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Volume 17, Number 1 2015


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


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.


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.


Australian Bureau of Statistics (ABS). (2012).

Reflecting a

nation: Stories from the 2011 census, 2012–2013


Retrieved from


Australian Bureau of Statistics (2013). Estimates of

Aboriginal and Torres Strait Islander Australians, June 2011.

Retrieved from


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





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





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