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Imagine being a parent of a child who you know has difficulty communicating and you are worried they are not ready for the classroom, or perhaps you worry they won’t make friends at recess or might be bullied. Now, imagine being a child growing up in a rural or remote area, struggling with speech difficulties, not even being understood by your own parents or teachers, and unable to make friends because you can’t communicate, tell jokes, or share stories.

To compound an already difficult situation, these country children live in areas with an acute shortage of Paediatricians and allied health clinicians, exacerbating the limited or non-existent support available. Intensified by the cumulative impacts of natural disasters our regional towns have faced and will continue to face, this is undeniably concerning…

Access to the right support, as early as possible, can positively reset a child’s life. We know that children who fall behind developmentally, face an uphill battle to catch up again. We need to be reaching and support country kids health before they start school. The earlier we are able to intervene with the right support, the greater the chance we have of shifting a country child’s trajectory so they can reach their full potential.

Sadly, the necessary services for ongoing care simply don’t exist in many country regions. But here at Royal Far West, we aim to support country kids health and wrap around rural and remote children, parents, and school communities to ensure families can access essential developmental and mental health services.

Olivia is an eight-year-old girl living in a rural NSW town with her mum and big sister.

From an early age, Olivia really struggled when separating from her mother. She found it easy to form connections with adults, but she had difficulty bonding with children her own age.

Even as a young child, Olivia was very aware of what was right or wrong and had no qualms about pointing this out or questioning why others were not following certain rules. She became anxious when her routine was changed, in addition to engaging in rituals, as she was worried something bad might happen if she didn’t.

Everyday tasks like going to the supermarket or to a restaurant were hard on Anne, as Olivia struggled with significant sensory aversions around food as well as a sensitivity to noises. It was hard for Olivia too, constantly feeling anxious and overwhelmed, as well as worrying she was disappointing her mum.

As she grew older and started school, these challenges became even more evident. While her classmates seemed to form friendships effortlessly, Olivia struggled to connect with her peers. Olivia’s closest bond was with her teacher. Luckily, this close connection fostered a safe and trusting school space despite her lack of interaction with her peers. Since Olivia tried so hard to focus on not standing out and trying to fit in with her classmates, she often came home drained and exhausted.

Around this time, Olivia’s symptoms, such as feeling overwhelmed and inability to control her emotions and reactions, were also increasingly noticeable in her behaviour at home. She took great joy in welcoming visitors, proudly giving them tours of their house, and eagerly sharing her latest interests and hobbies. Olivia delighted in providing extensive information, down to the smallest detail. But her overwhelming need for control was becoming increasingly apparent.

Anne explains, “Whether it was control over a situation, a game, or the attention given to herself or others, Olivia had to determine it. It was such a delicate balance, trying to accept her behaviour, show her the right level of love without overwhelming her, or making her feel guilty. I constantly had to push my needs aside.”

It wasn’t just Anne who noticed something may be different about Olivia’s behaviour. A teacher at school made an interesting observation that during recess and lunch, Olivia would spend her time alone on the monkey bars, to the point of developing painful blisters on her hands.

The teacher suggested that this might be Olivia’s way of self-regulating, much like jumping on a trampoline, swinging on the monkey bars provided deep muscle stimulation.

It was at this point Anne realized that her instincts about her daughter’s behaviour indicated that she was struggling; she needed help.

Luckily, one of the teachers at school knew of Royal Far West and how they support country kids health through appointments accessed by other school children and she was able to guide Anne to finding help for Olivia.

Comprehensive, multi-disciplinary assessments with the team at RFW including a Psychologist, Speech Pathologist, Developmental Paediatrician, Social Worker, and Occupational Therapist revealed Olivia has the following diagnoses: Autism and anxiety.

Our clinical team worked with Anne to help her understand what Olivia’s diagnosis meant, what therapy and services she needed, and how, as a parent, she could best support her. The team also put together a comprehensive plan to help manage Olivia’s Autism and anxiety, which included therapy sessions, plus strategies that Olivia, her family, and her teachers could implement at home and school.

Following their initial diagnosis, Olivia would continue to meet with her Royal Far West team including a Psychologist, Speech Pathologist and Occupational Therapist, and together, they would work on building life skills to help Olivia manage her emotions and her social skills as well as her ability to learn.

Olivia is just one of thousands of Australian country children who have complex, undiagnosed developmental, behavioural or mental health concerns, and have limited or no access to the vital services they need to change their life trajectory. The families of these children often come to us with no clear path forward, and for some, it is a lifeline when they have nowhere else to turn.

Without the appropriate care, their challenges can impact their growth, development, and ability to learn and thrive across their lifetime. In fact, country children are TWICE as likely to experience challenges with mental and developmental issues because of this very problem.

The ability to access the right support at the right time really does make the difference between a child flying or falling behind. Without access to vital developmental assessments and healthcare services, a child like Olivia faces a lifetime of additional challenges like poorer educational outcomes, reduced employment opportunities and relationship challenges.


* To ensure privacy and confidentiality for our client families, our stories are representative in nature and real names or images are not used.

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