Considering the impact of maltreatment on children in Out of Home Care when providing speech language pathology intervention: case examples

Abstract

ABSTRACTPurpose: As the number of children entering into Out Of Home Care (OOHC) increase, an increasing body of evidence is emerging, exploring the impact of maltreatment on a range of child development domains, for example, communication, behaviour, and cognition. Current research identifies the negative impacts of maltreatment on communication development, however to date, there is limited research relating to speech-language pathology (SLP) services with children in OOHC, including implementation and recommendation of modifications in SLP intervention.Method: A retrospective clinical audit of eight clients in OOHC who had accessed SLP services was conducted. The medical files were reviewed and general demographic data and clinical information was gathered. The files were reviewed for specific strategies that had been used or modified based on considerations of the child’s situation. These strategies were analysed across the cases by the authors in regards to patterns that emerged for successful implementation.Results: These children were more likely to present with a language delay, with improvements evident once the child had been in a stable language environment for 6 months. Careful selection of assessment tools and therapy resources by the speech-language pathologist along with the benefits of working with Foster Carers is discussed.Discussion: This paper builds upon previously identified challenges and strategies for working with children in OOHC and provides case examples of the journey through a SLP service. It provides preliminary discussions relating to the implementation of trauma-informed practice into the SLP therapeutic context, whilst also offering the learning and experiences of a specific SLP service as knowledge transfer. Finally, it also aims to promote further discussion and potential research into effective trauma-informed speech pathology practice for this vulnerable group of children.