Acquired Communication Disorders Research Articles

Addressing the Impacts of Acquired Communication Disorders on Sexuality: Speech-Language Pathologists’ and Clinical Psychologists’ Beliefs and Practice Patterns

Addressing the Impacts of Acquired Communication Disorders on Sexuality: Speech-Language Pathologists’ and Clinical Psychologists’ Beliefs and Practice Patterns

Augmentative and alternative communication: the experience of Malaysian speech-language pathologists and caregivers of individuals with aphasia

ABSTRACT Background Augmentative and Alternative Communication (AAC) serves as a compensatory intervention approach for individuals with aphasia and is often introduced by speech-language pathologists (SLPs) after outcomes from restorative approaches plateau. Communication partners (i.e., caregivers) have a pivotal role in ensuring the successful use of AAC by adults with aphasia. Despite there being a large body of research on the use of AAC by adults with aphasia little is known about the experience of caregivers of individuals with aphasia who use AAC in supporting its use. Aims This study conducted in Malaysia was aimed to (a) explore the practices of Malaysian SLPs when introducing AAC to adults with acquired communication disorders (ACD) including aphasia and (b) describe the experience of caregivers regarding the use of AAC by adults with aphasia under their care. Method & Procedures This mixed-methods study had two phases. In Phase 1, a survey was distributed to 200 SLPs throughout Malaysia. Thirty-seven SLPs who met the inclusion criteria of having a caseload of more than 80% adults and at least 20% adults with aphasia responded to the survey and provided information about their use of AAC. For Phase 2, eight caregivers of adults with aphasia who had been introduced to AAC were interviewed to obtain information about their experience using AAC. Outcomes & Results Findings from Phase 1 indicated that Malaysian SLPs most often introduced unaided and low-tech AAC to adults with ACD (including aphasia). Most of them felt that they lacked knowledge and skills in the provision of AAC services to adults and hoped for more training. Three themes emerged from the qualitative content analysis conducted on interview transcripts from Phase 2: (a) the positive impact of the use of AAC, (b) challenges faced when using AAC, and (c) hopes for the future. The findings of this study suggest that both SLPs and caregivers recognize the importance of AAC for adults with ACD including aphasia and need to work together closely to promote inclusion of adults with aphasia who use AAC and acceptance of AAC as a form of aphasia rehabilitation.

Rehabilitation Supported by Immersive Virtual Reality for Adults With Communication Disorders: Semistructured Interviews and Usability Survey Study.

Individuals who have acquired communication disorders often struggle to transfer the skills they learn during therapy sessions to real-life situations. Immersive virtual reality (VR) technology has the potential to create realistic communication environments that can be used both in clinical settings and for practice at home by individuals with communication disorders. This research aims to enhance our understanding of the acceptance, usefulness, and usability of a VR application (SIM:Kitchen), designed for communication rehabilitation. Additionally, this research aims to identify the perceived barriers and benefits of using VR technology from the perspective of individuals with acquired communication disorders. Semistructured interviews and usability surveys were conducted with 10 individuals with acquired neurogenic communication disorders aged 46-81 (mean 58, SD 9.57) years after trialing an immersive VR application. The audio-recorded interviews were transcribed and analyzed to identify themes. The quantitative data regarding the usability of the system associated with participants' immersion experience in the VR application were promising. Findings from semistructured interviews are discussed across five key thematic areas including (1) participant's attitude toward VR, (2) perceived usefulness of the VR system, (3) perceived ease of use of the VR system, (4) their willingness to continue using VR, and (5) the factors they perceived as challenges or facilitators to adopting this VR technology. Overall, participants in this study found the VR experience to be enjoyable and were impressed by the realism of the VR application designed for communication rehabilitation. This study highlighted personally relevant, immersive VR interventions with different levels of task difficulty that could enhance technology uptake in the context of communication rehabilitation. However, it is essential that VR hand controller technology is refined to be more naturalistic in movement and able to accommodate user capabilities.

