Zupan, B., Campbell-Woods, N., & Thompson, H. (2021). Scoping review: Language assessment practices for Aboriginal and Torres Strait Islander children in Australia and guidelines for clinical practice. Australian Journal of Rural Health. #lockedupknowledge for at $USD42.00 https://doi.org/10.1111/ajr.127661.
1. Summary: This cool scoping literature review (I love literature reviews!) found 9 studies on the topic of language assessment practices in three dimensions: how language abilities were assessed, the ways in which assessments are being adapted, and the context in which results are being interpreted. The concept of cultural safety is central to the article, with the 9 studies evaluated for components of cultural safety using the Cultural Formulation model.
2. Conclusion: “Overall, studies showed that standardised language assessments do not accurately represent the language abilities of Aboriginal and Torres Strait Islander children. If used, they should be used alongside other non- standardised tasks and/ or scoring should be adapted. Considerations for increasing cultural safety when assessing the language abilities of Aboriginal and Torres Strait Islander children are outlined.”
3. “The recommendations outlined in the discussion should assist student clinicians and speech pathologists as they work towards prioritising culturally safe practice.” (p. 16). Implications for culturally safe language assessment:
a. (cultural identity) consider the possibility that the child might be bilingual or multilingual so language difference vs disorder can be accurately differentiated.
b. (cultural explanations) the importance of creating and maintaining connections with the children, their families and local community was highlighted as a key practice principle
c. (cultural factors) consider the support a child is provided via their family and community but also any social stress that might be present.
d. (cultural elements) potential cultural and social mismatch between the assessor and child should also be considered – conduct assessments in environments familiar to children; take time to develop rapport with the children and family; and ensuring questions are meaningful and purposeful, task materials are culturally appropriate, and administration is interactive and conversational.
e. (cultural assessment) consider cultural differences when interpreting assessment results and be cautious when using standardised norms to identify Aboriginal and Torres Strait Islander children’s language abilities.
4. The coolness in this paper is the use of a Cultural Formulation model to assess how research papers reported on cultural factors. “Practice standards need to continue to be developed to shift to an approach that is more centred around respecting and valuing Aboriginal and Torres Strait Islander ways of socially interacting and exchanging information.” (p. 15)
5. Cultural Formulation model. This was developed in the United States in response to criticism of insensitivity to cultural issues in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It was argued that clinicians needed a method to take culture into account when conducting a clinical evaluation (Lewis-Fernandez R, Diaz N. The cultural formulation: a method for assessing cultural factors affecting the clinical encounter. Psychiatr Q. 2002;73:271– 295). It includes a battery of questions organised into five categories: cultural identity, cultural explanations, cultural factors, cultural elements, and cultural assessment.
6. Relationship between cultural safety and cultural formulation: this is flimsy because of “back-casting” or applying current standards to past practices. The cultural formulation model was developed in early 2000s in the United States and it has no philosophical grounding in cultural safety theory, principles, or practice. It certainly is not culturally validated with First Nations Australians. Therefore, apply scepticism to claims that meeting aspects of the cultural formulation model are associated with culturally safe speech pathology.
7. Another literature review that excludes First Nations Australians in the review process. This knowledge constructions processes – literature reviews – serve as a foundation for influencing policy and practice. “The recommendations outlined in the discussion should assist student clinicians and speech pathologists as they work towards prioritising culturally safe practice.” (p. 16)
However, First Nations Peoples’ intellectual contribution wasn’t considered in the question formulation, inclusion and exclusion criteria, reviewers decisions, determining the validity of the Cultural Formulation model, adaptation of narrative elements, identifying considerations for analysis, data analysis and interpretation, or recommendation formulation or writing.
8. Speech Pathology Australia recognises the need to “Develop guidelines for Aboriginal and Torres Strait Islander research published in SPA publications” (RAP), and “recognises, values and respects Aboriginal and Torres Strait Islander peoples’ cultures, knowledges, languages and ways of healing” (Apology to Aboriginal and Torres Strait Islander Peoples). The “Review template for Building the Evidence Base: Supporting Equitable Outcomes for Aboriginal and / or Torres Strait Islander Peoples” does not apply to literature reviews.
9. Makes a valuable contribution to developing culturally safe speech pathology. The key here is pushing the field to seriously consider what is culturally safe speech pathology. Reviews are a starting point and the next step could be to develop empirical research with First Nations Peoples, and using an Indigenist methodology.
Looking forward to reading more from the speech pathology mob!Speech Pathologists, what do you think?
Comment at the Facebook group, Cultural Safety and Security: https://www.facebook.com/groups/culturalsafety/posts/1057705548313511/