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PURPOSE: Self-determination is foundational to health and well-being for First Nations people. Colonisation has undermined self-determination and widespread effects are observed as disparities in health and well-being. Chronic middle ear disease is more highly prevalent in First Nations children, is associated with delays in speech and language and lower levels of educational readiness. However, there is a paucity of culturally and linguistically sensitive speech-language assessments and habilitation services globally. Focussing on high-income colonial-settler countries (including United States, Canada, Australia and New Zealand), where health disparities are significant, we aim to discuss the importance of and the challenges in providing culturally safe care to First Nations children with communication disabilities. RESULT: To be effective, both cultural and linguistic diversity and cultural safety must be considered in all aspects of assessment and intervention. Furthermore, speech-language pathologists must be equipped to work with First Nations children with communication disorders. CONCLUSION: To optimally support First Nations' children with communication disabilities, services need to be culturally safe, family-centred and strengths-based. This commentary focuses on the United Nations Sustainable Development Goals (SDGs)3, 4, 8 and 10.
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