“Working together… I can't stress how important it is”: Indigenous Health Liaison Officers’ insights into working with speech-language pathologists and Aboriginal and Torres Strait Islander peoples with stroke and TBI

Purpose Providing culturally safe speech-language pathology services to Aboriginal and Torres Strait Islander peoples with acquired communication disorders (ACDs) may be challenging for non-Indigenous speech-language pathologists (SLPs). Indigenous Health Liaison Officers (IHLOs) may share common histories and culture with patients, and provide valuable insights about cultural safety. The study aim was to explore IHLOs’ experiences of working with Aboriginal and Torres Strait Islander adults post-stroke or traumatic brain injury (TBI), and with the SLPs who provide services to these peoples. Method Using an interpretive description collaborative research design informed by culturally responsive principles, IHLOs (n = 7) participated in interviews facilitated by Aboriginal researchers and the principal investigator. Data were analysed using qualitative content analysis, informed by perspectives of Aboriginal researchers. Result Two themes, Connection and Spirit and Emotion, and six interdependent categories described how Aboriginal and Torres Strait Islander peoples have, and need, strong connections to family, country, health professionals, and ACD practices. Without these connections, patients’ wellbeing may be deeply affected. Conclusion SLPs must collaborate with IHLOs and patients’ family members and draw on their cultural knowledge, expertise, and guidance when working with Aboriginal and Torres Strait Islander peoples and ensure connections are created. These connections contribute to culturally safe and responsive speech-language pathology practice.

From concept to practice: a scoping review of the application of AI to aphasia diagnosis and management

Purpose Aphasia is an acquired communication disability resulting from impairments in language processing following brain injury, most commonly stroke. People with aphasia experience difficulties in all modalities of language that impact their quality of life. Therefore, researchers have investigated the use of Artificial Intelligence (AI) to deliver innovative solutions in Aphasia management and rehabilitation. Materials and methods We conducted a scoping review of the use of AI in aphasia research and rehabilitation to explore the evolution of AI applications to aphasia, the progression of technologies and applications. Furthermore, we aimed to identify gaps in the use of AI in Aphasia to highlight the potential areas where AI might add value. We analysed 77 studies to determine the research objectives, the history of AI techniques in Aphasia and their progression over time. Results Most of the studies focus on automated assessment using AI, with recent studies focusing on AI for therapy and personalised assistive systems. Starting from prototypes and simulations, the use of AI has progressed to include supervised machine learning, unsupervised machine learning, natural language processing, fuzzy rules, and genetic programming. Conclusion Considerable scope remains to align AI technology with aphasia rehabilitation to empower patient-centred, customised rehabilitation and enhanced self-management.

Converting to online conversations in COVID-19: People with aphasia and Students’ experiences of an online Conversation Partner Scheme

ABSTRACT Background A Conversation Partner Scheme (CPS) can provide an opportunity for students to learn about acquired communication disorders, develop skills to support adults in conversations and reflect on their personal attitudes about communication disability. It can also enhance communication, facilitate social inclusion and participation and increase well-being for CPS partners with acquired communication disabilities. The format of a CPS generally includes conversation-training workshops followed by face-to-face supported conversations. The COVID-19 pandemic and associated public health guidance necessitated the transition of all components of the scheme (training and conversations) to an online format. Aims The aim of this case study was to investigate the feasibility of an online CPS and explore the participants’ experience of this format. Methods & Procedures A case study design was undertaken with feasibility objectives examining Implementation, Practicality, Adaption, Integration and Acceptability of the online CPS. Data was gathered from students using questionnaires. Online semi-structured interviews were carried out with seven persons with aphasia (PwA) who participated as CPS partners. Technical challenges, duration of conversations and topics of conversations were also recorded. Results and Conclusions Twenty-seven speech and language therapy students and 14 CPS partners took part in the CPS. Eighty-five online conversation sessions were carried out. All seven PwA and many of the students (87.5%) perceived an online format as suitable for CPS conversations. However, many students highlighted the value of in-person contact and reported that the online format constrained the use of some communication ramps. The PwA repeatedly commended their student conversation partners and noted the CPS provided an opportunity for increased social interaction during the public health restrictions. The online CPS provided a timely opportunity for students to practice supported communication skills and was perceived to be important for student training and communication skills development.

