JCPSLP Vol 19 No 1 March 2017

of discourse expectations of non-Aboriginal teachers which reflected both cultural differences between what each considered significant aspects of what should be discussed, plus the effect of an externally constructed context (i.e., external to the Aboriginal participants). Malcolm concluded that: The discontinuity, as I see it, is always associated with the presence of Aboriginal communicators in a setting or speech event which is defined by non-Aboriginals. The key, if there is a key, to how Aboriginal people communicate, seems to me to lie in who defines the setting and determines the discourse pattern. There is therefore a commonality, in communicative terms between schools, classrooms, law courts, offices of government departments and anywhere where there are interactions in which the non-Aboriginal interlocutor defines the terms of communication. All of these settings will be associated with behaviour patterns which will not evidence the communicative competence of many Aboriginal people. (p. 150) Malcolm also writes about teachers not being able to “set up appropriate conditions for them [the students] to communicate in a way which demonstrates the extent of their competence” (p.151). These statements are very reminiscent of comments made about the aphasia rehabilitation context which question the role of the traditional assessment and treatment situation as tending to demonstrate incompetence rather than the person with aphasia’s competence (Kovarsky, Duchan, & Maxwell, 1999; Simmons-Mackie & Damico, 2008, 2009). While linguistic and sociolinguistic issues have been the focus of this paper, they must obviously be considered within the broader cultural context when working with Aboriginal clients. Issues such as construction of identity and disability within Aboriginal populations, co-morbidities, and attitudes to health services obviously need to be addressed when considering potential services (Armstrong, Hersh, Katzenellenbogen et al., 2015; Penn & Armstrong, in press). The centrality of such issues was noted by Ariotti (1999), for example, who wrote about “the social construction of Anangu disability”. In this paper, he discussed the importance of health providers taking into account historical, cultural and linguistic factors, in order to gain insight into their clients’ attitudes, customs, and beliefs. Similarly, Boddington and Räisänen (2009) discuss the holistic nature of Aboriginal definitions of health and explore the difficulties inherent in attempting to align western and Aboriginal definitions because of cultural differences. In order to accommodate language variation in assessment and treatment practices, much work has to be done within the discipline of speech pathology and the “sub-specialty” of aphasiology. The notion of aphasia “assessment” itself and its associated paradigms need to be first re-examined in contexts such as the Aboriginal Australian one described in this paper if clients are to be provided with rehabilitation that is both culturally sensitive and informed. As with all investigations involving language and cross-cultural research and clinical practice, linguistic and cultural awareness on the part of practitioners is an integral first step. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. References Ariotti, L. (1999). Social construction of Anangu disability. Australian Journal of Rural Health , 7 , 216–222.

ramifications for the assessment and treatment of aphasia by clinicians within Australia. Discussions of such differences, which at times can appear subtle on a surface level, also have implications for aphasiologists dealing with language variation worldwide. As language specialists, aphasiologists (and indeed speech-language pathologists in general) working in clinical settings need to have some knowledge of language differences in order to be able to accurately assess language skills and diagnose “disorder” as opposed to “difference”. In the paediatric field of language disorders, there has been much controversy within Australia regarding the use of tests standardised on SAE speaking children, for example, and it has been suggested that non-standardised assessment methods may indeed better accommodate language difference and reveal an AE speaking child’s actual linguistic abilities (Gould, 2008a, 2008b, 2008c, 2009). In the context of working across languages, Roger and Code (2011) have discussed the pitfalls associated with in working clinically with bilingual patients. These include situations where online translations of assessment tasks elicit responses which may be perfectly appropriate to the communicative context created through an interpreter-mediated interaction, but do not reflect the “correct” response targeted by the speech pathologist. This results in responses being labelled as “inappropriate” or “incorrect”. Implications of inaccurate assessments of language competence at any level in a person with aphasia, i.e., phonology, morphology, syntax, semantics, pragmatics, may equally lead to mis-directed treatment attempts to change the person’s first language skills, which may decrease that individual’s communicative functionality and underutilise any retained skills. Treatment goals based on inaccurate assessment would also seem inappropriate to the person and their family – potentially further alienating Aboriginal people from services which are already under attended (Edis, 2002). While differences at the levels of phonology, syntax and lexical semantics can appear relatively clear, it is the interaction of these levels with the pragmatic level and with socio-cultural factors which highlights important differences to be noted. Western methods of eliciting and analysing narratives, for example, may not be appropriate in an Aboriginal context. Elicitation techniques such as picture sequence cards, ordered to target a particular chronological order of events may well elicit discourse from Aboriginal speakers that is very different in structure from the targeted western narrative structure. As noted above, a western speaker’s pattern of integrating and presenting detail is very different from an Aboriginal speaker’s pattern. Hence, for a valid assessment of the speaker’s skill to be made, assessors must be aware of these differences. Conversational dynamics are very different as well; hence traditional analyses and subsequent advice to conversational partners would have to be modified. In assessing a person’s language skills, context is known to be central in how the person might communicate in a particular situation. In the same way that different conditions of eliciting language have been explored with English and European language speaking people with aphasia (e.g., Wright & Capiluto, 2009), speech pathologists are challenged with examining optimal ways of assessing Aboriginal peoples’ skills as appropriate and in a way that reflects true abilities. In a related but relevant article, Malcolm (1994) described the language behaviours of Aboriginal children in and outside the classroom (on the edges of the Western Desert in Western Australia) and found them very different. He identified different kinds

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JCPSLP Volume 19, Number 1 2017

Journal of Clinical Practice in Speech-Language Pathology