Waiting lists and prioritization of children for services: Speech-language pathologists’ perspectives

McGill, Nicole; McLeod, Sharynne; Crowe, Kathryn; Wang, Cen; Hopf, Suzanne

doi:10.1016/j.jcomdis.2021.106099

Cited by 19 publications

(5 citation statements)

References 30 publications

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“…Some SLTs described formal prioritisation guidelines in their workplaces such as a "clinical prioritisation tool" (167), while others described "a vague prioritisation policy which is not consistently implemented" (206) and thought that "a clear pathway for prioritisation" (206) with greater "consensus" (187) was needed to help manage waiting lists. Prioritisation of children for services based on child and service factors is consistent with previous research (McCartney, 2000;McGill, McLeod, Crowe et al, 2021;Roulstone, 2007). Prioritisation can be problematic as some children considered low priority may never receive support, despite the ability to benefit from therapy (McCartney, 2000).…”

Section: Workplace Processes and Policiessupporting

confidence: 89%

“…Two-hundred and seventy-six SLTs completed questionnaires. Two-hundred and sixty-four SLTs (95.7%) met the eligibility criterion by indicating they currently or had previously worked with children, and their responses to closed questions were analysed quantitatively and reported in McGill, McLeod, Crowe et al (2021). A subset of 187 SLTs (70.8%) responded to at least one of the open-ended questions within the same questionnaire and these SLTs formed the participant sample for the present qualitative study.…”

Section: Participantsmentioning

confidence: 99%

“…SLTs were asked to answer the questions based on a workplace they currently, or had recently, worked in with children. Closed questions about demographics, caseload size, waiting times, care pathways, and prioritisation parameters have been analysed separately and reported in McGill, McLeod, Crowe et al (2021). Relating to the focus of the present paper, SLTs were asked a series of questions regarding their feelings about the waiting list in their workplace, services/service delivery models provided in their workplaces, and their ideas and strategies for waiting list management.…”

Section: Instrumentmentioning

confidence: 99%

“…Access to speech and language therapy has been described as a "postcode lottery" where waiting times for services for children with speech and language needs are based on geographical location (I CAN and Royal College of Speech and Language Therapists [RCSLT], 2018). Children with speech and language needs must sometimes wait more than 12 months for assessment and therapy with a speech and language therapist (SLT) (I CAN and RCSLT, 2018;McGill, McLeod, Crowe et al, 2021;Ruggero et al, 2012). Waiting lists can have negative implications for consumers (e.g., parents, clients) and professionals (e.g., SLTs, doctors, educators), including psychological, physical, financial, and ethical burdens .…”

Section: Introductionmentioning

confidence: 99%

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Waiting list management: Professionals’ perspectives and innovations

McGill

McLeod

Hopf

2021

ACS

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BACKGROUND: Waiting lists for speech and language therapy exist when services do not meet demand. Waiting lists pose practical and ethical challenges for speech and language therapists (SLTs) and workplaces to manage, with potential flow on effects for children and families. OBJECTIVE: The present study aimed to describe SLTs’ perspectives about waiting lists for children with speech, language, and communication needs (SLCN) and explore waiting list management strategies. METHODS: The present study reports on 187 SLTs’ written responses to open-ended questions in a questionnaire. SLTs were from nine countries, had an average of 12 years’ experience in the profession (range 0.2–45 years), and either currently or had previously worked with children. Data were analysed qualitatively using thematic analysis. RESULTS: SLTs’ feelings about their waiting lists centred on three themes: (1) negative (e.g., “overwhelmed”, “stressed”, “anxious”, “embarrassed”); (2) neutral (e.g., “not too bad”, “okay”); and (3) positive (e.g., “manageable”, “proud”). Four themes related to waiting list management: (1) SLT service delivery (e.g., triage, use of technology in service provision); (2) workplace processes and policies (e.g., eligibility criteria, prioritisation); (3) SLT workforce actions (e.g., recruitment and retention of skilled SLTs); and (4) inaction (e.g., waiting list management was “out of my hands”). CONCLUSIONS: Waiting lists can have negative consequences and many SLTs take action to manage waiting lists; however, waiting list management strategies are not necessarily effective which can impact children’s outcomes. There is a need to reimagine service delivery and identify effective actions for managing speech and language therapy waiting lists at a local and systemic level in order to optimise outcomes for children and families.

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Section: Workplace Processes and Policiessupporting

confidence: 89%

Section: Participantsmentioning

confidence: 99%

Section: Instrumentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Waiting list management: Professionals’ perspectives and innovations

McGill

McLeod

Hopf

2021

ACS

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“…Furthermore, as this intervention considers the home visiting model central to its appeal, it is particularly relevant that there were no other home-visiting interventions focused on supporting children’s language and communication available at the time of implementation. This suggests there was limited risk of parents with concerns for their child’s language development accessing other services, particularly given long waiting lists for speech and language services [ 18 ].…”

Section: Research Objectivesmentioning

confidence: 99%

A randomised controlled feasibility trial of an early years language development intervention: results of the ‘outcomes of Talking Together evaluation and results’ (oTTer) project

Nielsen

d'Apice

Cheung

et al. 2023

Pilot Feasibility Stud

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Background Early language difficulties are associated with poor school readiness and can impact lifelong attainment. The quality of the early home language environment is linked to language outcomes. However, few home-based language interventions have sufficient evidence of effectiveness in improving preschool children’s language abilities. This study reports the first stage in the evaluation of a theory-based programme, Talking Together (developed and delivered by BHT Early Education and Training) given over 6 weeks to families in the home setting. We aimed to test the feasibility and acceptability of delivering Talking Together in the Better Start Bradford community prior to a definitive trial, using a two-armed randomised controlled feasibility study. Methods Families from a single site within the Better Start Bradford reach area were randomly allocated (1:1) to the Talking Together intervention or a wait list control group. Child language and parent-level outcome measures were administered before randomisation (baseline), pre-intervention (pre-test), 2 months post-intervention start (post-test), and 6 months post-intervention start (follow-up). Routine monitoring data from families and practitioners were also collected for eligibility, consent, protocol adherence, and attrition rates. Descriptive statistics on the feasibility and reliability of potential outcome measures were analysed alongside qualitative feedback on trial design acceptability. Pre-defined progression-to-trial criteria using a traffic light system were assessed using routine monitoring data. Results Two-hundred and twenty-two families were assessed for eligibility; of these, 164 were eligible. A total of 102 families consented and were randomised (intervention: 52, waitlist control: 50); 68% of families completed outcome measures at 6-month follow-up. Recruitment (eligibility and consent) reached ‘green’ progression criteria; however, adherence reached ‘amber’ and attrition reached ‘red’ criteria. Child- and parent-level data were successfully measured, and the Oxford-CDI was identified as a suitable primary outcome measure for a definitive trial. Qualitative data not only indicated that the procedures were largely acceptable to practitioners and families but also identified areas for improvement in adherence and attrition rates. Conclusions Referral rates indicate that Talking Together is a much-needed service and was positively received by the community. A full trial is feasible with adaptations to improve adherence and reduce attrition. Trial registration ISRCTN registry ISRCTN13251954. Retrospectively registered 21 February 2019

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