Assessment and rehabilitation of acquired communication disorders in Aboriginal and Torres Strait Islander adults with stroke or traumatic brain injury: a retrospective chart review

Purpose Speech-language pathologists’ (SLP) management practices for Aboriginal and Torres Strait Islander adults with acquired communication disorder (ACD), following stroke or traumatic brain injury (TBI), are not well understood. This study explores SLPs’ management approaches for ACDs for Aboriginal and Torres Strait Islander adults post-stroke or TBI. Materials and methods SLPs’ documented notes were analysed from a two-year retrospective medical record review of Aboriginal and Torres Strait Islander adults (≥18 years), admitted to a regional Queensland hospital with principal diagnoses of stroke or TBI. Results SLPs frequently used informal approaches to assess ACDs. English-language formal assessment tools were also used in conjunction with the informal approaches. ACD diagnosis was more common in stroke than TBI patients. One-third of patients with ACD received inpatient rehabilitation at the study site. SLPs infrequently documented cultural or linguistic adaptions to assessment or interventions. Conclusions Informal approaches to assess ACDs were commonly employed which may be because they are perceived to be more culturally appropriate. Clinical guidelines for stroke and TBI should accommodate the diversity of cultures and languages. Better consideration of Aboriginal and Torres Strait Islander communication styles and incorporation of these into SLP ACD management approaches may facilitate accurate diagnosis and culturally safe rehabilitation services. Implications for Rehabilitation Informal approaches for assessment and intervention of ACDs, that incorporate yarning and salient tasks, are likely to be more culturally appropriate and safe for Aboriginal and Torres Strait Islander peoples. More flexibility and guidance in the use of culturally and linguistically appropriate alternative assessment approaches are required in the National stroke guidelines for Aboriginal and Torres Strait Islander peoples. The adoption of enhanced models of culturally secure ACD service provision, that incorporate frequent SLP engagement with an Aboriginal or Torres Strait Islander support person during assessment and rehabilitation, are needed. There is an imperative for health professionals to actively account for culture and language difference in rehabilitation practices to ensure Indigenous peoples worldwide receive equitable and culturally-responsive services.

Post-stroke aphasia rehabilitation using computer-based Arabic software program: a randomized controlled trial

BackgroundAphasia is considered an acquired communication disorder. Language intervention in aphasia enhances the patient outcomes. Recently, computer programs are developed for the treatment of aphasia. It is an effective and a low-cost therapy choice. The aim of the study was to assess the effectiveness of language therapy using a computer-based Arabic software program for rehabilitation of post-stroke Arabic-speaking aphasic patients in comparison to the conventional language therapy. We conducted a randomized controlled trial with blinded endpoint evaluation. The trial included 50 aphasic patients. They were randomized into either group I or group II to receive 48 therapy sessions using the Arabic software program (group I) or the conventional therapy (group II). The primary outcome was a measure of improvement in language abilities. It was measured using the Arabic version of the Boston Diagnostic Aphasia Examination to detect any significant improvement in the language of both groups in comparison to pre-therapy results. The post-therapy results of both groups were compared to each other to document the effectiveness of the software program.ResultsA total of 105 aphasic patients were screened and 50 subjects were randomized to the intervention groups [40 subjects were males, mean age of the patients: 57.04 years± SD 10.88 for group I and 58.80 years ± SD 11.58 for group II]. The therapy results showed a significant improvement from the baseline in both groups. There was no significant difference in the post-therapy results between group I and group II except for some items whereas group I showed more significant improvement.ConclusionsLanguage therapy using a computer-based Arabic software program was as effective as the conventional therapy in the improvement of language abilities of Arabic-speaking aphasic patients.

“It’s really exciting to think where it could go”: a mixed-method investigation of clinician acceptance, barriers and enablers of virtual reality technology in communication rehabilitation

Purpose Acquired communication disorders can result in significant barriers to everyday life activities, and commonly require long-term rehabilitation. This research aimed to investigate usability, acceptance, barriers and enablers to the use of immersive virtual reality (VR) technology for communication rehabilitation from the perspective of speech-language pathologists (SLPs). Methods Semi-structured interviews and surveys (system usability and motion sickness) were carried out with 15 SLPs following their participation in communication activities typical of daily life, experienced within an immersive VR kitchen environment. Results The system usability scores were average. In addition, motion sickness symptoms were low after interaction with the VR system. The main findings from semi-structured interviews are discussed across five main themes: (i) attitude towards the use of VR in communication rehabilitation (ii) perceived usefulness of VR (iii) perceived ease of use of VR (iv) intention to use VR, and (v) clinical adoption barriers and enablers. Conclusions Overall, participants were positive about VR and its potential applications to communication rehabilitation. This study provides a foundation to inform the design, development, and implementation of a VR system to be used in the rehabilitation of individuals with acquired communication disorders. IMPLICATIONS FOR REHABILITATION Virtual Reality applications could simulate social communication situations within the clinic. VR could be used as a rehabilitation tool for communication assessment and/or outcome measure. VR requires customisation to the specific communication rehabilitation needs of the client. Participants identified barriers and enablers to adoption of VR by speech-language pathologists.

Music Improves Social and Participation Outcomes for Individuals With Communication Disorders: A Systematic Review

There is increasing interest in exploring the benefits of music in rehabilitation settings. In the field of speech-language pathology, an ultimate goal for individuals with communication disorders is to foster participation across multiple contexts. The goal of this systematic review was to explore social and participation outcomes for individuals with communication disorders who received arts-based interventions. A systematic search of the literature yielded 86 studies, which were coded and summarized in terms of participants, arts-based intervention, social and participation variables, outcome, and quality of evidence. The majority of identified studies (N = 71) utilized music. Results indicated that music-based interventions can improve social and participation outcomes, such as frequency of responses, initiation of communication, turn-taking, joint attention, and group participation for children and adults with autism spectrum disorder and developmental and acquired communication disorders; however, future research is needed to expand the use of varied arts-based interventions targeting a larger breadth of social and participation outcomes.

Speech-language pathologists’ perceptions and experiences when working with Aboriginal and Torres Strait Islander children

Purpose This study explored the perceptions of speech-language pathologists with regards to culturally responsive service delivery, assessment practices, and confidence when working with Aboriginal and Torres Strait Islander children. Method An online survey was used. Descriptive statistics were analysed with SPSS. Themes were derived from text responses using Braun and Clarke’s thematic analysis method. Result The 48 respondents were almost all non-Indigenous, equally spread across metropolitan and non-metropolitan regions, and had varied levels of experience. Respondents reported moderate to high levels of confidence. Identified barriers included accessibility, policy, impacts of colonisation, awareness of services and expectations and speech pathologist knowledge, training and experience. Engagement emerged as a facilitator to provision of culturally responsive services. A variety of speech-language pathology assessment methods were reported, not all of which were consistent with current recommendations. Conclusion Identified barriers and facilitators were consistent with previous research exploring work with adults with acquired communication disorders. A need to explore the perspectives of Aboriginal and Torres Strait Islander communities as users of speech-language pathology services was identified. Clinical implications are described for future training, clinical guidelines, and flexible service delivery.

Decision Making by People With Aphasia: A Comparison of Linguistic and Nonlinguistic Measures.

Purpose Decision making involves multiple cognitive and linguistic processes. The extent to which these processes are involved depends, in part, on the conditions under which decision making is assessed. Because people with aphasia (PWA) have impaired language abilities and may also present with cognitive deficits, they may have difficulty during decision-making tasks. Yet little research exists on the decision-making abilities of PWA. Thus, the purposes of this study were to investigate the performance of PWA on linguistic and nonlinguistic decision-making measures and to explore the relationship between decision making and cognitive test performance. Method A quasi-experimental design was used to compare the performance of PWA (n = 16) and age- and education-matched control participants (n = 16) on three decision-making tasks: Making a Decision subtest from the Functional Assessment of Verbal Reasoning and Executive Strategies (linguistic decision-making task), Iowa Gambling Task (nonlinguistic decision-making task with ambiguity), and Game of Dice Task (nonlinguistic decision-making task without ambiguity). Participants also completed assessments of language, working memory, and executive functions. Scores on the three decision-making tasks were compared between groups, and cognitive influences on decision-making performance were examined using correlation analyses. Results PWA differed significantly from control participants on linguistic decision making, particularly when required to verbalize their rationale for making their decision. PWA and control participants did not differ significantly on measures of nonlinguistic decision making. Performance on multiple cognitive measures was correlated with performance on the linguistic reasoning task, as well as one of the nonlinguistic tasks (Game of Dice Task). Conclusions Decision-making tasks that are heavily dependent on language, such as those used in capacity assessments, may disadvantage PWA. Assessments of decision-making capacity should include communication supports for people with acquired communication disorders; further investigation in the areas of decision making and aphasia is needed.

