title: Assessing services with communicatively impaired bilingual adults in culturally and linguistically diverse neurorehabilitation programs.
abstract: The combined effect of the steady increase in cultural and linguistic diversity and epidemiological factors in minority populations is estimated to continue having an impact on adult neurorehabilitation programs in the country, particularly in the number of bilingual individuals receiving clinical services. No comprehensive assessment of the present professional and clinical realities in service delivery to communicatively impaired adults in culturally and linguistically diverse (CLD) neurorehabilitation contexts has been conducted. The current survey research was undertaken to examine current professional training, clinical practices, and challenges in the services rendered to the steadily increasing numbers of communicatively disordered adults in CLD neurorehabilitation programs with a special focus on bilingual persons. A 36-question, 6-section survey was administered to health care-based SLPs working with adults to examine multiple factors regarding work setting and caseload, professional training, clinical tools and procedures, service delivery issues, and suggestions to improve clinical work with bilingual adults in CLD neurorehabilitation environments. Results support that SLPs presently make sensible decisions to serve communicatively disordered bilingual adults with neuropathologies despite training gaps and scant clinical resources. Responses additionally highlight critical areas to improve professional preparation and available resources. Results are discussed in terms of strengths and weaknesses as well as their implications to professional education and target research areas in order to minimize present gaps in service delivery with bilingual speakers in CLD adult neurorehabilitation programs.
  
  
  OBJECTIVE
  As a result of this activity, the reader will be able to: (1) Discuss the demographic and epidemiological factors that suggest a continued increase in the number of communicatively impaired bilingual adults in CLD neurorehabilitation programs. (2) Describe current strengths and weaknesses in the diagnostic and therapeutic practices employed by SLPs with bilingual clients in CLD adult neurorehabilitation programs. (3) Describe possible strategies to improve current limitations in professional training and clinical resources that would strengthen the current services given to bilingual adults in CLD neurorehabilitation programs.
authors.affiliation: St. John's University, New York City, United States. Electronic address: centenoj@stjohns.edu.
authors.forename: José G
authors.initials: JG
authors.lastname: Centeno
mesh_terms: D000328:Adult; D003147:Communication Disorders / Q000534:rehabilitation*; D003469:Culture; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D000066530:Neurological Rehabilitation; D011787:Quality of Health Care; D013066:Speech-Language Pathology / Q000592:standards*
keywords: Bilingual adults; Diversity; Neurogenic communication disorders; Speech-language services