JCPSLP Vol 19 No 1 March 2017

Some participants did not identify any strategies for the service: “I’m really happy with going now” (2). The different backgrounds and experiences of Aboriginal families were succinctly expressed by one participant: Everyone’s so different (7). Community awareness of SLP Some participants noted that other people in the Aboriginal community were not aware of SLP services, or the significance of communication impairments, and suggested greater community education: “Try and get out there [into schools and community] and provide more information to families” (6). Discussion The themes that were identified by the caregivers in this study are consistent with those identified in other studies investigating Aboriginal clients’ experiences with Aboriginal or mainstream health services, and clients’ (not specifically Aboriginal clients) experiences with SLP services, including the skills and knowledge of the caregiver (Department of Social Services, 2013; O’Callaghan et al., 2005), the impact of the service provider (NACCHO, 2001) and the relationship with the community (McBain-Rigg & Veitch, 2011). The caregiver perceptions of the SLP service were consistent with those identified by non-Aboriginal families attending similar SLP services elsewhere, such as relationship with the speech-language pathologist, flexibility, awareness, and access to transport (McAllister et al., 2011; O’Callaghan et al., 2005). This overlap in themes indicates that many issues are common for both Aboriginal and non-Aboriginal families attending SLP, but some issues (e.g., positive reinforcement, explanations of wider impact) may be more salient or be relevant (e.g., Aboriginal staff and resources) only to Aboriginal families. Factors that facilitate Aboriginal families to access services Participants in the present study were already engaged in SLP services, however, some participants did highlight that other Aboriginal people may not be aware of the need for SLP services, and this is consistent with previous research regarding SLP services (O’Callaghan et al., 2005). Caregivers need to be aware of the SLP service and its benefits in order to access and engage with the service. SLP services need to reinforce the benefits of attending therapy in relation to skills required for broader life and community aspects (e.g., social, vocational, and well-being benefits) through community education. However, if barriers still exist (e.g., knowledge, transport, location, other commitments, illness), then families may continue to have difficulties accessing and engaging with services. Participants identified that flexibility with the site where services were provided was important in regards to easy access to public transport. This could be further facilitated by SLP services routinely providing caregivers with information on transport options (e.g., public transport, community transport). Ways to increase Aboriginal families’ engagement with services Participants overwhelmingly cited improvements in their children’s communication and their own skills as being facilitative to their engagement with the SLP service. Improvements in the children’s communication skills encouraged attendance, with caregivers willing to accept

Receiving positive feedback from the speech-language pathologist was cited as important by some participants: “It’s good to hear it from a professional – that you’re doing the right thing” (7). Difficulty in knowing how to contact the speech-language pathologist was also mentioned: “If you lose a piece of paper, or move house, it can be difficult to know how to contact” (4). Location and physical access Participants were recruited from seven sites, so responses relating to location or transport varied depending on participant location. Some participants listed location and transport as factors impacting on attendance: It’s only 15–20 minutes away, so that’s good. (5) I don’t have a car, and to catch another bus would take half an hour and have to walk 10 minutes or more. That would make it really hard to get there. (3) Outreach services (e.g., in home or preschool) Attendance at an Aboriginal maternal and child health service was discussed by one participant, with benefits including home-visiting: “They come to you – this was helpful when I didn’t have a car” (4). Multiple services in one location Some participants mentioned services that they had attended which provided multiple services, e.g., an Aboriginal Medical Service: “The whole family goes there – my child has had the same doctor there since I was pregnant with him. They provide services like speech and dental” (5). Theme 3: Influence of the client’s community and Aboriginal culture Changes to child’s communication observed by others Caregivers reported receiving feedback from others in the community about changes they had noticed in the children’s communication: “More people are understanding him” (10); “Preschool noticed the difference” (5). Others’ perceptions of child Negative perceptions about children with communication impairment were raised: “Some people look down on you when you have children that have something wrong with them” (3). Aboriginal staff and resources Participants reported benefits of Aboriginal-specific services, relating to the resources, as well as the staff: My son loves the picture there – the Aboriginal pictures – he looks at all of them. (3) Having someone to understand culturally – no judgement. (4) My son has had the same doctor there since I was pregnant with him. (5) When asked how the SLP service could be made more culturally-appropriate, participants provided the following suggestions: Having someone call rather than send a letter. (4) Need to make people more aware of why there are no adults with speech delay. (10) Extra free lessons. (8) Some things that people may like are Aboriginal languages being included in therapy. (7)

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JCPSLP Volume 19, Number 1 2017

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