Considering Principles of Learning in the Treatment of Acquired Communication Disorders

Considering Principles of Learning in the Treatment of Acquired Communication Disorders

“You felt like a prisoner in your own self, trapped”: the experiences of Aboriginal people with acquired communication disorders

Purpose Aboriginal Australians are under-represented in brain injury rehabilitation services despite a high incidence of both stroke and traumatic brain injury in this population. This study aimed to explore the experiences of Aboriginal Australian adults with acquired communication disorders (ACDs) after brain injury for the first time to inform the development of accessible and culturally secure service delivery models. Methods and materials Semi-structured interviews were undertaken with 32 Aboriginal people who had experienced a brain injury resulting in ACDs (aged 35–79 years) and 18 family members/carers across Western Australia. Thematic analysis identified common themes across participants. Results Overall themes related to communication (both related to the communication disorder and general healthcare interactions), health and social contexts, recovery, and support, being away from family and country, knowledge and beliefs about brain injury, and follow-up. Conclusions An increase in healthcare staff’s appreciation of the health and social contexts of Aboriginal people after brain injury is needed in order to improve communication with Aboriginal patients and the ability to offer accessible rehabilitation services. Ongoing support is required, with cultural identity noted as key to ensuring cultural security and ultimately recovery. Involvement of family and other Aboriginal people in recovery processes, as well as access to relevant Aboriginal languages and proximity to ancestral lands is central. Implications for rehabilitation Acknowledgment of cultural identity and strengths through involvement of extended family and Aboriginal Hospital Liaison Officers, access to language and proximity to country all central to rehabilitation planning for Aboriginal people after brain injury. Cultural security training for rehabilitation staff is recommended focusing on clear two-way communication skills to make medical information accessible for Aboriginal patients and to listen to patients’ concerns in a way that respects cultural context. Information regarding practical support and implications for ongoing management of life after brain injury (for the person and their family) is essential, and should supplement the medical-related information provided. Follow-up post discharge from hospital best facilitated through establishing contact with local Aboriginal community through Aboriginal community controlled health services, community elders, and Aboriginal health workers across organisations.

PARTicipate: Art as Self-Expression for Persons with Aphasia

Background
 Aphasia is an acquired communication disorder resulting from a stroke or traumatic brain injury. Persons with Aphasia (PWA) have deficits in language comprehension and expression. Loss of communicative functions can be isolating for PWA as they may face barriers to accessing community-based leisure programs. Aphasia-friendly materials, visuals and simple written or oral instructions, can reduce such barriers and support communicative access.
 Objective 
 The pARTicipate project is a student-initiated art group that was piloted with the aim of encouraging PWA to trial an art class in a communicatively accessible and low-risk environment, as part of an outpatient rehabilitation program. By using a life participation approach for aphasia, this project aimed to promote participants’ discovery, or rediscovery, of a hobby. 
 Methods
 Four PWA completed six art projects over 9 weeks. Communicative access was enhanced by using aphasia-friendly instructions and demonstrations to teach the projects. Participants showcased their projects and taught their skills to family and community members on the final “Share Day”. 
 Results
 Qualitative and quantitative data was gathered from satisfaction surveys. One hundred percent of the participants indicated that they enjoyed sharing their art with the community, and that they would join the group again if it was offered. Additionally, all participants indicated they would be likely to continue exploring art in the future. 
 Conclusions
 It is expected that the skills learned by PWAs in pARTicipate may help increase their confidence about participating in other community-based art classes. As well, continuing to use these skills may help participants develop a sense of belonging to the artistic community. By learning to incorporate personal symbols, PWA can be deliberate in their use of art for self-expression in the future. Finally, PWA were empowered to assume a leadership role during “Share Day”. Having the opportunity to teach newly acquired artistic skills to their family and community members promoted positive feelings about the self and served to reveal their cometencies. 

