Transcript for
The role of speech pathology in child mental health

Narrator [00:00:02] Welcome to the Emerging Minds podcast.

Sophie Guy [00:00:08] You’re with Sophie Guy, and today I’m joined by Kerry Holland and Chantele Edlington, both speech pathologists based in Victoria. Kerry has worked for more than seventeen years in education and public mental health services, including adolescent inpatient and Community CAMHS, as both a mental health clinician and speech pathologist. Chantele also works in public mental health with perinatal, paediatric and adolescent patients. Both Kerry and Chantele are passionate about the role that speech pathologists can play in supporting children’s mental health, and we explore this as well as other topics in our conversation.

Kerry and Chantele, thank you very much for joining me on this Emerging Minds podcast episode. It’s really great to have you.

Kerry Holland Thank you. Thanks for having us.

Chantele Edlington Thanks, Sophie. Nice to meet you.

Sophie Guy [00:00:56] I was gonna start off by saying that, except for almost being convinced to study speech pathology when I was finishing school, actually (I) know very little about it. And when I was doing a bit of background research, though, I came across that about eighty percent of kids who use child mental health services have speech, language and communication difficulties. And about eighty percent of kids in out-of-home care also have speech, language and communication difficulties. So they’re pretty striking statistics, and I’m looking forward to getting into this conversation and learning more about this area. So to start off with, I wondered if each of you could just take a few moments to briefly tell us about your background and how you came to be working in the area of child mental health.

Kerry Holland [00:01:48] Yes, sure. So it’s Kerry speaking. And I came to work in child and adolescent mental health services following working with children in the Education Department and typically found that lots of kids that I worked with in the school setting had lots of mental health needs. And it would be true to say that the area in that I worked, we had lots of co-work with our local CAMHS office. So when a position became available within a CAMHS service, I was fortunate enough to end up working there for about seventeen and a half years or so. And now I’m currently working in private practice, but again with children and young people, but also those kids that I’m working with, there’s a high rate of those that have a variety of different mental health presentations or at risk. Chantele.

Chantele Edlington [00:02:47] So, yeah, similarly, I was working in the Department of Education and I was actually reflecting on this. “When did I first begin to think about trauma and the impacts of trauma on children’s behaviour as well as communication?” And I think it was probably about eleven years now when I was first introduced to that sort of work. And it was just one of those light bulb moments for me where I went, “oh, my goodness, I can see what’s happening now. I can see how this is developing.” And it really made me a little bit more interested in working with especially adolescents, because they seemed like the neglected group that weren’t potentially getting all the assessments and the interventions that other areas were getting. And from that, I started to become really passionate about it. And it was just a chance meeting that I met someone who said, “you know, you, you really like these adolescent-sort of work. Have you ever thought about working in a mental health inpatient unit or something like that?” And I was like, “I don’t even know what that is. I know nothing about mental health but it does sound interesting.” And then researched, and then along the job came and I was fortunate enough to enter into the mental health program that way. And since then, I’ve just been working within child and adolescent in a whole heap of different areas and learning a lot about not only mental health, but the overlap between mental health and communication. And, you know, what can happen to young people when they don’t have the adequate supports to be able develop their skills in that area.

Sophie Guy [00:04:10] Great. Thank you. And I want to also ask you, talking about speech, language and communication difficulties or problems, you know, they’re quite broad concepts. Could you define what speech, language and communication difficulties are and what sort of the right terms are to use around that?

Kerry Holland [00:04:29] I guess now the accepted term is speech, language, communication needs, and it encompasses the whole gamut of language, which is the words we used, how we understand them and understanding of language and how we use it put together with the grammar, the syntax, the sentence syntax, as well as our speech sound, how we put sounds together to create speech. But it also encompasses this area of pragmatics, which is how we functionally use our communication to communicate our needs and how we use our language and speech to relate to others. So there’s many aspects of speech, language and communication that come together under that umbrella. Chantele, would you add any?

Chantele Edlington [00:05:17] I guess, thinking about pragmatics, you know, if we think about that most of what we say is non-verbal or not necessarily given through words. Sometimes it can be through tone of voice, through body language and things like that. And they’re also areas that we do look at and focus on. And similarly, we can have difficulties in both the way we express ourselves through all of those sorts of pragmatic areas, but also the way we interpret it. So often, young people that we are seeing might misinterpret body language and cues and things like that. For instance, young people with trauma might perceive a neutral facial expression to be one that they might find frightening for whatever reason. So they’re some of the areas that we’re also working in as well and helping young people with, yeah.

