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Communication and Language Assistance Program

Reaching at risk communities Renee Bonnici Senior Speech Pathologist


Background CLAP model Outcomes Case study Future directions



Our target community

Target Suburbs NSW

Department of Housing CALD Unemployment One parent families Maternal Education Median Weekly Household income

58% 62% 11% 22% 19% $681

14% 21% 5% 15% 38% $1027


At risk communities... Increased prevalence of language delay

Disadvantaged community = 49% Non-disadvantaged community = 2-8%

Early intervention is crucial for success Decreased access to mainstream services Holistic service delivery

Family Social system Environment



visits Early childhood Targeted clinic Playgroup visits




Playgroup leaders, dieticians

Early childhood nurses

Caregivers and children


16 playgroups Visits by a Speech Pathologist, Early Childhood Nurse and Dietician Speech Pathology roles:

In-services Demonstrating strategies- individual and whole group Individual "chats" with caregivers Providing written information Observations of child/caregiver interactions Screening tests



Early Childhood Clinic

Collaboration with early childhood nurse Main focus

Screening and identification Strategies Referrals

I love working with Renee (Speech Pathologist), I have learnt so much from observing her within this clinic (ECN, 2008).

Home Visits

Assessment Goal setting Therapy Review of goals/outcomes Referrals to other services


Evaluation methods: Caregiver/worker focus groups Caregiver/worker questionnaires Annual knowledge and skills questionnaires Activity statistics Therapy outcomes


Playgroups Accessed over 400 children Communication delay - approx 160 children (40%)

2006 - 42%, 2007 - 38%, 2008 - 40%

Early Childhood Clinic Accessed over 100 children <3yrs Communication delay = approx 26% Overall Increase in communities access to SP services

23% in 2006 vs 43% in 2008

2007/2008 accessing SP information through their local playgroups


Parent skill


Communication Milestones

Specific language strategies Observations of parents reading/playing

2006 39 47 25

2007 68 50 63

2008 69 65 75


Playgroup leaders... Independently referring children Language rich environments


Home visits 147 children 75% of children achieved 70% or more of their goals set within therapy Main reason not achieved ­ attendance related How do we access the truly hard to reach families?

Case Study... Daniel

Daniel Early Childhood Clinic

Daniel 5-10 words Limited sound inventory Gestures 1 part instructions

Referrals to early childhood services

Typical 3 year old Speaks in sentences Asks/answers simple questions Follows 3 part instructions

Strategies and handouts

Waiting List Home Visits


Home Visits...background o Single mum o First child at 18 o Drug and alcohol abuse o Abusive relationship o Unemployed o Department of housing o Mental health issues o Poor history of attendance o Daniel previously sexually abused by natural father o DOCS caseworker involved


Home Visits

Severe expressive/moderate receptive delay Lack of language exposure Parent training

Labelling objects/action Simple sentences Signs and gestures Following the child's lead and interests

Goals tailored to families lifestyles Outcome: 5 new words/signs and following 1 part instructions


Home VisitsReferrals

Hearing test Early childhood services Department of education Medicare Scheme

Developmental assessment clinic

Borderline developmental delay & Mild delay in play and fine motor

Within normal limits

2 days/wk Preschool & 1 day/wk playgroup

Transition to school planning

5 sessions with a Private SP


Playgroup Continue to work with mum Collaborate with playgroup teachers

Appropriate activities Visual timetables to assist with transitioning between activities


Daniel today.... 5 years of age Receptive WNL, expressive severe delay Severe speech sound difficulties (dyspraxia) Functional gestures Smooth transition to school

Support class language placement


Future directions

Speech Pathology services for at risk children should combine universal, targeted and specific approaches


Use of community based model that is flexible, consistent and accessible


Thanks to the early childhood workers, caregivers and children who have been a part of the CLAP project.

Questions / Contacts

[email protected]


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