Background Image
Previous Page  19 / 60 Next Page
Show Menu
Previous Page 19 / 60 Next Page
Page Background


Volume 17, Number 1 2015


bicultural clients (Cheng, Battle, Murdoch, & Martin,

2001) and professional development for practising SLPs

in relation to assessment and management of bilingual

and CALD individuals (e.g., Kritikos, 2003).

Advocate for the resources needed to provide appropriate

and equitable services to this population, for example,

additional time; more interpreters and adequate access

to their services; bilingual SLPs from various cultural

backgrounds who could act as consultants to the SLP

clinical community (e.g., see Hersh, Armstrong, Panak,

et al., 2014; Jodache et al., 2014a).

Finally, it is evident that there is a pressing need for more

research relating to speech pathology management of

clients with aphasia who are bilingual or from a CALD

background. As Rose and colleagues (2014, p. 10)

noted in relation to CALD clients with aphasia, “such a

large discrepancy between case-load imperatives and

clinician preparedness/capacity needs urgent attention”.


This article outlined some of the key contextual issues and

challenges for SLPs working in an Australian context with

individuals who are bilingual or from a CALD background.

The unique linguistic environment in Australia and lack of

research in relation to management of aphasia in bilingual/

CALD individuals was discussed, along with some key

areas for consideration in delivering a speech pathology

service to this population. Areas for further research have

also been highlighted. Finally, recommendations for clinical

practice with individuals with aphasia who are bilingual or

from a CALD background have been provided to assist

SLPs currently working with this population.


Abutalebi, J., & Green, D. W. (2007). Bilingual language

production: The neurocognition of language representation

and control.

Journal of Neurolinguistics



, 242–275.


Ansaldo, A. I., Marcotte, K., Scherer, L., & Raboyeau, G.

(2008). Language therapy and bilingual aphasia: Clinical

implications of psycholinguistic and neuroimaging research.

Journal of Neurolinguistics



(6), 539–557. doi:10.1016/j.


Ansaldo, A. I., & Saidi, L. G. (2010). Model-driven

intervention in bilingual aphasia: Evidence from a case of

pathological language mixing.




(2), 309–324.


Armstrong, E., Hersh, D., Hayward, C., Fraser, J., &

Brown, M. (2012). Living with aphasia: Three Indigenous

Australian stories.

International Journal of Speech-

Language Pathology



(3), 271–280. doi:10.3109/175495


Australian Bureau of Statistics (ABS). (2009). Cultural

and linguistic diversity.

Perspectives on education and

training: Social inclusion, 2009

. Retrieved 27 Oct. 2014





Australian Bureau of Statistics (ABS). (2010).


Aboriginal and Torres Strait Islander social survey, 2008


Retrieved 10 Oct. 2014 from




Australian Bureau of Statistics (ABS). (2011a). Cultural

diversity in Australia.

Reflecting a nation: Stories from

Clinical recommendations

As the preceding review indicates, delivering speech

pathology services to individuals with aphasia who are

bilingual or from CALD backgrounds is currently, and will

remain for the foreseeable future, a challenging area of

practice for the speech pathology profession in Australia.

Some recommendations for clinical practice that may assist

with the management of this caseload are outlined below.

These recommendations are based on the available

research literature and the first author’s clinical and research

experience with this caseload.

Use clear and consistent terminology to refer to clients

from culturally and linguistically diverse backgrounds to

facilitate effective service delivery.

Obtain an accurate and comprehensive language history

and current language profile to assist with appropriate

diagnosis and goal setting with the bilingual/CALD

individual with aphasia (Lorenzen & Murray, 2008;

Roberts, 2008).

Obtain initial assessment data in both or multiple languages

wherever possible to obtain an accurate indication of the

relative strengths and weaknesses in and across languages,

to assist with accurate diagnosis, and to provide a

baseline for treatment (Lorenzen & Murray, 2008).

Beware of directly translating/interpreting English

aphasia assessments into other languages as this

may not account for cross-linguistic and cross-cultural

differences. Appropriate tools for assessment of bilingual

aphasia should be culturally adapted and linguistically

equivalent (Paradis, 2004).

Where formal assessment in the other language(s) is not

possible, identify a set of informal language assessment

tasks that may assist with diagnosis of aphasia and

obtain interpreter assistance in administering these (e.g.,

tasks that assess fluency, comprehension and repetition

may assist with differential diagnosis of the type of

aphasia). Other recommendations include the collection

and analysis of language samples (Lorenzen & Murray,

2008), including narrative outputs (Kiran & Roberts,

2012 ), and verbal fluency tasks (Kiran & Roberts, 2012).

Employ practices that will facilitate working with interpreters

(see Kambanaros & van Steenbrugge, 2004; Roger &

Code, 2011), for example, pre-session briefings to

explain the aim, purpose and format of the assessment;

education of inexperienced interpreters about typical

responses from people with aphasia; and the importance

of error information for assessment and diagnosis.

Be familiar with relevant bilingual language processing

models and use these to facilitate understanding of

aphasia presentation in a bilingual person.

Pool informal clinical resources for working with CALD

populations (that may have been developed by various

clinicians over time) in a central location that can be

accessed by SLPs nationally.

Identify and use relevant existing internet resources,

for example, Cue Cards in Community Languages

( and-transcultural-services/cue-cards/cue-cards-in- community-languages)

; The Internet Picture Dictionary


); Life as a Bilingual (http://


If therapy can be conducted only in English within the

clinical setting, try to use family members or other

volunteers to implement language tasks in the other

language(s) at home (see for example, Boles, 2000).

Provide appropriate education and training for speech

pathology students related to management of bilingual/