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 at the RCH involve?

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. 

Outpatient services

Speech Pathology is involved in a variety of outpatient clinics, and we see 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 (e.g., for cleft palate)
• A second opinion assessment is needed for specific reasons (e.g., the underlying cause for the communication and/or swallowing disorder is unclear, or there has been a deterioration communication and or/swallowing disorder). 
  

Speech Pathology Services:

• Cleft: Second opinion assessment and management planning of cleft palate related speech difficulties and velopharyngeal insufficiency (poor palate movement) to support relevant diagnoses for concerns regarding palate movement for speech.  
• Voice: Second opinion assessment for voice disorders and management planning. 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.
• Swallowing and Feeding: Second opinion assessments requested by community Speech Pathologists for feeding and swallowing difficulties (dysphagia), including requests for consideration of videofluoroscopy. A clear clinical question and reason for requesting a second opinion is required. This clinic is an assessment service and children are then 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. We also conduct palatal videofluroscopy to examine how the palate functions for speech
• Velopharyngeal Incompetency: Instrumental assessment (palatal videofluoroscopy and/or nasopharyngoscopy) and management of non-cleft and cleft VPI with support and liaison with other Cleft team members as required.Speech Pathology Second Opinion Services.
  
  

Speech Pathologists in Multi-disciplinary Clinics

In addition to the above outpatient services, Speech pathologists are present at a large number of specialist multi-disciplinary outpatient clinics (e.g., Tracheostomy Clinic, Aerodigestive Clinic, Laryngology Clinic, Neuromuscular Clinic, Saliva Clinic, Cleft Clinic etc). 

Coming to a Speech Pathology appointment

If you attend a Speech Pathology appointment at the RCH for eating/drinking/swallowing/videofluoroscopy, please

• bring the foods and drinks your child normally
• bring any special equipment, for example, special bottles, teats or cups.
• if appropriate/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, please bring any communication devices or supports your child normally uses.

Please bring any previous relevant reports to the appointment.

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.