Guddi Way Screen

The Guddi Way Screen is a culturally developed tool to identify cognitive impairment as a result of a brain injury in Aboriginal and/or Torres Strait Islander people.  

It screens for cognitive difficulty due to a brain injury across different functions of the brain including orientation, attention, concentration, language, recall, visuospatial skills, and executive function.

The Guddi Way Screen can only be administered by Aboriginal and Torres Strait Islander people using a ‘Proper Way’ culturally informed framework.  

‘Proper Way’ is a way of doing business that respects Aboriginal and/or Torres Strait Islander people’s wishes, values, and customs.  

Administering the Guddi Way Screen focuses on a culturally informed and informal yarning approach that builds trust and respects the story of the individual, their life experiences, culture, and community.  

The screen also uses items relevant to cognitive impairment that are culturally valid, recognised regardless of cultural background, and that are suitable for use in a prison environment.  

A Guddi Way Screen helps understand cognitive impairments, associated functional impacts, mental health symptoms, and unmet support needs that a person may have: 

• To indicate referrals for further assessment 

• To better tailor support for someone with cognitive impairment 

• To improve access to specialist and mainstream services and supports 

• To inform bail and parole conditions, and the support individuals may need to meet them.  

This is a great example of the way Synapse uses its research and evidence to give a voice to individuals and communities often frustrated by mainstream approaches that are culturally inappropriate and often harmful.

Synapse has undertaken significant work over recent years to build the tool into an online, secure and automated platform to improve accessibility. This interface allows a suitably trained person to undertake the screening of a person face-to-face and in real time, with the immediate generation of informative reports. These are intended to guide understanding of the likely impacts of cognitive difficulties on a person as well as identifying necessary referrals, should further assessment or diagnosis be necessary.

The Murri Court in Brisbane and Richlands are using the Guddi Way Screen for convicted Aboriginal and Torres Strait Islander peoples to help the Magistrate understand a person’s capacity and how the court can support them better through the Murri Court process. Since it has been used by the court, 71 per cent of participants were flagged with impairments of at least one cognitive domain—primarily domains affecting social interaction, self-management and learning.

Capturing cognitive impairments this way can help us understand why some people fail to meet the requirements within judgement from our judicial systems. As a result, not a single person that had participated in the Guddi Way Screen had ended up with a custodial sentence to date.

Background

Many Aboriginal and/or Torres Strait Islander peoples are exposed to risk factors for cognitive impairment. However, culturally appropriate methods for identifying potential cognitive impairment are lacking. This paper reports on the development of a screen and interview protocol designed to flag possible cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults over the age of 16 years.

Methods

The Guddi Way screen includes items relating to cognition and mental functions across multiple cognitive domains. The screen is straightforward, brief, and able to be administered by non-clinicians with training.

Results

Early results suggest the Guddi Way screen is reliable and culturally acceptable, and correctly flags cognitive dysfunction among Aboriginal and/or Torres Strait Islander adults.

Conclusions

The screen shows promise as a culturally appropriate and culturally developed method to identify the possibility of cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults. A flag on the Guddi Way screen indicates the need for referral to an experienced neuropsychologist or neuropsychiatrist for further assessment and can also assist in guiding support services.

To read the full research publication click here.

The word ‘Guddi’ means ‘Come Home, Come Heal, Come Rest’ in the traditional language of the Kuku Yalanji peoples of Far North Queensland.