Sophie Guy [00:06:03] You talked about the speech aspects like maybe a child has difficulty pronouncing words or finding the right words or things like that. And then this aspect of, you know, non-verbal communication. Within that, are there certain aspects that relate more to, say, trauma or associated with social and emotional wellbeing? How do you differentiate these things and how they might relate to child mental health?

Chantele Edlington [00:06:26] I guess in terms of if a young person has experienced trauma, sometimes can depend on where abouts in their development it’s occurred. So if it’s happened at a time when they would typically be developing their speech sounds and things like that, then they might be more affected in that area. Whereas if it’s sort of happened later on after those have developed, then obviously they might already have that foundation. So it can sometimes be a little bit like depending on when the trauma or the disruption has occurred. But having said that, then, you know, we can kind of look at the other side of things and think about, well, what is it that’s impairing them from getting back on track as well? So, sometimes it might be that they might be already struggling with one area of speech, language or things like literacy or things like pragmatic language, communication with other young people that might then have a negative downturn on their mental health as well. Self-esteem and all of that. Anything else, Kerry?

Kerry Holland [00:07:23] Yeah, I think it’s really important to consider the relationship bi-directional. So it’s not necessarily one leading to another that can occur, but it can be quite a complex relationship between the two, between mental health presentations as well as language presentations. And yeah, definitely that early reciprocal nature of communication development between that primary attachment figure can be quite significant in setting up some of those early patterns, become more complex as we develop.

Sophie Guy [00:07:55] Mm hmm. Could you talk a bit more about that, about that relationship between developing communication and early attachment with caregivers? And how does that relate to perhaps trauma or later emotional behavioural problems?

Chantele Edlington [00:08:09] I guess how we look at that is that very early on in the child’s life, as soon as we’re born, basically we’re born with a whole set of skills which we have that enable us to be able to interact with people around us. So humans being essentially born basically helpless, have already inbuilt mechanisms in which they can attract the attention of their caregiver and maintain that. And also, conversely, be able to interact with the caregiver. So even when a baby is only able to see a certain distance away, you know, the distance they’re able to see is basically from the breast to the eye. So we’re set up in a very unique way, human beings, in that we are able to form attachments and relationships really early on. And from those really early beginnings, you know, things like looking into baby’s eyes and baby looking into mum’s eyes, then baby looking away and then re-looking back at mum, we learn our turn-taking in our early interactional skills. And those then formed the basis for what we then go on in terms of our, in terms of our relationships. They get bigger and more complicated, we start to add in different things, like you said, gesture, shared attention and things like that, which means that we’re able to sort of make understanding of our world and also of the people around us. And that is the exciting thing that kind of helps us to be able to, as human beings, form relationships, maintain relationships and be able to continue to learn and grow.

Kerry Holland [00:09:32] And we’re constant, constantly modelling language back and forth from the moment babies start to babble, before babbling, when they’re cooing, they make a noise and we, we respond to that. And it becomes, as Chantele said, this turn-taking game, which sets up for later conversational skills and interrelational, interpersonal skills, as well as the physical, you know, stringing together of sounds and putting sounds into words that have meaning and convey a meaning. So there’s many functions along the way and the co-regulation aspect as, as the young look back to the primary attachment figure to kind of check out, “is this situation okay?”, and we help them regulate those and name feelings. So we may see those young people who’ve experienced trauma actually have a real paucity of language to describe that inner emotional world, because when you’re in this fight or flight situation, that vocab may not be demonstrated, may not be, you know, talked about when families are in crisis. And so we tend to say young people that can’t describe that, inner being. There’s lots attac- you know, set up with that early attachment. How it can then go on in terms of communication, but then how we can communicate those states feeling as well.

Sophie Guy [00:10:51] And I was curious, what are some of the main things that an infant and a very young child needs from their relationships and their environment in order for speech and language and communication to develop in a healthy way?

Kerry Holland [00:11:06] Safety and security, I think are probably the two big ones that just lead to family that’s feeling safe. Maybe that’s feeling safe and that can trust that the primary attachment’s there is, you know, huge. Chantele?

Chantele Edlington [00:11:24] Yeah, as you were saying, I completely agree. And those sort of things set up the ability for our brains to be able to be open to learning new things. And I guess then it’s about having the models available to us to be able to actually see what language is and to be able to learn from really good language models as well. So if you grew up with somebody who may not be feeling able or comfortable with their communication, then it can have an effect on how the child develops as well, because it’s the earlier we can get in, the better. The earlier young people learn these skills, the better they will essentially be at them. And yeah, that’s when we can make the most changes well if things aren’t going so well.

