Ipswich Children's Allied Health and Music Services--Strategic Perspectives Analysis

 Allied Health and Music Services in the Ipswich Region 2020-2022

We need a community-based response to children's allied health and music services--with funding directed to place-based strategic planning...

Introduction

This scoping study began by exploring allied health and music services in Ipswich. The purpose was to build my knowledge base for strategic planning of children’s therapy services. This is relevant for my private practice which offers occupational therapy and music services in Ipswich and surrounding areas of south east Queensland. The study is carried out through desktop research, and meeting with leaders of children’s services. It involves mapping service networks, and reflecting on my practice as a health professional in Ipswich. 

Background

I commenced work as an Occupational Therapist at Ipswich Hospital in 1981, and have been working in private practice from 1987 to the present. The new knowledge gained from strategic perspectives analysis is useful for informing my decisions about: siting my services geographically; and deciding on the scope of services that I offer. I currently provide Occupational Therapy through the National Disability Insurance Scheme (NDIS), Medicare programs, and private health insurance schemes. 

Soon after the study commenced in March, 2020, Australia experienced the first outbreak of the COVID19 pandemic. The data collected is, therefore affected by the social and political changes that occurred at this time and the broader repercussions on local, state, national, and global health policy and services. The mass media reporting of the pandemic contributed to the context of the study--based on newspaper accounts, website information, and personal opinions expressed through social media and professional learning networks. After studying the landscape of therapy services in Ipswich, the decision was made to include music services as well because they contributed to positive outcomes of children's development.

The method is descriptive and ethnographic. This proceeds from my socio-ecological approach to community-based health and children’s music services. I completed a Master of Philosophy at Queensland Conservatorium, Griffith University on Frameworks for Culturally Engaged Community Music in Rural Ipswich (Kirkwood, 2009), and several other community music research projects which form an evidence base for my understanding of community music services in Ipswich. Moving into private practice, I required a knowledge-base tailored to the local area, which provides: literature review, mapping of services, demographic details and analysis, consultation and liaison to inform my strategic planning. The findings are shared as a work in progress to support place-based networking and service development in the Ipswich region.

Ipswich City is located approximately 42 kilometres from Brisbane, the capital city of Queensland. The Ipswich City region covers 1,218 square kilometers, with a residential population of 210,546, including  20,507 children aged from birth to 5 years (AECD, 2018).

Method

The study is largely a scoping and mapping exercise through descriptive ethnography from the perspective of a service provider that has lived and worked in Ipswich and Brisbane since commencing employment with Ipswich General Hospital in 1981. Interviews were held to listen and better understand various perspectives. Based on this knowledge—trends, implications and resolves are described. Tentative recommendations are provided for the future--which is now in flux with the pandemic.

Strategic perspectives analysis has been designed as a flexible procedure that can be used to conduct both participatory and political applications of SIA. In a progression from position analysis techniques, the method uses strategic planning principles to elicit the vision, objectives, and strategies of each party (Dale & Lane, 1994).

The method of SPA was developed by Dale and Lane, 1994, Griffith University, social environment research group. Because SPA is based on socio-environmental concepts that support participation of stakeholders, then it is useful for supporting collaborative action research.

Literature Review

The reason that allied health and music services are important for children’s development is the imperative from the Improving Early Childhood Development Guideline, released by the World Health Organisation (2020, 5 March). The WHO Guideline states that:

Enabling young children to achieve their full developmental potential is a human right and an essential requisite for sustainable development. Given the critical importance of enabling children to make the best start in life, the health sector, among other sectors, has an important role and responsibility to support nurturing care for early childhood development.

The population characteristics of children and families in the Ipswich region and the areas of socio-economic disadvantage, are factors that impact on early childhood development.  Spending on health has increased according to OECD, 2018 data. This can be understood in relation to the 2019 third quarter employment situation (OECD, 2019).

