JCPSLP Vol 21 No 2 2019 DIGITAL Edition

Students worked school hours (8.30–3.30) with one half-day off per week for additional planning and administration. They assessed referrals, prioritised a caseload for intervention, decided dosage and scheduling, provided therapy, assessed outcomes, and wrote reports recommending future action, liaising with families and staff. Each student provided individual therapy for up to eight children, plus jointly running small groups for intervention targeting PA or whole language. Student support One month before the placement, JC met students in Melbourne for a 2-hour briefing and discussion. An orientation was given on the student’s first day at the placement. Students’ personal goals and the aims of the clinic were discussed. Student pairs were given the referral list for their site. Local SLPs provided additional information, having screened most referred cases for speech, language, narrative and/or PA skills. Students went to sites, met staff and explored resources. Student pairs then planned their caseload management strategy, including choice of assessments for specific children, to be administered in the first week. Resources available included selected standardised paediatric assessments provided by the university, including current clinical assessments of speech, language, literacy and narrative commonly available in clinics. Local assessment and treatment resources could also be requested. At the end of the first week, each referral was reviewed. Students decided and justified whether or not each child referred was to receive intervention. Students and clinical educators (CEs) discussed provisional diagnoses, intervention goals and strategies for the intervention block. CEs observed clinical sessions at each site 2 mornings a week and additionally when requested. Case discussions between CEs and students were held after school, one- to-one and in small groups. CEs demonstrated clinical techniques with some children. Two seminars were provided regarding differential diagnosis and treatment of speech sound disorders (SSD) and literacy intervention. Additional support could be requested from local clinicians and the university. Students developed or sourced their own treatment resources. Data Clinical records were used to describe caseload referrals. Students’ case files and reports were examined to determine goals, intervention approach and outcomes. Written service evaluation feedback was requested from each site’s principal. Each student chose one case for BD to reassess 2 months post-clinic. Results Caseload characteristics Across the four sites, 114 (11.2%) of the 1015 total children enrolled were referred for SLP assessment. More preschool than primary school children were referred (see table 1). Standardised assessment described children’s communication performance profiles. When difficulty in more than one domain was identified, severity and functional communication guided therapy target selection. One child received individual therapy from two students, one targeting speech and one language. Children’s poor performance on PA and story retell tasks during prior screening informed choice of intervention targets for group therapy.

experience working with other disciplines to enhance client outcomes. Jones, Lyle et al. (2015, p. 18) concluded that the pioneering Broken Hill RRCP redressed “allied health service access inequities”. The RRCPs in Young, NSW Since 2011, eight second-year SLP Masters students have provided a 4-week intensive student clinic in Young each year. Over the 7 years, the 56 students have assessed and/ or treated around 110 children each year. The placement goal is to provide experience in management of a referred paediatric caseload. Students make clinical decisions about each child’s need and prioritisation for therapy, diagnosis, therapy goals, intervention approach, and service delivery (for supervision model see Whitworth, Franklin, & Dodd, 2004). Although research has been limited, two longitudinal case studies evaluated the efficacy of intervention provided by SLP students during the Young RRCP. One case (Dodd & Poole, 2017) was referred four times for different aspects of communication: unintelligible speech (6;5 years); expressive language (7;5); literacy difficulties (8;6); and complex language comprehension (10;6) when his spoken and written language skills were age appropriate. McIntosh et al. (2017) described outcomes for a child (6;2) with delayed phonology and poor phonological awareness (PA) who attended a bi-weekly whole-language group. Follow- up assessment at 6;6 showed age-appropriate performance. This paper evaluates client outcomes for the 2017 clinical placement using data from student reports and school feedback. The paper describes: • the referred caseload; • students’ clinical management decisions for children; • intervention outcomes for treated cases; • three case synopses; and, • feedback from school and preschool staff. Method Description of the clinic The context The population of Young in the 2016 census was 10,500. Median income was below the Australian average, with 16% receiving government pensions. Many children lived on farms. In 2017, three SLPs (only one full-time) were employed by health, education and early intervention agencies. Services did not meet need. Residents travel to regional centres for health services like audiology, psychiatry and neurology. Clinical placement sites Four sites offered clinical placements in 2017: a private childcare centre (0–5 years), a preschool (3–5 years) and two primary schools (5–12 years) funded by the state government. Children were referred for assessment by parents, teachers or local SLPs. Parents received information about the student clinic and gave written consent for their child’s assessment and treatment for communication difficulties, and anonymous use of their child’s data for auditing outcomes. The sites supported printing and photocopying, provided a base room and use of toys, books and equipment. The university provided

Top to bottom, Vanessa Hally, Jane McKimmie, Naomi Mitchell and Stuart Tibbetts,

internet dongles. Student roles

In 2017, eight students were assigned in pairs to a placement site and supervised by the first two authors.

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JCPSLP Volume 21, Number 2 2019

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