ACQ Vol 10 No 2 2008

Work– l i f e balance : preserv i ng your soul

In conjunction with my boss, the District Guidance Officer, we tackled the issue of how to provide a service across the entire district. Using the models described above, we would seed services in the schools in larger country towns around Cairns. When a service was up and running, it would be withdrawn, citing distance, weather and road conditions as barriers to sustaining it. (Occasionally this was true – I once had two weeks “flood leave” when all roads out of my northern beach home were cut by floods.) The power of rural communities to influence government policy and spending was considerable in Queensland in the 1970s, and repre­ sentations by schools and community members to relevant parliamentarians would lead to creation of a new speech therapy position. In just a few years, the service grew from one (me) to five speech therapists in the district. One aspect of service delivery in FNQ that gave me particular pleasure was providing consultations over the School of the Air radio from the Flying Doctor base in Cairns. Teachers would occasionally ask me to “listen to this kid on the radio and tell me if he needs speech therapy”. This was no easy task given the static on the radio but a short conversation with child and then parent could sometimes establish the need for a referral to the Bush Children’s Health Scheme in Townsville for assessment and intensive therapy, or a visit to me next time they were in Cairns. Because I had grown up in “the bush”, I had great sympathy for the isolation and distance faced by these families and would happily come into the clinic for an evening or weekend consultation if they happened to come to Cairns at short notice for other reasons. In recent years, this interest in equity of opportunity for access to services has motivated my research with Telstra into the use of low-tech telehealth, using the IT and computers already available in the homes of many remote Australian families (Wilson, McAllister, Atkinson & Sefton, 2006; McAllister, Wilson & Atkinson, 2008). Another strategy for providing services to large numbers of children, teachers and schools was to involve as many speech therapy students as I could in my work. I asked the University of Queensland to send me students whenever they could, particularly in the school holidays. If students came in term time, they were exposed to the models of indirect service delivery I described above. They found this a great challenge as it was outside their experience to date. If the students came during school holidays, we would run intensive one-to-one and group therapy programs for children who needed direct therapy. The students served not only as many extra pairs of hands, but also as a lifeline for me to new ideas, resources, journals, and so on. In essence, they were my professional development program, and I remain gratefully in touch with many of them to this day. I had a wonderful five years in Cairns, interrupted by a year at Western Michigan University to complete a Masters in

and all the children who potentially required a service. It would have been easy to continue to do “the same old thing” because expectations of me were low. Had I stayed in “my clinic”, I might have been simply fulfilling the first two of three prevailing views held by many teachers of the day: that speech therapists “spent term 1 assessing, term 2 doing “a bit of therapy”, and term 3 getting pregnant and leaving”. However, I seized the opportunity to do things differently, spent little time in the clinic, and almost serendipitously found myself pioneering new ways of providing services across large areas. Through trial and error in the first year, I developed a plan for rotating through schools on a term basis, typically 2–3 schools each term. Schools would be responsible for identifying children of concern using a checklist I had developed. There was excellent support from the local schools for my work. At large seminars organised by the schools and conducted at the local teachers’ resource centre, I regularly explained how to use the checklist to identify, refer and work with children with speech and language problems in the classroom. At the start of a school’s target term, I would do screening assessments of all referred children, and use carbon paper to leave summary reports and suggested goals with the school on the same day. I would return in the next few weeks to run workshops on “how to help children with speech and language problems” in staff meeting times, and to meet with teachers about how we jointly could achieve these goals, preferably in the classroom. This might involve developing a program for the teacher, aide, parent or volunteer. If the teacher was willing, I would come into the classroom and co- teach an activity with in-built listening, and speech or language goals which would benefit the whole class as well as the target children. I would endeavour to see parents and explain their children’s needs and programs, providing additional home practice where possible. Once programs were running, I could move onto the next school, returning to the previous school on a fixed intermittent schedule to check on progress, adapt programs and so on. A school could expect to see a lot of me one term, less the next, and only once or twice for “check ups” in the third term. I was always available to teachers and parents by phone on the day a week I spent in the office. The approach to service delivery I developed was a com­ bination of what we now refer to as block or cycle therapy, collaborative consultation and co-teaching. These initiatives were reported in more depth in McAllister (1985). I did also provide more extensive assessments and traditional one-to- one therapy for children who required this, for example those with severe speech impairments (e.g., post-cleft palate sur­ gery, dyspraxia), and voice disorders. Children who stuttered I took to the Education Department clinic in Townsville during school holidays for an intensive program , and in later years I ran intensive group therapy with my new speech therapy colleague at the Cairns Base Hospital.

Electronic copies of ACQ Speech Pathology Australia members are able to access past and present

issues of ACQ via the Speech Pathology Australia website. www.speechpathologyaustralia.org.au Hard copies are available to everyone (members and non members) at a cost by emailing pubs@speechpathologyaustralia.org.au.

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ACQ uiring knowledge in speech , language and hearing , Volume 10, Number 2 2008