Prioritising Children for Speech Pathology Services: Insights from a New Study

Waiting lists for paediatric speech pathology can impose considerable stress on families. As a researcher and clinician, I’ve encountered parents who agonise over the drawn-out wait for their child’s much-needed assessment and intervention. The 2021 observational study, “Waiting lists and prioritization of children for services: Speech-language pathologists’ perspectives,” by McGill, Mcleod, Crowe, Wang, and Hopf (published in the Journal of Communication Disorders) goes a long way in clarifying why speech-language pathologists (SLPs) may prioritise certain children over others. Exploring these insights can help parents, carers, and fellow health professionals better advocate for timely support.

Why is Prioritisation So Crucial in Paediatric Speech Pathology?

Paediatric speech pathology often sees high demand, and limited resources can mean that not every child can be accommodated immediately. According to the authors, prioritisation decisions hinge on ensuring that children with the most pressing clinical needs—such as feeding difficulties or severe speech impairments—are seen first. This approach is also influenced by research indicating that early intervention for acute concerns can significantly enhance treatment outcomes. Paediatric feeding concerns, for instance, may intersect with nutrition, growth, and overall health, making them a critical focus area.

How Do Speech-Language Pathologists Decide Who Gets Help First?

One of the core insights from the study is that speech-language pathologists typically examine a range of clinical indicators when deciding how to triage children. The following table provides an overview of common priority areas noted by the authors:

Priority Area	Examples
Feeding Difficulties	Inability to swallow or chew effectively, poor weight gain, choking risks
Stuttering	Repetitive sound blocks, high frequency of disfluencies
Severity of Communication	Profound speech or language deficits, significantly limited intelligibility
External Factors	Institutional policies, service capacity, and family availability

Although these categories guide initial prioritisation, the study points out that SLPs must also consider each family’s unique context. For instance, a parent’s ability to attend regular sessions via telehealth or in person can affect how quickly a child is scheduled for therapy. Thus, prioritisation is neither purely scientific nor purely administrative; it is a nuanced blend of clinical need, resource availability, and family circumstances.

What Role Do External Factors Play in Waiting List Prioritisation?

While clinical severity is a prime factor, external influences—such as the available workforce, funding constraints, and referral pathways—often shape who receives therapy first. The observational findings emphasise how these factors can inadvertently disadvantage children who might not Clearly tick a top-priority box on paper, yet have contextual needs (for example, children living in remote locations with limited access to specialised paediatric care). Understanding these dynamics equips clinicians, policymakers, parents, and carers to collaborate in creating a fairer and more transparent system.

What Are the Potential Benefits for Families and Other Health Professionals?

Adopting a thorough prioritisation process can benefit all stakeholders. For parents and carers, transparency in how decisions are made can alleviate the anxiety of not knowing why their child’s appointment may be delayed. For speech pathologists, the process clarifies treatment pathways, ultimately leading to more efficient caseload management. For other health professionals, insight into prioritisation helps promote integrated care. When general practitioners or paediatricians understand the logic behind triage, they can tailor their referrals more accurately, ensuring the child is placed in the most appropriate urgency category.

Could This Research Transform Future Speech Pathology Practice?

The researchers underscore that prioritisation is complex and ever-evolving. As telehealth continues to grow in popularity—particularly in Australian contexts where families may be dispersed over vast geographical areas—further research might examine how digital platforms reduce certain barriers. Speech-language pathologists are increasingly learning about each family’s capacity to engage in remote therapy, how technology can facilitate or obstruct consistent attendance, and how these factors ought to be weighed in prioritisation. This study invites ongoing discussion, urging clinicians, administrators, and policymakers to refine triage systems that are optimally aligned with both evidence-based practice and family-centred care.

Putting Research into Practice: Key Takeaways

• Severity guides most prioritisation decisions, with stuttering and feeding difficulties often topping the list.
• External factors—such as service capacity, parental availability, and resource constraints—can play a crucial role in triage outcomes.
• Greater transparency on waiting lists can help families reduce anxiety and advocate more effectively.
• Future research may further examine how telehealth and emerging technologies fit into prioritisation frameworks.

If you or your child need support or have questions, please contact us at Speech Clinic.