The April 2020 employment situation in Ipswich, revealed job losses resulting from the COVID-19 pandemic that are reported in daily news broadcasts. The Job Seeker allowance from the Australian Government was due to be released for eligible employers/employees in May 2020. The unemployment allowance and the Job Seeker benefits are likely to see a reduction in finances available to many families. The education situation was volatile during the 2020 Easter School Holiday break with the uncertainty of school returning on 20 April for children of essential workers, and online education for children remaining at home. The Australian Government announced that free Childcare would be provided for essential workers in April, 2020, to allow them to continue employment and services. The fear was that further services may close if they cannot sustain business and pay overheads in this economic climate.  

The long-term consequences of the dramatic downturn in the economy was not yet known for children’s allied health and music services. Many adults were working from home and caring for children who are no longer attending school campuses. This changed the equilibrium of social relations and the demographic characteristics of communities. Non-essential travel was restricted and state borders were closed by the government. It was not clear how long the restrictions would be in place, but the economic consequences on society were thought to have long term consequences.

The Ipswich region has unique characteristics that require different strategic responses to other areas of Queensland due to the West Moreton Hospital and Health Service being separate from the Child Health Queensland services. The February, 2020 newsletter of the Darling Downs and Ipswich Primary Healthcare Network stated:

West Moreton is experiencing unprecedented growth in our paediatric population, many of whom have co-morbidities and developmental delays. West Moreton Health is currently working to implement sustainable, evidence-based models to improve outcomes for children and families. This redesign recognises the pivotal role of GPs in the early recognition of problems and identification of at-risk children and young people.

From January 2020, West Moreton Health is creating an integrated service between Paediatrics and Child Development Service (CDS). West Moreton Health will no longer be able to accept GP referrals directly to Allied Health Professionals in the CDS. From April 2020 the “drop-in” Child Development Service will cease. Additionally, in 2020 Health Pathways and Clinical Prioritisation Criteria (CPC) will be available on the West Moreton Health website [which] will assist GP’s to refer into the Health Service.

The changes to CDS aim to improve equity of access, patient safety and service delivery optimisation. The building of shared care partnerships and having GPs as the first point of contact will support this continuum of care.

The new criteria for the children (between the ages of 0 to 18) are eligible to access services is:

·       if they require diagnostic assessment for moderate developmental delay in two or more of the following domains:

·       posture and large movements

·       fine motor/visual motor

·       communication (receptive and expressive)

·       cognition and learning

·       social behaviour/play

·       adaptive (feeding, sleeping, regulation & sensory organisation)

(see DDWMPHN newsletter on “Paediatrics & Child Development,” Feb 2020).

The Population Experts interactive ID website allows particular locations with higher population of children and disadvantage within Ipswich City to be analysed with diagrams, statistics and maps of localities (see https://profile.id.com.au/s_ipswich/demographics). The data from the 2016 census does not show the latest trends in population boom in new suburban developments.

Child vulnerabilities data is available through the Ipswich Community Profile on the Australian Early Development Census website (AECD) (see https://www.aedc.gov.au/). Mapping of percentages of children who were developmentally vulnerable in 2018 is shown in Table 1.

Geography	Physical	Social	Emotional	Language	Communication	Vuln 1	Vuln 2
Australia	9.6	9.8	8.4	6.6	8.2	21.7	11.0
QLD	12.3	11.9	10.5	8.0	10.1	25.9	13.9
Ipswich	15.2	15.1	12.6	9.7	12.8	30.7	17.8

Table 1: Australian Early Development Census (AECD)—Ipswich Community Profile

The data reveals that Ipswich shows greater percentage of developmentally vulnerable children, than the state average, for all areas of child development (birth to 5 years of age). The Queensland percentages of developmentally vulnerable children are higher in all areas of development than the national percentages. According to AEDC, 2018 Ipswich Community Profile, the localities that have the greatest percentage of developmentally vulnerable children from birth to 5 years of age are: Leichhardt (22.7%), North Booval, (21.3%), North Ipswich (24.6%), Redbank (26.7%), Rosewood (25%), and Thagoona (21.9%). Since this time, the population has expanded greatly in the Ripley corridor and Plainlands locality (pers. corresp. Nichola Godfrey, Team Leader, Child Development, West Moreton Health, 9 March, 2020).

