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Speech, Language and Hearing Services to First Nations, Inuit and Métis Children in Canada, with a Focus on Children 0 to 6 Years of Age

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Speech, Language and Hearing Services to First Nations, Inuit and Métis Children in Canada, with a Focus on Children 0 to 6 Years of Age Speech, Language and Hearing Services to First Nations, Inuit and Métis Children in Canada, with a Focus on Children 0 to 6 Years of Age Speech, Language and Hearing Services to First Nations, Inuit and Métis Children in Canada, with a Focus on Children 0 to 6 Years of Age Speech, Language and Hearing Services to First Nations, Inuit and Métis Children in Canada, with a Focus on Children 0 to 6 Years of Age December 2010 © 2010, CASLPA Copyright is held by the Canadian Association of Speech-Language Pathologists and Audiologists. No part of this publication may be reprinted, reproduced, stored in a retrieval system, or transcribed in any manner (electronic, mechanical, photocopy, or otherwise) without written permission from CASLPA. Contact [email protected] To cite appropriate credit must be given (CASLPA, publication name and page number[s]). Speech, Language and Hearing Services to First Nations, Inuit and Métis Children in Canada, with a Focus on Children 0 to 6 Years of Age Speech, LanguageLanguage and and Hearing Hearing Services Services to to Indigenous First Nations, People inInuit Canada, and Métis Australia, Children New in Zealand Canada, and with the a UnitedFocus on States: Children 0A toLiterature 6 Years of Review Age and Report on Key Informant Interviews October 2010 © 2010, CASLPA Copyright is held by the Canadian Association of Speech-Language Pathologists and Audiologists. No part of this publication may be reprinted, reproduced, stored in a retrieval system, or transcribed in any manner (electronic, mechanical, photocopy, or otherwise) without written permission from CASLPA. Contact [email protected] To cite appropriate credit must be given (CASLPA, publication name and page number[s]). ABSTRACT Little is understood about the availability and nature of speech-language and hearing services for First Nations, Inuit and Métis children, 0 to 6 years old, in Canada. This summary of a literature review and key informant interviews describes service accessibility issues, service providers and how service is delivered in Canada, the Australia, New Zealand and the United States. The authors identify common service barriers, such as location, service coordination and cultural and community fit, and highlight current practices that address the need for improved and appropriate services. Keywords: speech-language pathology, audiology, First Nations, Inuit and Métis children. Consultants: Margaret O‘Hara and John Rowlandson Funding for this report was provided by Health Canada‘s First Nations and Inuit Health Branch, Child and Youth Division. The work and any opinions therein are not those of Health Canada. Correspondence concerning this article should be addressed to Sharon Fotheringham, Director of Speech-Language Pathology and Standards, the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA), Ottawa, ON. E-mail: [email protected]. A Literature Review / Key Informant Interviews Page i TABLE OF CONTENTS ACKNOWLEDGEMENTS ......................................................................................................... v EXECUTIVE SUMMARY ......................................................................................................... vi INTRODUCTION......................................................................................................................... 1 Terminology .............................................................................................................................. 1 Rationale and Goals of the Literature Review and Key Informant Interviews Summary ................................................................................................................................... 1 Methodology ............................................................................................................................. 2 Literature review ................................................................................................................. 3 Key informant interviews .................................................................................................... 5 National Aboriginal Organizations ........................................................................................... 6 POPULATION HEALTH AND SERVICE DELIVERY ......................................................... 8 Demographics ........................................................................................................................... 9 Health Status ........................................................................................................................... 11 First Nations, Inuit and Métis health frameworks ............................................................. 11 Health Service Delivery .......................................................................................................... 13 Children and youth services .............................................................................................. 15 Aboriginal Head Start ................................................................................................. 19 Speech-Language and Hearing Health .................................................................................... 21 Prevalence of speech-language difficulties ....................................................................... 22 Prevalence of conditions affecting hearing and hearing disabilities ................................. 24 Prevalence of conditions affecting hearing in First Nations children ......................... 26 Prevalence of conditions affecting hearing in Inuit children ...................................... 27 Prevalence of conditions affecting hearing in Métis children .................................... 29 Speech-Language and Hearing Difficulties as Reported for Indigenous Children in Australia, New Zealand and the USA ..................................................................................... 29 Aboriginal and Torres Strait Islander children .................................................................. 29 Māori and Pasifika children .............................................................................................. 32 Native American and Alaskan Indian children ................................................................. 33 Speech-Language and Hearing Service Delivery ................................................................... 34 Speech-language and hearing service delivery for Indigenous children in Australia, New Zealand & the USA .................................................................................................. 37 BARRIERS TO EFFECTIVE SERVICE DELIVERY .......................................................... 38 Location .................................................................................................................................. 38 Accessibility ...................................................................................................................... 39 Availability ........................................................................................................................ 40 A Literature Review / Key Informant Interviews Page ii Affordability of alternative service delivery options ........................................................ 41 Suitability of services ........................................................................................................ 43 Service Coordination .............................................................................................................. 44 Cultural and Community Fit ................................................................................................... 46 Cultural appropriateness .................................................................................................... 46 Linguistic appropriateness ................................................................................................. 48 Building trusting relationships .......................................................................................... 50 Flexibility to community needs ......................................................................................... 51 Barriers in Service Delivery to Indigenous Children in Australia, New Zealand and the USA ................................................................................................................................... 52 Australia ............................................................................................................................ 53 New Zealand ..................................................................................................................... 55 USA ................................................................................................................................... 57 CURRENT PRACTICES THAT ADDRESS BARRIERS ..................................................... 62 Workforce Development ......................................................................................................... 62 Service Delivery Options ........................................................................................................ 64 Jurisdictional innovations .................................................................................................. 65 Community-based services ............................................................................................... 66 Telehealth .........................................................................................................................
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