Walking together : the journey to co-developing Ezhi-Gkendaagziyang, a linguistically and culturally responsive communication sssessment process for Anishinaabek children

Abstract

Conventional speech-language pathology (SLP) assessment approaches in Canada often overlook the values, priorities, and lived experiences of First Nations families. Implemented through Western frameworks, these approaches increase the risk of misdiagnosis, foster mistrust in health systems, reduce engagement, and ultimately result in worse outcomes for children. Though research highlights the importance of culturally and linguistically responsive services, little effort has been made to develop practical tools that SLPs can create collaboratively with First Nations communities. This dissertation had two related aims to address this gap. The first was to co-develop a culturally and linguistically appropriate communication assessment process for junior and senior kindergarten-aged Anishinaabek children in collaboration with the community of Dokis First Nation. The second was to explore how using this process could support more meaningful, equitable, and culturally grounded SLP practices. Guided by an Indigenous mixed-methods approach, the study combined Western literature on culturally responsive practices with community-based data from focus group discussions and interviews to identify local priorities and values. The resulting tool, Ezhi-gkendaagziyang, was locally validated by examining its inter-method agreement with the CELF-P3 and its social validity through topic-based interviews with caregivers and educators. Findings revealed that community members placed less emphasis on the specific content of assessments and prioritized SLPs' behaviours and approaches, including respect, relationality, and contextual understanding. Caregivers and educators perceived the Ezhi-gkendaagziyang as more meaningful and reflective of children’s communication than the CELF-P3. In contrast, quantitative analysis showed no agreement beyond chance between the two tools, underscoring the misalignment of norm-referenced tools with First Nations children’s linguistic realities. This dissertation presents one of the first culturally and linguistically grounded SLP assessment processes for First Nations children and shows how collaborative, community-driven assessment practices can change clinical methods. Although created specifically for Dokis First Nation, Ezhi-gkendaagziyang provides a framework for establishing fairer, contextually appropriate SLP assessment practices in partnership with other First Nation communities.