“It is primarily the family who provides the nurturing care that children need to develop in the earliest years.  Many parents and other caregivers need support to put this into practice” (WHO, 2020, p. 1).

The WHO guideline contains four recommendations aimed at caregivers, health professionals and other workers who can assist them, as well as policy-makers and other stakeholders. The recommendations relate to:

i)               providing responsive care and activities for early learning during the first 3 years of life;

ii)             including responsive care and early learning as part of interventions for optimal nutrition of infants and young children; and

iii)           integrating psychosocial interventions to support maternal mental health into early childhood health and development services.

According to the Nurturing Care for Early Childhood Framework (WHO, 2019): “investing in early childhood development is one of the best investments a country can make to boost economic growth, promote peaceful and sustainable societies, and eliminate extreme poverty and inequality.” Investing in early childhood development is necessary to uphold the right of every child to survive and thrive. Allied health services are necessary to support the WHO Early Childhood Development Guidelines (2020), and WHO Early Childhood Development Framework (WHO, 2019).

Strategic Perspectives Analysis

Unstructured interviews were held with leaders and representatives of allied health children’s services delivery and networks. These stakeholders were identified through the Darling Downs and Ipswich Primary Healthcare Network and author’s knowledge of services in the local area.

1.0       Meeting with Leaders of Children’s Services

Nicola Godfrey, Team Leader, Child Development, Ipswich (9 March, 2020 Meeting)

(prior to the Covid-19 outbreak in Australia)
Drop-in clinics ceased on 6 April. The new model for the team is assessment and diagnostic service. No further single discipline referrals will be accepted, or intervention other than target to specific goals. NDIS do not accept: “substantial reduction in one functional capacity unless the child requires a sequence of special interdisciplinary or generic care.”

Nicole explained that one of the greatest concerns was the high incidence of children with social-emotional issues from abuse and neglect, domestic violence, and disadvantage. This is evident in all cultural groups. Many of the children with psycho-social needs do not qualify for State Government services (NDIS or Child Development Team, West Moreton Hospital and Health Services). Families with low socio-economic disadvantage are unable to meet co-payments for Medicare-funded services and are unlikely to have private health insurance. Nichole also provided references for research on children’s allied health services in Ipswich, and contacts of the Nursing Team Leader for information on children’s developmental screening clinics. Further information on the West Moreton Child Development Service is available on the website (see) https://www.westmoreton.health.qld.gov.au/services-and-care/women-children-and-family/child-development-service

A meeting with EACH, the service provider for the Early Childhood Intervention program, was planned. However, email advice from EACH (pers. correspondence, date) advised that they would not meet with service providers due to not wanting to give any service preferential treatment over another. EACH agreed for publicity information on services to be emailed to info@EACH. The same message was received from Carer’s Queensland, the Local Area Coordinator for the National Disability Services Insurance Scheme (NDIS) who advised that details of services can be posted by the NDIS on their website. Meetings with these Australian Government service providers were not possible face-to-face or through telecommunications. The potential for strategic planning was reduced to following the provisions already in place. There was no avenue for negotiation, or creative collaboration in the new socio-economic context of the COVID-19 pandemic. The NDIS announced some changes to services on their website which were aimed at facilitating better support for service providers and people with a disability. The regulations changed on a day-to-day basis during April, 2020.

 

2.0       Mapping Existing Service Networks

As a result of the current COVID-19 pandemic, many front-line children’s services resorted to remote or online communication with parents / guardians and children. Therefore, mapping needs to be undertaken in March, 2020 at the start of the COVID-19 pandemic, and then at intervals afterwards, to reveal the change in the socio-economic and political landscape. Entitlements to services were in flux in April, 2020. A list of children’s allied health and music services that were available in Ipswich when COVID-19 was declared a pandemic in March 2020 was gathered. The information was collated from websites and brochures on display at community centres and at Ipswich Community and Health services.  The major ‘Flag Ship’ children’s services are outlined below.

West Moreton Health provides nursing staff that conduct developmental screening and provide advice through drop-in clinics. [Schedule of clinics to be provided—Ripley is 1pm on Tuesdays.]
The nursing staff formerly referred to the Child Development Team, Allied Health staff. There was a 12-month waiting list for therapy. The Child Development Team now provides very limited and target services for assessment and diagnosis only if children meet the criteria of having developmental delays in multiple areas, requiring multiple disciplines involved.

