ACQ Vol 13 no 3 2011

Cultural diversity

What’s the evidence? Working bilingually with language disordered children Linda Hand

Speech pathology has been facing the challenge of working with clients and families from multilingual and multicultural contexts for some time now. However, it is an area in which professionals continue to feel a lack of sufficient knowledge or skills, and where there seems to be little consensus. This edition of What’s the evidence draws on codes of ethics documents and human rights principles to suggest that speech pathologists could take a more advanced view of practices with bilingual clients. It then discusses how the current evidence base may be used to support the arguments for bilingual support and intervention for language disordered populations. Clinical scenario You have a number of children from bilingual or multilingual homes in your practice, including children whose parents were recent migrants or refugees to this country, or are in strongly identified cultural communities. These cultures and languages include Vietnamese, Chinese Mandarin- speaking, Mãori, Samoan, Lebanese-Arabic, Greek, and Somali. You want to discuss with the schools and with associated professionals the need to incorporate multiple cultural communication models and support for bilingualism in the work with these children. The first senior school person you speak with says “we believe very strongly in helping these children succeed in school and the thing they need most is the best English they can have. We treat all children equally here – it doesn’t matter what culture or language they come from. We put a lot of support into helping their English. If they speak their other language at school, they won’t learn English fast enough”. This sounds difficult to argue against, and it seems to be a rejection of your original intention. You are not sure how to respond. You discuss it with some of your speech pathologist (SP) colleagues and find some saying “It is too hard for children already struggling with language to deal with two (or more) languages. Besides, I don’t speak their languages, and they are in this country now; what they need most is English and that is my responsibility. It would be unethical and unrealistic for me to try to deal with any other language – I have over 60 different ones in my area! I can’t possibly

know them all”. The conversation is largely about languages, and it proves difficult to get any discussion going on cultural aspects of communication. You realise you need some good evidence to put the case for cultural communication and language support being the business of SPs and schools. Response to this scenario When you stop to reflect on this scenario, you feel that your colleagues have taken a position which seems well supported by “commonsense” or ethical and social justice principles, and which shows some consensus between the professions. For example, you can appreciate that English is dominant in countries like Australia, New Zealand, and the United Kingdom, and is also the language of school, so perhaps we should give them only English? Similarly, perhaps our colleagues are right to expect that learning multiple languages will be too hard for children with language disorders and that we may be right in only teaching one? However, you are also aware that they are adopting the strong legacy of an underlying monocultural model of practice. You wonder whether the current evidence base actually supports this model of practice and whether “commonsense” reflects what the ethical and social principles really say. In response to the scenario, it seems timely and paramount that we put the commonsense perspectives aside and look to what the evidence and our ethical codes are actually telling us. What enables bilingual children to succeed? what can a SP who does not speak every language achieve? and what do the principles of social justice and equity, and ethics actually say? Before turning to the evidence, you decide to review your code of ethics to determine whether you are right in questioning the monocultural model of practice. The code of ethics of Speech Pathology Australia (2010) states “we do not discriminate on the basis of race, religion, gender”, we “respect the context in which [our clients] live”, we “strive to provide clients with access to services consistent with their need”, and we ensure “our resources (such as assessment tools and communication aids) are current, valid and culturally appropriate”, while we “recognise our competence and do not practice beyond these limits” (p. 1). While this seems to support the position taken by your colleagues, you feel that further clarification is needed about what is meant by (the clients’) “context” and “need”. If we see all children’s needs as similar, and that treating all

Linda Hand

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ACQ Volume 13, Number 3 2011

ACQ uiring Knowledge in Speech, Language and Hearing