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JCPSLP Volume 17, Number 1 2015 5
reflect upon current practices both at the individual and
organisational level at the stages of referral, assessment,
intervention, collaboration, and discharge to identify
possibilities for incorporating aspects of cultural
competence into existing practices (Verdon, McLeod &
Wong, 2014). Once these possibilities have been identified,
achievable changes can be implemented to enhance
practice with culturally and linguistically diverse families.
Larger changes may challenge the existing practice of an
organisation and thus require more planning, thinking, and
negotiation.
Be a boundary pusher: Challenge
existing practices
SLPs can play a key role in enacting both bottom-up
changes to practice through their daily activities, and
advocating for top-down changes at the organisational
level. Individual SLPs have the power to make small
changes in their own practice which can have positive
flow-on effects for larger changes to practice in their
workplace. It is important for SLPs to have a vision of ideal
practice and to actively take steps towards achieving this
ideal by taking an activist stance towards promoting and
enacting culturally competent practice. Oftentimes creating
positive change requires SLPs to push the boundaries of
existing practices when new evidence or more efficient
approaches to practice are identified. SLPs can use the
principles outlined in this article to think outside of existing
practice and identify opportunities to enhance their current
practice. If every professional incorporated these principles
into their individual practice with culturally and linguistically
diverse families, positive steps could be taken towards
supporting all people with speech, language, and
communication needs to reach their potential as competent
communicators and active participants in society.
Acknowledgments
Sarah acknowledges support from a scholarship from the
Australian Department of Education, the Research Institute
for Professional Practice, Learning and Education (RIPPLE),
and an Excellence in Research in Early Years Education
Collaborative Research Network scholarship from Charles
Sturt University. Sarah would like to thank the professionals
in the Embracing Diversity, Creating Equality study for their
hospitability, generosity of ideas, and for the contribution
they have made to the profession by sharing their
experiences of multilingual and multicultural practice.
References
Australian Bureau of Statistics (ABS). (2012). Reflecting a
nation: Stories from the 2011 census, 2012–2013 .
Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/lo
okup/2071.0main+features902012-2013
Australian Bureau of Statistics (2013). Estimates of
Aboriginal and Torres Strait Islander Australians, June 2011.
Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/
mf/3238.0.55.001
Bedford, J., Mackey, S., Parvin, A., Muhit, M., & Murthy,
G. V. S. (2013). Reasons for non-uptake of referral: Children
with disabilities identified through the Key informant
method in Bangladesh. Disability and Rehabilitation, 35(25),
2164–2170.
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-
Firempong, O. (2003). Defining cultural competence: A
practical framework for addressing racial/ethnic disparities
in health and health care. Public Health Reports, 118(4),
293–302.
The Intelligibility in Context Scale, a screening tool
available in English with accompanying translations in many
of the languages spoken by Australian families:
Collaborating with other key people
Professional collaboration is important for providing holistic
services to culturally and linguistically diverse families. If the
family is not fluent or confident in English, it is important to
collaborate with interpreters to ensure that families are fully
informed at all times (Campinha-Bacote, 2002). Additionally,
cultural brokers – that is support workers from the family’s
cultural background – can be used to create a bridge of
understanding, familiarity, and trust between SLPs and
families from different cultural backgrounds (McElroy &
Jezewski, 2000). If a cultural broker is not available, it may
be worthwhile consulting a trusted member of the
community to build trust and mutual understanding so that
families feel comfortable and safe when accessing services.
When working with children, collaboration with teachers
and parents during assessment is important to gain a
holistic picture of children’s communication and interactions
as these are the people who spend the most time with the
children and see them in everyday settings. Collaboration
with parents and teachers is also important during
intervention with all children to ensure follow-through
between the home, school, and clinical contexts.
It is also important to consider whether families would
benefit from the input of other professionals (such as
physiotherapists, occupational therapists, social workers,
dieticians or psychologists, etc.). Once a trusting
relationship has been established with a professional,
that professional can act as a bridge for the family to
learn about and access other services. Additionally, the
knowledge and skills of colleagues and co-workers may
be useful if they speak other languages or have experience
in diverse cultures that could be drawn upon to support
practice. Collaborating with more knowledgeable others is
a vital component of ongoing professional development and
developing cultural competence.
Being flexible: one size does not fit all
A dilemma in health practice is that often a generalisable
“one size fits all” approach to practice can be sought and
applied. In contrast, the most important component of
culturally competent practice is recognising that each
individual is different and therefore will require a unique
approach to practice. This approach will be based on the
individual’s language, culture, beliefs, interests, and goals.
Engaging in culturally competent practice does not require
SLPs to do away with current practice and start again;
rather by using the principles described in this article SLPs
can adapt existing practice to ensure that it is culturally
responsive and meets the needs of families from culturally
and linguistically diverse backgrounds.
Applying these principles to
individual contexts
The application of the six principles described above will be
different depending on the context in which SLPs practice
and on the backgrounds and individual perspectives of the
families they serve. Services based in settings such as
schools, hospitals, universities, community health services,
and private practice will each have their own barriers and
facilitators to adapting aspects of practice to ensure that
services are culturally competent. A key starting point is to