SPCH3211 - The Community as a Client

This is a deck of flashcards to assist in studying for the SPCH3211 end of semester exam.

the three core concepts of child development

1. experiences build brain architecture

2. serve and return interaction shapes brain circuitry

3. toxic stress derails healthy development

five key domains of development as captured by the AEDC

1. physical health and well-being

2. social competence

3. emotional maturity

4. language and cognitive skills

5. communication skills and general knowledge

the main findings of the AEDC 2024 report

1. In priority groups, the percentage of children who are developmentally on track across all five AEDC domains has decreased since 2021.

2. In 2024, the percentage of children who are ‘developmentally on track’ has decreased by 1.2 points to sit at 75.9%.

the social determinants of language development

1. Language development is a public health issue.

2. Language development is shaped by a range of social, economic, and environmental factors.

3. The speech pathology profession needs to widen its lens and include a systems-level view.

4. Speech pathologists need to address social inequalities as part of their practice and advocate for broader systemic changes to reduce disparities in social determinants of language development.

key messages from McKean and Reilly (2023)

1. Early language development is a public health priority.

2. Inequities in access and outcomes demand systemic change.

3. A multi-tiered, whole-systems framework is needed.

4. Interventions must be proportionate, responsive and co-designed with families and communities.

three levels of mosaic intervention

specialist

targeted

universal

steps on co-designing (e.g. shared book reading)

1. environmental observation + interviews

2. focus groups

3. implementation of changes aligned with observation and community input

4. environmental observations of the changes + online surveys

community benefits of co-design

• build community capacity

• systemic impact

• ‘nothing about us without us’ → lived experience expertise leads to more relevant, appropriate, sustainable interventions for people who are actually going to use the services!

• diverse perspectives → leads to creative and innovative solutions!

• interventions are more effective and efficient (because they’re tailored to the specific needs/context of the community)

• more compassionate and patient-centred solutions

• users who are involved in co-design are more likely to engage in the intervention (note: think about the importance of shared goal-setting!)

• voices of marginalised groups are centred and amplified!

• increased confidence, agency, and sense of community

types of prevention

Primary prevention

Focusses on reducing risk factors to prevent a disease or disorder before it arises.

Secondary prevention

Focusses on the early detection and best practice management of a disease or disorder to reduce deterioration and long-term effects

Tertiary prevention

Focusses on reducing harm in people with a disease or disorder and minimising their functional impairment.

examples of health promotion campaigns

General

national stroke week

swallowing awareness day

aphasia awareness

Acute

Eat, Walk, Engage

Communication accessibility

Scope

Dementia space

Maggie Beer’s Big Mission

purpose and steps of a community needs assessment

purpose: look at the well-being of a community

• identify gaps

• identify strengths

• identify weaknesses

• identify priorities

• set goals

community needs: categories and definitions

• Perceived needs → what the community believes it needs (based on surveys, etc.)

• Expressed needs → what the community takes action on to address a perceived need. based on data (e.g. how many families enrolled children in kindy this year)

• Normative needs → based on established standards (e.g. are the community’s needs being met to the legal standard)

• Absolute needs → universal survival needs

• Relative needs → based on equity between multiple community groups (e.g. need more healthcare providers in indigenous communities)

steps in Australian government’s Institute of Family Studies needs assessment survey framework

1: scope of the assessment → who? what resources? how is the community involved? who has final say?

2: determine assessment criteria → understand the issue, the context, the agency, the resources

3: plan for the data collection → do we have access to the data we need?

4: collect, analyze, present data → how will we decide what we get started on first?

5: apply the criteria and prioritize needs

6: identify next steps and report back → how can we step into advocacy and community engagement from here?

the posture of cultural humility

Definition:

“Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.”

Tervalon & Murray-Garcia, 1998, p. 117

A mindset of asking yourself how your own bias and worldview will impact the way that you treat others. Recognition of this will allow us to provide more responsive and patient-centred care to clients. This involves life-long learning by maintaining a curious attitude towards others.

how power shapes outcomes

powerful groups can drown out the voices of less powerful groups

if we don’t acknowledge the impact of power, we can accidentally silence the voices of the people we are actually trying to help

prioritizing at risk populations for community intervention in Australia

data from AIHW may help identify priority groups

National Preventative Health Strategy 2021 → identifies groups with disproportionate burden of disease

WHO identifies that at risk populations are disproportionately effected because of (social inequality + social disadvantage)

priority populations in Australia:

• Aboriginal and Torres Strait Islander people

• CALD communities

• LGBTQIA+

• mental health conditions

• pw disability

• pw low socioeconomic status

• rural/remote communities