JCPSLP Vol 17 No 1 2015_lores

Diversity in practice

Managing aphasia in bilingual and culturally and linguistically diverse individuals in an

In Australia, cultural and linguistic diversity is a crucial factor to be addressed in planning and delivering rehabilitation services for individuals with aphasia and their families. Challenges include the extensive number of languages spoken by Indigenous and migrant Australians, as well as limited research evidence pertaining to assessment and intervention for people with bilingual aphasia. In addition, clinical challenges include lack of consistent terminology used to refer to people with aphasia who are bilingual or from culturally and linguistically diverse (CALD) backgrounds and limited existing resources for speech pathology management of this population. This paper outlines key issues relevant to speech pathology management of people with aphasia who are bilingual or from CALD backgrounds and identifies gaps in the existing research literature. Recommendations for clinical management are discussed and the imperative for further research is illustrated. A ustralia is a culturally and linguistically diverse society. Aboriginal and Torres Strait Islander people, the original inhabitants of the Australian continent (Department of Foreign Affairs and Trade, n.d.), have a rich and diverse cultural and linguistic heritage. In contemporary Australian society, more than a quarter of the population were born overseas and around one-fifth speak a language other than English at home (Australian Bureau of Statistics [ABS], 2011a). The cultural and linguistic diversity found among the Australian populace can create challenges for speech-language pathologists (SLPs) working with individuals with communication disability. A recent survey investigating the aphasia rehabilitation practices of Australian SLPs found that around 50% of respondents rated their knowledge of, and confidence in, working with culturally and linguistically diverse (CALD) clients as less than adequate (Rose, Ferguson, Power, Togher, & Worrall, 2014). Similarly, a national survey exploring SLP practices with Indigenous Australians with acquired communication disorders identified that 67% of respondents who were currently seeing Indigenous clients Australian context Challenges and future directions Samantha Siyambalapitiya and Bronwyn Davidson

felt less confident working with Indigenous than non- Indigenous clients (Hersh, Armstrong, Panak, & Coombes, 2014). This article provides an overview of key contextual issues and challenges in managing aphasia in bilingual and CALD individuals in Australia, as well as providing practical recommendations SLPs can implement within their clinical practice. Linguistic environment in Australia According to data from the 2011 Australian census, nearly one in five people (around 4 million in total) speak a language other than English (LOTE) at home (ABS, 2013c). This figure does not indicate whether these individuals also speak English or other additional languages. Those who do speak English or other languages, in addition to the language spoken at home, may be considered to be bilingual or multilingual while others may simply be non-English speakers or have limited proficiency in English. One of the unique characteristics of the Australian linguistic environment is the wide diversity of languages spoken: over 260 languages from diverse areas of the globe (Department of Social Services, 2013). The specific proportion and pattern of language diversity can vary between different regions of Australia and may also change over time. For example, in Brisbane, two or more languages are reportedly spoken in 15.5% of households, with the top five LOTEs being Mandarin, Vietnamese, Cantonese, Samoan, and Spanish (ABS, 2013a). In contrast, 32.4% of households in Melbourne report two or more languages being spoken, with the top five LOTEs being Greek, Italian, Mandarin, Vietnamese and Cantonese (ABS, 2013b). In recent years, Chinese languages have become the most widely spoken LOTEs in Australia, overtaking Italian and Greek, and this may reflect changes in immigration patterns. Regional differences, as well as changes in language use over time, also exist for speakers of Indigenous languages. In 2008, 73% of Indigenous people aged 15 years or over living in a remote area spoke, or spoke some words of, an Aboriginal or Torres Strait Islander language, in comparison to 32% of people living in metropolitan areas and 28% in regional areas (ABS, 2010). A crucial issue in relation to Australian Indigenous languages is the loss of languages over time. The most recent National Indigenous Languages Survey indicated that only 120 out of 250 Australian Indigenous languages were still spoken, with around 110 described as severely or critically endangered (Marmion, Obata, & Troy, 2014).

KEYWORDS APHASIA MANAGEMENT BILINGUAL APHASIA CROSS- CULTURAL CULTURAL AND

LINGUISTIC DIVERSITY

THIS ARTICLE HAS BEEN PEER- REVIEWED

Samantha Siyambalapitiya

(top) and Bronwyn Davidson

13

JCPSLP Volume 17, Number 1 2015

www.speechpathologyaustralia.org.au