Aboriginal and Torres Strait Islander status

7.5 Speech pathologists should routinely check Aboriginal and Torres Strait Islander status in clients’ health records and with the clients themselves.

References: Australian Institute of Health and Welfare, 2010: Best practice guidelines; Cochrane et al., 2021: Retrospective chart review; Penn & Armstrong, 2017: Discussion paper

NHMRC level of Evidence: GPP

Rationale: Under-identification of Indigenous status has significant implications for clinical decision-making, data collection, and resource allocation across health settings. Specific health interventions and health care services may be available to Aboriginal and Torres Strait Islander people, such as Aboriginal Liaison Officers who can assist in navigation through health services. Furthermore, it is important to be aware of a client’s ethnic and cultural background in order to understand potential linguistic and/or pragmatic behaviours (Cochrane et al., 2021; Penn & Armstrong, 2017).

Without knowledge of the client’s cultural background, particularly in terms of linguistic issues in the context of speech pathology (e.g., languages/dialects spoken), misdiagnoses are possible and inappropriate assessment and intervention practices may be used. At the same time, some Aboriginal people may choose not to openly identify as Aboriginal in a healthcare setting. This too needs to be respected by clinicians. Guidelines are available to assist clinicians in asking all clients about Aboriginal and Torres Strait origins (see Australian Institute of Health and Welfare, 2010)

References: 

1.   Australian Institute of Health and Welfare (2010). National best practice guidelines for collecting Indigenous status in health data sets. Cat. no. IHW 29. Canberra: AIHW
2. Cochrane, F., Siyambalapitiya, S., & Cornwell, P. (2021). Clinical profile of Aboriginal and Torres Strait Islander adults with stroke and traumatic brain injury at a regional Australian hospital: a retrospective chart audit. Brian Impairment, 22(3). 281-293. DOI: 10.1017/BrImp.2021.1
3. 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