Over the past 18 months we have been funded by a grant to the Charles Sturt University Rural Health Research Institute from the Commonwealth of Australia, represented by the Department of Health (Grant Activity 4-DGEJZ1O/4-CW7UT14):
We have learned, achieved, and, impacted children's speech, language and communication across rural Australia. The people involved in our project were: Dr Kate Margetson, Dr Carolyn Gregoric, Sarah Bartlett and Emily-Jane Woodhead - a great team.
Here is a short summary from our final report:
Improving access to speech pathology services for rural children with speech, language and communication needs (RHRI Project 8)
AIMS
- The first aim of this project is to understand the prevalence and service requirements of children from a rural Aboriginal Community Controlled Health Organisation and to design a trial to improve access to speech pathology services that best meets their needs
- The second aim is to equip rural SLPs to work cross-culturally and cross-linguistically, especially in languages they do not speak
SUMMARY OF OUTCOMES
1. Rural Indigenous children’s speech, language and communication
Five stages were undertaken to co-create evidence to support Indigenous children’s speech, language and communication within a rural Aboriginal Community Controlled Health Organization (ACCHO).
Stage 1. Baseline practice data. Data regarding children’s communication were not routinely collected at the ACCHO. Children’s hearing was assessed. Ad-hoc speech pathology services were offered in partnership with local services.
Stage 2. Indigenous Australian children with SLCN. A longitudinal study of 1,534 Indigenous children compared outcomes for preschool children with parent-reported SLCN (30.4%) with those with no parent-reported concern. Concern was significantly associated with children’s literacy and numeracy outcomes at school across all NAPLAN subtests after controlling for covariates (e.g., age, sex, hearing, disability, socio-economic status) (McLeod, Harrison et al., 2025).
Stage 3. Resource review. The ACCHO child health navigator selected 56 children’s books by Indigenous authors then evaluated by 32 staff (149 evaluations) who highlighted culturally friendly design, connection with children, culture and language, and being easy to read (McLeod, Woodhead et al., 2025). Four Little Libraries were established at the ACCHO after consultation with local elders and children.
Stage 4. Testing service models. Two service models for young children with SLCN were piloted demonstrating caregiver and educator support. First, experiences and engagement of parents of later talkers (18-36 months) was examined during the 16-week Target Word™ Hanen Program® for Parents (Bartlett, 2024). Second, feasibility and acceptability of two screening measures was examined with 48 rural children (24-35 months), 8 educators, 8 nurses and 48 parents (Matthews, 2025).
Stage 5. OAMS trial. A trial screening assessment and intervention program is underway co-designed with the ACCHO staff and local services to expand capacity (Bartlett, McLeod & Gregoric, 2025)
In the last month of the project, the ACCHO invited the research team to provide a 45-minute presentation at their Continuous Quality Improvement Day with over 100 ACCHO staff in attendance to summarise the findings. ACCHO staff (n = 52) provided reflective feedback to support consolidation for recommendations into policy and practice
2. Rural multilingual children’s speech, language and communication
Three stages were undertaken using an implementation science framework to co-create evidence to develop and test the feasibility of the Speech Assessment of Children’s Home Language(s) (SACHL) (Margetson & McLeod, 2015), a clinical protocol to equip rural SLPs to using culturally responsive, collaborative practices.
Stage 1. Workshops. Seven workshops were provided (person and online) to train SLPs and SLP students in the SACHL to enable them to assess multilingual children (in languages that the SLPs do not speak).
Stage 2. Feedback. 459 SLPs and SLP students who attended the workshops and responded to a questionnaire to provide feedback on the acceptability of the SACHL, recommendations for change and barriers and facilitators to using the SACHL in clinical practice.
Stage 3. Resource development. Fifteen multilingual SLPs and SLP students volunteered to collaborate with the research team to develop language-specific resources for the SACHL (e.g., Vietnamese, Spanish, Portuguese, Japanese) and participated in focus groups to provide specific feedback on the protocol and implementation
Findings from both objectives have been synthesised providing recommendations to improve access to speech pathology services for children with SLCN in rural settings that is culturally safe and effective.
