Speech-language pathology services for acquired communication disorders among indigenous peoples: A systematic review

Indigenous adults experience higher rates of neurological incidents than non-Indigenous populations, increasing their risk of acquired communication disorders (ACD). However, access to culturally safe speech-language pathology (SLP) services in their language remains challenging. This review explored issues raised in the literature concerning SLP services for Indigenous adults with ACD globally. More specifically, it explored Indigenous adults with ACD"s perspectives, highlighted the barriers reported by speech-language pathologists, and identified avenues for improvements. Despite the global scope of the search, the fourteen included articles were all based in Australia and Aotearoa New Zealand. Three descriptive themes emerged from the perspectives of Indigenous adults: 1) the impacts of language and culture; 2) a lack of information; 3) the context of SLP services. Two themes emerged as barriers to SLP care according to clinicians: 1) a lack of appropriate resources and cultural education; 2) the geographical and service delivery contexts of SLP services. Finally, the need for cultural safety emerged as the main theme for improving SLP care. Enhanced cultural education, along with adapted SLP materials, is needed to provide culturally safe care to Indigenous adults with ACD. However, these initiatives must be accompanied by systemic changes to the organizational policies shaping SLP services.