Sophie Guy [00:12:07] We’ve sort of touched on it, but I wonder if you could just elaborate a bit more on how trauma can affect speech and language and communication. And is there, do you sort of see a difference between developmental, repetitive sort of traumas versus the big, more traumatic single events? Do you differentiate in that way with the kids that you work with?

Kerry Holland [00:12:29] Yeah, you might get different sorts of presentations. Yes, we can have a trauma that’s associated with a single incident. Or there’s the ongoing trauma that we might conceptualise in terms of how the relationship is interrupted by potentially maternal mental health, domestic violence, constant stresses such as, we know that young people from lower socio-economic backgrounds and disadvantage and disability, when you’re adding on different layers, there’s different levels of potential trauma and vulnerability. So if those particular traumas are ongoing, like in the instance of domestic violence and familial violence, that may not be obvious, then the trauma is ongoing. So you may see different types of presentations with those young people where the safety in the primary attachment is not necessarily there, as opposed to a young person who has a secure attachment and has a single trauma episode, knows that they’re held in mind by those primary attachment figures and it has a different level of safety and security around it. So it may be similar to like us as adults, may experience a significant trauma and find ourselves being really unable to describe it. When we’re under complete stress, the ability to think and communicate becomes impaired for a certain amount of time. However, once some of that’s resolved, we’re able to communicate and think in a different way. When that trauma is ongoing and that process in a young developing brain, you’re getting very different pathways set down. So neural pathways in terms of ongoing development of language and communication so they can present quite differently.

Sophie Guy [00:14:15] Okay. Did you want to add anything to that, Chantele?

Chantele Edlington [00:14:19] Yeah, I’m just sort of thinking about, you know, the kids that we see that have presented after some sort of randomise trauma, for instance, things like there was a bushfire event or something like that. They tend to be just like in any other area of mental health, they tend to be the ones that can kind of get back to normal more quickly. And they might go through a period of re-calibrating to having to integrate that. But with a lot of, you know, narrative and support and all of that, they can kind of go back to normal and continue their development. And sometimes the ones that get a little bit stuck in terms of ongoing development are the ones where they’ve actually had a trauma that they haven’t been able to work through. And they’re sort of the ones that would tend to come up to us more often than not. And like Kerry was saying, they tend to be the ones that really do have difficulties in the attachment relationship to begin with. So, you know, it might be that mum or dad are coming to us and saying, “oh look, Johnny stopped talking after the car smashed into a kangaroo or something like that.” But when you start to dig, you’ll actually find that, “oh actually was pretty quiet beforehand, and actually there was some domestic violence going on.” And you’ll find more things. It doesn’t tend to usually be a single-incident trauma. I guess the interesting thing at the moment with COVID-19 is that it’s sort of the thing that’s affecting everybody in the community, and now young people are stressed and it’s often because the adults around them are stressed. So we’re starting to see some manifestations of that in not only their communication and relationships, but also in things like their ability to attend school. So then, of course, that has a bit of a flow-on effect back to us because it means that they’re not actually getting the access to literacy and numeracy and all of those sorts of things. So, again, that’s a very big overlap with those sorts of traumas as well that are ongoing like this one at the moment. But essentially, the kids with their early relationship difficulties are going to be at a different risk and tend to be the ones that are more pervasive and lifelong, so as Kerry was saying.

Sophie Guy [00:16:17] Okay. And I’d like to explore a little bit about, how do speech pathologists work with trauma or children who’ve got speech and language difficulties, as well as emotional behavioural problems as well?

Kerry Holland [00:16:30] I guess it’s not that dissimilar to how we would work with other young people to present with the same types of speech and language presentations. I think the thing that we need to keep most in mind though is that it can take a little bit more time to establish the relationships for therapy to have an impact. So it may take a lot of time for those young people to actually feel safe with you, trust you to be able to do the work. But again, it would be looking at as with any person who presents with speech and language, communication, difficulty with presenting issues, particularly when we might be looking at with this sort of population, you tend to see a narrower vocab range. So not having the ability to use that really precise words to describe what they’re doing. But not only that, to be able to give you the narrative and be able to give you the story, so we might work on how to scaffold those young people, how to be able to put those narratives in an order that they’re able to discuss. So we may make to work on some concepts of, even right back to, you know, what’s happened at the beginning, what happens next and get those concepts of sequential information. So sometimes it can be really hard to get a real understanding from some of these kids about what’s happening. They may not be able to tell you, even asking them, “what did you do it at school today?” “Nothing.” Is the big one, you know, “it’s boring.” And just being able to order and have those planning and organisation type-skills that we see, and I guess the more executive-function types of skills helping provide some frameworks around those procedures to be able to order their sorts and then be able to lay them down.