Ipswich General Hospital provides acute hospital services to children, but the sickest and most serious cases are transferred to Queensland Children’s Hospital [further details needed here].

EACH provides the Early Childhood Intervention Services in the Ipswich region through the NDIS to children from birth to 6 years of age. This Federal Government program replaced the earlier FACSIA program (Department of Families, Community Services, and Indigenous Affairs).

Medicare Benefits Scheme (MBS) Federal Government subsidises the cost of allied health services to children referred by local medical officers, paediatricians, psychiatrists and other medical specialists. 85 per cent of the recommended MBS fee is reimbursed through HICAP billing or parents/guardians submitting claims. Providers may opt to bulk-bill allied health services, or charge the scheduled or additional fees which cannot be reimbursed by private health insurance. There may be possibility for the NDIS to subsidise the gap for MBS services, but this would have to be negotiated for NDIS-eligible recipients.

The key MBS allied health initiatives are: (a handout on these services and schedule of fees and benefits is available on request from the author)

·       Chronic Disease Management

·       Focussed Psychological Strategies, Mental Health Care Plans with oversight by GP

·       Helping Children with Autism, Pervasive Development Disorder, or approved Disability

·       Indigenous Health follow-up after health check

·       Diabetes

·       Eating Disorders

The changes in the uptake of Telehealth technologies were restricted by geographical boundaries which targeted ‘rural and remote’ above metropolitan areas. The Monash regions 4-7 were eligibility criteria for rural and remote patients to access Telehealth consultations prior to the COVID-19 pandemic. In mid-March, 2020, MBS announced that Focussed Psychological Strategies can now be delivered by eligible Allied Health practitioners through Telehealth). The telehealth was only available to consumers that live more than 15 minutes away from the health service provider.

However, on 23 March, 2020, further changes resulted in vulnerable health practitioners receiving permission to conduct telehealth for all MBS item numbers that they are eligible to provide. ‘Vulnerable’ applies to health practitioners over 70 years of age; or 60 years with chronic disease; or Indigenous Australians over 50 years of age. The geographical boundary requirement relaxed as a consequence of the COVID19 pandemic. This reduced inequities and opened access to telehealth for more patients over a broader geographical area.

Australian Government expanded Medicare to Telehealth announcement from OT Australia 29/3/2020:

 The Hon Greg Hunt has announced that Australian Government is expanding Medicare-subsidised telehealth services for all Australians. This means that those MBS items currently delivered face to face by Occupational Therapists can be delivered by telehealth, including chronic disease management, autism and eating disorders. While this is a positive outcome from the considerable advocacy work in recent weeks, AHPA and OTA will continue to advocate for more funding support for occupational therapists and allied health services. The full media statement is available at  https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/covid-19-whole-of-population-telehealth-for-patients-general-practice-primary-care-and-other-medical-services

The media release and new regulations on the MBS website actually omitted occupational therapist item number 10958 for Chronic Disease Management from the new telehealth provisions, except for Aboriginal and Torres Strait Islander people. When I phoned and inquired with MBS, I was advised that at this time, occupational therapists cannot proceed with billing MBS for Telehealth for Chronic Disease Management referrals from GPS—only direct face-to-face consultations are approved. The loss of this detail translated to a loss of occupational therapy services and loss of income for occupational therapists in Australia. The MBS phone line was running hot with this question which we hope will be clarified in the very near future.

The number of visits per year for MBS Better Access to Mental Health program was increased during the pandemic period from 10 per calendar year, to 20 per calendar year. This greatly improved access for  children and young people who benefited from Psychology, Occupational Therapy, and Social Work services delivered face-to-face or through Telehealth. Unfortunately, the supplementary sessions are only available until 31 December, 2022, and will revert to 10 per calendar year in 2023. The Better Access to Mental Health program did not cover assessments, or report writing and was limited to Focussed Psychological Strategies that were thought to be beneficial (not really pertaining to children's needs). The supplementary sessions that were offered did not have the travel allowance included that the regular 10 sessions have; therefore, home visiting not feasible. Allied health professional and music organisations needed to lobby for more comprehensive service coverage, since music was not a service supported by MBS.

