What does Speech Pathology at the RCH involve?

The Speech Pathology Department at The Royal Children's Hospital (RCH) provides clinical services to children and adolescents from birth to 18 years in Victoria.  We also provide specialised services to some children living interstate and overseas. Speech Pathologists work closely with families, carers, schools, doctors, community providers and other health professionals to ensure best care for all of our patients.

We provide services across a wide range of clinical specialties for both inpatients and outpatients of the hospital. Our Speech Pathologists provide assessment, advice and a range of treatments to infants, children and adolescents with communication and/or feeding/swallowing difficulties.

Most Speech Pathologists at the RCH work in the Speech Pathology Department but there are some Speech Pathologists who work in other departments of the hospital such as Wallaby (Hospital in the Home), Complex Care Hub, Victorian Paediatric Rehabilitation Service (VPRS), RCH ECIS, and the RCH Mental Health service.

What services does the Speech Pathology department offer?

Inpatient services

Speech Pathology sees children admitted under all medical units and wards. A child may be referred for the following reasons:

• Acute changes in their communication or swallowing skills
• The child needs additional support while in hospital to be able to communicate with staff and their family
• Therapy for developmental feeding, speech and/or language delays during long hospital stays or when the child is not able to access community services due to their medical condition (eg. oncology patients)
  

Outpatient services

Speech Pathology is involved in a variety of outpatient clinics (listed below) and sees children for the following reasons:

• Follow up relating to an inpatient episode of care
• Children with complex medical/surgical needs who frequently attend the RCH
• A tertiary (specialist) Speech Pathology assessment and management is required
• A second opinion assessment is needed because the underlying cause for the communication and/or swallowing disorder is unclear, or because the communication and or/swallowing disorder has not improved with therapy
  

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 Pathologist, Occupational Therapist and Dietitian (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: Paediatric Fellow and Speech Pathology (fee for SP consult)
• 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
  

Coming to a Speech Pathology appointment

If you are coming to a Speech Pathology appointment at the RCH for eating/drinking/swallowing/videofluoroscopy you should make sure that you bring the foods and drinks that your child normally has as well as any special equipment, for example, special bottles, teats or cups. If possible, please avoid feeding your child prior to the appointment so that feeding can be observed during the session.

If you are coming to a Speech Pathology appointment at the RCH for communication you should make sure that you bring any communication devices that your child normally uses.

For all appointments please bring any previous relevant reports.

Speech Pathology appointments may take place in different parts of the hospital so please refer to your appointment letter to check where you need to go and when you need to arrive.

• Speech Pathology appointments that are held in Specialist Clinic B take place on level 1 of the hospital. The closest lifts to Specialist Clinic B are the green lifts. When you walk out of the green lifts on level 1, Specialist Clinic B will be right in front of you.
• Speech Pathology appointments that are held in Specialist Clinic A take place on the ground floor of the hospital. The closest lifts to specialist clinic A are the yellow lifts. When you are walking along the “main street” of the hospital on the ground floor, Specialist Clinic A is opposite the Creature sculpture.
• Speech Pathology appointments that are held in Specialist Clinic D take place on level 1 of the hospital. The closest lifts to Specialist Clinic D are the yellow lifts. When you walk out of the yellow lifts on level 1 you will need to walk across the walkway in front of the lifts, through the glass door, and down to the end of the corridor.
• Speech Pathology appointments for a videofluoroscopy are held in Medical Imaging on the lower ground floor (LG) of the hospital. The closest lifts to Medical Imaging are the green lifts. When you walk out of the green lifts on lower ground (LG), Medical Imaging will be right in front of you.

Useful links for making your way around the hospital:

The Royal Children's Hospital Map

The Royal Children's Hospital Virtual Tour

The Royal Children's Hospital Mobile Apps

Referrals

Speech Pathology accepts referrals for inpatients and outpatients. All referrals are triaged according to the Speech Pathology department eligibility criteria.

Inpatients

Medical, nursing and allied health staff can refer to the inpatient Speech Pathology team. Please note there is no service on weekends or public holidays. If you have concerns regarding your child’s communication or feeding/swallowing please speak to your child’s doctor or nurse who can send a referral to Speech Pathology.

Outpatients

Your child can be referred by RCH medical or allied health professionals or by their GP, paediatrician, maternal and child health nurse or community Speech Pathologist. A family cannot self-refer.

Once the referral has been triaged you will receive a letter telling you whether the referral was accepted or rejected. If the referral is accepted you will receive a letter with an appointment time. The appointment letter will also tell you if you need to bring anything to the appointment. It is always helpful to bring your child’s “My Health, Learning and Development Record” (green book) and any videos that you have that show your child’s communication or feeding/swallowing concerns.