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Early Start Early Success

Southern NSW Local Health District
Project Added:
27 November 2015
Last updated:
11 December 2015

Early Start Early Success


Southern NSW Local Health District (SNSWLHD) provides speech pathology students with the opportunity to complete their placements within childcare centres, where they can provide speech pathology services, health education initiatives and early intervention as required. 


To improve the clinical skills of speech pathology students and provide early identification and management of children with additional needs.


  • Allows speech pathology students to gain clinical experience in a low-risk, community-based setting.
  • Improves communication and collaboration between childcare staff, clinicians and carers.
  • Increases the professional satisfaction of childcare staff and speech pathologists.
  • Enhances the timeliness of care provided, with early intervention principles delivered in a family-friendly setting.
  • Provides childcare centres with an opportunity to be a learning hub for staff, speech pathology students, clinicians, children and their carers.
  • Promotes an inclusive approach to health education, promotion and prevention.
  • Group models of service delivery allow childcare staff to help children build their language, speech sounds, literacy and social skills.

Project status

Project dates: August 2014 – September 2015

Status: Sustained - the initiative has been implemented and is sustained in standard business.


Traditionally, speech pathology students have completed placements within healthcare facilities such as hospitals and community health services. However, students often experienced below optimal face-to-face contact with children. Overall student clinical hours were reduced by clients failing to attend their scheduled appointments. Aboriginal children and children with special needs frequently do not present to community health facilities, which also reduced the ability for students to gain experience delivering services to this group of children.

In SNSWLHD, clinicians provide time-limited assessment, consultation and interventions to childcare services throughout the year. It was decided that student placements within these childcare services would provide them with clinical experience in a low-risk, community-based environment, with supervision by community agencies and NSW Health clinicians.


  • Two final-year undergraduate speech pathology students are placed in each participating childcare centre, for peer support and collaborative learning. Students in their final year of postgraduate Masters Studies in Speech pathology may also participate and require less supervision than usual by a senior clinician. They have peer support and receive on-site support and modelling of teaching behaviour from childcare staff.
  • The placement is for a maximum of eight hours per day, four days per week for six to eight weeks.
  • Students are placed with participating childcare centres using the ClinConnect electronic platform for student allocation to the placement.
  • Childcare centres indicate their preferred time slots and duration of service delivery for clinician participation and student placements. They also make referrals and obtain carer consent for children to participate in speech pathology services.
  • Students and clinicians collaborate with childcare staff to develop care plans for these children by the end of each placement. These care plans and reports can be retrieved from the child’s Community Health Information Management Enterprise (CHIME) medical records.
  • Participating childcare centres can refer children who are placed on speech pathology or community health paediatric waiting lists throughout the year.

Implementation sites

  • Bandara Children’s Services
  • Bega Preschool
  • Eden Preschool
  • Eden Childcare Centre
  • Merimbula Tura Kindergarten


  • ClinConnect, Sydney University
  • University of Wollongong
  • Child care centres in the Bega Valley


  • Over 100 children have been referred to Bega Valley Speech Pathology during four student placements held in 2014 and 2015. All children are assessed and have care plans formulated by the end of the student placement, so carers can provide interventions as required.
  • There has been an increase in service access for disadvantaged children or those with additional needs. An average of 73 hours per student was spent in assessing children. An average of 103 hours per student was spent in treatment related activities (see sample student timetable).
  • Referrals to speech pathology from childcare centres increased during the project, due to the increased awareness by childcare staff about paediatric communication disorders. However, children who are attending participating centres are promptly seen by the student clinicians. The service provided by student clinicians reduces the number of children who would be subsequently placed on a community health waiting list for speech pathology assessments.
  • Student participation in this project has led to an increase in overall clinical contact hours, recorded in the student’s log record and CHIME diary as occasions of service. This is evidenced by an average of a total of 188 hours per student, spent in the provision of assessment and treatment services to the child care centres (see log hours).
  • Student clinicians have helped provide a more accurate identification of children with developmental issues in childcare centres, as evidenced by comprehensive reports (see sample de-identified assessment report).
  • Children who have learning needs and require a transition to school process have been more readily identified prior to school entry. This has allowed them to receive additional and appropriate support within the childcare centre (see sample language programming plan).
  • Students have provided educational workshops to staff, parents and carers, to provide strategies which enhance children’s language and early literacy skill development.


This project was a nominee in the 2015 SNSWLHD Quality Award: Integrated Health Care.

Lessons Learnt

The model of care developed for the project is sustainable and can be replicated in other local health districts. However, the availability of senior clinicians who are willing and able to supervise these students and manage referrals will determine the ongoing sustainability of this program. It was found that the growing demand for acute, chronic and complex care services within generalist caseloads may potentially conflict with the provision of paediatric services.


Further Reading

  1. Girolametto L, Weitzman E, Greenberg J. Facilitating Emergent Literacy: efficacy of a model that partners speech-language pathologists and educators. American Journal of Speech-Language Pathology 2012; 21: 47-63.
  2. Health Education and Training institute (HETI). The Superguide: a handbook for supervising allied health professionals. Sydney: HETI; 2012.
  3. Hodge T, Downie J.  Together We Are Heard: effectiveness of daily ‘language’ groups in a community preschool. Nursing and Health Sciences 2004; 6(2): 101-107.
  4. McAllister L. Work Integrated Learning. Keynote address at ‘Our Knowledge Our Future’ seminar on 31 May 2013 at The Canberra Hospital, ACT.
  5. McLeod S, Harrison L. Epidemiology of speech and language impairment in a nationally representative sample of 4 to 5-year-old children. Journal of Speech, Language and Hearing Research 2009; 52(5): 1213-29.
  6. Nungesser N, Watkins RV. Preschool teachers’ perceptions and reactions to challenging classroom behaviour: implications for speech-language pathologists. Language, Speech & Hearing Services in Schools 2005; 36(2): 139-151.
  7. Pence KL, Justice LM, Wiggins AK. Preschool teachers’ fidelity in implementing a comprehensive, language-rich curriculum. Language, Speech & Hearing Services in Schools 2008; 39(3): 329-41.
  8. Ruggero L, McCabe P, Ballard KJ, Munro N. Paediatric speech-language pathology service delivery: an explanatory survey of Australian parents. International Journal of Speech-Language Pathology 2012; 14(4): 338-50.


Pauline Nirmala Mendes
Senior Speech Pathologist
Southern NSW Local Health District
Phone: 02 6492 9620 

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