Evaluation of aphasia in a culturally and linguistically diverse
context: Practices of and challenges faced by speech-language
pathologists
Abstract
Rationale, aims and objectives: Cultural and linguistic diversity is a
major challenge faced by speech-language pathologists (SLPs) in
conducting evaluation of aphasia, especially in low-resource regions.
Without proper consideration of cultural and linguistic issues when
adapting English-based language tests to other languages, performance of
individual with aphasia may not be valid and reliable. The present study
was conducted: (a) to identify the practices of SLPs in conducting
aphasia evaluation in Malaysia, which is a country consisting of
multiethnic populations, and (b) to determine challenges faced by SLPs
when conducting aphasia evaluation involving a diverse group of
individuals. Methods: An online survey was distributed to SLPs who are
practicing in Malaysia involved in the management of aphasia during the
period of data collection. The questionnaire was developed to gather
data on participants’ background, their practices in evaluating people
with aphasia, and challenges that they face related to aphasia
evaluation. Proportions were calculated for each item in the
questionnaire to determine patterns related to background information,
SLP practices and related challenges. Results: Malaysian SLPs were found
to gather information about their patients via interviews with
caregivers, medical records, and direct testing and observation.
Abilities of people with aphasia that were consistently reported to be
assessed frequently include auditory language comprehension, verbal
expression, repetition of words and sentences, and social communication.
Two major challenges identified were linguistic barrier and lack of
standardized assessment tools for aphasia evaluation. Conclusions: There
are some similarities in terms of SLP practices and challenges faced by
the participants in comparison with other studies conducted in diverse
contexts. Issues related to cultural and linguistic diversity
complicates the development of appropriate resources for aphasia
evaluation. Consideration of those issues in development of original and
adapted evaluation tools may improve the accuracy of diagnosis,
identification of severity, and planning of intervention.