JCPSLP Vol 17 No 1 2015_lores

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JCPSLP Volume 17, Number 1 2015 3
Getting to know yourself
The important starting point for culturally competent
practice is for SLPs to engage in self-reflection (Tervalon &
Murray-Garcia, 1998). It is necessary that SLPs know who
they are, what they believe, and how this impacts upon the
way they view the world and engage in practice. To facilitate
self-reflection, SLPs can ask themselves some key
questions such as:
• What is my culture?
• What are my beliefs, values, and attitudes?
• Why do I have these beliefs, values, and attitudes?
• What are my attitudes towards people of different
gender, race, language background, sexual orientation,
and level of ability?
• What biases do I bring to my practice?
Through self-reflection comes self-awareness. Such
awareness can help SLPs to understand when a barrier
between themselves and a family is present and what
may be the cause of this barrier. An important part of
overcoming barriers is cultural humility, whereby all cultures,
belief systems and explanatory models are valued in
clinical decision-making, rather than simply adopting the
cultural approach to practice valued by the professional or
dominant society (Tervalon & Murray-Garcia, 1998).
Resources: The American Speech-Language-Hearing
Association website provides resources to facilitate
reflection on professional practice, service delivery, and
policies and procedures. These can be accessed at http://
and include:
Personal reflection activity for professionals:
Activity for reflecting on organisational policies and
procedures:
Activity for reflecting on service delivery with culturally
and linguistically diverse clients:
Knowing and forming relationships with
families and communities
Taking time to get to know and build trusting relationships
with families is key to engaging in culturally competent
practice. By taking time to get to know families, SLPs are
better informed to make decisions about diagnosis and
appropriate ways to proceed with intervention if necessary.
It is important that SLPs gain an understanding of the home
environment; for example, what the main language used in
the home is, what other languages are spoken, when and
where these languages are used, and what languages the
family wants to work in (De Houwer, 2007). This will help
with understanding the linguistic influences upon speech
and language when planning assessment. A complete case
history of the family’s cultural and linguistic diversity will
assist in making an accurate and well-informed diagnosis.
Knowledge of the languages spoken is also important for
planning intervention as multilingual speakers have been
found to benefit most from intervention provided in their
primary language, with the potential for positive
generalisation of effects to occur in their additional
language(s) depending on the nature of the communication
need (Gutiérrez-Clellen, 1999; Kohnert, Yim, Nett, Kan, &
Duran, 2005).
Engaging in western health practices may be an
unfamiliar concept for culturally and linguistically diverse
adaptation of services to meet culturally unique needs”
(Betancourt, Green, Carrillo & Ananeh-Firempong, 2003, p.
294). Culturally competent practice demonstrates an
understanding of, and respect for, cultural and linguistic
differences among individuals and responds to these
differences in a culturally sensitive and appropriate manner.
Developing cultural competence is an ongoing process that
requires SLPs to actively seek new knowledge about the
families they work with and to reflect upon their own
practice to ensure it is respectful and inclusive so that
services are effective, useful, and relevant to the needs of
the families they serve (International Expert Panel on
Multilingual Children’s Speech, 2012; Verdon, McLeod &
Wong, 2014).
SLPs need strategies to support their practice with
culturally and linguistically diverse families to ensure the
effective communication of purpose, ideas, beliefs, and
desired outcomes. To identify practical pathways for
supporting culturally and linguistically diverse families, this
article draws upon research undertaken in the Embracing
Diversity, Creating Equality study (see Verdon, 2014 for
more information). The Embracing Diversity, Creating
Equality study investigated international practices with
culturally and linguistically diverse children in 14 sites on
four continents in five countries including Brazil, Italy, Hong
Kong, Canada, and the USA. The sites were based in many
different settings including private practice, preschools,
schools, hospitals, universities, and community-based
settings, representing the diversity of SLPs’ practice around
the world. From the vast amount of data collected and
analysed regarding practice with culturally and linguistically
diverse families, six key principles for SLPs to translate
these findings into practice were identified. These were:
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 (see Figure 1). As
every individual has their own unique culture, these six
principles are useful in guiding practice with all families. The
importance of each of these key principles, their application
in individual contexts and resources to support enactment
of these principles (where appropriate) are explored below.
Culturally
competent
practice
Getting to
know yourself
Collaborating
with other key
people
Using
appropriate
tools and
resources
Knowing and
forming
relationships
with families and
communities
Being-flexible:
One size does
not fit all
Setting
mutually
motivating
goals
Figure 1. Six key principles for culturally competent practice