The nature and piloting of a tool to screen for acquired communication disorders in Aboriginal Australians after brain injury: Exploring culturally valid assessment to improve rehabilitation pathways

Identification of acquired communication disorders (ACD) after brain injury is an important first step in ensuring that brain injury survivors receive appropriate services and support. However this endeavour presents significant challenges when screening and assessment tools are not appropriate for use across cultures. This is especially important, given the centrality of linguistic and cultural differences in communication. A significant amount of work has been undertaken to translate communication disorder assessments into different languages. However, less attention has been paid to core cross-cultural differences in communication and how to reflect these in assessment tools. The current study explored this issue with Aboriginal Australians who comprise 3% of the Australian population and whose cultural needs are often not met when interacting with the health system. Under-identification of ACD likely contributes to current under-representation of Aboriginal people in rehabilitation services (Katzenellenbogen et al., 2010; Thrift, Cadilhac, & Eades, 2011). A new screening tool – the Aboriginal Communication Assessment after Brain Injury (ACAABI) – was developed to enhance pathways to rehabilitation services. Details of consultative and collaborative processes involved are reported elsewhere (Armstrong et al., 2017). This article describes the final version of the tool and the lessons learned during the piloting phase