Private Health Insurance is variable, depending on the consumer’s financial means to afford cover, and the extent of their coverage for allied health services. Each fund has different regulations and codes for telehealth or direct face-to-face service. The information is currently in flux during the early stages of the COVID-19 pandemic, with announcements conveyed through professional associations on a day-to-day basis. For example, OT Australia provided bulletins to Occupational Therapists concerning Bupa new COVID-19 telehealth arrangements for service provision and benefits payable to their members. Information on telehealth coaching is available on the BUPA website (see https://www.bupa.com.au/health-programs/about-bupa-telehealth ).

National Disability Insurance Scheme

The National Disability Insurance Scheme (NDIS) provides a complex range of services to people under 65 years of age with an eligible disability in Australia. The National Disability Insurance Scheme Act 2013 (NDIS Act) is the legislation which establishes: The National Disability Insurance Scheme, and The National Disability Insurance Scheme Launch Transition Agency (known as the National Disability Insurance Agency or NDIA). Through the NDIS, children’s needs are assessed on an individual basis and referrals made to allied health professionals if the child or young adult is eligible for assessment, assistive equipment, home modifications, and / or therapy consultations for a time-limited period. The programs are based on personal goals that are set in consultation with service planners. Disability equipment is termed ‘assistive technology,’ in accordance with the World Health Organisation terminology. Carers Queensland is the Local Area Coordination for the NDIS in Ipswich. Further information and NDIS rules are available at https://www.ndis.gov.au/about-us/governance/legislation .

Through the NDIS, telehealth is permissible as an equivalent method of face-to-face contact, if it is clinically justified. In late March, 2020, the NDIS announced a 10 per cent increase in the hourly rate paid to NDIS service providers in late March, 2020, but there was no corresponding increase in the funds made available to consumers in their NDIS package. This resulted in a 10 per cent reduction in tangible services to people with a disability that had NDIS plans in place. Due to the COVID-19 pandemic, NDIS announced in mid-March, 2020, that NDIS plans would be extended for another 12 months to avoid consumers having to go through annual reviews. Concessions are being made and announced on a weekly basis at present.

3.0       Personal Reflection from Practice

As an allied health professional who worked in the Ipswich region from 1981 in various hospital and health organisations, education, private practice, and community services, it is apparent that services to children were declining in April, 2020. With the increase in population, children’s allied health and music services were not able to keep up with the demand. The demographic trends of population growth attest to growing numbers of children with unmet needs and greater frequency of trauma experiences from abuse and neglect. Personal accounts are likely to describe the pressure on families. Such accounts were collected through research undertaken by Early Childhood Early Intervention services (ECEI). The findings were not available to the public. The information on identification of causes are important for making informed decisions on resolves that are required. Further information on feedback from stakeholders, and consumers is important for developing a descriptive portrait of the experiences of caregiver and service providers experiences before, during, and after the pandemic period. Qualitative research is recommended with people who are interested to participate from children’s support services and networks. I informed ECEI services of my interest in local research findings. On the basis of information gleaned in April 2020, I made sketches of possible trends, implications, resolves.

Trends

The landscape of services to children and parents/guardians is complex and information is restricted due to the uncertainties of the Covid19 pandemic. The context of service delivery is changing on a daily basis with government health decisions impacting on employment. The mechanics of providing services moved toward virtual, online, and telehealth participation. This resulted in less hands-on provision of allied health and music services, hence there was a greater tendency to work from home, with coaching parents / guardians through telephone and video-conferencing. Telehealth met with limited success, with therapists and educators working directly with infants, children and students.

The withdrawal of the West Moreton Child Development service from drop-in clinics and comprehensive therapy resulted in loss of services to children with a dysfunction in only one area of development. Many children did not meet the eligibility criteria of complexity required for the NDIS. The Ipswich (West Moreton) region was unique in not being a part of the statewide Queensland Children’s Health service. This brought the issues of the pandemic into local crises and new ways of meeting needs of children and families were required.

