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ACQ Volume 13, Number 3 2011 147
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Suggestions
In summary, when working with patients who either do not
speak any English or who are limited in their English
proficiency, speech pathologists may consider the following:
• book extra time with the interpreter, especially on the
first few sessions;
• consider the need for formal assessment and plan and
modify assessments in advance;
• investigate the availability of resources in other languages;
• request cultural awareness training with the interpreter,
especially for cultures the speech pathologist is
unfamiliar with;
• use professional interpreters and also engage any
English-speaking family as early as possible;
• request the same interpreter for consistent translation
services;
• consider age- and gender-matching of the interpreter
and speech pathologist to the patient;
• be mindful of confidentiality in small ethnic communities;
• liaise with the interpreter to check appropriateness of
treatment;
• consider the location of management (clinic, ward, or
home) and the effect of this location on your ability to
conduct management as well as the impact this may
have on the patient;
• set goals with the patient, family, and interpreter and
clarify patient priorities;
• consider the patient’s previous exposure to formal
education and literacy levels which may result in a lack
of familiarity with western teaching techniques and
reduced self-confidence with therapy;
• encourage home practice and provide linguistically
appropriate materials;
• attempt to use culturally appropriate and functional
therapy activities;
• consider access to appropriate community services;
• include non-English-speaking or LEP patients into
research to investigate the suitability of speech
pathology interventions for this population.
Summary
Quality, consistent professional interpreting services are
essential to build rapport and deliver efficient and effective
speech pathology management when working with patients
who have LEP. Understanding a patient’s background can
increase the speech pathologist’s cultural competence
which may, in turn, improve rapport and patient outcomes.
LEP patients such as Gloria are at risk of decreased access
to health care but can benefit from home-based speech
pathology with cultural, linguistic, and time modifications.
Acknowledgements
The author greatly acknowledges Gloria and her family, The
National Stroke Foundation for funding the Clinical
Research Development Award, and Professor Graeme
Hankey and the staff at Rehabilitation in the Home, Royal
Perth Hospital for their ongoing support and advice.
Katy Stewart is a senior speech pathologist at Rehabilitation in the
Home, Royal Perth Hospital. Her research interests include stroke
rehabilitation and the use of therapy assistants.
Correspondence to:
Katy Stewart
Senior Speech Pathologist
Rehabilitation in the Home, Royal Perth Hospital
GPO Box X2213, Perth, Western Australia, 6001
phone: 618 6477 5152
email: