SpeakOut_December2014_FINAL_eCopy

BRANCH news northern territory

Following a decade of clinical work in the United States and Kenya I recently moved “home” to Australia, choosing Darwin as the place to alight. I work for Carpentaria Disability Services providing Early Intervention Services, where we use a relationship- attachment model of service provision. What attracted me to this way of working is the way children and their caregivers are repositioned in the therapeutic model, away from clients who we do something to, to clients we work with. By helping parents shape their role in the interaction they become the “agents of change” for their child (Geller & Foley, 2009). In taking up this model, I’ve noticed the following changes in my practice: • Because the children we see come with complicated stories, diagnoses and patterns of care, the team spends a lot of time in consultation, clinical supervision, and meetings ‘behind the scenes’ about the families. • I rarely engage with the child directly! The parent serves as the play partner while I

• I have a knee-jerk

Bea Staley at Carpentaria

tendency to fix things before they occur (e.g. move something out of the way, put a toy in within reach of the child, loosen a lid). However, I often jump in too fast, undermining a parent’s responsibility and capacity to find a solution, or robbing a child of a chance to try something, and then find a better way so they have success. • We can shape a child’s play and learning by providing a well set-up room. By giving children various toys and play scenarios I set the scene for working on the goals I have agreed on with the parents, without “leading” the child. • Transdisciplinary teaming requires role release which is time intense and requires lots of communication and skill development between therapists. Further, the ultimate role release is to the parent. Working within a relationship- attachment model has reinvigorated my thinking about clinical service and the role we play in families’ lives, and reminds me that there is always more to learn as clinical service providers.

Disability Services.

Parents as agents of change and other realisations

‘When I actually follow a child’s lead, for as long as that takes, I see the child’s play more clearly – I see patterns, the number of repetitions needed to consolidate learning and the depth of the child’s engagement with a single activity.’

talk with their child if they have had experience and success doing so in the clinic.

• Speech pathologists often talk about

‘following a child’s lead’ but in my experience we tend to be quite directive. When I actually follow a child’s lead, for as long as that takes, I see the child’s play more clearly – I see patterns, the number of repetitions needed to consolidate learning and the depth of the child’s engagement with a single activity. I frequently want to show the child new or different ways, disrupting their natural play patterns and often shutting down their natural engagement with the activity.

coach the parents on things to say and do to support their interaction. Because we want the parent to have the play experience with their child, we don’t model very often. If I model the interaction, I risk the caregiver thinking “well I can’t do that, that’s too hard.” Parents are more likely to sit and play and

Bea Staley Speech Pathologist

Reference: Geller, E. & Foley, G. (2009). Expanding the “ports of entry” for speech-language pathologists. American Journal of Speech-Language Pathology , 18 , 4–21.

22 Speak Out December 2014

Speech Pathology Australia