ACQ Vol 11 No 1 2009

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ACQuiring knowledge in sp eech, language and hearing, Volume 11, Number 1 2009 3
MULTICULTURALISM AND DYSPHAGIA
Speech Pathology in the Context of
Cultural and Linguistic Diversity
Working with people from an Arabic background
Samar Al-amawi, Alison Ferguson, and Sally Hewat
Keywords:
aphasia assessment and treatment,
Arabic population,
bilingual,
interpreters,
linguistic and cultural diversity
Australia is a country which defines itself as a multicultural
nation; this is due to the relatively large number of
immigrants who have settled in the country since colonisation.
Of those immigrants who are from non-English-speaking
backgrounds, many will continue to have poor English
language proficiency for a considerable period, especially if
they were older at the time of their migration. According to
the Australian Bureau of Statistics (2006), almost 400 different
languages were spoken in homes across Australia in 2006.
Close to 79% of Australia’s population spoke only English at
home, a decrease from 82% in 1996, indicating that 21% of
Australia’s population were using a language other than
English at home. The top five languages spoken at home
(other than English) were Italian, Greek, Cantonese, Arabic
and Mandarin. Fifty per cent of Australians in 2006 had at
least one parent born overseas and 22.2% identified themselves
as born overseas. The top five countries of birth (other than
Australia) were England, New Zealand, China, Italy and
Vietnam. There is an increasing body of literature in speech-
language pathology that discusses the issues, challenges and
opportunities that are relevant for the practice of speech
pathology for these populations (Battle, 2000; Isaac, 2002;
Roberts, 1998). This paper will discuss issues in relation to
working with children and adults from an Arabic background,
as it is suggested that more needs to be known about how
best to provide speech pathology services to this culturally
and linguistically diverse population.
Few studies have focused on how the English-speaking
speech pathologist can best provide services for bilinguals
(Roger, Code & Sheard, 1996; 2000), and how speech
pathologists can improve their skills for dealing with such
patients. Even fewer studies have focused on providing
speech pathology services for Arabic patients with communi­
cative disorders and what could be valid assessment tools to
assess their language abilities in the context of linguistic and
cultural diversity. Isaac (2002) stated that there has been
relatively little research and literature giving consideration to
multicultural perspectives in clinical practice: “research is
needed in SLP to substantiate the (probably valid) assumptions
we often make about our clinical procedures and polices” (p.
123). She reported that many speech pathologists have their
own clinical tools and procedures for assessing or treating
patients from cultural and linguistic minority backgrounds
and that these resources have not been clinically trialled or
widely distributed. Battle (2000) also has stated that limited
contemporary Arabic, Urdu, and other language tools and
instruments exist and few have been standardised on Arabic
speakers (Butler, 1989; Crago, 1990). She also reports that Wiig
and El-Halees (2000) have developed an objective, culturally
and linguistically authentic Arabic language-screening test for
children between 3 and 12 years. This new test was
challenging to develop because of the diversity among Arabic
speakers’ dialects, the diversity of their cultures, and the
paucity of information about the speech and language develop­
ment in Arabic-speaking children. This test was developed to
be used with children in Jordan and Palestine, so it is not clear
whether it will be useful for work with Arabic children from
other Arabic countries because of dialectal diversity. Given
that the few available materials may not be appropriate for all
Arabic speakers, how might the English-speaking speech
pathologist use the available materials to assess Arabic
patients here in Australia? To only provide speech pathology
services for the Arabic population by Arabic-speaking speech
Speech and language assessment for the Arabic popu­
lation who experience communication disorders may
present as a challenge for speech pathologists in Aus­
tralia. Language diversity is not the only issue that makes
it difficult to deal with such patients; cultural diversity
and the role of the interpreter mediating the interaction
between the speech pathologist and the bilingual patient
also play a part. This paper provides a brief review of
cultural and linguistic diversity in Australia, and dis­
cusses the need for more speech pathology research
focusing on specific populations such as the Arabic
population. The paper identifies some of the major Arabic
cultural issues (habits, behaviours, beliefs and customs)
that need to be taken into consideration by the English-
speaking speech pathologist who is working with Arabic
patients, and suggests the need for cross-cultural training
to be provided for speech pathologists working with an
Arabic population.
This article has been peer-reviewed
Samar Al-amawi, Alison Ferguson, and Sally Hewat