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6
S
p eech
P
athology
A
ustralia
MULTICULTURALISM AND DYSPHAGIA
traditional common words and phrases automatically
such as:
enshalla, Ishallah
(if God wills it),
elhamdulillah,
hamdillah, kattirkairallah
and
ishkorallah
(thanks be to God),
and sm’allah (in the name of God) (Feghali, 1997; Bahaa-
Eddin, 2006). Note that such words may be used
unconsciously by the Arabic person who has severe
speech or language disorders. Such phrases may be
preserved as automatic, stereotypic phrases in cases of
severe or global aphasia. Also,
Ishallah
is used frequently
by the Arabic population, which can reflect various
meanings, i.e., it may mean ‘“yes’”, ‘“no’”, or ‘“I
promise’”, with its meaning depending on the intonation
associated with its production.
n
Indirectness
– Feghali (1997) noted that the following are
features of a general communication style in Arabic:
indirectness (hiding of the speaker’s intents and needs),
elaborateness (rich and expressive language use), and
effectiveness (persuasion of the listener of the speaker’s
beliefs, thoughts and ideas). In general for the Arabic-
speaking population, the use of an indirect request as a
form indicates politeness. Isaac( 2002) notes that the use of
a direct request may put the user at risk of being
interpreted as impolite in a culture where politeness forms
are commonly used and expected.
n
Prosodic features
– Many Arabic speakers use very rapid
and loud speech, especially when discussing their
emotions or stress, and many may use these stress patterns
even when talking in another language such as English.
This may cause misunderstanding between the Arabic
speaker and a partner who does not share this cultural
background.
n
Word choice
– Some English words sound similar to vulgar
words in Arabic and should be avoided if possible, such
as: zip, zipper, air, tease, kiss, cuss, nick, unique, and biz
(Wilson, 1996).
Cultural communication roles
The speech pathologist needs to respect the value placed by
the particular family they are working with as to the role of
the nuclear and extended family, and the role hierarchy
within the family (Schwartz, 1999). Some Arabic families also
may be unwilling to discuss their disorder or disability with
people from outside the extended family, which might affect
the accuracy of the case history obtained (Sharifzadeh, 1998).
In some Arabic families there may be a preference for the
father or the older son to discuss other family members’
problems rather than the mother, while the mother ’s
responsibility might be to carry out the treatment suggestions
(Battle, 2000). However, not all Arabic families follow this role
division, since for most Arabic modern families there is an
equal balance between the male and the female responsibilities
within the family.
Gender roles need to be considered in relation to service
provision. Some people from an Arabic background believe
that women are to be separated from men (Battle, 2000),
although modern Arabic families respect the role of the
female in different jobs, and the importance of being involved
in mixed gender situations. Female clinicians may be
preferred in work with Arabic females, rather than with male
clinicians (Wilson, 1996), although when a female clinician is
not available, it would be acceptable to work with a male
clinician.
Naturally, the above summary is only a brief introduction to a
wide range of diverse cultural communication issues. There
are an increasing number of resources that might help speech
pathologists who are working with Arabic patients to know
sources to be used in the sessions working with Arabic
patients, even if the patient is non-Muslim (Battle, 2000).
Customs
n
Handshaking
– For people from a Muslim religious back
ground, handshaking is forbidden between male and
female. Arab men shake hands when greeting or parting
(Battle, 2000). To greet a woman, the man should not offer
his hand for a handshake unless the woman extends hers
first (Bahaa-Eddin, 2006).
n
Kissing
– There are at least four common types of kiss: a)
head kissing, indicating respect and in a wedding context
where a groom kisses his bride’s head while giving her a
gift and saying
maasih-
?
aleeki bil maal wil h- alaal
(to show
that this is a legal bond for which the groom has paid a
dowry); b) cheek kissing, commonly between females; c)
nose touching involving two or three nose-touches is an
unmarked greeting; and d) hand kissing is another
indication of respect and deference (Bahaa-Eddin, 2006).
n
Visiting
– A visitor may be expected to take off their shoes
before entering a home (Bahaa-Eddin, 2006). There is a
very elaborate etiquette of coffee-offering in most Arabic
countries. It is very embarrassing and disgraceful not to
offer coffee to a guest and it could be regarded as
inappropriate not to accept it. Normally, the one who is on
the right will get coffee first. Once s/he is done, s/he
should shake the cup if s/he does not want any more
coffee (Bahaa-Eddin, 2006).
Non-verbal communication
n
Distance
– People from an Arabic background usually
maintain a conversational distance of a bit more than half
a metre between speaker and listener, but prefer to keep
greater interpersonal distance when communicating with
the opposite gender (Battle, 2000).
n
Touch
–Men frequently touch each other (but do not touch
women) (Battle, 2000)
n
Smiling
– It is appropriate for an Arabic female to not
smile when meeting a stranger (Bahaa-Eddin, 2006).
n
Pointing
at someone with a finger can be perceived as rude
(Bahaa-Eddin, 2006). Avoid sitting in such a way that your
feet are pointing directly at someone else (Bahaa-Eddin,
2006).
n
Using the right hand
is always more acceptable than using
the left in giving and receiving (Bahaa-Eddin, 2006).
n
Gestures
– Arabic speakers use many gestures during
conversation (Battle, 2000).
n
Eye contact
is generally avoided in most cross-gender
encounters (Bahaa-Eddin, 2006). During conversations,
people from an Arabic background tend to maintain
steady eye contact with the listener, but pious Muslim
males will seek not to maintain eye contact when talking
to a female.
n
Silence
may have a number of unexpected meanings. It
may indicate a lack of understanding, respect for what the
speaker has said, or respect for the older status of the
other person. For Arabic women, silence may indicate
embarrassment if talking with males present.
Verbal communication
n
Religious expression
– El-Sayed (1990) has noted the
importance of religious expressions in expressing
politeness in Arabic. One example of this can be seen in
the use of such expressions as discourse management
resources, for example, in turn-taking, or as fillers. The
Arabic language is characterised by repeating some