JCPSLP Vol 21 No 2 2019 DIGITAL Edition

how speech-language pathologists may be unwittingly contributing to the disproportionate rate of vulnerable youth being placed in special education in US schools through the use of biased assessments. Gould (2008a) documents “significant detrimental impacts” for Australian Aboriginal children where standardised assessments have been used to medicalise linguistic variation. Recent studies identifying up to 50% of cohorts of Aboriginal children as having language “difficulties” or “disorders” are a case in point (e.g., Kippin et al., 2018). Kippen et al. acknowledged the Clinical Evaluation of Language Fundamentals (CELF) (Wiig, Secord, & Semel, 2013) was not reflective of the linguistic background of the participants by adjusting the scoring. However, they were unable to account for the participants’ unfamiliarity with the culture of testing (Farrugia-Bernard 2018) and the “alien” content (i.e., contexts, underlying schemas). For example, the stimulus pictures and pragmatics of the “Formulated sentences” subtest require experience with testing culture, and American social contexts and schemas. Engaging in testing procedures where the language, format and content are unfamiliar can have negative impacts for participants (Macqueen et al., 2018). Treatment and goal-setting Assessment relates directly to treatment and treatment outcome measures, which inherently involve some form of “goal-setting”. In addition to language/communication impairment/ competence measures, personal goals are now also taken into account and used as potential measures of treatment outcomes (Hersh et al., 2012). The way(s) in which these goals are developed are just as important as the way(s) language assessments are undertaken. The notions of an individual’s “goals” and associated “person-centredness” (Leplege et al., 2007) are often described in relation to treatment processes but it must be noted that these notions are primarily western concepts. In collectivist societies, goals may not be individual but may relate just as much to family and community. Pre-determined notions of “family”, e.g., wife, husband, daughter, son, rather than notions related to extended family networks and responsibilities delegated to particular extended family/community members can also interfere with appropriate discussions and “negotiation” of what “goals” and activities are, relevant to the clients. In order to explore some of the issues raised above, current practice will be examined in both paediatric and adult contexts. Current SLP practice Working with children Assessment practices for SLPs working with Aboriginal children are currently the subject of debate. While substantial evidence exists (Gould, 2008a; Pearce & Williams, 2013; Pearce, Williams, & Steed, 2015; Toohill, McLeod, & McCormack, 2012) which clearly contraindicates the use of standardised tests, the Clinical Evaluation of Language Fundamentals (Wiig, Secord, & Semel, 2013) and other standardised tests continue to be used to diagnose communication disorders (e.g., Kippin et al., 2018). Changes to scoring and validation using natural language samples fail to address the irrevocable truth that this type of “testing” assessment is an arbitrary but very powerful social construct. It establishes a standard linguistic, pragmatic, cultural and worldview that is not

with other Englishes, since the dialect represents maintenance of English, but there is also change, since the speakers of the dialect also maintain continuity with their cultural origins, with their experience of language contact, and with their contemporary life as a speech community, and these necessitate a change in English as they adopt it. (Malcolm, 2018, p. 7) For the purposes of this paper, which is focused on clinical practice, we will use the term “home language” instead of AAE. The term AAE remains controversial even within Aboriginal communities, whereas “home language” is more commonly used and we feel may be more accessible to Aboriginal clients. “Home language” does not refer to traditional Aboriginal language per se; rather it refers to the same phenomena discussed around AAE. It is spoken by most Aboriginal peoples (with its own diverse sub-varieties), has its own phonology, grammar, and semantics, and differs from SAE in a number of ways, particularly in terms of semantics, discourse patterns, and pragmatics (Armstrong, McKay, & Hersh, 2017; Butcher, 2008; Malcolm, 2018). Attempts at assessment of linguistic competence must clearly be undertaken with such knowledge in mind in order for assessments to be accurate. For SLPs, an appreciation of dialect is essential if “difference” is not to be wrongly identified as “error” or “bad English” – particularly in the case where one dialect is privileged over another, with the majority dialect used being labelled “standard” and the minority dialect “non- standard”. It is important to emphasise that there is no hierarchy in language typologies, i.e., one dialect is not superior/inferior to another dialect, and a dialect is not inferior to a “language”. It should also be pointed out that many Aboriginal peoples do not use the term “dialect” and the discussion at times may seem academic. However, suffice to say that different forms of English should be acknowledged as separate entities, and are equivalent to each other. Concerns about current assessment practices The above comments speak to the point that SLPs must know what it is they are assessing before allocating meaning to measurements that may or may not reflect the linguistic competence of their clients. In writing about mental health assessment in relation to Aboriginal Australians, Adams, Drew, and Walker (2014) raise issues concerning the way(s) in which historical and political factors have influenced both how and why assessments are undertaken, and how they are perceived by Aboriginal peoples. They discuss the power involved in assessment and assessment results that still today drive decision-making about Aboriginal peoples’ welfare and access to resources: “Inappropriate assessments resulting in poor ‘test’ outcomes not only perpetuate the marginalisation of Aboriginal people, but can result in inadequate treatment and access to appropriate services” (Adams et al., 2014, p. 272). Misuse of assessment tools in speech-language pathology may similarly perpetuate stereotypes of high rates of “disorder”/pathology in Aboriginal populations. Pillay and Kathard (2015) raise the pitfalls in using philosophies of essentialism and reductionism in our clinical practices, resulting in the reification of “norms” based on increasing modular and smaller segments of broad social phenomena. Farrugia-Bernard (2018) discusses

Ann Carmody (top) and Tara Lewis

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JCPSLP Volume 21, Number 2 2019

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