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increasing education and continuing PD about appropriate aphasia assessment and intervention practices with CALD populations. Increased research needs to also be considered, alongside mechanisms to support the development of suitable assessment and treatment materials for Australian wide distribution. It will not be sufficient to educate SLPs without equipping them with the right materials. References Al-amawi, S. (2012). The assessment of aphasia in the context of cultural and linguistic diversity . (Unpublished doctoral dissertation). The University of Newcastle, NSW. Retrieved from http://www.newcastle.edu.au/school/hss/ rhd-site/rhd-graduates/samar-alamawi.html Australian Bureau of Statistics. (2012). 2011 Census quick stats: All people – usual residents . Retrieved from http://www.censusdata.abs.gov.au/census_services/ getproduct/census/2011/quickstat/0 Berg, B. L. (1998). Qualitative research methods for the social sciences (3rd ed.) Needham Heights, MA: Allyn and Bacon. Centeno, J. G. (2009). Issues and principles in service delivery to communicatively impaired minority bilingual adults in neurorehabilitation. Seminars in Speech & Language , 30 , 139–152. doi: 10.1055/s-0029-122951 Deloitte Access Economics. (2012). The economic impact of stroke in Australia. Retrieved from http:// strokefoundation.com.au/site/media/Final-Deloitte-Stroke- Report-14-Mar-13.pdf Engelter, S. T., Gostynski, M., Papa, S., Frei, M., Born, C., Ajdacic-Gross, V., . . . Lyrer, P. A. (2006). Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis. Stroke , 37 , 1379–1384. doi: 10.1161/01.STR.0000221815.64093.8 Kiran, S., & Goral, M. (2012, June). One disorder, multiple languages. ASHA Leader , 17 (7). Retrieved from http:// www.asha.org/Publications/leader/2012/120605/One- Disorder-Multiple-Languages.htm Lorenzen, B., & Murray, L. L. (2008). Bilingual aphasia: A theoretical and clinical review. American Journal of Speech- Language Pathology , 17 , 299–317. doi: 10.1044/1058- 0360(2008/026) McGill. (2014). Bilingual Aphasia Test. Retrieved from http://www.mcgill.ca/linguistics/research/bat/ Mok, Z., Rose, M., & S., Pang (2013, June). Post- stroke SLP services in a culturally and linguistically diverse society . Paper presented at Speech Pathology Australia Conference, Broadbeach, Qld. Portney, L., & Watkins, M. (2009). Foundations of clinical research: Applications to practice (3rd ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Roberts, P., M. (1998). Clinical research needs and issues in bilingual aphasia. Aphasiology , 12 , 119–130. doi: 10.1080/02687039808250467 Roger, P., Code, C., & Sheard, C. (2000). Assessment and management of aphasia in a linguistically diverse society. Asia-Pacific Journal of Speech, Language and Swallowing , 5 , 21–34. Rose, M., Ferguson, A., Power, E., Togher, L., & Worrall, L. (2013). Aphasia rehabilitation in Australia: Current practices, challenges and future directions. International Journal of Speech-Language Pathology , 16 , 169–180. doi: 10.3109/17549507.2013.794474

and intervention strategies, a smaller but still sizeable proportion reported less than adequate skills. A common suggestion for improvement was to provide education and training at both university and PD levels. However, the findings of our survey suggest that existing university education programs may be less than adequate in equipping student graduates with knowledge and skills for work with this population. Further, while SLPs in our study reported high interest in PD opportunities, this contrasted with the low frequency with which they sought PD activities. This discrepancy may reflect a lack of appropriate PD opportunities relevant to their specific needs. The SLPs in our study also indicated the need for resource materials to be made easily accessible and understood in the form of clear protocols and guidelines. Additionally, gaps in the availability of assessment and intervention materials were identified. These limitations are not specific to Australia and have been found elsewhere, such as the USA (Centeno, 2009). This study points to an urgent need for improvement at multiple levels, such as in university entry-level programs, continuing PD opportunities, service policies and resources, as has been recommended by Speech Pathology Australia (2009), to better support clinicians working with CALD populations. Underlying the suggestions to address the knowledge, skills, and resource gaps, is perhaps the need for more research in aphasia management for CALD populations, as identified by several respondents in this survey and also in the existing literature (Centeno, 2009; Kiran & Goral, 2012; Lorenzen & Murray, 2008). The challenges identified in this study may have implications for the quality of care provided. A sizeable proportion of the SLPs in this survey reported less than adequate confidence levels in their assessment and treatment, and also in their abilities to provide positive outcomes for their clients. The lower levels of confidence stand in contrast to Rose et al’s. (2014) survey where SLPs reported very high confidence levels regarding adopting the range of social, functional, and neuropsychological approaches to aphasia intervention for monolingual English-speaking clients. Limitations The relatively small sample size in the current study suggests the results may not be generalisable to the entire Australian aphasia rehabilitation SLP population. The exact number of members in the target population, however, was unknown and it was not possible to determine the exact representativeness of the recruited sample. Future implications For a comprehensive understanding of the service practices across all areas of adult focused speech-language pathology, further investigation are recommended, in particular, adopting a more in-depth approach such as in-depth interviewing or focus groups, with an emphasis on contextually relevant factors requiring attention in order to mitigate change. Conclusion The results in this study add to the growing evidence that SLPs are still facing significant challenges in aphasia management for CALD populations. This is despite repeated calls by professional bodies and from the scholarly literature for changes to occur (Centeno, 2009; Lorenzen and Murray, 2009; Speech Pathology Association of Australia, 2009). Universities and SLP departments are urged to consider

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JCPSLP Volume 17, Number 1 2015

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