A screening tool for acquired communication disorders in Aboriginal Australians after brain injury: lessons learned from the pilot phase

ABSTRACT Background: Screening for communication disorders in a cross-cultural context presents numerous challenges, especially when the screening tool has been designed for use in one specific cultural and linguistic context. Translation enables it to be administered to speakers of a variety of languages, but does not account for the effects of worldview nor the linguistic and cultural context that motivated the original version. Clients assessed with tools not appropriate for their culture may be at a disadvantage in completing the assessment. Furthermore, this may influence diagnostic/screening judgements and decision-making related to access to relevant services. Aims: To describe the piloting of a screening tool developed to detect acquired communication disorders in Aboriginal Australians after stroke and traumatic brain injury – the Aboriginal Communication Assessment After Brain Injury (ACAABI). The study aims to i) assess whether a non-speech pathologist (e.g., Aboriginal Health Practitioner) can easily and accurately administer the tool, ii) determine whether the tool can identify acquired communication disorders of any type, and iii) describe a series of practical challenges encountered. Methods and procedures: Aboriginal Research Assistants (ARAs) reflected the role of the Aboriginal Health Practitioner. ARAs administered the tool to 38 Aboriginal brain injury survivors across Western Australia. A Speech Language Pathologist (SLP) observed the assessments to evaluate test administration. Another SLP undertook an independent communication assessment to provide information to an expert panel who produced a consensus diagnosis with which to compare the tool results. Sensitivity and specificity analyses were undertaken in terms of the total score and individual section scores. Field notes captured challenges encountered. Outcomes and results: Aboriginal Research Assistants could administer the tool effectively for the majority of participants, with some variations occurring. The tool appeared to be sensitive to detection of acquired communication disorders but had a high false-positive rate. However, small sample size and lack of comparative groups of non-brain-damaged individuals and those without communication disorders limits interpretation at this time. Challenges included participant recruitment, scheduling of appointments across large geographical distances, and availability of Aboriginal Research Assistants. Conclusions: The ACAABI looks promising in its ability to provide a culturally appropriate and secure way to screen for acquired communication disorders in Aboriginal people after brain injury for the purpose of referring onwards for further investigation. However, numerous challenges were encountered in the piloting and further work is needed to adjust the tool, enabling reliability, sensitivity and specificity analyses to be conclusive.

General practitioners’ perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders

ObjectiveAboriginal people have high rates of stroke and traumatic brain injury (TBI), often with residual, chronic communication deficits and multiple co-morbidities. This study examined general practitioners’ (GPs’) perceptions of their communication with Aboriginal patients with acquired communication disorders (ACD) after brain injury. Effective communication underpins good care but no previous research has explored this specific context. MethodsA qualitative descriptive approach was employed using interviews and focus groups with 23 GPs from metropolitan Perth and five regional sites in Western Australia. Data were analysed thematically. ResultsGPs reported low visibility of Aboriginal patients with ACD in their practices, minimal training on neurogenic ACD, and difficulty distinguishing ACD from cultural-linguistic factors. They had few communication resources, and depended on families and Aboriginal Health Workers to assist in interactions. They rarely used formal interpreting services or referred to speech pathology. They reported communication (dis)ability having low priority in consultations. ConclusionGPs report difficulty recognising ACD and their lack of prioritising assessment and treatment of communication ability after brain injury potentially compounds the disadvantage and disempowerment experienced by many Aboriginal people. Practice implicationsGPs require further communication and cultural training. Improved access to speech pathology and formal interpreting services would be beneficial.

‘I’ve got to row the boat on my own, more or less’: aboriginal australian experiences of traumatic brain injury

