JCPSLP Vol 21 No 2 2019 DIGITAL Edition

Table 2: Principles of practice in adult settings

This includes phonology, syntax, semantics and pragmatics.

Principle 1: Become familiar with linguistic patterns of home language Principle 2: Ensure interpreting services are available as needed

Ask clients/assisting Aboriginal hospital liaison officers (AHLOs) in hospital settings if the client needs an interpreter (even in the case where the client and/or family members speak English).

Principle 3: Include extended family in assessments

Inclusion of extended family in assessment and treatment both in hospital and community settings ensure external validity for any diagnoses of disorder or difference through comparison with pre-injury function. Efforts to contact family if client is off country in hospital should be made through the use of the AHLO. In particular, clearly explain the nature and purpose of the assessment to brain injury survivors and their families. Visual imagery and the use of analogies for brain function (e.g., a river being blocked with rocks/silt, fuel lines being blocked in a car, being analogous to an artery in the brain being blocked). Ensure that activities are relevant to the client’s language/ dialect/culture as well as being familiar and of interest to an adult. Be mindful that standardised tests, e.g., involving naming (when purpose is not clear) may be considered demeaning to some Aboriginal clients so should be used carefully and with maximal explanation and sensitivity to the client’s response (brokered through an AHLO). It is important to establish literacy level of the client/family before assuming written information will be understood. Checking with clients and their families on comprehension of materials is important. Intergenerational workshops on issues that affect the whole community, i.e., hearing loss, ear disease facilitate community to generate their own strategies. Discussion of issues related to general health, family, country, community status, e.g., eldership, will provide a context in which to then establish the potential presence of a communication disorder, with the client, family and AHLO providing a variety of perspectives on the client’s communicative competence. The term “goals” may not be familiar or meaningful to many Aboriginal clients. It may be more appropriate to discuss clients’ “concerns.” Even a clinician who emphasises general “functional” areas of communication may not focus on issues that Aboriginal clients see as important. For example – “no language impairment” on the AusTOMS is “consistent verbal and written language output”. In an Aboriginal context, this does not consider the individual as a whole (i.e., perhaps the person was not literate prior to their stroke/injury or had a strong emphasis on non-verbal communication rather than consistent verbal communication to convey their message).

Principle 4: Provide clear explanations re purpose of assessment Principle 5: Ensure relevance of testing or treatment activities

Principle 6: Gauge literacy levels of client and family

Principle 7: View the client holistically

Principle 8: Talk about “concerns” rather than “goals”

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JCPSLP Volume 21, Number 2 2019

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