The high rate of socio-economic disadvantage, combined with domestic violence and child abuse resulting in unmet needs for families that could not afford the MBS co-payments, and private health insurance. High rates of referral to Child Safety and Suspected Child Neglect and Abuse were likely to result from the gap in services—with children at risk of removal from families and placement in care and/or youth detention centres. Early intervention is and was a priority for effective response to children at risk of abuse and neglect. The pressure on the NDIS, ECEI, and Child Development government services could not cater for all the needs of the children and young adults. A gap in services resulted, which could be partially met through Medicare Benefits Scheme, private health insurance, and NDIS services. The children with lesser acuity disability were less likely to receive government-funded consultations with allied health professionals. Consultations were less direct, being offered through telehealth and telephone services. The burden of care fell to parents/guardians, welfare carers, educators, and early childhood intervention to close this gap. There were complications and impact on children's mental health from home schooling regimes that were instituted in the pandemic.

Implications

As a result of the pressure on healthcare services to respond to the Covid-19 pandemic, and the recent economic down-turn and job loss, many families experienced greater disadvantage. It was not possible to provide the same or better level of children’s services in this climate. A further loss of attention to the child development issues occurred when resources were diverted away from children’s services which exacerbated the gap and risk of  child neglect, abuse, injuries and reduced attainment of children's developmental milestones. Instead of critical hands-on therapy to children in need, support to families was increasingly delivered through telecommunications—if at all. It was more difficult to diagnose the root cause of child developmental issues through remote ICT applications. Families seemed to be less inclined to report serious concerns and incidences of injuries which may be hidden from view. In some cases, the home environment was less stimulating than the early childhood centres and schools with professional educators. Developmental enrichment and stimulation were deemed important for nurturing children’s functional abilities in all areas, which attracted some goverment subsidisation in the pandemic period. This situation occurred in the context of children staying at home with parents / guardians/carers, as directed by Australian Government and the Health Minister. Grandparents were less able to assist due to travel restrictions in lockdown, and the greater vulnerability of aged persons to the virus.

 

Resolves

There is likely to be a crisis result in children’s development and access to allied health and music services.  Government and non-government services need to work together to bridge the gap between children’s services, allied health programs and community-led development initiatives. If there are fewer services available then the risks may escalate, resulting in sickness, injuries, hospitalisation and greater removal of children from families. This raises the pressure on children’s health and hospital services in the climate of reduced community-based child development services.

The priority is to have quick response which supports and enables families to meet the needs of children in their care. General practitioners, early childhood educators and teachers are primary sources of referral to children’s services. With schools and non-essential services closing, there may be less direct oversight of children’s needs.

Therefore, networking and strategic planning with all children’s services is vital. Strategic planning needs to be based on current evidence that is emerging from first-hand accounts, consumer/health professional perspectives expressed on social media, news reports, and the statistics available from organisational databases. The usual sources of demographic information are now out-of-date in relation to the current social context of the Covid-19 pandemic. The most current data is needed to formulate scenarios for the future—if action is taken, or not taken. We need to listen to parents / guardians, and children themselves and have qualitative research findings publicly available to all service providers.

Working Toward Recommendations for the Future

Recommendations, based on this information are tentative and must stay in line with the Health Minister, Australian and Queensland Government leads. Announcements about the pandemic were made on a daily basis which changed the landscape, implications, and resolves for service development from 2020-2021.

1.     Every service has an important role to play in the current Covid-19 pandemic crisis. Music services are just as relevant to children's development as allied health services. Both can be considered for planning.

2.     Strategic perspectives analysis is vital to build a  demographic profile and evidence-base for decision making—in relation to allied health and music services for children.

3.     Service provision should be based on the current and projected scenarios, not continuation of past programs.

4.     All stakeholders, including parents/guardians, children, young adults, and service providers need to collaborate and plan resolves creatively.

5.     Place-based planning in local neighbourhoods may hold the key to building bridges with communities.

6.     Support for networking and sharing resources is important at this stage within the COVID-19 pandemic. Databases of demographic information and community responses are needed to inform strategic planning.

