Assessment of a Samoan–English speaker with bilingual aphasia: “it’s hard”

Abstract

Background: Speech-language therapists need to provide culturally and linguistically appropriate services for their clients. However, language assessment with bilingual adults with aphasia can be challenging for clinicians, due to the complexity surrounding both aphasia and bilingualism. There are few investigations focusing on the assessment of bilingual speakers with aphasia. More research is needed, particularly in relation to the specific experience of the individuals involved in the assessment process.

Aim: This study aimed to explore the experience of an outpatient language assessment involving a Samoan–English speaker with bilingual aphasia, from the perspectives of the participants in the process.

Methods & Procedures: An instrumental case study was used to explore one case involving a community speech-language therapist’s assessment of a bilingual Samoan–English speaker with aphasia. Data collection involved three phases: participant observation of the two assessment sessions; semi-structured interviews with the individual with aphasia, her family member, her speech-language therapist, and one of the interpreters; and a stimulated-recall interview with the speech-language therapist. Qualitative content analysis was used to identify themes within the data.

Outcomes & Results: Eight themes were revealed in relation to assessment of a bilingual adult with aphasia: Samoan–English language assessment is a hard process for the individuals involved; Samoan–English language assessment as a team process; differences in understanding of communication impairments and the assessment process; time; preparation; appropriateness of assessment tasks and resources; uncertainty; and flexibility.

Conclusions: The findings highlight the complex nature of language assessment involving a bilingual Samoan–English speaker with aphasia and provide valuable insights into the experience of the process. The investigation identified a number of useful clinical implications that can help to inform clinical practice for clinicians working with assessment of bilingual aphasia both in Samoan–English speakers and in other bilingual populations.