ACQ Vol 11 No 1 2009

MULTICULTURALISM AND DYSPHAGIA

Quraan (Muslim) or Bible (Christian) may be acceptable for the Arabic aphasic patient; n some Arabic male patients may not accept receiving speech therapy in front of their wives or children as culturally, they may feel shame to appear as a weak person in front of their family. Issues for improving services Reviewing the literature regarding the Arabic culture in Australia leads us to suggest that this population is at risk of having reduced opportunities to receive speech pathology services. In turn, the reduced visibility of Arabic-speaking patients in serviced population may reduce the opportunities that speech pathologists have to learn about the Arabic language and culture and how to provide services more appropriately. Similar issues have been discussed in a study organised by the Centre for Citizenship and Human Rights at Deakin University (Kenny, Mansoure, Smiley, & Spratt, 2005), which focused on the types of linkages that exist between the Arabic community and the wider community surrounding them in Australia. The study identified that the Arabic community reported their lack of knowledge about culturally sensitive resources and services due to their lack of social connectedness. Arabic people preferred not to use the avail­ able health service because of their limited English language proficiency and some cultural perceptions (for example, the shame associated with non-reliance upon family), and also reported more trust in community-specific services (which provide culturally and linguistically appropriate services) than in mainstream services. It is also important to focus on the health service employees themselves and their lack of knowledge about others’ cultural backgrounds. In the study conducted in metropolitan Sydney hospitals by Roger, Code and Sheard (1996), one of the findings was that speech pathologists reported their lack of knowledge about bilingual patients’ language and cultural background. Developing cross-cultural competence Cultural competence is generally held to be critical to the achievement of national multicultural policy objectives and to the success of the immigration and settlement process in Australia, and so a number of studies have been conducted focusing on this area. For example, Bean’s (2006) study aimed to evaluate the effectiveness of cross-cultural training programs over time in Australian public sector organisations. The study took place over an 11-month period from July 2005 to June 2006 and involved engaging the participants in training based on general cultural awareness, programs on specific cultures, working with interpreters, specialised programs for fields such as health and policing, and managing culturally diverse workforces. The main objectives were to develop awareness of the cultural dimensions of interactions and effectiveness in situations and environments characterised by cultural diversity. The study showed that the immediate post-training evaluation ratings showed increases in all areas of knowledge and awareness against which participants self- rated themselves in the pre-survey. The highest percentage point increases were in the areas of understanding of organisational policies and issues, knowledge of cross-cultural skills, and understanding of other cultures. There were smaller improvements in understanding of the effects of one’s own culture on oneself, awareness of the effects of cultural

differences on interactions, and confidence in dealing with people from different cultures. The findings from this study might encourage us to think about the importance of providing speech pathologists in Australia with cross-cultural training which might help them to improve their knowledge and skills in working with bilingual patients. This may, in turn, enhance the quality of speech pathology services provided to patients from different cultural and linguistic backgrounds. Conclusion This discussion of the literature in relation to speech pathologists’ work with culturally and linguistically diverse speakers in Australia shows clearly that more needs to be known about ways to improve services for these clients. In particular, in light of the issues we have discussed in relation to speakers from an Arabic background, we suggest that there is a need to develop ways that would facilitate interpreter- mediated assessments of Arabic speakers with aphasia that could better identify areas of communication functional need. We have also suggested that there is a role for ongoing professional education to support the development of increasing levels of cross-cultural competence in the profession. References Al-amawi, S., Ferguson, A., & Hewat, S. (2008, 2–3 October). Assessing aphasia in Arabic speakers: Work in progress . Paper presented at the 13th Aphasiology Symposium of Australia, Brisbane. Alireza, M. (1991). At the drop of a veil . Boston: Houghton Mifflin. Australian Bureau of Statistics. (1999). 1999 census of population and housing . Retrieved 20 April 2008 from http:// www.abs.gov.au Australian Bureau of Statistics. (2001). Year book Australia 2001 , cat. no. 1301.0. Canberra: ABS. Australian Bureau of Statistics. (2006). 2006 census of population and housing . Retrieved 22 April 2008 from http:// www.abs.gov.au. Bahaa-Ediin, M. (2006). Emirati Arabic politeness formulas: An exploratory study and a mini-mini-dictionary. The seventh annual UAE University research conference , vol. 22, 17–27. UAEU Funded Research Publications. Baker, R. (1995). Communicative needs and bilingualism in elderly Australians of six ethnic backgrounds. Australian Journal on Ageing , 14 , 81–88. Battle, D. E. (2000). Communication disorders in multicultural populations (3rd ed.). Boston: Butterworth Heinemann. Bean, R. (2006) The effectiveness of cross-cultural training in the Australian context . Department of Immigration and Multicultural Affairs: Canberra: AUS: 249. (TRAI.11) www. immi.gov.au/media/publications/research/cross_cultural/ index.htm, accessed 18 December 2008. Butler, K. (1989). From the editor: Language assessment and intervention with LEP children: Implications from an Asian/ Pacific perspective. Topics in Language Disorders , 9 (3), iv–v. Clyne, M. (1991). Community languages: The Australian experience . Cambridge: Cambridge University Press. Clyne, M. (2003). Dynamics of language contact: English and immigrant languages . Cambridge: Cambridge University Press.

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