Implementation of local protocols

7.4 Speech pathologists should implement local protocols that guide working with Aboriginal and Torres Strait Islander communities.

Reference: Armstrong et al., 2022: Co-design study; Cochrane et al., 2020: Systematic review of 6 studies (4 qualitative, 1 quantitative, 1 mixed methods); Indigenous Allied Health Australia, 2019: IAHA Framework; McDermott, 2019: Discussion paper; Penn & Armstrong, 2017: Discussion paper

NHMRC level of Evidence: GPP

Rationale: The development and implementation of local protocols can assist in ensuring the delivery of culturally appropriate services. General principles can underpin these protocols and assist in the development of relationships and appropriate cross-cultural communication and cultural security. Such principles may include (Indigenous Allied Health Australia, 2019):

●       being respectful,
●       being open and self-aware.
●       being informed and informing others,
●       establishing sustainable relationships,
●        behaving ethically,
●       being meaningful,
●       being outcomes-focussed, and
●       ensuring that follow-up and feedback occur.

It should be recognised that every community is unique, and that great diversity exists in Aboriginal and Torres Islander society with respect to language and culture (e.g., Cochrane et al., 2020; Penn & Armstrong, 2017). Therefore, long-term authentic engagement and collaboration between speech pathologists and local Aboriginal and Torres Strait Islander communities (at personal and systemic levels) are necessary to develop respectful local protocols (Armstrong et al., 2022; McDermott, 2019)

References:

1. Armstrong , E., Gapany, D., Maypilama, L., Bukulatjpi, Y,. Fasoli, L., Ireland, S., & Lowell, A. (2022). Räl-manapanmirr ga dhä-manapanmirr - Collaborating and connecting: Creating an educational process and multimedia resources to facilitate intercultural communication. International Journal of Speech-Language Pathology, 24(5), 533-546. DOI: 10.1080/17549507.2022.2070670 
2. Cochrane, F., Siyambalapitiya, S., & Cornwell, P. (2020). Speech-language pathology services for Indigenous Australian adults with acquired communication disorders: A systematic review. Speech, Language and Hearing, 23(2), 79-90. DOI: 10.1080/2050571X.2018.1544729
3. Indigenous Allied Health Australia Ltd. (2019). Cultural responsiveness in action: An IAHA Framework. 3^rd Edition V8. Retrieved from: https://iaha.com.au/workforce-support/training-and-development/cultural-responsiveness-in-action-training/
4. McDermott, D. (2019). arms? International Journal of Speech-Language Pathology, 21(3), 252-262, DOI: 10.1080/17549507.2019.1617896
5. Penn, C., & Armstrong, E. (2017). Intercultural aphasia: New models of understanding for Indigenous populations. Aphasiology, 31(5), 563-594. DOI: 10.1080/02687038.2016.1213788

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 In line with research proposing and evaluating service delivery models in Aboriginal and Torres Strait Islander populations (Isaacs et al., 2010; Reibel & Walker 2010; Keightly et al., 2009) , people-centred primary care is a central notion, with communities being involved in all steps of the development of viable and sustainable programs.  A recent study (Gauld, Smith & Kendall, 2011) noted that Community Based Rehabilitation (CBR) (Helander, 2007) for people with TBI was only successful if extensive community consultation occurred, with all key stakeholders included in the development of such programs.

Recommendation: Talk to the Aboriginal Liaison Officer about local networks, elders in order to be able to follow up, as contact details may change.  Community links are essential to maintain contact.