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Volume 17, Number 1 2015


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



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).


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:

http://www. Personal-Reflection.pdf

Activity for reflecting on organisational policies and

procedures: Competence-Checklist-Policies-Procedures.pdf

Activity for reflecting on service delivery with culturally

and linguistically diverse clients: uploadedFiles/Cultural-Competence-Checklist-Service- Delivery.pdf

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.




Getting to

know yourself


with other key




tools and


Knowing and



with families and



One size does

not fit all





Figure 1. Six key principles for culturally competent practice