JCPSLP Vol 22 No 1 2020

Expanding possibilities: Foci on reading and interdisciplinary practices

Speech-language pathology in the Northern Territory Shifting the focus from individual clinicians to intercultural, interdisciplinary team work Bea Staley, Emily Armstrong, Rebecca Amery, Anne Lowell, Tanya Wright, Caroline Jones, Louise Taylor, and Jessica Hodson

Speech pathologists (SLPs) are routinely called on to develop and deliver culturally appropriate practices for working with Aboriginal clients. We posit that to create real change in practices with Aboriginal clients, we need to shift the focus beyond the individual clinician. Aboriginal community partners, researchers, academics and linguists need to be engaged with SLPs in clinically applicable, collaborative, intercultural, interdisciplinary teamwork. To do this we ask the profession to reconsider the way our work is envisioned, and urge funding bodies and government agencies to better support teams engaged in implementation science. Shifting the focus from individual practising clinicians towards teamwork is a more generative solution to engaging in culturally responsive practices with Aboriginal clients and in line with the commitments made in Speech Pathology Australia’s Apology to Aboriginal and Torres Strait Islander Peoples . We present three cases of interdisciplinary, collaborative work which might serve as informative practice examples for the profession. I n the Northern Territory (NT), it is the norm for Aboriginal 1 children to grow up multilingual (Armstrong, Carmody, Robins & Lewis, 2019; Simpson & Wigglesworth, 2008) and as a part of complex and changing “linguistic ecologies… whether they speak traditional languages, new languages, or live in diaspora communities” (Simpson & Wigglesworth, 2019, p. 75). Aboriginal communities across the NT are diverse and multiple cultural groups may live within one community, each with unique cultural practices, languages, political agendas, and geographical boundaries (AIATSIS, 2019). In any one community, there may be several languages and dialects spoken (Simpson et al., 2018) and English may be the third or fourth language learned. Many communities continue to speak and maintain their Aboriginal languages or dialects (e.g., Simpson & Wigglesworth, 2008) with

English used only in schools and other government-run spaces (Lowell et al., 2018a). Bilingual and multilingual children have been historically over (and under) identified as having educational and learning needs due to differences in their language development (e.g., Laffey, Pearce, & Steed, 2014) and lack of recognition of children’s and family’s learning styles and strengths (Lowell et al., 2018a). Though there is limited accurate data regarding the prevalence of communication disabilities in Aboriginal children in the NT (Lowell, 2013), one Australian longitudinal study of Indigenous children (FaHCSIA, 2012) found 17.2% of families (n = 1402) had “some concern” about their child’s expressive language and 5.6% had “some concern” about their children’s receptive language. Yet, referral and assessment processes for Aboriginal children with suspected communication delays in the NT are often complicated for a plethora of reasons related to service availability and accessibility, service appropriateness, time and travel. Waitlists are common and lengthy for children requiring speech pathology (SLP) services in the NT whether government or private. Clinicians flying or driving to remote communities to provide government or National Disability Insurance Scheme (NDIS) services may make infrequent visits per year and have little opportunity to spend sufficient time in the community getting to know families and clients. Further, there is a notable lack of culturally appropriate assessment tools for multilingual Aboriginal children (Armstrong, Carmody, et al., 2019; Gould, 2008; Lewis, Hill, Bond, & Nelson, 2017). There are also few culturally or linguistically appropriate therapy tools available to support families and children who have identified communication difficulties. In Speech Pathology Australia’s (SPA’s) Apology to Aboriginal and Torres Strait Islander Peoples , the organisation acknowledged that using inappropriate assessment methodologies and tools (e.g., formal, standardised and norm-referenced processes), diagnostic frameworks and services, has contributed to deficit-based narratives, unsafe and inaccessible services (SPA, 2019). Language development specifically, and communication more broadly, are inextricably interwoven with culture, and any assessment and support for a child and their family should be embedded in a thorough understanding of the child’s home language(s) and cultural context(s). Language is connected to identity for many Aboriginal people and children’s language development is supported by families using purposeful, intensive and specific strategies (Lowell et

KEYWORDS ABORIGINAL CLIENTS COLLABORATION CULTURE INTERDISCIPLIN-

ARY TEAMS LINGUISTIC DIVERSITY SPEECH- LANGUAGE PATHOLOGY

Bea Staley (top) and Emily Armstrong,

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JCPSLP Volume 22, Number 1 2020

Journal of Clinical Practice in Speech-Language Pathology