Decomposing DEA self-efficiency: A cross-efficiency-based quantity-price framework.

Speech and language are inseparable from culture; they encode identity, worldview, relational norms, and culturally grounded ways of interacting with the world []. Because Speech‑Language Pathologists (S-LPs) work directly with communication, effective practice must engage the cultural, linguistic, and social contexts that shape how people use and value language. Accordingly, cultural competence, responsiveness, and humility are essential for addressing social determinants of health and educational barriers affecting culturally and linguistically diverse (CLD) populations [,]. Despite this imperative, S-LP assessment and intervention in Canada have largely been shaped by white, Eurocentric models that do not align with the lived realities or communication systems of many communities []. This misalignment is especially pronounced for First Nations, Inuit, and Métis peoples, for whom standardized assessments frequently fail to recognize cultural and linguistic strengths. Such limitations contribute to misidentification and misdiagnosis, with downstream consequences for educational trajectories, psychosocial wellbeing, and health outcomes [–]. First Nations, Inuit, and Métis peoples are recognized as “Aboriginal peoples” under Section 35(2) of the Constitution Act, 1982, which affirms the constitutional recognition of Aboriginal and treaty rights held collectively by Indigenous Nations and communities. They therefore cannot be conceptualized as one minority group among many; their distinct status as Indigenous Nations and collective rightsholders with specific languages, histories, and legal recognition requires approaches grounded in cultural safety and strength‑based, relational practice. While the term is widely used within Canadian health and rehabilitation literature and is included in this review for methodological completeness, it is applied here with attention to Indigenous‑identified critiques of deficit‑based framing and an emphasis on resilience, continuity, and self‑determination. Other marginalized groups in Canada, often described as equity‑deserving, such as racialized communities, immigrants and refugees, and 2SLGBTQIA+ individuals, also experience cultural, linguistic, and systemic barriers to equitable S-LP services [,]. However, their sociopolitical contexts differ markedly from those of Indigenous Nations. Accordingly, this review examines Indigenous peoples and other populations experiencing inequities in parallel but never interchangeably, maintaining a distinctions‑based approach throughout.