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JCPSLP
Volume 19, Number 1 2017
Journal of Clinical Practice in Speech-Language Pathology
of discourse expectations of non-Aboriginal teachers
which reflected both cultural differences between what
each considered significant aspects of what should be
discussed, plus the effect of an externally constructed
context (i.e., external to the Aboriginal participants).
Malcolm concluded that:
The discontinuity, as I see it, is always associated with
the presence of Aboriginal communicators in a setting
or speech event which is defined by non-Aboriginals.
The key, if there is a key, to how Aboriginal people
communicate, seems to me to lie in who defines the
setting and determines the discourse pattern. There
is therefore a commonality, in communicative terms
between schools, classrooms, law courts, offices
of government departments and anywhere where
there are interactions in which the non-Aboriginal
interlocutor defines the terms of communication. All
of these settings will be associated with behaviour
patterns which will not evidence the communicative
competence of many Aboriginal people. (p. 150)
Malcolm also writes about teachers not being able to “set
up appropriate conditions for them [the students] to
communicate in a way which demonstrates the extent of
their competence” (p.151). These statements are very
reminiscent of comments made about the aphasia
rehabilitation context which question the role of the
traditional assessment and treatment situation as tending to
demonstrate incompetence rather than the person with
aphasia’s competence (Kovarsky, Duchan, & Maxwell,
1999; Simmons-Mackie & Damico, 2008, 2009).
While linguistic and sociolinguistic issues have been the
focus of this paper, they must obviously be considered
within the broader cultural context when working with
Aboriginal clients. Issues such as construction of identity
and disability within Aboriginal populations, co-morbidities,
and attitudes to health services obviously need to be
addressed when considering potential services (Armstrong,
Hersh, Katzenellenbogen et al., 2015; Penn & Armstrong, in
press). The centrality of such issues was noted by Ariotti
(1999), for example, who wrote about “the social construction
of Anangu disability”. In this paper, he discussed the
importance of health providers taking into account
historical, cultural and linguistic factors, in order to gain
insight into their clients’ attitudes, customs, and beliefs.
Similarly, Boddington and Räisänen (2009) discuss the
holistic nature of Aboriginal definitions of health and explore
the difficulties inherent in attempting to align western and
Aboriginal definitions because of cultural differences.
In order to accommodate language variation in assessment
and treatment practices, much work has to be done within
the discipline of speech pathology and the “sub-specialty”
of aphasiology. The notion of aphasia “assessment” itself
and its associated paradigms need to be first re-examined
in contexts such as the Aboriginal Australian one described
in this paper if clients are to be provided with rehabilitation
that is both culturally sensitive and informed. As with all
investigations involving language and cross-cultural research
and clinical practice, linguistic and cultural awareness on
the part of practitioners is an integral first step.
Declaration of interest:
The authors report no conflicts of
interest. The authors alone are responsible for the content
and writing of the paper.
References
Ariotti, L. (1999). Social construction of Anangu disability.
Australian Journal of Rural Health
,
7
, 216–222.
ramifications for the assessment and treatment of aphasia
by clinicians within Australia. Discussions of such
differences, which at times can appear subtle on a surface
level, also have implications for aphasiologists dealing with
language variation worldwide. As language specialists,
aphasiologists (and indeed speech-language pathologists in
general) working in clinical settings need to have some
knowledge of language differences in order to be able to
accurately assess language skills and diagnose “disorder”
as opposed to “difference”. In the paediatric field of
language disorders, there has been much controversy
within Australia regarding the use of tests standardised on
SAE speaking children, for example, and it has been
suggested that non-standardised assessment methods
may indeed better accommodate language difference and
reveal an AE speaking child’s actual linguistic abilities
(Gould, 2008a, 2008b, 2008c, 2009). In the context of
working across languages, Roger and Code (2011) have
discussed the pitfalls associated with in working clinically
with bilingual patients. These include situations where
online translations of assessment tasks elicit responses
which may be perfectly appropriate to the communicative
context created through an interpreter-mediated interaction,
but do not reflect the “correct” response targeted by the
speech pathologist. This results in responses being labelled
as “inappropriate” or “incorrect”. Implications of inaccurate
assessments of language competence at any level in a
person with aphasia, i.e., phonology, morphology, syntax,
semantics, pragmatics, may equally lead to mis-directed
treatment attempts to change the person’s first language
skills, which may decrease that individual’s communicative
functionality and underutilise any retained skills. Treatment
goals based on inaccurate assessment would also seem
inappropriate to the person and their family – potentially
further alienating Aboriginal people from services which are
already under attended (Edis, 2002).
While differences at the levels of phonology, syntax
and lexical semantics can appear relatively clear, it is the
interaction of these levels with the pragmatic level and
with socio-cultural factors which highlights important
differences to be noted. Western methods of eliciting and
analysing narratives, for example, may not be appropriate
in an Aboriginal context. Elicitation techniques such as
picture sequence cards, ordered to target a particular
chronological order of events may well elicit discourse from
Aboriginal speakers that is very different in structure from
the targeted western narrative structure. As noted above,
a western speaker’s pattern of integrating and presenting
detail is very different from an Aboriginal speaker’s pattern.
Hence, for a valid assessment of the speaker’s skill to
be made, assessors must be aware of these differences.
Conversational dynamics are very different as well;
hence traditional analyses and subsequent advice to
conversational partners would have to be modified.
In assessing a person’s language skills, context is known
to be central in how the person might communicate
in a particular situation. In the same way that different
conditions of eliciting language have been explored
with English and European language speaking people
with aphasia (e.g., Wright & Capiluto, 2009), speech
pathologists are challenged with examining optimal ways
of assessing Aboriginal peoples’ skills as appropriate and
in a way that reflects true abilities. In a related but relevant
article, Malcolm (1994) described the language behaviours
of Aboriginal children in and outside the classroom (on
the edges of the Western Desert in Western Australia)
and found them very different. He identified different kinds