Purpose: The overall objective of the present study was to conduct a series of investigations to examine the need for, and use of speech pathology services by school-aged children in Tasmania. Specifically, investigations aimed to: a) report the prevalence of speech and/or language impairment amongst the preparatory student population enrolled in 2005 in the Northern Branch of the Department of Education Tasmania; b) determine the extent to which speech pathology services were used by this preparatory student population during their prior kindergarten year (2004); c) quantify the presence and degree of any unmet speech pathology service need within this specific student population; d) examine the nature and accuracy of teacher identification of speech and language impairment amongst the student population during their prior kindergarten year using current mandatory educational assessment (Kindergarten Development Check [KDC]); and e) explore teacher referral patternsfor students identified as having speech and/or language impairment on mandatory educational assessment, to speech pathology services. Methods: To address the aims of the present study, three individual data sets were used. The first data set was obtained through direct assessment of the speech and language skills of a cohort (N = 308) of preparatory students by a speech-language pathologist in 2005. This data was used to determine the prevalence of speech and/or language impairment. The second data set was information pertaining to the number of enrolled preparatory students who had accessed speech pathology services in their prior kindergarten year (2004), sourced from the speech pathology database of the Northern Branch of the Department of Education Tasmania. Comparison of data from the direct assessment of students by the speech-language pathologist and information from the speech pathology database enabled a determination of the presence and degree of any unmet speech pathology service need within this specific student population. The third and final data set was the results of the KDC, conducted by teachers on all students in their kindergarten year (2004). This data was obtained following a search within the electronic KDC database. Subsequent comparison between the student results from this KDC database and the direct assessment by the speech-language pathologist determined the accuracy of teacher identification of speech and/or language impairment using this specific tool. Further comparison of the student results from the KDC database, direct assessment and the speech pathology database also yielded information on teacher referral patterns for students identified as either speech or language-impaired on the KDC, together with the overall percentage of confirmed speech or language-impaired students referred to speech pathology services.Results: The overall prevalence of speech and/or language impairment was found to be 41.2% within the population studied. Specifically, 8.7% of students were found to have isolated speech impairment, 18.2% had isolated language impairment, and 14.3% were diagnosed with comorbid speech and language impairment. Despite the high overall prevalence of speech and/or language impairment, only 18.4% of the total enrolled preparatory student population was found to have accessed speech pathology services during their kindergarten year. It was therefore estimated that 36.1% of speech-impaired and 75.8% of language-impaired preparatory students respectively did not access speech pathology services during their first year at school. Comparison of student data from educational and speech pathology testing observed that the current teacher-administered kindergarten assessment (KDC) was ineffective in facilitating student access to speech pathology services where needed. The sensitivity of teacher identification of speech and language impairment on the KDC was only 50% and 15% respectively, indicating that 50% of all students confirmed as having speech impairment and 85% of students confirmed as having language impairment on speech pathology testing failed to be identified by teaching professionals on this specific tool. Further consideration of teacher referral patterns found that only 57.1% of students identified by teachers as having some type of communication impairment on the KDC were subsequently referred to speech pathology services. Of those students referred, only just over half (51.4%) were confirmed by speech pathology assessment as being either speech or languageimpaired, with the remainder found to have typical speech and language skills. When the total speech and language-impaired population was examined, the percentage of children appropriately referred by teachers was therefore only 25.3%.Conclusions: The present study illustrated that speech and language impairment are prevalent conditions within the preparatory student population of northern Tasmania. Unfortunately, a substantial number of these speech and/or language-impaired students failed to access available speech pathology services during their kindergarten year. Teacher administration of mandatory educational assessment, designed to identify ‘at risk’ kindergarten students, has been identified as one reason for poor student access to speech pathology services during the first year of formal schooling. Not only were teachers found to be inaccurate in identifying students with speech, and to a greater extent language impairment using the KDC, but students identified as having speech and/or language impairment on this specific tool were not routinely referred to speech pathology services. Given the key role of teachers in administering the KDC to identify students in need of speech pathology services, local speechlanguage pathologists must seek to improve: a) the sensitivity of the KDC; and b) the knowledge of teaching professionals regarding the presentation of speech and/or language impairment and the importance of early referral.
Identifer | oai:union.ndltd.org:ADTP/253992 |
Creators | Belinda Jessup |
Source Sets | Australiasian Digital Theses Program |
Detected Language | English |
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