ABSTRACTBackground:The overarching cultural context of the brain injury survivor, particularly that related to minority peoples with a history of colonisation and discrimination, has rarely been referred to in the research literature, despite profoundly influencing a person’s recovery journey in significant ways, including access to services. This study highlights issues faced by Australian Aboriginal traumatic brain injury (TBI) survivors in terms of real-life consequences of the high incidence of TBI in this population, current treatment and long-term challenges.Method:A case study approach utilised qualitative interview and file review data related to five male Aboriginal TBI survivors diagnosed with acquired communication disorders. The five TBI survivors were from diverse areas of rural and remote Western Australia, aged between 19 and 48 years at the time of injury, with a range of severity.Case Reports:Common themes included: significant long-term life changes; short-term and long-term dislocation from family and country as medical intervention and rehabilitation were undertaken away from the person’s rural/remote home; family adjustments to the TBI including permanent re-location to a metropolitan area to be with their family member in residential care; challenges related to lack of formal rehabilitation services in rural areas; poor communication channels; poor cultural security of services; and lack of consistent follow-up.Discussion and Conclusion:These case reports represent some of the first documented stories of Aboriginal Australian TBI survivors. They supplement available epidemiological data and highlight different contexts for Aboriginal people after TBI, contributing to an overall profile that is relevant for rehabilitation service planning.

Speech pathologists and professional interpreters managing culturally and linguistically diverse adults with communication disorders: a systematic review.

Speech pathologists who work with culturally and linguistically diverse (CALD) adults with acquired communication disorders (ACDs), in predominately English-speaking countries, are legally and ethically bound to work with professional interpreters to overcome language barriers and provide equitable services. As levels of migration and ageing populations continue to rise globally, there will be an increasing need for speech pathologists to work with professional interpreters to manage the growing numbers of CALD adults with ACDs. Speech pathologists and professional interpreters face unique challenges when working together due to the need to focus on the intricacies of communication. This systematic review explores how speech pathologists and professional interpreters work together to manage CALD adults with ACDs by investigating the existing research context and the challenges and strategies reportedly used by these professions. A systematic quantitative literature review methodology was used to guide the review process, along with relevant items from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Five online scholarly databases (CINAHL, PubMED, Scopus, ScienceDirect and Web of Science) were searched using key search terms. Study inclusion criteria were: (1) original research reported in English; (2) informed our understanding of speech pathologists and professional interpreters working together; (3) focused on the management of ACDs; and (4) focused on working with CALD adults. Ten studies that met inclusion criteria were identified and included in the review. Half of the studies were conducted in Australia. Study designs were either surveys or single-case designs (e.g., case reports or qualitative case studies). Most participants were monolingual, female speech pathologists. Interpreter participants were mainly involved in assessment tasks using face-to-face service delivery. Common challenges reported by participants were speech pathologists being unsure of the accuracies of interpretations by interpreters, and unclear role expectations from both professions. Pre-session briefings and training of both professions were the primary strategies used and recommended. This review identified emerging research relating to speech pathologist and professional interpreter interactions, which were limited predominantly to the perspectives of speech pathologists. Several challenges were reported. While strategies to facilitate interprofessional practice were proposed, the efficacy and utility of the strategies has not been investigated to date. Further in-depth studies are needed to examine how the professions work together, and to explore feasibility and effectiveness of implementing proposed strategies to optimize service delivery to CALD adults with ACDs.

The Wangi (talking) project: A feasibility study of a rehabilitation model for aboriginal people with acquired communication disorders after stroke

Purpose: Aboriginal Australians are under-represented in stroke rehabilitation services and rehabilitation practices that are sensitive to the needs of Aboriginal people are not currently available. This project tested the feasibility and acceptability of a rehabilitation model and approach to therapy with Aboriginal people with acquired communication disorders post-stroke.Method: Eight Aboriginal people with acquired communication disorders post-stroke were recruited to this study. Sixteen treatment sessions were provided twice weekly at the person’s place of residence by a speech-language pathologist and Aboriginal co-worker. Feasibility was measured by analysing the number of sessions conducted jointly by the speech-language pathologist and Aboriginal co-worker and participant attendance. Participant acceptability was measured through the analysis of a post-therapy questionnaire. The Aboriginal co-worker’s and speech-language pathologists’ perceptions of the acceptability were collected through semi structured interviews.Result: Across all sessions 84.2% were attended by the Aboriginal co-worker and speech-language pathologist and seven of the eight participants completed all prescribed sessions. Positive feedback was provided by participants, the Aboriginal co-worker and speech-language pathologist on the key components of the programme.Conclusion: The rehabilitation model used within Wangi appears to be feasible and acceptable to participants and therapists. It provides direction to improve the quality of care for Aboriginal stroke survivors.