Intellectual disability and indigenous Australians: An overview

Abstract

The review summarizes important literature in the emerging field of intellectual disability (ID) in indigenous Australians. Search of various electronic databases revealed 19 papers that provide information regarding prevalence, sociodemographic factors, and issues in assessment and management. Overall, there is limited information regarding ID in indigenous Australians, which is reported to be more prevalent compared with nonindigenous Australians. Sociocultural constructs affect what is considered to be ID in indigenous communities and this may be at odds with western notions. Other difficulties include lack of validated psychometric instruments to effectively measure cognitive functioning in indigenous Australians. Prenatal, perinatal, and postnatal factors are significant factors that impair brain development and contribute to ID in indigenous communities. Comorbid physical and psychiatric disorders need to be assessed and managed. This paper provides an overview of current knowledge regarding this important area that requires further research, appropriate training, and resourcing.

How well does the National Disability Insurance Scheme respond to the issues challenging Indigenous people with disability?

“…Services generally organised pursuant to the medical model provide support to people with disability from a health perspective and do not take into account the cultural and lifelong needs of Indigenous people with disability and their families (Ariotti, 1999;Farrelly & Lumby, 2008;Greenstein, Lowell, & Thomas, 2016a, 2016b. This blocks Indigenous willingness to engage with disability services, and widens Indigenous reluctance to identify disability issues and negative attitudes towards "authorities" Farrelly & Lumby, 2008;Green et al, 2016;Nagel et al, 2008;Roy & Balaratnasingam, 2014).…”

“…Caring for a person with disability in Indigenous society is traditionally assigned to family members (Ariotti, 1999;Clements et al, 2010;Farrelly & Lumby, 2008;Gething, 1994;Gilroy, Donelly et al, 2016;Green et al, 2014;Kendall & Marshall, 2004;Lin et al, 2012;Nagel et al, 2008;Roy & Balaratnasingam, 2014;Sloane, 2003;Stephens et al, 2014). The care requirements can burden family members when the person with disability has complex and multiple requirements, or there are many persons in the family in concurrent need of such care, or other problems currently exist for the family (e.g., poverty and unemployment).…”

“…Indigenous people with disability face additional barriers when assessments and instruments do not satisfactorily take cultural diversity into account (Clements et al, 2010;Hersh, Armstrong, Panak, & Coombes, 2015;Roy & Balaratnasingam, 2014). The study findings of Bohanna, Catherall, and Dingwall underline the financial and political supports needed to develop "reliable, valid and culturally acceptable instruments", such as the Kimberley Indigenous Cognitive Assessment that has primarily succeeded in assessing dementia in Indigenous Australians (Bohanna et al, 2013, p. 587).…”

“…A literature search also reveals a significant lack of cultural competence and cultural diversity in the workforce in service settings Clements et al, 2010;Gething, 1994;Green, 2013;Green et al, 2014;Greenstein et al, 2016b;Hersh et al, 2015;Kendall & Marshall, 2004;Roy & Balaratnasingam, 2014). Several references make recommendations about cultural awareness training to staff, further investment in skills and qualifications of employed community members and more flexible working conditions being offered to health workers and carers (Dew et al, 2014;Gilroy, Dew et al, 2016;Gilroy, Donelly et al, 2016;Green et al, 2016;Hersh et al, 2015;Stephens et al, 2014;Wolstenholme, 1996).…”

“…Due to social and attitudinal barriers, communication issues often challenge the capacity of Indigenous people with disability when trying to express their needs (Clements et al, 2010;Green et al, 2014;Kendall & Marshall, 2004;Roy & Balaratnasingam, 2014;Sloane, 2003). In some remote areas where English is not the first language of Indigenous people, lack of accessible information regarding disability services is also reported (Farrelly & Lumby, 2008;Greenstein et al, 2016b;Stephens et al, 2014).…”