Wylie Karen, McAllister Lindy, Davidson Bronwyn, Marshall Julie
The University of Sydney, Sydney, Australia.
Int J Speech Lang Pathol. 2013 Feb;15(1):1-13. doi: 10.3109/17549507.2012.745164.
The World Report on Disability provides a major challenge to the conceptualization and delivery of services for people with communication disabilities around the world. Many people, in both Majority and Minority World countries, receive limited or no support in relation to their communication disability. In this paper the prevalence of communication disability across the world (and the challenges to obtaining these data) are discussed, particularly in relation to disability more broadly. Populations that are under-served by speech-language pathology services in both Majority and Minority World countries are described. The paper describes organizational change theory and the potential it has, together with a biopsychosocial model of disability, to assist in understanding and influencing development of relevant services for people with communication disabilities (PWCD), particularly those who are under-served. Aspects of, and influences on, service delivery for PWCD are described. The need for novel ways of conceptualizing development of services, including population-based approaches, is highlighted. Finally, the challenges and opportunities for PWCD and for speech-language pathologists which arise from the nine recommendations of the World Report on Disability are considered and readers are encouraged to consider new and novel ways of developing equitable services for people with communication disabilities, in both majority and minority world settings.
《世界残疾报告》对全球沟通障碍者服务的概念化及提供构成了重大挑战。在世界多数地区和少数地区国家，许多沟通障碍者获得的支持有限或根本没有得到支持。本文讨论了全球沟通障碍的患病率（以及获取这些数据所面临的挑战），特别是更广泛意义上的残疾问题。描述了世界多数地区和少数地区国家中言语语言病理学服务未充分覆盖的人群。本文阐述了组织变革理论及其与生物心理社会残疾模型相结合，在协助理解和影响为沟通障碍者（PWCD），特别是那些未得到充分服务的人提供相关服务发展方面的潜力。描述了为沟通障碍者提供服务的各个方面及其影响因素。强调了采用新颖方式来概念化服务发展的必要性，包括基于人群的方法。最后，探讨了《世界残疾报告》的九项建议给沟通障碍者和言语语言病理学家带来的挑战与机遇，并鼓励读者思考在世界多数地区和少数地区环境中为沟通障碍者开发公平服务的新方法。
