Aboriginal and Torres Strait Islander clients

Preface: Working with people from Aboriginal and Torres Strait Islander backgrounds

These best practice statements were compiled by members of the Missing Voices research team (NHMRC project ID 1046228) and two external speech pathologists with significant experience working with Aboriginal people. The inclusion of these statements represents an important step towards understanding, respecting and representing Indigenous worldviews, encouraging culturally appropriate working practices and valuing cultural diversity.

The burden of stroke in Aboriginal and Torres Strait Islander populations is substantially higher than non-Indigenous Australians, with a younger age distribution among Indigenous cases and higher fatality (Department of Health, Western Australia, 2012). There is therefore a need for increased focus on reducing Aboriginal stroke incidence and improving stroke outcomes in metropolitan and regional areas. More information about incidence of stroke and other acquired brain injuries in Aboriginal and Torres Strait Islander populations. 

As reported by the Western Australian Department of Health’s 'Model of Stroke Care 2012', "the particular needs of Aboriginal people demand special attention and resources. In March 2010, the National Stroke Foundation (NSF) surveyed a number of Aboriginal and Torres Strait Islander and non Aboriginal and Torres Strait Islander health professionals and researchers concerning stroke care for Aboriginal and Torres Strait Islander people. The survey results reinforced stroke-specific and whole health system issues previously identified and outlined in the Aboriginal Stroke Project Report (2003). Whole health system issues include access to and equity of appropriate services (including transportation), cultural safety, workforce development (Aboriginal health workers and training for non-Aboriginal health workers) and improving communication and knowledge. These issues are consistent with current national policy and program initiatives including the National Strategic Framework for Aboriginal and Torres Strait Islander Health." More information about provision of services for Aboriginal and Torres Strait Islander populations. 

Some of these statements may also apply to clients from other culturally and linguistically diverse backgrounds.

Best Practice Statements

These statements have been updated by the NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation (Aphasia CRE) in 2024 in accordance with the most up to date research and expert opinion. (Statements originally developed by the NHMRC CCRE in Aphasia Rehabilitation in 2014)

Click on the statement for NHMRC level of evidence ratings, supporting rationales, resources and further information.

7.3 Speech pathologists should engage in training and other activities to develop interpersonal skills and reflective practices for examining cultural safety and anti-racism with particular reference to Aboriginal and Torres Strait Islander cultures.

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

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

7.6 Speech pathologists should offer the involvement of an Aboriginal Liaison Officer (ALO) and/or Aboriginal Health Worker (AHW)* where possible to advise on cultural issues and liaise with the person with aphasia and their family.

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.

Speech pathologists should explain speech pathology terms in a way that is relevant and culturally appropriate to the Aboriginal and Torres Strait Islander person and their family.

7.8 Speech pathologists should incorporate clinical yarning as a means to build rapport and trust with the Aboriginal and Torres Strait Islander person and their family and to discuss speech pathology terms in a relevant and culturally appropriate way.

Speech pathologists should talk with the Aboriginal and Torres Strait Islander person with aphasia and their family about the roles the client has in the family and community. 

7.9 Goal setting and aphasia management should be person-centred and strength-based and should be considerate of Aboriginal and Torres Strait Islander models of health and wellbeing.

7.10 When considering assessment of aphasia in Aboriginal and Torres Strait Islander clients, speech pathologists should be mindful of the significant limitations of and potential harms in using formal assessment tools. 

7.11 Speech pathologists should develop an awareness of local Aboriginal health services and Aboriginal specific social services.

7.12 Speech pathologists should develop reflective practice skills so that they learn from each experience with an Aboriginal or Torres Strait Islander client and improve the service they provide with each new client, with the guidance of a mentor.

 

References:

1. Dept of Health of Western Australia. (2011).  Epidemiology of Injury in Western Australia 2000-2008 Report. Perth, Australia: Dept of Health of Western Australia

Acknowledgements:
This section was written by Beth Armstrong.