Background: Strong communication skills support connections to community and culture and increased social and educational outcomes. However, due to the ongoing impacts of colonisation, Aboriginal and Torres Strait Islander children are more likely to have speech, language and communication needs (SLCN) than non-Indigenous children. To address SLCN, speech language pathology (SLP) is recommended, however for many Australian children barriers exist that prevent access to SLP services. It is not known whether these barriers also impact Aboriginal and Torres Strait Islander children.
Objectives: This study identifies 1) the prevalence of SLCN in Aboriginal and Torres Strait Islander children across early childhood (0 – 6 years) and 2) facilitators and barriers to accessing support for SLCN.
Methods: This was a longitudinal cohort study using the Birth cohort of the Footprints in Time: Longitudinal Study of Indigenous Children (LSIC). Descriptive statistics determined prevalence and odds ratios, binary logistic modelling and qualitative content analysis explored facilitators and barriers to accessing support.
Results: 47.0% of children were identified as having SLCN. The prevalence in children under 3 years of age was 6.2 – 6.5% and 18.2% - 23.3% in children above 3 years. Only 48.0% of children with SLCN accessed support. Factors associated with higher support access included having a disability (p= 0.009) and poorer global health (p = 0.015). Barriers to accessing support were service availability (50.4%), awareness of the service and the benefits of accessing (48.4%) and affordability (1.2%).
Conclusions: SLCN were prevalent in Aboriginal and Torres Strait Islander children, however, only half accessed support indicating that many Aboriginal and Torres Strait Islander children receive no support for their SLCN concerns. Possible solutions include reducing the barriers to accessing SLP services identified in this study. Another solution includes the implementation of collaborative public health models of service delivery, including health promotion and prevention.

At the conclusion of this presentation, attendees will take away:

- Knowledge that speech, language and communication needs impact around half of Aboriginal and Torres Strait Islander children in early childhood (0-6 years), though only around half of those with speech, language and communication needs access support to address these needs.
- Evidence informed knowledge of barriers and facilitators for Aboriginal and Torres Strait Islander children that impact access to services for their speech, language and communication needs.
- Recommendations that may improve access for Aboriginal and Torres Strait Islander children to services for their speech, language, and communication needs.

The study uses data from the Birth cohort of the Footprints in Time: Longitudinal Study of Indigenous Children (LSIC) to identify the prevalence of speech, language and communication needs in Aboriginal and Torres Strait Islander children, and explore facilitators and barriers to accessing support to address speech, language and communication needs. LSIC aims to better understand the lives of Indigenous children and determine factors that support them to grow up strong. Our research study uses the LSIC data to acknowledge the strength and resilience of Aboriginal and Torres Strait Islander peoples. It adopts a strengths-based approach and incorporates an Indigenous view of health and wellbeing. The team completing the study is comprised of Aboriginal and non-Aboriginal researchers. The co-design of the LSIC and this study with Aboriginal and Torres Strait Islander researchers ensured that the study design, conduct and outcomes (including presentations and publication) provide culturally responsive research evidence by incorporating only research evidence gathered from a position of understanding and respect of cultural differences to achieve effective outcomes and benefits for Aboriginal people and communities as outlined by the National Health Medical Research Council (2018). It was also guided by the principles of Consent, Research Agreements, Cultural and Intellectual Property and Cultural Competency (National Health Medical Research Council, 2018), Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research and the Australian Institute of Aboriginal and Torres Strait Islander Studies (AISTSIS) Guidelines for Ethical Research in Australian Indigenous Studies. The study outcomes aim to provide culturally responsive evidence based guidelines to assist SLPs facililate improved access to speech pathology services for Aboriginal and Torres Strait Islander children.