Outpatient Services

The Royal Children's Hospital Speech Pathology provides second opinion outpatient assessments in the following areas where specific referral criteria are met: 

Speech Pathology Second Opinion Services 

• Cleft: Second opinion assessment and management planning of speech difficulties related to cleft palate and velopharyngeal insufficiency (poor palate movement). Children are referred to local therapy services for ongoing management. 
• Voice: Second opinion assessment and management planning for voice disorders. Instrumental assessments such as nasendoscopy may be conducted with ENT in this clinic. Children are referred to local therapy services for ongoing management.
• Swallowing and Feeding: Second opinion assessments requested by community Speech Pathologists for feeding and swallowing difficulties (dysphagia), including requests consideration for videofluoroscopy. A clear clinical reason/question for requesting a second opinion is required. This clinic is an assessment service. Children are linked back with their community Speech Pathologist for ongoing management. Referral to local health services for a second opinion should be considered in the first instance.  
• Speech and language: Assessment of complex speech and language presentations primarily those requiring medical or surgical management considerations (e.g., pre and post epilepsy surgery). Children are referred to community services for therapy as needed.
• Videofluoroscopy: Instrumental assessment of swallowing. A clinical assessment is undertaken prior to determine if videofluroscopy is needed. 
• Velopharyngeal Incompetency: Instrumental assessment of palatal function (i.e., palatal videofluoroscopy and/or nasendoscopy).
  

Speech Pathologists in multidisciplinary clinics

Speech pathologists also attend many specialist multi-disciplinary outpatient clinics (e.g., Tracheostomy Clinic, Aerodigestive Clinic, Laryngology Clinic, Neuromuscular Clinic, Saliva Clinic, Cleft Clinic etc). 

Instrumental investigations

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

Speech Pathologists working in other RCH programs

There are speech pathologists working in other RCH programs. Further details about these programs are located on the RCH website

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

Referring to Speech Pathology

Please address all referrals to RCH SPECIALIST CLINICS. You can either email, fax, or post referrals:    

• EMAIL to RCH Specialist Clinics Referrals:       screferrals@rch.org.au               
• FAX to RCH Specialist Clinics Referrals:           (03) 9345 5034            
• POST to RCH Specialist Clinics Referrals:        RCH Specialist Clinics, The Royal Children's Hospital, 50 Flemington Rd, Parkville, Victoria 3052 

In the referral, please state you are requesting Speech Pathology. Please don't send referrals directly to the speech pathology department or speech pathology email addresses.  

Please include the below in your referral. Missing information can cause delays. 

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
• Health profession you want referral directed to (e.g., Speech Pathology)
• Recent assessment report
• Management to date
• Investigation results
• Relevant medical history
• Allergies
• Relevant medications

Referrer details

• Your name and organisation
• Your contact number (one we can easily contact you on such as mobile and direct clinic reception. Do not put 1800 or switch numbers etc for large organisations)
• Your 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 is more appropriate. 

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 actively managed at RCH by multiple specialist teams
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 on 9345 9300

Some local hospitals and community health centres offer publicly 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

Patients referred for a Videofluoroscopy attend a clinical swallowing assessment appointment with an RCH Speech Pathologist prior to being booked for a Videofluoroscopy. We encourage local Speech Pathologists to attend 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:

Bronwyn Carrigg