The management of multilingual adults with aphasia in Malaysia: current practices, needs, and challenges

Abstract

ABSTRACT Background Aphasia management can be challenging in multilingual settings. A lack of understanding of the needs and challenges faced by speech-language therapists (SLTs) might lead to insufficient capacity building and policymaking. To optimize aphasia rehabilitation, it is important to determine the current practices, needs, and challenges faced by SLTs in a multilingual context. Aims This study aimed to explore how SLTs in Malaysia approach aphasia assessment and intervention for multilingual people with aphasia (PWA). Further, it aimed to identify the challenges SLTs experience, as well as the resources and strategies drawn upon to support the management of multilingual aphasia. Methods & Procedures Fifty participants who are SLTs in Malaysia completed an online questionnaire. The questionnaire consisted of four sections: Language Use; Aphasia Rehabilitation; Service Provision for Multilingual Clients with Aphasia; and Background Information. Five participants who took part in the survey also participated in the online focus group discussion. Outcomes & Results For the first study objective, it was found that participants primarily conducted individual aphasia interventions (100%), utilized informal tests of aphasia (~80%), and focused on improving language and social communication skills (~80%). More than half of the participants reported the experience of not sharing their clients’ language and resorted to choosing a particular language for aphasia intervention. From the survey and FGD, participants indicated seeking assistance from family members to translate SLTs’ questions and instructions during aphasia intervention. In addressing the second objective, language barriers and lack of appropriate resources were identified as two prominent challenges in multilingual aphasia management. For the third objective, participants suggested involving professional interpreters who are trained in assisting aphasia management to reduce language barriers. Developing tools and materials in multiple local languages and best practice guidelines were suggested for addressing the shortage of resources for multilingual aphasia management. Conclusions Malaysian SLTs used rehabilitation approaches that were consistent with practices in other countries, such as the frequent use of informal approaches for aphasia assessments and the focus on improving language and communication skills of PWA. Challenges in aphasia rehabilitation in Malaysia were posed by several factors, including linguistic diversity and a lack of resources. There is a critical need to develop culturally and linguistically appropriate resources, including standardised assessment tools and best practice guidelines for multilingual aphasia rehabilitation. The involvement of professional interpreters in aphasia rehabilitation may enhance the quality of intervention.