How do primary health-care practitioners identify and manage communication impairments in preschool children?
Sue Woolfenden A F , Kate Short B , Roger Blackmore C , Rene Pennock D and Michael Moore EA Sydney Children’s Hospital Network – Community Child Health, corner Avoca and BarkerStreet, Randwick, Sydney, NSW 2031, Australia.
B South West Sydney Local Health District – Speech Pathology Department, corner Goulburn and Campbell Streets, Liverpool, Sydney, NSW 2170, Australia.
C South West Sydney Local Health District – Community Paediatric Department, Hugh Jardine Building, Elizabeth Street, Liverpool, Sydney, NSW 2170, Australia.
D South West Sydney Medicare Local, PO Box 5919, Minto DC, Sydney, NSW 2560, Australia.
E Inner West Sydney Medicare Local, Level 1, 158 Liverpool Road, Ashfield, Sydney, NSW 2131, Australia.
F Corresponding author. Email: susan.woolfenden@sesiahs.health.nsw.gov.au
Australian Journal of Primary Health 21(2) 176-181 https://doi.org/10.1071/PY12152
Submitted: 19 November 2012 Accepted: 11 October 2013 Published: 12 November 2013
Abstract
Communication impairments (CIs) in preschool children are common and can have long-term adverse consequences if not detected and treated early. This study investigated the knowledge, training and practice of primary health-care practitioners in the identification and management of CIs in preschool-aged children. A cross-sectional survey of 277 primary health-care practitioners in the Inner West and South West Sydney was undertaken. The majority of practitioners surveyed understood the importance of early identification of CIs. Eight per cent of practitioners correctly identified all of the ‘red flags’ for verbal and non-verbal communication. The majority (80%) correctly described the management of a typical case presentation. Two-thirds of practitioners reported using a tool in their practice for developmental surveillance, but the quality of surveillance tools was variable. One-third felt their training in this area was poor and 90% indicated they would like further training. Barriers to referral included waiting times, availability and cost of services. We concluded that primary health-care practitioners are aware that CIs are significant and they need to be identified early. There are opportunities for further training and promoting high-quality developmental surveillance in primary care. In addition, there are broader health system issues that include promotion of an integrated response to the detection and management of CIs.
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