Chantele Edlington [00:18:18] Yeah, it does take a lot longer. And so people can, I guess, feel a little bit disheartened with treatment with these kids at times. And, you know, realistically, if you don’t have those initial frameworks early on in your relationships that like turn-taking and sharing attention and things like that, it means that you’re starting from a lower base. And sometimes you actually have to teach some of those skills overtly, whereas, you know, for a normal relationship, we would have them internally, they’ll be something that would be pre-verbal that we just know how to do. Whereas for some of these kids, they can come across as being quite rigid or looking a little bit, sort of like they’ve got a neuro developmental difficulties because they don’t actually understand some of these really subtle communication cues and techniques that we just take for granted. So sometimes we have to be very clear in actually teaching them how to do this in a step by step manner, which can be a little bit different in some other areas of mental health, so that’s some of the work that we do as well. But as Kerry was saying, you know, these kids, again, if they’ve come from a situation that’s been scary, unpredictable, unruly, they’re not going to know how to sequence, they’re not going to know how to organise, they’re not going to know what to pack in their bags if it’s a cold day today. You know, they’re just living in the moment to moment. And again, that’s reflected in their language. Their language is very much in the here and now. They really often struggle with things like time and, and when did that happen and why did that happen? You know, there’s not really that problem-solving that cause and effect in the same way. Essentially, you know, if you’re thinking about how your brain kind of works, you’re kind of talking to yourself all the time about, what am I going to do next or is that a good decision or not? That’s all language that you’re using in your mind as you’re making decisions. But if you are somebody who doesn’t have that language well-developed in your mind, then also your problem solving skills and your ability to see between the lines or identify ulterior motives and things like that, they’re all disrupted as well. So it’s not just the talking that we are looking at in mental health and with kids with trauma, we’re actually looking at all these other sorts of things as well. And sometimes we can give really simple things to assist in terms of the young person has come into hospital, for instance, and they’re really struggling to be able to talk.

[00:20:31] It might just be about giving them a vocabulary board or the pain scale or identifying feelings on a picture board or things like that to assist them to be able to communicate and form relationships with staff on the wards and things like that. So there are simple things we can do for the meaningful work to occur. It does need to occur in a long-term safe space.

Sophie Guy [00:20:51] Yeah. How do other practitioners who perhaps aren’t so familiar with this area, how do they interpret children who perhaps have speech, language, communication difficulties and are giving one-word answers and not seeming very communicative? Do you find that there’s sometimes a risk that they get labelled with other things or…?

Chantele Edlington [00:21:11] All the time, I think that’s what we’re all so passionate about, isn’t it Kerry? It’s always that label of, they’re not trying or they’re not engaged or they’re not attending or, you know, those sorts of things.

Kerry Holland [00:21:21] They’re just naughty. They want things their way. They’re just used to getting things their own way and they demand it. They just want it their way. Is things I’ve heard. So in a classroom where attention hasn’t been given directly to a young person and immediately throwing pens, papers, books, pushing of other children down or ripping up other children’s work. So they’re just a few things that I’ve seen just in the last month in particular, and they’re all from one student as well. One very young student. So if can’t be first, we’ll throw the children to the, to the ground to be first. And that was all interpreted as being, “this kid’s just naughty and just has to be first.” But when a teacher is transitioning children throughout a school, they’re usually at the front. So this child was just trying to position themselves with the adults to be close to the adult, to, to feel safe and secure with the adult. And whaever goes in the way is kind of extraneous. So looking on, that’s what it looked like when we kind of reframed it. I wonder whether she’s needing some more time with you, or maybe she’s not feeling so comfortable today. Something might have been happening at home that she might be needing some more time. And then when that was addressed, and some time was set up with the appropriate adult within the school, it contained those feelings.

Chantele Edlington [00:22:52] Yeah, sometimes all we do is interpret for the kids, don’t we?

Kerry Holland [00:22:54] Yeah, look and-

Chantele Edlington [00:22:56] Sometimes you know, we’re the mouthpiece for them. We have to say the words that they can’t say. We have to be the ones that actually observe the behaviour, have the belief that communication or behaviour is a form of communication. And we hold that belief very strongly. And we then have to interpret what’s going on with the kid to the adults around in order to be able to look after the young person to help them see them as not bad or naughty, but as someone who isn’t able to communicate, you know, these really horrible feelings that are going on for them.

