Exploring clinical reasoning in child language assessment through decoloniality

Area of Science:

• Speech-language pathology
• Decolonial studies
• Qualitative research

Background:

• Western epistemologies for clinical reasoning are insufficient for Indigenous contexts.
• Decolonial frameworks are needed to address cultural complexities in healthcare.
• Sri Lankan speech-language pathologists navigate diverse knowledge systems.

Purpose of the Study:

• Explore how Sri Lankan speech-language pathologists integrate Indigenous and Western perspectives in clinical reasoning.
• Examine the negotiation and valuation of different knowledge systems within a decolonial framework.
• Understand the impact of socio-political forces on clinical reasoning in diverse cultural settings.

Main Methods:

• Participatory research methodology within a decolonised qualitative research paradigm.
• Collaborative data generation with eight Sri Lankan speech-language pathologists.
• Oral history narratives and object-based textual reflections analyzed iteratively using visual-textual and reflexive thematic analysis.

Main Results:

• Four key themes emerged: professional education, individuality in practice, holistic thinking, and balancing interests and priorities.
• Social, political, and economic forces significantly impact practitioners' clinical reasoning.
• Participants collaboratively analyzed and interpreted data, fostering shared understanding.

Conclusions:

• Practising science within Indigenous contexts presents challenges due to colonial legacies.
• Imperialism affects service delivery in marginalized communities.
• Practitioner self-awareness of identity and wisdom can foster culturally relevant and equitable practices.