Thesis
Executive Functioning Assessment with Aboriginal and Torres Strait Islander Peoples: Current Practice
Southern Cross University
Doctor of Philosophy (PhD), Southern Cross University
2025
DOI:
https://doi.org/10.25918/thesis.523
Appears in Recent Southern Cross PhD Theses
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Abstract
Background: Aboriginal and Torres Strait Islander peoples in Australia experience significant health disparities due to historical and systemic injustices. These disparities include higher rates of early-life adversity, psychosocial stressors, and neuropsychological conditions that impact Executive Functioning (EF). Assessment and support for EF in these populations are further hindered by systemic barriers and a lack of culturally appropriate, evidence-based resources. This thesis addresses the urgent need to guide clinicians in conducting safe, reliable, and culturally sensitive EF assessments. It is informed by a Facilitated Development Approach (FDA), which fosters collaboration between researchers and Aboriginal services to establish research priorities and ensure culturally informed methodologies.
Method: This sequential, multi-stage research project begins with a systematic review (Chapter 2) of 339 articles; 43 met inclusion criteria. Twenty-two EF tools were identified, predominantly performance-based cognitive assessments. However, there was limited evidence supporting their cultural validity and clinical appropriateness for Aboriginal and Torres Strait Islander populations. Chapter 4 involved yarning with a Cultural Guidance Group (n = 4) to explore community perspectives on cognitive assessment. Key themes included challenges in culturally responsive assessment and the value of embedding Aboriginal ways of knowing and being into practice. The group proposed a cultural mentoring program for postgraduate psychology students to enhance cultural competence.
In Chapter 5, a two-round Delphi survey with psychologists (n = 15) explored current EF assessment practices. Participants reported a lack of valid tools, resources, and cultural training, resulting in inconsistent and potentially unsafe assessment practices. This study produced a clinical practice guide to support psychologists working with Aboriginal and Torres Strait Islander clients.
Chapter 6 addressed the identified resource gap through the co-design of a psychoeducation resource with the Cultural Guidance Group, later reviewed by an expert working group (n = 7). This resource aimed to build understanding of EF and its impacts among professionals working with Aboriginal communities, including psychologists, educators, counsellors, and allied health workers.
Conclusion: This thesis integrates evidence-based literature with Aboriginal community and clinical perspectives to improve EF assessment practices. This thesis exposes the absence of validated EF assessment tools with Aboriginal and Torres Strait Islander peoples and highlights challenges faced by the community and experienced psychologists due to limited education and resources for EF assessment. The findings of this thesis provide a foundation for future research, including the development or modification of EF-specific assessment tools and psychoeducation materials for use by Aboriginal and Torres Strait Islander community members.
Details
- Title
- Executive Functioning Assessment with Aboriginal and Torres Strait Islander Peoples: Current Practice
- Creators
- Tamara Belsito
- Contributors
- John Maurice Hurley (Supervisor) - Southern Cross UniversityEmily Amanda Hindman (Supervisor) - Southern Cross UniversityKylie Radford (Supervisor) - Southern Cross UniversityLouise M Lavrencic (Supervisor) - Neuroscience Research Australia
- Awarding Institution
- Southern Cross University; Doctor of Philosophy (PhD)
- Theses
- Doctor of Philosophy (PhD), Southern Cross University
- Publisher
- Southern Cross University
- Number of pages
- 324
- Identifiers
- 991013318228202368
- Copyright
- © Tamara L. Keiller 2025
- Academic Unit
- Faculty of Health
- Resource Type
- Thesis