JCPSLP Vol 14 No 1 2012

Professional issues

Clinical insights Strategies to enhance effective service delivery for Aboriginal people Gwendalyn Webb

There are some fundamental tenets 1 which have been found to be successful when working with Aboriginal populations, both in Australia and more globally. The Little Yarns project, funded through the NSW government depart­ ment of Aging Disability and Home Care (ADHC) as an innovative service has attempted to adopt these tenets in order to deliver quality early intervention services to the local Aboriginal children and families. The Little Yarns project has been funded for four years to focus on language development and intervention for Aboriginal children under school-age who attend the Awabakal Children’s Services. The project aims to support families to (a) access mainstream services, (b) provide training for staff and families to increase their knowledge of, and skills in, communicating with children who are language impaired, and (c) increase the awareness of non-Aboriginal workers about providing culturally appropriate services to the Aboriginal population. Paradigm shift? Much of the information in the literature (Eckermann et al., 2010; Hoy et al., 2010) suggests that for intervention (in health and allied health) to be effective with Aboriginal populations, deviations from the traditional clinical model of service delivery are required. The strength of the differences in models of service delivery, and the struggle to achieve them nudges one to question whether speech pathologists are experiencing a paradigm shift in how we service Aboriginal people. Fundamental tenets Several key themes are emphasised in the literature addressing intervention with Aboriginal people. These include the importance of: • developing relationships at both organisational and personal levels to develop trust between services and individuals (Eckermann et al., 2010; Hoy et al., 2010); • consulting with the community regarding areas of need, services required and the best way to deliver these (Eckermann et al., 2010);

• utilising existing community relationships and services (Aldred, Forsingdal, & Baker, 2002; Nelson & Allison, 2004); • being flexible in service delivery (Speech Pathology Australia, 2000a, 2000b, 2009); • pacing the service delivery appropriately for those involved (McSwan, Ruddell, & Searston, 2001); • transferring knowledge and understanding between professionals and the people in the Aboriginal community, to develop lasting, sustainable outcomes (Hoy et al., 2010; McSwan et al., 2001); • acknowledging the depth of the many social issues involved, and the inter-relatedness of many factors which may impact on the intervention (Australian Department of Families, Housing, Community Services and Indigenous Affairs, 2009; Eckermann et al., 2010; Hoy et al., 2010); • acknowledging the current and historical negative experiences of these people with health, education, and government initiatives (Eckermann et al., 2010; Nelson & Allison, 2004); • acknowledging “Shame” and the benefits of Aboriginal translator/liaison person in all stages of the intervention (Gould, 2008; McSwan et al., 2001; Philpott, 2003). Guiding principles The guiding principles of the Little Yarns project were developed out of consultation with representatives from the local Aboriginal community and based upon the fundamental tenets documented in the literature. These are described in more detail below. Extended time to develop relationships Prior to the commencement of this project a longstanding relationship had been established between the local Aboriginal children’s service (Awabakal) and an early intervention outreach service (Firstchance Inc.). Once the project actually commenced, time was allowed for the Little Yarns team (Firstchance Inc.), who consisted of three early intervention teachers and a speech pathologist, to develop relationships with staff from the Aboriginal children’s services as well as the children and families who attend these services. As the project has evolved over the past three years, relationships have also developed with key community representatives. These representatives have acted as gatekeepers to other existing community groups. The strengthening of these relationships has allowed trust and respect to develop between the community and the Little Yarns team.

Keywords ABORIGINAL ALTERNATIVE SERVICE DELIVERY CULTURALLY APPROPRIATE EARLY INTERVENTION

Gwendalyn Webb

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JCPSLP Volume 14, Number 1 2012

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