsay

doi:10.1111/j.1440-1854.2005.00686.x

Cited by 61 publications

(52 citation statements)

References 6 publications

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“…The trial provides the best evidence yet that language delay can be systematically identified and efficiently addressed before formal schooling starts. Such a well-tested intervention, delivered to children by a range of health and educational professionals, might help address inequitable distributions and perceived shortages of speech-language therapists in many English-speaking countries [37][38][39] and thence a real and timely health services policy imperative. 34 Further follow-up is ongoing.…”

Section: Discussionmentioning

confidence: 99%

Randomized Trial of a Population-Based, Home-Delivered Intervention for Preschool Language Delay

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Preschool language delay is associated with poorer academic performance, more limited employment opportunities, and relationship difficulties. Despite its importance within public health, there has been little progress toward effective population-based prevention and intervention approaches to improve outcomes. WHAT THIS STUDY ADDS:It is feasible to identify low language in 4-year-olds on a population basis and deliver a 1-on-1 intervention. By age 5 years, this resulted in better phonological awareness and letter knowledge. There was weak evidence of better expressive, but not receptive, language. abstract OBJECTIVE: Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years. METHODS:A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals -Preschool, 2 nd Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. RESULTS:A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention 2 control, 2.0; 95% confidence interval [CI] 20.5 to 4.4; P = .12) but not receptive (0.6; 95% CI 22.5 to 3.8; P = .69) language. The intervention improved phonological awareness skills (5.0; 95% CI 2.2 to 7.8; P , .001) and letter knowledge (2.4; 95% CI 0.3 to 4.5; P = .03), but not other secondary outcomes. CONCLUSIONS:A standardized yet flexible 18-session language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework. Pediatrics 2013;132:e895-e904 AUTHORS:

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Section: Discussionmentioning

confidence: 99%

Randomized Trial of a Population-Based, Home-Delivered Intervention for Preschool Language Delay

et al. 2013

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“…Evidence from the literature search Urban, suburban, rural Urban areas are more likely to have higher ethnic minority populations [70][71][72] Rural areas are more likely to have reduced availability, frequency and choice of services; SLTs in rural areas are more likely to have a consultative role 73 In rural areas SLTs are more likely to have diverse roles; there are fewer specialist therapists 74 In rural areas there is a greater distance between the homes of clients and services; lower availability of public transport has been found to result in lower levels of access 73 Socioeconomic status Lower SES is associated with a greater need for SLT input, a greater likelihood of speech and language delays 75,76 and poor scores on SLT assessments…”

Section: Categoriesmentioning

confidence: 99%

Evidence-based intervention for preschool children with primary speech and language impairments: Child Talk – an exploratory mixed-methods study

Roulstone

Marshall

Powell³

et al. 2015

Programme Grants Appl Res

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Coad J, et al. Evidence-based intervention for preschool children with primary speech and language impairments: Child Talkan exploratory mixed-methods study. Programme Grants Appl Res 2015;3(5). Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0109-10073. The contractual start date was in January 2011. The final report began editorial review in April 2014 and was accepted for publication in October 2014. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health. If there are verbatim quotation...

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“…For services such as speech-language pathology, this is not always the case McLeod, Press & Phelan, 2010;O'Callaghan, McAllister, & Wilson, 2005;Verdon, Wilson, Smith-Tamaray, & McAllister, 2011;Wilson, Lincoln, & Onslow, 2002).…”

Section: Population-based Measures Of Developmentmentioning

confidence: 99%

“…In rural and remote areas of Australia, travels costs and limited public transport exacerbate the problems associated with distance to services. Other factors that may contribute to poor service access in Australia are: parents' and educators' lack of confidence in identifying communication impairment , limited knowledge about possible long-term negative outcomes for individuals with communication impairment, parents' limited awareness of speech-language pathology services (O'Callaghan et al, 2005), and SLPs' cultural competence and confidence in providing services to children from CALD backgrounds (Verdon, McLeod & McDonald, 2014).…”

Section: Speech-language Pathology Service Provisionmentioning

confidence: 99%

Mapping speech pathology services to developmentally vulnerable and at-risk communities using the Australian Early Development Census

McCormack

Verdon

2015

International Journal of Speech-Language Pathology

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Barriers to accessing rural paediatric speech pathology services: Health care consumers’ perspectives

Abstract: Barriers to access paediatric speech pathology services limit rural and remote consumers' usage of health services, regardless of need, indicating a possible inequity if compared to larger, more accessible urban areas.

Cited by 61 publications

References 6 publications

Randomized Trial of a Population-Based, Home-Delivered Intervention for Preschool Language Delay

Randomized Trial of a Population-Based, Home-Delivered Intervention for Preschool Language Delay

Evidence-based intervention for preschool children with primary speech and language impairments: Child Talk – an exploratory mixed-methods study

Mapping speech pathology services to developmentally vulnerable and at-risk communities using the Australian Early Development Census

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