Assessment choice

Where possible, assessments should be used that are appropriate to the languages/dialects and cultural backgrounds of each Aboriginal and Torres Strait Islander client. 

Reference: Bohanna et al., 2013
NHMRC level of evidence: Qual. 

Rationale: There are currently no existing standardised tests available to assess acquired communication impairments in Aboriginal and Torres Strait Islander peoples.  Unless the purpose of the assessment is to assess the person’s Australian English, the use of existing tools (not standardized for use with Aboriginal or Torres Strait Islander Australians) may yield misdiagnoses. A lack of familiar vocabulary, grammar and format may significantly disadvantage Aboriginal and Torres Strait Islander Australians leading to an underestimation or misinterpretation of an individual's language competency. In particular, pragmatics and narrative styles are significantly different between Aboriginal and Torres Strait Islander Australians and non-Aboriginal and Torres Strait Island Australians. Hence caution must be taken especially in these areas. Assessment of activity and participation should involve more than the use of tools with a patient and instead, assessment processes should explore the impact of the communication impairment on cultural, family and community functioning.  There should also be reduced importance placed on work/leisure distinctions, as these distinctions are not always made in Aboriginal cultures. 

References:

1. Bohanna, I., Stephens, A., Wargent, R., Catherall, J., Timms, C., Graham, D., & Clough, A. (2013). Assessment of acquired brain injury in Aboriginal and Torres Strait Islander Australians: Guidance for DisabilityCare Australia.  Cairns: The Cairns Institute.