B – 44 Cultural and Linguistic Barriers in Neuropsychological Assessment of TBI Patients: Implications for Accurate Diagnosis and Rehabilitation

Abstract Objective Neuropsychological assessment plays a critical role in diagnosing traumatic brain injury (TBI) and guiding rehabilitation, yet current practices often disadvantage culturally and linguistically diverse (CALD) patients. This review examines how cultural and language mismatches compromise the validity of TBI assessments and contribute to inequities in treatment outcomes. Method Ten peer-reviewed empirical and review articles published within the past decade were selected for analysis. Inclusion criteria required that studies address cultural and linguistic barriers in the neuropsychological assessment of TBI, with particular attention to diagnostic validity, ethical practice, and rehabilitation outcomes. Results CALD individuals frequently underreport TBI-related symptoms due to language barriers or culturally distinct expressions of distress. This often leads to missed CT scans or delayed referrals for neuropsychological evaluation. Once assessed, individuals with TBI are typically administered tests that place heavy demands on verbal fluency, timed responses, and culturally specific reasoning strategies. As a result, CALD patients with TBI may appear more impaired, or neuropsychologists may overlook real deficits due to culturally incongruent test performance. These compounded limitations can severely affect outcomes such as accurate diagnosis, discharge planning, and access to post-acute TBI rehabilitation. Conclusion Culturally responsive neuropsychological assessment is essential to ensuring diagnostic equity in TBI treatment. Because TBI symptoms often affect domains that are vulnerable to cultural bias in testing, standard assessments must be adapted to reflect diverse patient populations. Improving test development and expanding normative samples are necessary to reduce diagnostic errors, increase access to appropriate rehabilitation for CALD patients with TBI.