Interpreters

7.7 Where the speech pathologist is not proficient in a language of the person with aphasia, a trained and qualified interpreter, knowledgeable in the specific requirements for speech pathology, should be used.

Reference: Cochrane et al., 2020: Systematic review of 6 studies (4 qualitative, 1 quantitative, 1 mixed methods); Flores, 2005: Systematic review of 36 studies; Karliner et al., 2007: Systematic review of 28 studies (4 qualitative, 24 quantitative); Larkman et al., 2023: Scoping review of 20 studies (10 descriptive papers, 8 surveys, 2 interview studies)

NHMRC level of Evidence: Qual.

Rationale: The use of trained and qualified interpreters improves quality of clinical care, reduces communication errors, and increases patient satisfaction (Flores, 2005; Karliner et al., 2007), and should be considered essential when the speech pathologist and the person with aphasia do not speak the same language (Larkman et al., 2023) 

There are particular considerations to be made when working with interpreters for Aboriginal and Torres Strait Islander clients. In collaboration with the client, Aboriginal Liaison Officers (ALO) and/or Aboriginal Health Workers (AHW) and family should be consulted – these parties may be able to assist in:  
·        identifying all languages spoken by the client, in order to seek the services of the correct interpreter,
·        deciding whether the involvement of an interpreter is appropriate for a specific client, and
·        identifying the client’s preferences – for example, regarding culturally sensitive issues such as men’s and women’s business. 

A record of all languages spoken by the client should be documented in the notes.

While there may be challenges to accessing a qualified interpreter for all languages, it is known that health professionals do not always access interpreters for Aboriginal and Torres Strait Islander clients even when they are available (Ralph et al., 2017). Where interpreters are not available in the geographical area of the hospital/rehabilitation service, services should be sought via telephone or other media. Speech pathologists may need to explore their health networks and state interpreting services to find interpreters. It is important to note that while ALOs/AHWs may be able to provide linguistic assistance if no trained interpreters are available, this cannot be assumed due to the wide range of Aboriginal and Torres Strait Islander languages and dialects (Cochrane et al., 2020).

When working with an interpreter, pre- and post-session briefings with the interpreter, the ALO/AHW, and the speech pathologist may be necessary to clarify the purpose of therapy sessions and the role of the interpreter. Please refer to statement 7.14 for additional information about working with interpreters

References:

1. 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
2. Flores, G. (2005). The impact of medical interpreter services on the quality of health care: a systematic review. Medical care research and review, 62(3), 255-299.
3. Karliner, L. S., Jacobs, E. A., Chen, A. H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research, 42(2), 727-754.
4. Larkman, C.S., Mellahn, K., Han, W., & Rose, M.L. (2023). Aphasia rehabilitation when speech pathologists and clients do not share the same language: A scoping review. Aphasiology, 37(4), 635-657, DOI: 10.1080/02687038.2022.2035672