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Cultural diversity
120
ACQ
Volume 13, Number 3 2011
ACQ
uiring Knowledge in Speech, Language and Hearing
Examining culturally valid
language assessments for
Indigenous children
Petrea Cahir
anecdotally that some Australian SPs working with
Indigenous children are not confident that their methods
of assessment are culturally and linguistically valid (Speech
Pathology Australia, 2010). While there are multiple
contributing factors to the use of suboptimal assessment
procedures (e.g., the assessment is used to qualify for extra
services [Gould, 2008a]), SPs can no longer ignore the fact
that it is an ethical disservice to culturally and linguistically
diverse (CALD) populations to provide invalid, non-evidence
based clinical diagnoses and recommendations (Scarinci,
Arnott, & Hill, 2011). The risks of ignoring this void include
the continuation of over- (see Gould, 1999, cited in Gould,
2008b) and under-diagnosis of language disorders in CALD
children (Bedore & Peña, 2008).
Valid assessments of language skills are necessary for
the accurate classification of language
disorder
versus
language
difference
for Indigenous CALD children (Gould,
2008b). While research into the bilingual child’s speech and
language development is becoming increasingly available
(e.g., Guttiérrez-Clellen & Peña, 2001; Nicoladis & Genesée,
1997) there remains a paucity of valid published guidelines
or measurement tools for assessing speech and language
development of Indigenous children around the globe. It is
therefore not surprising that Döpke (2003), Gould (2008b),
and Kritikos (2003) each found that when assessing the
language development of CALD children, monolingual SPs
tended to use assessments valid for monolingual English
language development only. Such assessments do not
account for a) the path of bi- or multilingual development,
b) linguistic differences (e.g., dialects), or c) other cultural
and social differences. The result is the misclassification of
the Indigenous child’s language abilities, which has health,
economical, social and political ramifications.
Over-diagnosis can place unnecessary stress on
families, lengthen waiting lists, add needless strain to
funding resources, and skew policy-makers’ knowledge
of communication disorder prevalence. Underdiagnosis
can also result in family stress and anxieties as caregiver
concerns go unvalidated. Clinically, under-diagnosis
is an ethical issue since children with communication
disorders potentially go unidentified. Furthermore, given
the relationship between language abilities, literacy, and
subsequent educational and occupational opportunities,
under-identification is by no small measure a violation
of a child’s rights to intervention. Being experts in
communication, SPs should be leading the way in
health and education to think outside the standardised
In 2008, the Council of Australian
Governments (COAG) committed itself to
reducing Indigenous
1
disadvantage and
closing the life-expectancy gap between
Indigenous and non-Indigenous Australians
within one generation. Given the established
links between language development,
literacy, well-being, and life expectancy, the
majority of COAG’s endorsed areas of focus
(“building blocks”) relate directly to services
provided by speech pathologists. Speech
pathologists are therefore invited to take their
places in affording change to achieve this
overall goal. A step towards successful
provision of services is the application of
valid and reliable assessment methodologies
for a given population. The aim of this non-
exhaustive literature review is to provide
some of the evidence available to speech
pathologists working with Indigenous
children regarding culturally safe and valid
cross-cultural communication assessments.
It is hoped that speech pathologists will treat
this review as an introductory resource when
investigating relevant assessment options for
culturally valid research and/or clinical
practice.
Speech pathology in an Indigenous
Australian context
Speech pathologists (SPs) are experts in language and
communication who work with clients and families from
diverse social, cultural, and linguistic backgrounds.
Communication behaviours vary cross-culturally and these
differences require careful consideration from SPs when
discerning language
disorder
from language
difference
. In
Australia, this is of course true for SPs working with
Indigenous children growing up in monolingual, bilingual,
multilingual, or bidialectal communities.
A recent web-based Speech Pathology Australia
Discussion board entitled “Aboriginal Australians and
Language” (moderated by Dr Cori Williams) showed
Petrea Cahir
This article
has been
peer-
reviewed
Keywords
ABORIGINAL
CHILD
LANGUAGE
ASSESSMENT
CROSS-
CULTURE
INDIGENOUS
SPEECH
PATHOLOGY