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Diversity in practice
2
JCPSLP
Volume 17, Number 1 2015
Journal of Clinical Practice in Speech-Language Pathology
Enhancing practice with
culturally and linguistically
diverse families
6 key principles from the field
Sarah Verdon
decisions, and actions (Spector, 1985). Culture is not rigid
and unchanging among distinct groups but varies among
individuals (Gray & Thomas, 2005). Culture is an essential
component of how explanatory models for illness,
difficulties, and disabilities are formed. An explanatory
model is a belief system by which a person or people from
a cultural group explain, diagnose, and identify possible
treatments for an illness or disability (Kleinman, Eisenberg &
Good, 1978). From a western cultural standpoint, often the
cause of illness or disability is deemed to be of an
anatomical or physiological nature and therefore medical or
professional intervention is needed to remediate the issue.
Other cultural standpoints may identify the cause of illness
or disability as being related to spirituality, religion, or family
history, and therefore may identify other means of
overcoming the issue (Nuckolls, 1991; Vukic, Gregory,
Martin-Misener & Etowa, 2011). Differences in the cultural
background of SLPs and the families they serve means that
each party may approach the same situation from a very
different viewpoint. A lack of cultural understanding can
result in a communication breakdown between SLPs and
families leading to ineffective and culturally inappropriate
practice. To avoid such communication breakdowns, SLPs
are encouraged to engage in culturally safe practice, a
philosophy of practice that originated in nursing and is
defined as practice with “a person or family from another
culture, and is determined by that person or family”
(Nursing Council of New Zealand, 2005, p.4).
The challenges of cross-cultural practice have been
well documented in the literature (Caesar & Kohler, 2007;
Jordaan, 2008; Kritikos, 2003, Stow & Dodd, 2003;
Williams & McLeod, 2012), with the major ones identified as
a lack of culturally appropriate tools for assessment; limited
developmental norms for linguistically diverse populations
upon which to make a differential diagnosis; and insufficient
professional support and training for working with families
from different cultural backgrounds. The mismatch
between the cultural diversity of Australian SLPs and the
cultural diversity of the Australian population means that it
is essential that all SLPs develop cultural competence in
order to engage in culturally safe and competent practice
(Verdon, McLeod & McDonald, 2014).
Cultural competence
Culturally competent practice is defined as practice that
“acknowledges and incorporates, at all levels, the
importance of culture, assessment of cross-cultural
relations, vigilance toward the dynamics that result from
cultural differences, expansion of cultural knowledge, and
Australia is a highly culturally and linguistically
diverse nation. In order to support all Australians
to develop their speech, language, and
communication skills for positive lifelong
outcomes, SLPs need to engage in culturally
competent practice. This article draws upon
an international study investigating practice
with culturally and linguistically diverse families
in 14 sites across four continents and five
countries. The findings of this research have
identified six key principles from the field that
are useful for enhancing the current practices
of SLPs working with families from culturally
and linguistically diverse backgrounds. These
six principles are: 1) getting to know yourself;
2) knowing and forming relationships with
families and communities; 3) setting mutually
motivating goals; 4) using appropriate tools
and resources; 5) collaborating with other key
people, and 6) being flexible: one size does
not fit all.
A
ustralia, like many other English dominant countries,
is highly culturally and linguistically diverse. What
makes Australia unique is that there is no dominant
second language or culture, but rather Australia is made up
of people from many different backgrounds. According to
the 2011 census, 27% of the population are first generation
Australians, meaning that they were born overseas and
have migrated to Australia, while 23.2% of Australians
report that English is not the first language spoken in
their home (Australian Bureau of Statistics [ABS], 2012a).
In addition to diversity arising from migrant cultures and
languages, the Aboriginal and Torres Strait Islander people
of Australia make up approximately 3% of the Australian
population (ABS, 2013). As a result of the high degree of
cultural and linguistic diversity in Australia, speech-language
pathologists (SLPs) are likely to engage in practice with
families who speak various different languages and are from
different cultural backgrounds.
Working across cultures
Every person has a culture, defined as the sum of beliefs,
rituals, customs, and practices that guide thinking,
KEYWORDS
CHILDREN
CULTURAL
DIVERSITY
MULTILINGUAL
PRACTICE
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
Sarah Verdon