JCPSLP Vol 21 No 2 2019 DIGITAL Edition

Measurement and evaluation in practice

Assessment and outcome measures for Aboriginal Australians with communication disorders Elizabeth Armstrong, Ann Carmody, Alice Claire Robins and Tara Lewis

This paper reflects on issues surrounding clinical assessment and outcome measures with Aboriginal clients with communication disorders. The paper situates speech- language pathology assessment practices within a broader context of clinical assessment related to Aboriginal peoples accessing health services generally, and discusses what “assessment” could look like with a better understanding regarding an Aboriginal worldview, and incorporating notions of cultural security. It critically evaluates current measures used in speech- language pathology practice, their purpose, and processes involved in their application. Finally, the authors draw on their own clinical and research experiences to suggest ways of modifying existing tools if necessary, and using new methods to further the development of culturally appropriate and secure assessment practices within speech- language pathology. How they worded the report made me feel really emotional, I didn’t understand and thought they were saying bad things about my child. (Aboriginal mum, Member of the Home Interaction Program for Parents and Youngsters (HIPPY) Midland, WA) A ustralia has always been a multilingual country; many Aboriginal 1 peoples continue to speak multiple languages and dialects of those languages, although this varies across geographical regions. Colonisation brought a variety of Gaelic languages, with German at one stage being the dominant or preferred language used in business and newspapers in Melbourne and Adelaide (Ellis, Gogolin, & Clyne, 2010). English was later imposed as the dominant language largely for purposes of power, exploitation and domination, and the myth that Australia was a monolingual mono-cultural country emerged and has been perpetuated since (Ellis, Gogolin, & Clyne, 2010). This has led to a context of “invisibility” of many Indigenous languages and dialects

in Australia, and frequent lack of acknowledgment of Indigenous students as learners of English as an additional language or dialect (EAL/D) (Sellwood & Angelo, 2013). In order to ensure equity and diagnostic accuracy in speech- language pathology services for Aboriginal clients, speech- language pathologists (SLPs) in Australia need to be cognisant of current issues related to the integrity of post- colonial Englishes versus the notion of “standard Australian English” (SAE) and related concepts of domination and power. Particular attention needs to be paid to what is being assessed, measured, and treated when the SLP and the client do not have the same cultural background, and may speak different languages or dialects, as well as having different worldviews. While much work has been done in translation of speech-language pathology assessments into a variety of languages, there has been less discussion of underlying tenets of language and language use which are crucial for clinicians to understand if the surface level features of phonology and syntax, for example, are to be put into perspective. This is of particular importance in the discussion involving the language(s) of Aboriginal Australians and how linguistic competence is assessed in a speech-language pathology context. In the Aboriginal context, there is a rich linguistic and cultural history. Colonisation, however, directly and swiftly impacted language, with many speakers being forced to abandon their own first language(s) in schools, missions and other institutions, and adopt English (Fozdar, Wilding, & Hawkins, 2009). This not only led to devastation within communities forced to give up a central part of their identity (their language). It ultimately led to the demise of numerous Aboriginal languages. Of the 250 languages spoken prior to colonisation, only 145 (many of which are now only spoken by small numbers of people) remain (Department of Communications, Information, Technology and the Arts, 2005). Malcolm (2018) articulates the way(s) in which Aboriginal people adopted English but developed their own dialect – Australian Aboriginal English (AAE) – in his definition of dialect: A dialect … is a linguistic and social phenomenon which arises in response to a particular communication need common to a group of people. The existence of the dialect implies, with respect to the language from which it derives, both continuity and change. In the case of Aboriginal English, there is linguistic continuity

THIS IS AN INVITED ARTICLE KEYWORDS ABORIGINAL ENGLISH ASSESSMENT CULTURAL SECURITY INDIGENOUS SPEECH- LANGUAGE PATHOLOGY

THIS ARTICLE HAS BEEN PEER- REVIEWED

Alice Claire Robins (top) and Elizabeth Armstrong

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JCPSLP Volume 21, Number 2 2019

Journal of Clinical Practice in Speech-Language Pathology