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enough to proceed. Reflecting on the situation in hindsight makes one think about the questions one would ask or the response that would be given if a client made a similar comment in the future. It may be important to find out further information but it would be critical to do so without leading the child on or asking a loaded question. It was important to ask ourselves the following questions which structure the narrative approach. What was the child’s background story? What might have led the child to make such comments? Was the child able to clearly and correctly articulate what was occurring at home? What was the child’s current story? What was known about the child and their current home life? How could we find out more information about the client’s situation? What was the child’s future story? What would be the potential outcome if we did report? What would be the outcome if we didn’t report the child’s comments? There could have been potential consequences for reporting something that wasn’t an issue and rather was a miscommunication by the child and misinterpretation by the student clinician and clinical educator. There could have been serious consequences for not reporting if indeed the child was being physically abused at home. In line with the SPA Code of Ethics (2010), we saw the importance of telling the truth and preventing further harm for the child. We were aware that it was important to share this information with the teacher and principal for both legal and compelling moral reasons. The school staff members were aware of the child and her history and would able to deal with this information accordingly. As health professionals who were new to the setting and new to working with the child, we did not know the answers to many of these questions. The child, her teacher, and the school principal were all important characters in the narrative as they could all provide details and different perspectives to the story and ethical dilemma. The narrative approach highlights the importance of obtaining the full story. The teacher and principal were well aware of the background story for this child and were able to provide us with some insight into the important factors in the child’s history. As we were unsure how to interpret the child’s comments, it was important to gain further information from the school staff members to support our decision-making. Due to privacy and confidentiality they were unable to share specific information; however, their comments made us confident in reporting the child’s comments as unfortunately the child’s comments seemed to “fit” with the child’s previous experiences and family history. (Further action was taken by the school staff after we made our report.) This was not an isolated event – there were other occasions where children disclosed experiences of abuse to the university students on clinical placement. These experiences were quite upsetting for the university students and, as a clinical educator, it was important to ensure that both the university students’ well-being and the well- being of the children were protected. The first experience of disclosure provided the team with a precedent that allowed for more efficient and ethical management of future examples as per the casuistry approach which supports case-based learning (Leitão et al., 2014). Reflections on working in this setting We had daily debrief team meetings where we could discuss issues and events of the day. This was frequently focused on the challenges and possible solutions of working with CALD clients. The university students had not

had significant experience with this population and benefited from the support and advice of their peers. They also found they were reading more research in order to up skill for this new client group. The clinical educator was aware that she was responsible for the students and so supervised closely to ensure that they acted within their competence. She kept more complex cases for later on in the students’ placements when they had developed their confidence and clinical skills with CALD clients. These meetings meant that our practice was always being evaluated and improved, and we were able to deliver a high-quality, ethical and efficient service to the school population. These debrief sessions and case discussions allowed the university students to broaden the focus on the clinical aspects of the cases and discuss numerous ethical dilemmas which prepared them for other ethical dilemmas that they faced over the course of their placement. The casuistry approach to ethical decision-making (Leitão et al., 2014) supports decisions and reasoning to be based on previous cases that a team has either experienced, read about or discussed. As the clinical educator I needed to use my past knowledge and experience in the placement to guide and assist the students to follow the narrative approach to ethical decision-making and to refer them back to previous cases using the casuistry approach. Not only did the university students develop their clinical knowledge and skills in this setting but they also had the experience of working through numerous ethical issues that were unique to the cultural and linguistically diverse clients in that setting. Both the students and my own ethical decision- making skills and problem-solving abilities were greatly challenged. The placement allowed all of us the opportunity to develop two different methods of ethical reasoning, the narrative approach and the casuistry approach, that could be used to resolve ethical issues in the future. References Leitão, S., Bradd, P., McAllister, L., Russell, A., Block., S. Kenny, B.,… Wilson, C. (2014). Ethics education package . Melbourne: Speech Pathology Australia. The Speech Pathology Association of Australia. (2010). Code of ethics. Retrieved from http://www. speechpathologyaustralia.org.au/library/Ethics/ CodeofEthics.pdf World Health Organization (WHO). (2007). International Classification of Function, Disability and Health (ICF) . Retrieved from http://www.who.int/classifications/icf/en/ Shannon Golding is a speech pathologist with an interest in research and culturally and linguistically diverse children. Her PhD focused on the speech and language development of children adopted from overseas. She also has experience supervising health science students on inter-professional placements both in school settings in Perth and in hospital settings in Cambodia. Suze Leitão is chair of the Ethics Board and interested in applying the various theoretical approaches described within the 2014 Speech Pathology Australia Ethics Training Package to a range of workplace contexts.

Correspondence to: Suze Leitão School of Psychology and Speech Pathology Curtin University, Perth WA email: s.leitao@exchange.curtin.edu.au

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JCPSLP Volume 17, Number 1 2015

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