ACQ Vol 11 No 1 2009

MULTICULTURALISM AND DYSPHAGIA

We also know that competent bilinguals have greater metalinguistic skills as a group than monolinguals. Using one language to support the other metalinguistically may be a new goal and a new speech pathology skill. Speech pathologists are well equipped to tackle detailed understandings of similarities and differences in the nature of the languages involved, with assistance from skilled bilinguals. As part of this, teaching the speech pathologist about the other language may be desirable – the negotiation of meaning between languages involved could itself become part of the therapy. Similarly, the functions or purposes that involve only the non- English language should be included as goals and practices in intervention, such as conducting phone conversations with grandparents, or cultural events which take place only in that language. The fact that the clinician does not speak that language is not a reason for leaving them out of the program, as there are ways to include them with a team approach. As well as goals being different in a bilingual environment, the interactional skills within a language intervention session may also be quite different. The interpreter or other bilingual person may become the primary interactant, so the speech pathologist may need to plan for how she will become part of that interaction and at what points her knowledge about English and about the other language becomes a salient part of that interaction. For example, she may suggest the interpreter use 3-word utterances with a child, and must be aware of how this might vary between the two languages. Accordingly, decisions will need to be made about how and how much each language should be used. For example, should it be that each target or part of an activity should be conducted first in one language, then the other? Should both be involved? Should code switching be incorporated? Should interpreting from one language to another occur constantly, or intermittently? What kind of feedback should be used? All these possibilities should be available, and subjected to studies of outcomes and efficacies, to increase our evidence base. A change in the role of the clinician in this direction is consistent with the family-centered practice, collaborative, and ICF frameworks, with their ideas of the social realities of the client and family and handing over of power and control towards those most involved. Therefore, it may not be a greater shift in thinking than we are already being urged towards from multiple sources, and it may be a way to enable us to put more of these best practice principles into operation. A new model of language intervention practice may be emerging. Conclusion Speech pathologists the world over tend to find working with communication disorders in bilingual clients to be problematic. We know that representation of non-dominant groups in speech pathology clinics tends to be lower than their proportion in the broader population, that clinicians tend to feel less competent in dealing with such client groups, that there is a lack of appropriate assessment tools and analysis techniques, and that there are many unknowns about how effective intervention is with these groups. There are many facets to possible solutions, including more research and the development of better tools. However, this paper has suggested that ways of thinking or concepts in the profession are also barriers to competence. We contend that one of these ways of thinking is that speech-language pathology as a profession treats bilingualism in children as a kind of multiple monolingualism: one language or the other. The literature, however, suggests that the whole is more than the sum of the parts, and that we need to change our thinking to encompass some potentially radical ideas about how we assess, set goals

and conduct intervention with bilingual populations. We have also suggested that it is possible to do this in languages that the speech pathologist does not speak. These suggestions turn out to be consistent with a number of current best practice frameworks, including the ICF, family-centred practice, culturally competent practice, and collaborative and consultative practice. This material has the potential to make our profession more effective, and also more approachable and more affirming for culturally and linguistically diverse populations. There are long-term consequences both for individual children and for greater social movements in this area of practice. For example, tests often form the basis of entry to special education, further education and employment, and thus the issue of fairness of language tests or language-based tests for children of bilingual backgrounds needs discussion at the level of policy- making. It has been suggested already that speech pathologists should act as advocates for these children and ensure that test scores are used fairly in their communities (Cummins 2003; Kritikos, 2003). Speech pathologists should also aim to understand the sociopolitical factors affecting their own professional decisions and whether these are justified in evidence based practice. We would suggest that education in speech-language pathology should include more on the nature of bilingualism, more on alternative models of assessment and intervention that we could only suggest in this paper, and more research direction for investigating bilingualism and language disorder. These include developing assessment tools and protocols examining language competence in bilinguals that are not about separating two languages, and efficacy of intervention using some of the different models and practices we have suggested. The initial step of acknowledging that bilinguals communicate differently to monolinguals should give the clinician some insight into interpreting bilingual language data, and we look forward to more suggestions from future publications on how speech pathologists can better manage their multilingual caseload. Given that multi­ lingualism is the norm for most of the world’s communicators, further study of multilingual communication in a manner that embraces their natural communicative characteristics is essential for enhancing our understanding of how the major­ ity of people in the world communicate and learn language. References Baker, C. (2000). The care and education of young bilinguals: An introduction for professionals. Clevedon, UK: Multilingual Matters. Baker, C. (2003). Foundations of bilingual education and bilingualism (3rd ed.). Clevedon, UK: Multilingual Matters. Battle D (Ed.) (2002). Communication disorders in multicultural populations (3rd ed). New York: Butterworth. Brice, A. (2000). Code switching and code mixing in the ESL classroom: A study of pragmatic and syntactic features. Advances in Speech-Language Pathology , 2 (1), 19–28. Brice, A. (2001). Choice of languages in instruction: One language or two? Teaching Exceptional Children , 33 (4), 10–16. Brice, A., & Anderson, R. (1999). Code mixing in a young bilingual child. Communication Disorders Quarterly , 21 (1), 17– 22. Campbell, W. & Skarakis-Doyle, E. (2007). School-aged children with SLI: The ICF as a framework for collaborative service delivery. Journal of Communication Disorders . 40 , 513– 535. Chang, J. (2001). Chinese speakers. In M. Swan & B. Smith (Eds.), Learner English: A teacher’s guide to interference and other problems (2nd ed., pp. 310–324). Cambridge: Cambridge University Press.

ACQ uiring knowledge in sp eech , language and hearing , Volume 11, Number 1 2009

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