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Missing Voices: Communication Difficulties After Stroke and Traumatic Brain Injury in Indigenous Australians
The Missing Voices research project aimed to:
- investigate the extent and impact of Acquired Communication Disorders (ACD) in urban and rural Aboriginal and Torres Strait Islander populations in Western Australia (WA) following stroke or traumatic brain injury (TBI)
- develop and validate a culturally appropriate ACD assessment tool for use by health professionals working with Aboriginal people after stroke and TBI
- describe the current status of communication rehabilitation services for Aboriginal and Torres Strait Islander peoples
- develop accessible and culturally appropriate service delivery models for the individuals and their families experiencing ACD.
The Missing Voices project 'gave voice' to and identified the needs and wants of Aboriginal people with ACD and their families, in respect to rehabilitation and daily life after stroke and TBI. The project also increased awareness of the extent and impact of ACD in the Aboriginal community of WA and within mainstream and Aboriginal health services, increasing the profile of stroke, TBI and rehabilitation. It also created the first ever screening tool to be used specifically with Aboriginal people to aid in the identification of acquired communication disorders after a stroke or TBI.
Going forward, the Missing Voices project will trial culturally secure models of service delivery in stroke and traumatic brain injury rehabilitation with Aboriginal people, families, communities and health services.
The Missing Voices project was funded by the National Health & Medical Research Council.
Abstract adapted from the National Health and Medical Research Council
Professor Elizabeth Armstrong
Foundation Chair in Speech Pathology
School of Medical and Health Sciences
Edith Cowan University
270 Joondalup Drive
Joondalup WA 6027
Ph: (08) 6304 2769
Ph: (08) 6304 5101
Fax: (08) 6304 2640
Armstrong EM, Ciccone N, Hersh D, Katzenellebogen J, Coffin J, Thompson S, Flicker L, Hayward C, Woods D, McAllister M (2017)
Development of the Aboriginal Communication Assessment After Brain Injury (ACAABI): a screening tool for identifying acquired communication disorders in Aboriginal Australians.
International Journal of Speech-Language Pathology; Early Online(http://dx.doi.org/10.1080/17549507.2017.1290136): 1-12
Katzenellenbogen JM, Atkins ER, Thompson SC, Hersh D, Coffin J, Flicker L, Hayward C, Ciccone N, Woods D, McAllister M, Armstrong EM (2016)
Missing voices: profile and extent of acquired communication disorders in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia using linked administrative records.
International Journal of Stroke; 11(1): 103-116
Hersh D, Armstrong E, Bourke N (2015)
A narrative analysis of a speech pathologist's work with Indigenous Australians with acquired communication disorders.
Disability and Rehabilitation; 37(1): 33-40
Hersh D, Armstrong E, Panak V, Coombes J (2015)
Speech-language pathology practices with Indigenous Australians with acquired communication disorders.
International Journal of Speech-Language Pathology; 17(1): 74-85
Armstrong E, Hersh D, Hayward C, Fraser J (2015)
Communication disorders after stroke in Aboriginal Australians.
Disability and Rehabilitation; 37(16): 1462-1469
Armstrong E, Hersh D, Katzenellenbogen JM, Coffin J, Thompson SC, Ciccone N, Hayward C, Flicker L, Woods D, McAllister M (2015)
Study protocol: Missing Voices - communication difficulties after stroke and traumatic brain injury in Aboriginal Australians.
Brain Impairment; 16(2): 145-156
Armstrong E (2014)
Australian Aphasia Rehabilitation Pathway: Aboriginal and Torres Strait Islander populations: best practice statements.
Retrieved 2014 from
This web-based resource aims to encourage culturally appropriate working practices for speech pathologists working with Aboriginal and Torres Strait Islander people who have been affected by a stroke.
The 12 statements outline the following attributes of best practice:
- cross cultural competence training
- implementing local protocols
- checking Aboriginal and Torres Strait Islander status
- involving an Aboriginal liaison officer (ALO)
- using interpreter services
- using appropriate terminology
- including yarning time
- exploring patient's family and community roles
- taking a holistic management approach
- providing assessment choice
- being aware of local services
- reflective practice.
Australian Indigenous HealthInfoNet abstract
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