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Diversity in practice
JCPSLP Volume 17, Number 1 2015 13
felt less confident working with Indigenous than non-
Indigenous clients (Hersh, Armstrong, Panak, & Coombes,
2014). This article provides an overview of key contextual
issues and challenges in managing aphasia in bilingual and
CALD individuals in Australia, as well as providing practical
recommendations SLPs can implement within their clinical
practice.
Linguistic environment in
Australia
According to data from the 2011 Australian census, nearly
one in five people (around 4 million in total) speak a
language other than English (LOTE) at home (ABS, 2013c).
This figure does not indicate whether these individuals also
speak English or other additional languages. Those who do
speak English or other languages, in addition to the
language spoken at home, may be considered to be
bilingual or multilingual while others may simply be
non-English speakers or have limited proficiency in English.
One of the unique characteristics of the Australian linguistic
environment is the wide diversity of languages spoken: over
260 languages from diverse areas of the globe (Department
of Social Services, 2013). The specific proportion and
pattern of language diversity can vary between different
regions of Australia and may also change over time. For
example, in Brisbane, two or more languages are reportedly
spoken in 15.5% of households, with the top five LOTEs
being Mandarin, Vietnamese, Cantonese, Samoan, and
Spanish (ABS, 2013a). In contrast, 32.4% of households in
Melbourne report two or more languages being spoken,
with the top five LOTEs being Greek, Italian, Mandarin,
Vietnamese and Cantonese (ABS, 2013b). In recent years,
Chinese languages have become the most widely spoken
LOTEs in Australia, overtaking Italian and Greek, and this
may reflect changes in immigration patterns.
Regional differences, as well as changes in language use
over time, also exist for speakers of Indigenous languages.
In 2008, 73% of Indigenous people aged 15 years or over
living in a remote area spoke, or spoke some words of, an
Aboriginal or Torres Strait Islander language, in comparison
to 32% of people living in metropolitan areas and 28% in
regional areas (ABS, 2010). A crucial issue in relation to
Australian Indigenous languages is the loss of languages
over time. The most recent National Indigenous Languages
Survey indicated that only 120 out of 250 Australian
Indigenous languages were still spoken, with around 110
described as severely or critically endangered (Marmion,
Obata, & Troy, 2014).
In Australia, cultural and linguistic diversity is
a crucial factor to be addressed in planning
and delivering rehabilitation services for
individuals with aphasia and their families.
Challenges include the extensive number of
languages spoken by Indigenous and migrant
Australians, as well as limited research
evidence pertaining to assessment and
intervention for people with bilingual aphasia.
In addition, clinical challenges include lack of
consistent terminology used to refer to
people with aphasia who are bilingual or from
culturally and linguistically diverse (CALD)
backgrounds and limited existing resources
for speech pathology management of this
population. This paper outlines key issues
relevant to speech pathology management of
people with aphasia who are bilingual or from
CALD backgrounds and identifies gaps in the
existing research literature. Recommendations
for clinical management are discussed and the
imperative for further research is illustrated.
Australia is a culturally and linguistically diverse
society. Aboriginal and Torres Strait Islander
people, the original inhabitants of the Australian
continent (Department of Foreign Affairs and Trade, n.d.),
have a rich and diverse cultural and linguistic heritage. In
contemporary Australian society, more than a quarter of
the population were born overseas and around one-fifth
speak a language other than English at home (Australian
Bureau of Statistics [ABS], 2011a). The cultural and
linguistic diversity found among the Australian populace can
create challenges for speech-language pathologists (SLPs)
working with individuals with communication disability.
A recent survey investigating the aphasia rehabilitation
practices of Australian SLPs found that around 50% of
respondents rated their knowledge of, and confidence in,
working with culturally and linguistically diverse (CALD)
clients as less than adequate (Rose, Ferguson, Power,
Togher, & Worrall, 2014). Similarly, a national survey
exploring SLP practices with Indigenous Australians with
acquired communication disorders identified that 67% of
respondents who were currently seeing Indigenous clients
Managing aphasia in bilingual
and culturally and linguistically
diverse individuals in an
Australian context
Challenges and future directions
Samantha Siyambalapitiya and Bronwyn Davidson
KEYWORDS
APHASIA
MANAGEMENT
BILINGUAL
APHASIA
CROSS-
CULTURAL
CULTURAL AND
LINGUISTIC
DIVERSITY
Samantha
Siyambalapitiya
(top) and
Bronwyn
Davidson
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED