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Diversity in practice



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.


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,











Sarah Verdon