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ACQ
uiring knowledge
in
sp eech
,
language and hearing
, Volume 11, Number 1 2009
15
MULTICULTURALISM AND DYSPHAGIA
and conduct intervention with bilingual populations. We
have also suggested that it is possible to do this in languages
that the speech pathologist does not speak. These suggestions
turn out to be consistent with a number of current best
practice frameworks, including the ICF, family-centred
practice, culturally competent practice, and collaborative and
consultative practice.
This material has the potential to make our profession more
effective, and also more approachable and more affirming for
culturally and linguistically diverse populations. There are
long-term consequences both for individual children and for
greater social movements in this area of practice. For example,
tests often form the basis of entry to special education, further
education and employment, and thus the issue of fairness of
language tests or language-based tests for children of
bilingual backgrounds needs discussion at the level of policy-
making. It has been suggested already that speech pathologists
should act as advocates for these children and ensure that test
scores are used fairly in their communities (Cummins 2003;
Kritikos, 2003). Speech pathologists should also aim to
understand the sociopolitical factors affecting their own
professional decisions and whether these are justified in
evidence based practice.
We would suggest that education in speech-language
pathology should include more on the nature of bilingualism,
more on alternative models of assessment and intervention
that we could only suggest in this paper, and more research
direction for investigating bilingualism and language
disorder. These include developing assessment tools and
protocols examining language competence in bilinguals that
are not about separating two languages, and efficacy of
intervention using some of the different models and practices
we have suggested. The initial step of acknowledging that
bilinguals communicate differently to monolinguals should
give the clinician some insight into interpreting bilingual
language data, and we look forward to more suggestions
from future publications on how speech pathologists can
better manage their multilingual caseload. Given that multi
lingualism is the norm for most of the world’s communicators,
further study of multilingual communication in a manner that
embraces their natural communicative characteristics is
essential for enhancing our understanding of how the major
ity of people in the world communicate and learn language.
References
Baker, C. (2000).
The care and education of young bilinguals: An
introduction for professionals.
Clevedon, UK: Multilingual
Matters.
Baker, C. (2003).
Foundations of bilingual education and
bilingualism
(3rd ed.). Clevedon, UK: Multilingual Matters.
Battle D (Ed.) (2002).
Communication disorders in multicultural
populations
(3rd ed). New York: Butterworth.
Brice, A. (2000). Code switching and code mixing in the ESL
classroom: A study of pragmatic and syntactic features.
Advances in Speech-Language Pathology
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(1), 19–28.
Brice, A. (2001). Choice of languages in instruction: One
language or two?
Teaching Exceptional Children
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Brice, A., & Anderson, R. (1999). Code mixing in a young
bilingual child.
Communication Disorders Quarterly
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22.
Campbell, W. & Skarakis-Doyle, E. (2007). School-aged
children with SLI: The ICF as a framework for collaborative
service delivery.
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535.
Chang, J. (2001). Chinese speakers. In M. Swan & B. Smith
(Eds.),
Learner English: A teacher’s guide to interference and other
problems
(2nd ed., pp. 310–324). Cambridge: Cambridge
University Press.
We also know that competent bilinguals have greater
metalinguistic skills as a group than monolinguals. Using one
language to support the other metalinguistically may be a new
goal and a new speech pathology skill. Speech pathologists
are well equipped to tackle detailed understandings of
similarities and differences in the nature of the languages
involved, with assistance from skilled bilinguals. As part of
this, teaching the speech pathologist about the other language
may be desirable – the negotiation of meaning between
languages involved could itself become part of the therapy.
Similarly, the functions or purposes that involve only the non-
English language should be included as goals and practices in
intervention, such as conducting phone conversations with
grandparents, or cultural events which take place only in that
language. The fact that the clinician does not speak that
language is not a reason for leaving them out of the program,
as there are ways to include them with a team approach.
As well as goals being different in a bilingual environment,
the interactional skills within a language intervention session
may also be quite different. The interpreter or other bilingual
person may become the primary interactant, so the speech
pathologist may need to plan for how she will become part of
that interaction and at what points her knowledge about
English and about the other language becomes a salient part
of that interaction. For example, she may suggest the
interpreter use 3-word utterances with a child, and must be
aware of how this might vary between the two languages.
Accordingly, decisions will need to be made about how and
how much each language should be used. For example,
should it be that each target or part of an activity should be
conducted first in one language, then the other? Should both
be involved? Should code switching be incorporated? Should
interpreting from one language to another occur constantly,
or intermittently? What kind of feedback should be used? All
these possibilities should be available, and subjected to
studies of outcomes and efficacies, to increase our evidence
base.
A change in the role of the clinician in this direction is
consistent with the family-centered practice, collaborative,
and ICF frameworks, with their ideas of the social realities of
the client and family and handing over of power and control
towards those most involved. Therefore, it may not be a
greater shift in thinking than we are already being urged
towards from multiple sources, and it may be a way to enable
us to put more of these best practice principles into operation.
A new model of language intervention practice may be
emerging.
Conclusion
Speech pathologists the world over tend to find working with
communication disorders in bilingual clients to be problematic.
We know that representation of non-dominant groups in
speech pathology clinics tends to be lower than their
proportion in the broader population, that clinicians tend to
feel less competent in dealing with such client groups, that
there is a lack of appropriate assessment tools and analysis
techniques, and that there are many unknowns about how
effective intervention is with these groups. There are many
facets to possible solutions, including more research and the
development of better tools. However, this paper has
suggested that ways of thinking or concepts in the profession
are also barriers to competence. We contend that one of these
ways of thinking is that speech-language pathology as a
profession treats bilingualism in children as a kind of multiple
monolingualism: one language or the other. The literature,
however, suggests that the whole is more than the sum of the
parts, and that we need to change our thinking to encompass
some potentially radical ideas about how we assess, set goals