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"People like numbers": A descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory

Dingwall, Kylie M., Pinkerton, Jennifer and Lindeman, Melissa (2013). "People like numbers": A descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory. BMC Psychiatry,13(42):1-13.

Document type: Journal Article
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IRMA ID 11035xPUB18
Title "People like numbers": A descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory
Author Dingwall, Kylie M.
Pinkerton, Jennifer
Lindeman, Melissa
Journal Name BMC Psychiatry
Publication Date 2013
Volume Number 13
Issue Number 42
ISSN 1471-244X   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84873048863
Start Page 1
End Page 13
Total Pages 13
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Achieving culturally fair assessments of cognitive functioning for Aboriginal people is difficult due to a scarcity of appropriately validated tools for use with this group. As a result, some Aboriginal people with cognitive impairments may lack fair and equitable access to services. The objective of this study was to examine current clinical practice in the Northern Territory regarding cognitive assessment for Aboriginal people thereby providing some guidance for clinicians new to this practice setting.

Method
Qualitative enquiry was used to describe practice context, reasons for assessment, and current practices in assessing cognition for Aboriginal Australians. Semi-structured interviews were conducted with 22 clinicians working with Aboriginal clients in central and northern Australia. Results pertaining to assessment methods are reported.

Results
A range of standardised tests were utilised with little consistency across clinical practice. Nevertheless, it was recognised that such tests bear severe limitations, requiring some modification and significant caution in their interpretation. Clinicians relied heavily on informal assessment or observations, contextual information and clinical judgement.

Conclusions
Cognitive tests developed specifically for Aboriginal people are urgently needed. In the absence of appropriate, validated tests, clinicians have relied on and modified a range of standardised and informal assessments, whilst recognising the severe limitations of these. Past clinical training has not prepared clinicians adequately for assessing Aboriginal clients, and experience and clinical judgment were considered crucial for fair interpretation of test scores. Interpretation guidelines may assist inexperienced clinicians to consider whether they are achieving fair assessments of cognition for Aboriginal clients.
Keywords Cognition
Assessment
Cross-cultural
Testing
Indigenous
Aboriginal
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 3.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 3.0 License
Link to published version
URL https://creativecommons.org/licenses/by/3.0/au/legalcode
http://www.biomedcentral.com/1471-244X/13/42/abstract


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