Decolonizing Speech-Language Pathology Practice in Acquired Neurogenic Disorders

Abstract

Indigenous peoples throughout the world, despite being known to suffer from increased risk of stroke and traumatic brain injury (TBI), are marginalised in terms of access to rehabilitation services and have poorer health outcomes than non-indigenous peoples. Speech-language pathology services for indigenous people with aphasia have rarely been discussed in either clinical or research fora in this field, with few guidelines available for clinicians when working with indigenous clients, families, and communities. Exploiting the broad input gathered through the collective problem-solving of a focus group, the paper integrates the input of a group of practitioners and researchers at an international roundtable held in 2016 to generate a “declaration” of issues that need to be addressed regarding aphasia services for indigenous clients with aphasia. The paper aims to promote a transformative approach to service delivery that is driven by decolonizing attitudes and practices, and acknowledges historical, sociopolitical, linguistic, and family contexts as a framework for understanding indigenous clients with aphasia.

Intersectionality and Its Relevance in the Context of Aboriginal People with Brain Injury in Australia

“…For example, considerations of how the outcomes of an individual with aphasia may be influenced by experiences of racism in interactions with the health system, with the associated risks to health (Markwick Ansari Clinch & McNeil 2019), are not addressed. Penn Armstrong Brewer et al (2017), , Watermeyer and Neille (2022) have each highlighted the need for aphasiologists to examine ways of transforming both clinical and research practice in post-colonial contexts by increasingly acknowledging their clients' diverse linguistic and cultural backgrounds as well as acknowledging the social and clinical contexts they must constantly navigate. These include issues related to gender, socioeconomic status, family and community roles, general health, location, and the cultural security of services currently offered.…”

Aphasia management in growing multiethnic populations

“…monolingual speakers of minority languages, bi-/multilingual speakers and users of dialectal varieties of local languages) and life realities (i.e. socioeconomic circumstances, educational experiences, sociocultural histories, and worldviews) (Armstrong et al, 2015;Centeno & Harris, in press;Penn et al, 2017). Yet, despite the high aphasia prevalence in the growing multilingual-multiethnic neurorehabilitation programs worldwide, there are critical evidential and clinical limitations in aphasia management.…”

“…Articles in this issue offer a promising illustrative sample of the broad empirical and clinical enterprise required to enhance efficiency and sensitivity in aphasia service provision in ethno-racially diverse contexts. As aphasia neuroscientific advances expand (Kiran & Thompson, 2019), the systematic integration of these findings with client-unique factors and group-specific social, cultural, and linguistic understandings (Armstrong et al, 2015;Penn et al, 2017) will propel the evolution of aphasia management in the rapidly growing ethno-geriatric stroke caseloads across the world (Centeno & Harris, in press).…”

The experiences of whānau and kaiako with Speech-Language Therapy in Kaupapa Māori education

“…Speech-language therapy is a service intended to support children and adults with communication difficulties. Internationally there has been growing awareness that such services derive predominantly from dominant Western cultures and that non-dominant cultures tend not to be well served within this framework (Penn et al, 2017). Services that are striving to improve their effectiveness are often aware of their inadequacies but not well-equipped to overcome them.…”