ACQ Vol 11 No 1 2009

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8 Sp eech Pathology Australia
MULTICULTURALISM AND DYSPHAGIA
differences on interactions, and confidence in dealing with
people from different cultures. The findings from this study
might encourage us to think about the importance of
providing speech pathologists in Australia with cross-cultural
training which might help them to improve their knowledge
and skills in working with bilingual patients. This may, in
turn, enhance the quality of speech pathology services
provided to patients from different cultural and linguistic
backgrounds.
Conclusion
This discussion of the literature in relation to speech
pathologists’ work with culturally and linguistically diverse
speakers in Australia shows clearly that more needs to be
known about ways to improve services for these clients. In
particular, in light of the issues we have discussed in relation
to speakers from an Arabic background, we suggest that there
is a need to develop ways that would facilitate interpreter-
mediated assessments of Arabic speakers with aphasia that
could better identify areas of communication functional need.
We have also suggested that there is a role for ongoing
professional education to support the development of
increasing levels of cross-cultural competence in the
profession.
References
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population and housing. Retrieved 20 April 2008 from http://
Australian Bureau of Statistics. (2001). Year book Australia
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Bahaa-Ediin, M. (2006). Emirati Arabic politeness formulas:
An exploratory study and a mini-mini-dictionary. The seventh
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UAEU Funded Research Publications.
Baker, R. (1995). Communicative needs and bilingualism in
elderly Australians of six ethnic backgrounds. Australian
Journal on Ageing, 14 , 81–88.
Battle, D. E. (2000). Communication disorders in multicultural
populations (3rd ed.). Boston: Butterworth Heinemann.
Bean, R. (2006) The effectiveness of cross-cultural training in the
Australian context . Department of Immigration and
Multicultural Affairs: Canberra: AUS: 249. (TRAI.11) www.
index.htm, accessed 18 December 2008.
Butler, K. (1989). From the editor: Language assessment and
intervention with LEP children: Implications from an Asian/
Pacific perspective. Topics in Language Disorders, 9 (3), iv–v.
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Quraan (Muslim) or Bible (Christian) may be acceptable
for the Arabic aphasic patient;
n some Arabic male patients may not accept receiving
speech therapy in front of their wives or children as
culturally, they may feel shame to appear as a weak
person in front of their family.
Issues for improving services
Reviewing the literature regarding the Arabic culture in
Australia leads us to suggest that this population is at risk of
having reduced opportunities to receive speech pathology
services. In turn, the reduced visibility of Arabic-speaking
patients in serviced population may reduce the opportunities
that speech pathologists have to learn about the Arabic
language and culture and how to provide services more
appropriately. Similar issues have been discussed in a study
organised by the Centre for Citizenship and Human Rights at
Deakin University (Kenny, Mansoure, Smiley, & Spratt, 2005),
which focused on the types of linkages that exist between the
Arabic community and the wider community surrounding
them in Australia. The study identified that the Arabic
community reported their lack of knowledge about culturally
sensitive resources and services due to their lack of social
connectedness. Arabic people preferred not to use the avail­
able health service because of their limited English language
proficiency and some cultural perceptions (for example, the
shame associated with non-reliance upon family), and also
reported more trust in community-specific services (which
provide culturally and linguistically appropriate services)
than in mainstream services.
It is also important to focus on the health service employees
themselves and their lack of knowledge about others’ cultural
backgrounds. In the study conducted in metropolitan Sydney
hospitals by Roger, Code and Sheard (1996), one of the
findings was that speech pathologists reported their lack of
knowledge about bilingual patients’ language and cultural
background.
Developing cross-cultural competence
Cultural competence is generally held to be critical to the
achievement of national multicultural policy objectives and to
the success of the immigration and settlement process in
Australia, and so a number of studies have been conducted
focusing on this area. For example, Bean’s (2006) study aimed
to evaluate the effectiveness of cross-cultural training
programs over time in Australian public sector organisations.
The study took place over an 11-month period from July 2005
to June 2006 and involved engaging the participants in
training based on general cultural awareness, programs on
specific cultures, working with interpreters, specialised programs
for fields such as health and policing, and managing
culturally diverse workforces. The main objectives were to
develop awareness of the cultural dimensions of interactions
and effectiveness in situations and environments characterised
by cultural diversity. The study showed that the immediate
post-training evaluation ratings showed increases in all areas
of knowledge and awareness against which participants self-
rated themselves in the pre-survey. The highest percentage
point increases were in the areas of understanding of
organisational policies and issues, knowledge of cross-cultural
skills, and understanding of other cultures. There were
smaller improvements in understanding of the effects of one’s
own culture on oneself, awareness of the effects of cultural