Kerry Holland [00:23:24] Yeah, and as a five-year-old to the limited vocab that they would have for those feeling states anyway is challenging. But she just didn’t have the language to say, “I’m feeling really sad today.” And there’s a plan in place for when that happens. So children do go on to receive diagnosis of oppositional defiant disorder. We tend to see that particularly in our older later age in adolescence, getting those sorts of diagnoses, ADHD as well. And look these, ADHD may be concomitant diagnoses, but it wouldn’t be uncommon to see that kind of presentation.

Sophie Guy [00:24:03] And is it, do you sometimes find that actually ADHD isn’t an accurate diagnosis once there’s been work done around speech and language difficulties? Or is it not that simple?

Kerry Holland [00:24:16] No, it’s not it’s probably not that simple, because I think certainly around those kinds of presentations, the relational work is probably just as important. So speech and language work, I’m not sure you can substitute some of the work that needs to happen together. Or maybe a time where really the speech and language work isn’t the priority. The relational work is, but with some special considerations, because that’s a lot of work to put on one young person or one family. So I guess it’s, it’s really important that the team can work together to work out, well when’s the right point of entry. When’s the right timing for any of these sorts of interventions? Because when a young person is in crisis, that’s not the time to be doing the types of therapy that we were talking about. That’s the time for crisis management, that’s the time for containment and providing a safe environment and putting into place some things like Chantele was mentioning before, you know, we used thermometers in terms of the largest problem, keeping things into perspective, being able to give the vocabulary, choosing from picture boards for emotions, to be able to give the vocabulary in those instances, those kinds of things, when there’s less arousal is probably the time when you’re going to get the most out of speech and language intervention.

Sophie Guy [00:25:37] Yeah.

Chantele Edlington [00:25:38] Engaging that upstairs brain, isn’t it?

Kerry Holland [00:25:40] Yeah, because we’re asking an awful lot of a young person to do all of that at once.

Sophie Guy [00:25:49] So would there be some key messages that you would have for practitioners who are not speech pathologists but that are important to maybe consider when they’re meeting a child and a family and they’re finding it hard to communicate or engage, that could help alert them to some speech, language, communication need that the child might have?

Chantele Edlington [00:26:09] Probably the biggest one is, if in doubt, assume that there is some difficulty going on there because it’s likely anyone that’s working with these young people, they’re more than likely to actually have some difficulties in one or more areas of speech, language and communication needs. And then if that is the case, are you able to get a formal assessment completed and one that is able to pick up on some of the more nuanced aspects of communication? And then I guess if you’re unsure, try and err on the side of caution and keep your sentences short, try to avoid jargon and try to avoid sarcasm, try to make sure that you’re getting that young person’s attention before you talk to them. All of the very simple things that are actually gold, even just pausing between sentences, can mean the difference between someone being able to catch up and, and understand this next sentence coming versus not being able to know what you’re talking about, and completely zoning out and not trying anymore.

Kerry Holland [00:27:05] And not jumping in too soon. I think sometimes you just need a little bit longer to formulate thoughts and to find the language to come for an answer, but I think also if clinicians are really paying attention to their developmental history now, typically they, they gather really good, solid developmental histories and really need to think carefully about some of those red flags that might come up in terms of developmental milestones, but also paying attention to what do people think of them, you know, what did the kinder teacher, if the child attended kinder, were there any, any concerns raised? Did they learn their early sounds at school? Could they develop their letter and sounds? How quickly did they pick up some of the reading skills? What did the teacher say to them, you know, describe their academic skill acquisition, ands ome of those things can give you a red flags as to how the young person has achieved academically, because it’s everything you do at school is so language-based and is very loaded with language and particularly, you know, this big relationship, there was literacy development as well. So that would be a really big indicator as what level is their reading, literacy skills, reading and writing.

Sophie Guy [00:28:23] Yeah. We’ve touched on quite a lot of things. Is there anything in particular that either of you would like to go into or sort of raise as being particularly important from your perspectives around speech and child social and emotional wellbeing?

