Screening, assessing, and diagnosing disability in people from refugee backgrounds can have added complexity due to:
- Lack of early screening and assessment – for example, refugee children/adolescents have often missed screening for visual or hearing problems (RCH, 2015)
- Lack of early intervention
- Previous exposure to illnesses that no longer exist in Australia – such as polio
- Previous illness or injuries that have not received proper treatment.
Cross Cultural Assessment
Standardised tests of cognitive functioning may be inappropriate for people from refugee backgrounds for a range of reasons:
- Most formal assessment tools have been designed and standardised within the majority, Australian born-population, and are therefore not validated for use in refugee background populations
- Limited literacy in a person’s first language, combined with limited or no English proficiency limits the use of tests which require such proficiency (Victorian Cross-Cultural Psychological Assessment Working Group, 2010)
- There are a number of problems with conducting language-based cognitive testing in a person’s second language or with an interpreter. For example, interpreters may differ in the way they translate tests, so that administration of the test is no longer standardised (VCCPAWG, 2010)
- Factors associated with a history of persecution can influence test performance when assessing cognitive functioning, including lack of familiarity with the testing environment, anxiety about the purpose of the test, fear of authority figures, and fear about the use of test results (VCCPAWG, 2010)
- The effects of trauma and the refugee experience may also affect test performance (Kaplan, 2009).
- Royal Children’s Hospital Immigrant Health Service – Developmental assessment webpage includes clinical guidance on assessment, screening and management of refugee and asylum seeker children with a developmental delay/disability.
- Royal Children’s Hospital Immigrant Health Service – Education assessment webpage includes guidance on clinical assessment, formal assessment tools, formal supports for schools, and other resources.