7.     Flexibility to change service provision in response to the socio-economic environment is essential as government announcements affect daily lives, education, work, social relationships and family life.

8.     Telecommunications may assist but are not the only answer to closing the gap in services and maintaining communication through regional networks.

9.     In the event that community volunteers can assist, they would need to be screened, trained, supported and assigned to projects with local community leadership in collaboration with health, education and early childhood, school and youth programs.

10Provision of Child Safety ad mental health services are essential for a timely response for children that experience trauma from  abuse and neglect. This needs to be augmented by community services and parent/guardian partnerships.

11We do not know, what we do not know, so there will be an ongoing need for data collection and strategic perspectives analysis over time—for several years to provide evidence-based rationale for strategic plans. Placed-based action plans are needed at regional and local levels.

1FFurther interviews are needed to provide a rich descriptive ethnography of the current socio-ecological context in the Ipswich region, and access to case studies and personal accounts from reliable sources. Further research has been carried out by: EACH Early Childhood Early Intervention in Ipswich, 2021 (not yet available to the public); and the recent Queensland Family and Child Commission is currently conducting research during October, 2021, to hear views of children aged 13 to 18 years about growing up in Queensland during the COVID-19 pandemic period.

References

Australian Early Development Census (AEDC) Ipswich Community Profile, retrieved from https://www.aedc.gov.au/.

Federal Register of Legislation. National Disability Insurance Scheme Act 2013. NDIS Children Rules (2013) Retrieved from https://www.legislation.gov.au/Details/F2013L01070

Australian Government. (2013). National Disability Insurance Scheme Legislation Amendment Act no. 44.  Retrieved from https://www.legislation.gov.au/Details/C2013A00044.

BUPA. (2020). About BUPA telehealth health coaching.   Retrieved from https://www.bupa.com.au/health-programs/about-bupa-telehealth

Dale, A., & Lane, M. (1994). Strategic perspectives analysis: A procedure for participatory and political social impact assessment. Society and Natural Resources, 7(3), 253-267.

Interactive Demographics of Ipswich Website. Retrieved from https://profile.id.com.au/s_ipswich/demographics

Kirkwood, S. (2021) Sandra Kirkwood Research Portfolio. Last updated 2021. Retrieved from https://orcid.org/0000-0003-1770-4656

Kirkwood, S. (2009) Frameworks of culturally engaged community music in rural Ipswich, Australia. Master of Philosophy research thesis. Griffith University. Retrieved from
https://research-repository.griffith.edu.au/handle/10072/3678

OECD. (2018). Data on health spending. Retrieved from https://data.oecd.org/healthres/health-spending.htm

OECD. (2019). Employment situation - OECD third quarter 2019. Retrieved from OECD website: http://www.oecd.org/sdd/labour-stats/employment-situation-oecd-third-quarter-2019.htm

Darling Downs West Moreton Primary Healthcare Network news on Paediatrics and Child Development, retrieved from https://www.ddwmphn.com.au/news/west-moreton-helath-update-paediatrics-and-child-development-referrals

West Moreton Child Development Service Website retrieved from https://www.westmoreton.health.qld.gov.au/services-and-care/women-children-and-family/child-development-service

World Health Organization. (2020). Early childhood development guideline. Retrieved from https://www.who.int/publications-detail/improving-early-childhood-development-who-guideline

World Health Organisation. (2019). Nurturing care for early childhood framework Retrieved from https://www.who.int/maternal_child_adolescent/child/nurturing-care-framework/en/ 

 

Biography

Sandra Kirkwood is a Consultant Occupational Therapist currently employed in primary healthcare and child health, in Ipswich, Queensland. Sandra founded Music Health Australia, and continues to support the growth and development of community music in South-East Queensland. She is a published author and provides consultancy and professional development. Sandra is experienced in project management with a focus on equity and cultural diversity. Qualifications include: Bachelor of Occupational Therapy; Bachelor of Music; Master of Philosophy; and Graduate Certificate Education (Digital Learning and Leadership). My research portfolio is available online at https://orcid.org/0000-0003-1770-4656