Chantele Edlington [00:28:37] I guess just reinforcing how interlinked they, they really are. And in that, you know, one can have a negative or a positive effect on the other, and then that can then influence or change the projection of the young person going forward in terms of their development. And a lot of the time it’s not one way or the other is I think also touched on in that sometimes it might be that you have a young person who hasn’t had a language-rich environment who’s then gone to school and might have found it difficult to concentrate or difficult to interact with their peers. And then, you know, they sort of get this label of not being the same as their peers or different then that sort of then has an impact on their self-esteem and their mental health, and that might change how they behave, and then, of course, if they’re behaving in a way that’s perceived as negative or, or uncooperative, then that can again mean that they have less and less opportunities in order to be able to practise some of their skills so it can really reinforce itself. And I guess one of the reasons it’s so important is that we know that young people with speech, language and communication needs go on to have poorer health outcomes. We know that they have poorer academic outcomes. We know that they’re more likely to get into trouble with justice systems. We know all of this stuff. And sometimes what we find still is that in places especially where there isn’t a speech pathologist or someone in that field around, that these kids go unnoticed or they might just kind of be missed. And that can be a really sad thing, and then they not have the opportunities to change or they’ve been identified, but they’ve been identified at a really late stage at a point where they’ve already developed a very strong sense of who they are or who they are not. And that might be the kid that thinks, “I’m dumb, I’m stupid, I can’t do school. You know, I’m just leaving.” Those sorts of examples which we see over and over again. And that’s just really sad because you can actually, for example, literacy is actually very, very simple to teach if it’s taught in a way that’s at the right level for the young person. And similarly with language, we can actually teach that if we are able to get it to a level that’s accessible for them, that we’re able to scaffold for them, we can actually teach them a lot. We can teach them a lot about how to interact with people and how to also manage their emotions and their communication of emotions at the exact same time. It can all be taught, it’s not stuff that if you’re not genetically born with it, you can’t learn it. You can learn it. It’s about having access to being able to learn it. Having a communication partner that’s able to help you practise those things or partners and then being able to actually feel good about yourself. So it’s all really, really intertwined.

Sophie Guy [00:31:09] That sounds like such an important point. I wanted to ask you, how easy is it for kids to get access to speech pathology services? Do they need a referral? How does it work?

Kerry Holland [00:31:19] So that will vary state to state and it will vary organisation to organisation, even within Victoria, where Chantele and I are, CAMHs and KIMs services will have a range of different staff configurations. Most have speech pathology amongst their staffing profile, but their roles may, may vary from mental health clinician to a discipline-specific role, or to a combination of both. They may carry roles in specialist assessment team, such as autism assessment teams or other neuropsychological-type assessment, developmental assessment teams at various combinations of those. So within a mental health service, that can vary depending on the service delivery model. And some states have more or less access to speech pathologist within both child and adolescent as well as adult mental health services. So then it may fall onto other health and education systems and private systems or NGOs within the system.

[00:32:25] So I guess it’s important to know your local situation as to how you will access, if it’s not from within, then it’s a probably really good practise for services to just have a relationship with either another arm if they’re a public service, if you’re part of a health service, is there another part of the health service that provides speech pathology services that you can access service, so could be community health services as people exit the service? But again, it depends on the local situation, I guess, of how services are set up. But certainly making a partnership in some way with another organisation or service is usually helpful. People are really keen to do, you know, secondary consults. I know we do them a lot and have done and continued to with other services and that’s usually part of your scope of practice no matter where you work.

Chantele Edlington [00:33:17] And of course, Speech Pathology Australia does have a list of speech pathologists and you can look up their website to find details about that. It may not have all that many that have specified mental health as an interest area. It’s certainly a developing area and something that we’re trying really hard to get more speech pathologists into this area. But it’s a little bit, again, about people understanding the need for speech pathologists and how mental health speech pathologist might differ from, say, for instance, an acute speech pathologist in the hospital and trying to reinforce the need for them. And then, then actually having enough service providers to be able to provide that service out in the community is the other end of the spectrum. So while we’re getting more and more people going, “okay, well, this person needs a speech pathologist who understands mental health, who understands trauma”, we don’t necessarily have that many out there yet. Speech Pathology Australia and local services is trying to work really hard to build up the skills base in not only speech pathologists within their services, but external to their services as well, because it really does have a flow-on effect to everyone.

Sophie Guy [00:34:22] Yeah, okay. I think that’s been a really great first coverage of the context of how speech pathology and speech language and communication needs fits into the picture of mental health and down the track, it would be good to delve into something in a bit more detail. So we’ll finish there today. And thank you very much for your time, both of you, Chantele and Kerry.

Chantele Edlington [00:34:46] Not a problem, thanks.

Kerry Holland [00:34:47] Thank you.

Narrator [00:34:50] Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.