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Study Protocol: Missing Voices – Communication Difficulties after Stroke and Traumatic Brain Injury in Aboriginal Australians

  • Elizabeth Armstrong (a1), Deborah Hersh (a1), Judith M. Katzenellenbogen (a2), Juli Coffin (a3) (a4), Sandra C. Thompson (a2), Natalie Ciccone (a1), Colleen Hayward (a5), Leon Flicker (a6), Deborah Woods (a4) and Meaghan McAllister (a1)...


Background: Aboriginal and Torres Strait Islander Australians experience stroke and traumatic brain injury (TBI) with much greater frequency than non-Aboriginal Australians. Acquired communication disorders (ACD) can result from these conditions and can significantly impact everyday life. Yet few Aboriginal people access rehabilitation services and little is known about Aboriginal peoples’ experiences of ACD. This paper describes the protocol surrounding a study that aims to explore the extent and impact of ACD in Western Australian Aboriginal populations following stroke or TBI and develop a culturally appropriate screening tool for ACD and accessible and culturally appropriate service delivery models.

Method/Design: The 3-year, mixed methods study is being conducted in metropolitan Perth and five regional centres in Western Australia. Situated within an Aboriginal research framework, methods include an analysis of linked routine hospital admission data and retrospective file audits, development of a screening tool for ACD, interviews with people with ACD, their families, and health professionals, and drafting of alternative service delivery models.

Discussion: This study will address the extent of ACD in Aboriginal populations and document challenges for Aboriginal people in accessing speech pathology services. Documenting the burden and impact of ACD within a culturally secure framework is a forerunner to developing better ways to address the problems faced by Aboriginal people with ACD and their families. This will in turn increase the likelihood that Aboriginal people with ACD will be diagnosed and referred to professional support to improve their communication, quality of life and functioning within the family and community context.


Corresponding author

Address for correspondence: Elizabeth Armstrong, School of Psychology & Social Science, Edith Cowan University 270 Joondalup Drive, Joondalup, Western Australia, 6025. Phone: 61 8 6304 2769. E-mail:


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