Issues and Principles in Service Delivery to Communicatively Impaired Minority Bilingual Adults in Neurorehabilitation

ABSTRACT

Demographic and epidemiological trends coupled with health-care needs in minority populations highlight the imperative need to develop effective, culturally appropriate clinical approaches for minority adults with communication impairments. The steady increase in linguistic and cultural diversity in the country includes a large number of bilingual adults, which is estimated to continue. Because strokes are quite prevalent in racial/ethnic minorities, the number of bilingual adults with acquired communication disorders will similarly increase. However, members of minority groups presently confront disparities in health-care services compared with the general population that translates into reduced health outcomes. This article discusses the current clinical needs and complexities in service delivery to communicatively impaired minority adults, with a special focus on bilingual adults with aphasia.

KEYWORDS

Minority adults - aphasia - bilingualism - service disparities

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APPENDIX A: EXAMPLES OF QUESTIONS USING LIKERT SCALES IN THE SURVEY STUDY

Frequency

17. Use the scale below to indicate the frequency with which you have worked with bilingual adult clients from the following ethnic/racial groups in the last 5 years.

Never	Infrequently	Sometimes	Frequently	Very Frequently
1	2	3	4	5

1. White   1   2   3   4   5

2. Hispanic/Latino(a)   1   2   3   4   5

3. Black (African American, Caribbean black, African)   1   2   3   4   5

4. Asian/Pacific Islander (Filipino, Chinese, Asian Indian, Hawaiian, Samoan, etc.)   1   2   3   4   5

5. Native American or Alaskan Native   1   2   3   4   5

6. Other (please specify): ____________________________   1   2   3   4   5

Extent of Preparation

19. On the scale below, circle the number that indicates the extent of preparation you received to work with bilingual clients during your professional training.

None or No Extent	Small Extent	Moderate Extent	Great Extent	Very Great Extent
1	2	3	4	5

Degree of Satisfaction

34. On the scale below, circle the number that indicates how satisfied you feel with the amount of information and resources available to enhance speech-language services with bilingual adults.

Very Dissatisfied	Dissatisfied	I Don't Know	Satisfied	Very Satisfied
1	2	3	4	5

Importance

38. Use the scale below to indicate the importance of the following items as possible areas that college training programs should emphasize to improve professional preparation to work with bilingual clients.

Very Unimportant	Somewhat Unimportant	Somewhat Important	Important	Very Important
1	2	3	4	5

• a. Language acquisition in bilingual children   1   2   3   4   5

• b. Language acquisition in bilingual adults/second language acquisition   1   2   3   4   5

• c. Understanding what language proficiency in bilingual speakers means   1   2   3   4   5

• d. Testing procedures with bilingual speakers   1   2   3   4   5

• e. Working with interpreters/translators   1   2   3   4   5

• f. Treating language disorders in bilingual speakers   1   2   3   4   5

• g. Understanding when there is a language difference, resulting from bilingualism, or a real language disorder, resulting from a genuine problem   1   2   3   4   5

• h. Understanding aphasia and other neurogenic communication problems in bilingual speakers   1   2   3   4   5

• i. Discussions on research on bilingual speakers that has clinical use in speech-language pathology services   1   2   3   4   5

• j. Course content on minority populations   1   2   3   4   5

• k. Other (please specify): _______________________________________________________________________________________   1   2   3   4   5

Extent of Interest

39. On the scale below, circle the number that corresponds to your extent of interest in participating in continuing education opportunities related to bilingual adults.

Not at All Interested	Mildly Interested	Moderately Interested	Quite Interested	Extremely Interested
1	2	3	4	5