By Greg Basky for SHRF
Saskatoon audiologist Charlotte Douglas says it isn’t the children whose hearing problems she identified early and acted on who stick with her. She always knew those kids would go on to hit the same developmental benchmarks as their hearing peers. “It’s when problems aren’t picked up at birth, and you have a kid who walks into the office for the first time after they’ve started school, and is basically not using language competently,” says Douglas. “That kind of breaks your heart.”
New research, funded by the Saskatchewan Health Research Foundation (SHRF) through its Solutions Program, is tapping into the perspectives and experiences of speech-language pathologists (SLP) and audiologists (AUD) to develop a clearer picture of how well current hearing and language programs are meeting the needs of Saskatchewan families -- and preventing such instances of children slipping through the cracks.
Lead investigator Laureen McIntyre is interviewing providers across the province who work in the health and education systems and private practice. In Saskatchewan, the hearing, and speech and language needs of children who are pre-school aged are the responsibility of the Ministry of Health, while these services fall under the Ministry of Education for Pre-K/K to 12 students.
Changes to funding in both sectors in 2017-18 have led to many services being concentrated in Saskatoon and Regina, a shift to more private clinics, and longer wait times, according to McIntyre. She and members of her research team -- which includes Douglas -- are concerned funding and access have not kept pace with increased need to support children and their families.
“We have a very geographically diverse province and simply putting services in urban centers and expecting the majority of the province to travel to get services isn't feasible for most people...it's not affordable,” says McIntyre, an associate professor of educational psychology and special education at the University of Saskatchewan who is also a registered SLP.
Why the research?
Research on the benefits of early intervention and action is unanimous: “The earlier you intervene when children are in those developmental stages, when their brain is best able to respond to things, the better,” says McIntyre. “Down the road, it just gets more expensive and more difficult because you've missed those opportunities.”
Most of the available Canadian research on SLP and AUD services is from Ontario. There’s a lack of good evidence on availability of programs or job satisfaction among providers in this province, says McIntyre. And despite potential benefits, the pandemic-driven shift to virtual delivery of programs -- telepractice -- may not be working for all families. That’s something she’s trying to explore through the research as well.
A 2019 report card from the Canadian Infant Hearing Task Force graded Saskatchewan’s early hearing detection and intervention (EHDI) programming as “insufficient.” It recommended this province implement a coordinated and comprehensive EHDI program and do more work to improve and sustain services.
Interviews are well underway
“What we want to do is speak to frontline service providers about the challenges they're experiencing and the positives they're experiencing, to find out what we can do, to better meet clients’ and families’ needs,” says McIntyre. She hopes to wrap up interviews by Christmas, then release a report in spring 2022 that summarizes what they heard and makes recommendations to the provincial government and the Saskatchewan Health Authority.
If she can secure more grant funding, McIntyre would next like to talk to parents and families accessing hearing and language services, and administrators in the health and education sectors -- and from there, broaden out the research to see if there are similar issues and opportunities in Alberta and BC.
Douglas says the research will not only identify current gaps in service, but also shine a spotlight on what’s working well, and point to new opportunities. “There are a lot of options around remote care, and ways to better coordinate the services of the existing professionals in the province,” says Douglas, who was a senior audiologist in the public system for many years before opening her own clinic. “Because we don’t have a ton of professionals in our fields, and we don't have coverage everywhere in the province, it's really important we maximize the resources that we do have.”
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