Access to Communication Assessment and Intervention for Adults With Intellectual Disabilities.
Caitlin Chaney, Ann Nguyen Do, Amanda Elitawi and 2 others
Of 234 adults with intellectual disability recommended a full communication assessment after a swallowing screen, only 93 (39.7%) received one.
Lack of funding and lower clinical priority for communication over dysphagia were the main barriers.
Key findings
1Of 234 consultations where a full communication assessment was recommended after a communication screen during swallowing or mealtime management, only 93 (39.7%) received the assessment.
2The most commonly reported barriers in the clinical notes were communication being ranked lower priority than dysphagia (77% of reports) and lack of funding or cost (80%).
3Facilitators for completing the assessment included speech pathologist advocacy (noted in all 93 completions), challenging behaviours linked to communication breakdowns (41%), and paid carers in residence (34%).
Still to come
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Single private practice in Sydney; the findings may not reflect public hospitals, other states, or other service models. Retrospective design; the authors could not interview patients or carers about their experience of access. The qualitative themes come from clinicians' own notes, not from patient-reported experience, so they reflect how the practice documented barriers rather than what patients felt. The study period overlapped with the start of the pandemic (March 2020), which altered service delivery and introduced telehealth, making it hard to separate pre- and post-pandemic access patterns. Descriptive statistics only; no comparison group, no before-and-after, no measure of whether the 93 who received the assessment had better outcomes than the 141 who did not.
Declared interests
The authors declare no conflicts of interest and no funding to report.
The easy way to misread this
This is one private practice in Sydney, not a national picture. The barriers and facilitators come from clinicians' own notes, not from patient or carer interviews, so they reflect how this practice documented access rather than what patients experienced.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →