Speech Pathology Australia: Communication is a Basic Right for all Australians

[hr]Gail Mulcair of Speech Pathology Australia speaks out as part of a current Senate Inquiry.[hr]
Right now more than 1.1 million Australians are having difficulty communicating with their friends, colleagues and loved ones. Communication disorders affect people of all ages, cultures and socio-economic situation, and the impacts are often long term and severe.
Communication is fundamental. Disorders seriously impact on quality of life: through difficulties learning, interacting socially, finding and keeping a fulfilling job, and even on mental health and wellbeing. Likewise swallowing is critical and severe swallowing difficulties can lead to death. Other swallowing difficulties can lead to malnutrition and respiratory problems.

The statistics are compelling:

• 20 per cent (one in five) of children under 5 years have difficulty understanding what is said to them and/or expressing themselves


• 12 per cent of children in Australian primary schools have a communication disorder


• 46 per cent of young Australian offenders have a language impairment


• Indigenous children are three times more likely than non-Indigenous children to have hearing problems that impact on their speech and language development


• 33 per cent of people suffer from loss of language (aphasia) after a stroke


• 1.1 million Australians have difficulty swallowing (dysphagia), including 40 percent of babies admitted to neonatal intensive units and up to 78 per cent of those who have had a stroke


• Up to 96 per cent of older Australians living in residential aged care facilities have a communication disorder.

With our ageing population, this last statistic is particularly worrying.
Despite this, communication disorders are largely absent from public policy and the public discourse - which is ironic, as it is communication that allows these things to take place.
Communication and swallowing should be a public health priority in Australia and Commonwealth leadership is required to ensure all governments and government programs recognise the needs of people with these difficulties.
The first step in the right direction is the recently announced Senate Community Affairs References Committee Inquiry into the prevalence of different types of speech, language and communication disorders and speech pathology services in Australia.
The essential things in changing the lives of people with communication and swallowing disorders are government leadership; raising awareness; early identification; and access to services.

Government leadership 

Communication and swallowing disorders need increased policy attention – and it needs to be led by the Commonwealth and acknowledged by all State and Territory governments in Australia.
People with communication and swallowing disorders do not have a voice in public policy. They use an extremely broad range of government services: from hospitals and community health, in schools and aged care, to disability, mental health and justice. Governments must recognise that this large part of the community deserves a voice, one their disorders have taken away.
[pullQuote] “Communication and swallowing should be a public health priority in Australia and Commonwealth leadership is required to ensure all governments and government programs recognise the needs of people with these difficulties.” [/pullQuote]

Awareness

Awareness is not just about understanding the broad scope of speech pathology practice, but creating greater understanding within the community about the existence of communication and swallowing disorders and the impact these have on the daily lives and the future prospects of these babies, children, young people, adults and older Australians.
We need to make sure that law makers, politicians, educators, teachers and health professionals understand the importance of communication in enabling people to participate in their lives. We also need to target people working in those sectors where professionals work closely with people likely to suffer from a communication or swallowing disorder.
Fundamentally, in order to improve the lives of people with communication and swallowing disorders, we need to raise awareness that communication is a human right. We need to ensure that law makers, policy makers, educators and teachers, clinicians and other health professionals, law enforcement officers, members of the judiciary, carers and mums and dads understand that everybody has the ability to communicate and that people with communication difficulty can be helped, and that helping them communicate to the best of their abilities, in turn enriches our society.

Early Identification

There is no doubt that early identification of a problem and gaining intervention at an early stage – improves outcomes. And not just for children. The earlier the detection of the problem at any stage in the lifespan, the better the outcome and the more cost-effective the treatment.
Better identification processes and education are needed to make sure disorders are picked up as soon as they appear, in hospitals, GP surgeries, schools, community health centres, residential aged care facilities and mental health services. We need to give people the best chance of effective treatment by intervening early in the problem.

Access to services

With appropriate identification of problems comes a need for treatment, however there are significant challenges in accessing services at a time and level which is most effective, as supported by the research evidence in Australia. One of the focuses of the Senate Inquiry is looking at the adequacy of services for people with communication difficulties in Australia.
At the moment, the system is inequitable, it is inconsistent and there is not enough funding. The services a person receives depends on where they live and whether they rely on the public health or education system, and are even more limited if they live in a regional or remote area, are from a lower socio-economic background, or are Indigenous.
Worse still, public funding does not allow for the implementation of evidence based practice therapies. Services rationalised for resourcing needs leads to care being reduced to a small fixed number of sessions – the number of sessions, frequency and type of care is not usually based on what the evidence says ‘works’.
People receive a lesser quality care but it also means that speech pathologists’ clinical decision making in how to best treat their client is compromised. Would you wonder why your chest infection hadn’t cleared up if you were only given half your antibiotic treatment from the doctor? Funding bodies assume that a ‘bit’ of speech pathology is better than none – when the evidence is very clear about what type of speech pathology is needed to effectively treat a particular condition.
While it is understood that these challenges aren’t unique to communication and swallowing disorders and the speech pathology profession, the social and economic cost of continuing to ignore them is becoming too high. Communication is vital to life and I look forward to the Senate Community References Committee’s inquiry shedding light – and good policy - onto this silent problem.
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Speech Pathology Australia (SPA) is the national peak body for speech pathologists in Australia, representing over 6000 members. Speech pathologists are university educated professionals with specific knowledge and expertise in all areas of speech, language, communication and swallowing, including disorders of speech, language, literacy and numeracy, as well as difficulties with eating and drinking. Speech pathologists work with children, adolescents, adults and the elderly with communication and swallowing difficulties, within the public and private sectors, and across early childhood, education, health, disability, mental health, aged care and the juvenile and criminal justice systems.
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Speech Pathology Australia’s submission to the Senate Inquiry can be found at speechpathologyaustralia.org.au. A high number of individual and organisation submissions were also received by the Senate Committee. Hearings will be conducted in the near future, with a report and recommendations to Government to follow. Further information may also be obtained from www.aph.gov.au/Parliamentary_Business/Committees/Senate/ Community_Affairs/Speech_ Pathology.