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References American Speech-Language Hearing Association (ASHA). (2011). Cultural competence in professional service delivery . Retrieved from http://www.asha.org/policy/ KS2004-00215.htm American Speech-Language and Hearing Association (ASHA) Board of Ethics (2013). Cultural and linguistic competence [Issues in ethics]. Retrieved from http://www. asha.org/Practice/ethics/ Barrett, H. (2013). “Education for all”? Access to primary- level education for children with complex learning disabilities in countries with “free primary education” in sub-Saharan Africa: A review of the literature . (Unpublished master’s thesis). University of Manchester, UK. Barrett, H., Turatsinze, F., & Marshall, J. (2016). International working: strategic thinking achieves change. RCSLT Bulletin , July , 18–19. Brown, S., & Lehto, X. (2005). Travelling with a purpose: understanding the motives and benefits of volunteer vacations. Current Issues in Tourism , 8 (6), 479–496 Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care , Volume I. Washington, DC: CAASP Technical Assistance Center. Crowley, C., & Baigorri, M. (2011). Effective approaches to international work: Substance and sustainability for speech-language pathology student groups. Perspectives on Global Issues in Communication Sciences and Related Disorders , 1 (1), 27–35. Hall E. (1984). The dance of life: the other dimension of time . New York, NY: Anchor Press. Hartley, S., Murira, G., Mwangoma, M., Carter, J., & Newton, C. (2009) Using community/researcher partnership to develop a culturally relevant intervention for children with communication disabilities in Kenya. Journal of Health Services Research and Policy , 31 , 490–499. Hickey, E.M., McKenna, M., Woods, C., & Archibald, C. (2014). Ethical concerns in voluntourism in speech- language pathology and audiology. Perspectives on Global Issues in Communication Sciences and Related Disorders , 2 , 40–48. Indigenous Allied Health Australia (IAHA). (2015). Cultural responsiveness in action: An IAHA framework . Australia: Author. Leadbeater, C., & Litosseliti, L. (2014). The importance of cultural competence for speech and language therapists. Journal of Interactional Research in Communication Disorders , 5 ,1–26. Levi, A. (2009). The ethics of nursing student international clinical experiences. Journal of Obstetric, Gynecologic and Neonatal Nursing , 38 (1), 94–99. Marsh, H. W., and MacDonald-Holmes, I. W. (1990). Multidimensional self-concepts: Construct validation of responses by children. American Educational Research Journal, 27 (1), 89–117. Papadopolous, I., Tilki, M., & Taylor, G. (1998). Transcultural care: A guide for healthcare professionals . Wilts, UK: Quay Publications. Ridley, C.R., Baker, D.M., & Hill, C.L. (2001). Critical issues concerning cultural competence. The Counselling Psychologist , 29 (6), 822–832. Robinson, H., Afako, R., Wickenden, M., & Hartley, S. (2003). Preliminary planning for training speech and language therapists in Uganda. Folia Phoniatrica et Logopaedica , 55 , 322–328. Royal College of Speech and Language Therapists (RCSLT) (2003). Reference framework underpinning

relevant, responsive and effective services both at home and overseas, a wider recognition of the need for cultural competence to be grounded in the concept of humility needs to be a common and central concern of speech- language pathology governing bodies, training institutions, service providers. Ultimately, it needs to be championed by individual members of the profession. It is vital that the speech-language pathologists contributing to service development in the majority world reflect upon both their motivations and their ability to provide appropriate input that is sensitive to the needs of local service users and providers (Hickey et al., 2014). Thus, practitioners need to reflect upon some widely accepted personal and professional cultural beliefs and be led by local partners to reach workable and realistic solutions to the challenges that they identify. Participatory and emancipatory research is therefore necessary to expound the needs of people with communication disabilities in different contexts, and what they, and their communities, feel is the most appropriate way forward to address those needs. Conclusion As global mobility increases, it has never been so important to look beyond our own cultural reference points and adopt an attitude of open-minded and continuous learning about others. As societies are becoming increasingly multicultural, awareness, knowledge, skills and sensitivity towards others are essential in speech-language pathology practice. However, the profession must ask if the current conceptualisations of cultural competence adequately represent the multidirectional interaction between all of the professional attributes required to work effectively with people from cultures vastly different from our own. Ensuring appropriate training on cultural competence on speech-language pathology courses is an important step towards increasing trainees’ awareness and knowledge about cultural diversity and its implications for effective clinical practice. However, sensitivity and skills come with experience and, arguably, the multifaceted dimensions of cultural competence are governed by an individual’s ability to demonstrate cultural humility and by their own attitudes. Essentially, the onus lies with individuals to embrace diversity in both their personal and professional lives, critically appraise themselves and their practice, accept the unease that comes with stepping outside their comfort- zone with people from other cultures (Walters, 2015), and actively seek to develop their own interpretation of the term cultural competence. 1 Training courses are in place in Uganda, Kenya and Tanzania and under development in Rwanda. 2 Shalmani (2015) states: “The term ‘Majority world’ highlights the fact that the majority of the world’s population lives in these parts of the world traditionally referred to as ‘developing’. The term ‘Minority world’ is similarly used to refer to those countries traditionally referred to as ‘developed’, where a minority of the world’s population resides” . The author recognises the problematic nature of using a “two world’s approach” (Young, 2010), but has opted to use the above terms for clarity of argument. 3 Identities can include age, ethnicity, gender, linguistic background(s), national origin, religion, sexual orientation, socioeconomic status (see ASHA, 2013; Papadopolous et al. 1998). 4 Whereby people seek to exchange knowledge and skills to enhance each other’s practice

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JCPSLP Volume 18, Number 3 2016

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