Services offered

The Royal Children's Hospital Speech Pathology department offers outpatient services as part of the following services/clinics:

Speech Pathology clinics

• Cleft: Assessment and management planning of cleft palate related speech difficulties and velopharyngeal insufficiency (poor palate movement), including second opinion assessments requested by community Speech Pathologists to support relevant diagnoses for concerns regarding palate movement for speech. This clinic provides assessment, review and limited therapy therefore children are referred to community services for therapy as needed. 
• Eating, Drinking, Swallowing: Second opinion assessments requested by community Speech Pathologists for feeding and swallowing difficulties (dysphagia), including requests for consideration of videofluoroscopy. This clinic is an assessment service and children are then linked back with their community Speech Pathologist for ongoing management.
• Feeding/dysphagia: Assessment and management of feeding and swallowing difficulties (dysphagia) referred from internal services or external doctors. This clinic provides assessment, review and limited therapy therefore children are referred to community services for therapy as needed.
• Gender Service: Assessment and consultation for transgender and gender diverse voice and communication issues.
• Neonatal Follow-Up clinic: Developmental assessment of children aged 2 years old who are referred by Neonatology at the RCH.
• Speech and language: Assessment of complex speech and language presentations, particularly those requiring medical or surgical management considerations as well as second opinion assessments requested by community Speech Pathologists for complex communication issues and differential diagnosis. Children are referred to community services for therapy as needed.
• Videofluoroscopy: Instrumental assessment of swallowing or palate function for speech
• Voice: Assessment and management of voice disorders. This clinic provides assessment, review and limited therapy therefore children are referred to community services for therapy as needed. Instrumental assessments such as nasopharyngoscopy/nasendoscopy are conducted as part of this clinic with the ENT team.
• VPI: Instrumental assessment (palate videofluoroscopy and/or nasopharyngoscopy) and management of cleft and non-cleft VPI, with support and liaison with other Cleft team members as required.

Multi-disciplinary clinics attended by Speech Pathology

• Allied Health Developmental Assessment Clinic (AHDAC): Occupational Therapy, Physiotherapy and Speech Pathology
• Allied Health Feeding Clinic: Speech Pathology, Occupational Therapy and Dietetics (internal referrals only)
• Autism Multidisciplinary Developmental Assessment Clinic (AMDAC): Occupational Therapy, Paediatrics, Audiology and Speech Pathology
• Cleft Clinic: Plastic Surgery, Cleft Nurse, ENT, Paediatrics, Dental and Speech Pathology
• Communication Clinic: Paediatrician and Speech Pathology 
• Complex Developmental Assessment Service: Paediatrics, Psychology and Speech Pathology
• Epilepsy Allied Health Assessment Clinic: Occupational Therapy, Physiotherapy and Speech Pathology 
• Laryngology Clinic: ENT and Speech Pathology
• Pathways to Good Health: Paediatrics, Psychology and Speech Pathology
• Saliva Control Clinic: Clinic Nurse Coordinator, Paediatrics, Dental, Plastic Surgery and Speech Pathology
• Speech Genetics Clinic (Childhood Apraxia of Speech): Speech Pathologist, Clinical Geneticist, Neuropsychologist and Neurologist (Research Clinic)
• Tracheostomy clinic: Paediatrics, ENT, Respiratory, Respiratory Clinical Nurse Consultant, Complex Care Clinical Nurse Consultant and Speech Pathology
• Voice Clinic: ENT and Speech Pathology

Community Health services for catchment area

• Pathways to Good Health
• Communication Clinic

Instrumental investigations

• Nasendoscopy for voice
• Nasopharyngoscopy for VPI
• Videofluorscopy (swallow and palate studies)
  

Additional RCH affiliates

Speech Pathologists also work in the following RCH programs:

• Complex Care Hub
• Hospital in the Home
• RCH Early Childhood Early Intervention Service
• RCH Mental Health
• Rehabilitation Service - Victorian Paediatric Rehabilitation Service (VPRS)

Referring a patient to the Speech Pathology department

Referrals for outpatient Speech Pathology should be either

Faxed to:         

Central Intake Specialist Clinics on Fax (03) 9345 5034

OR

Posted to:        

Central Intake
RCH Specialist Clinics
The Royal Children’s Hospital
50 Flemington Rd Parkville Victoria, 3052

To ensure appropriate and timely review and triage of referrals please ensure the following information is included:

Patient demographic information

• Full name and date of birth
• Name of parent, guardian or carer
• Address
• Mobile (or best contact) phone number for parent, guardian or carer
• Medicare number
• ATSI (indigenous status)
• CALD (interpreter requirements)

Clinical information

• Reason for referral
• Physical examination results
• Management to date
• Investigation results
• Relevant medical history
• Allergies
• Relevant medications

Referrer details

• Name and organisation
• Contact number and/or email address

Who can refer

Referrals are only accepted from GPs, Paediatricians or other relevant medical specialists. Families cannot self-refer.

Referrals for second opinion assessments are accepted from Speech Pathologists, please complete the Speech Pathology Second Opinion Referral Form and must be accompanied by a recent assessment report completed by the managing Speech Pathologist.

Eligibility criteria and how to refer

The RCH Speech Pathology department offers a consultative assessment service for outpatients. Ongoing therapy is not offered and is best provided in the community. Some referrals will not be accepted if a Speech Pathology service in the community would more appropriately meet the child’s needs.

Outpatient referrals are only accepted on the basis of:

1)     Requirement of tertiary-level Speech Pathology assessment and recommendations prior to, or following, an acute RCH admission/intervention
OR
2)     Requirement of tertiary-level Speech Pathology assessment and recommendations for a communication or swallowing issue relating to a complex medical condition
OR
3)     Tertiary-level Speech Pathology assessment or second opinion is required to make recommendations concerning management

If you require further information regarding Speech Pathology referrals, please contact the Speech Pathology Manager. 

Some local hospitals and community health centres offer publically funded paediatric Speech Pathology services.  They should be contacted individually to determine what services are available.

Your patient may be best managed by a private Speech Pathologist closer to home, including if they have Speech Pathology as part of their NDIS package. You can search for a Speech Pathologist in their local area through the ‘Find a Speech Pathologist’ function of the Speech Pathology Australia website. 

When to refer for Videofluoroscopy 

A Videofluoroscopy Swallowing Study (VFSS) is recommended when there is concern about how well a child or infant swallows, how well the airway is protected during swallowing, and/or how well food moves from the mouth through the oesophagus. A Videofluoroscopy may be considered if some of the following symptoms occur regularly and haven’t improved after intervention with a Speech Pathologist:

• Frequent choking
• Coughing or gagging during meals/drinking
• Trouble managing saliva
• Gurgly/wet breathing during or after meals
• Chronic respiratory problems including chest infections/pneumonia
• Difficulty swallowing

All patients referred for a Videofluoroscopy will be invited to attend a clinical swallowing assessment with an RCH Speech Pathologist prior to being booked for a Videofluoroscopy. Community Speech Pathologists are encouraged to attend these appointments where possible.

Please note: A Videofluoroscopy is a different procedure to a barium meal, barium swallow, or barium follow-through.

How to contact a Speech Pathologist at the RCH

The Speech Pathology Department can be contacted on (03) 9345 9300 between 8.30am and 5.00pm.  As we are often treating children during the day we may not be able to take your call immediately but we will call you back as soon as we can.

Manager:

Jill Steadall