JCPSLP Vol 17 No 1 2015_lores

Diversity in practice

Enhancing practice with culturally and linguistically diverse families 6 key principles from the field Sarah Verdon

Australia is a highly culturally and linguistically diverse nation. In order to support all Australians to develop their speech, language, and communication skills for positive lifelong outcomes, SLPs need to engage in culturally competent practice. This article draws upon an international study investigating practice with culturally and linguistically diverse families in 14 sites across four continents and five countries. The findings of this research have identified six key principles from the field that are useful for enhancing the current practices of SLPs working with families from culturally and linguistically diverse backgrounds. These six principles are: 1) getting to know yourself; 2) knowing and forming relationships with families and communities; 3) setting mutually motivating goals; 4) using appropriate tools and resources; 5) collaborating with other key people, and 6) being flexible: one size does not fit all. A ustralia, like many other English dominant countries, is highly culturally and linguistically diverse. What makes Australia unique is that there is no dominant second language or culture, but rather Australia is made up of people from many different backgrounds. According to the 2011 census, 27% of the population are first generation Australians, meaning that they were born overseas and have migrated to Australia, while 23.2% of Australians report that English is not the first language spoken in their home (Australian Bureau of Statistics [ABS], 2012a). In addition to diversity arising from migrant cultures and languages, the Aboriginal and Torres Strait Islander people of Australia make up approximately 3% of the Australian population (ABS, 2013). As a result of the high degree of cultural and linguistic diversity in Australia, speech-language pathologists (SLPs) are likely to engage in practice with families who speak various different languages and are from different cultural backgrounds. Working across cultures Every person has a culture, defined as the sum of beliefs, rituals, customs, and practices that guide thinking,

decisions, and actions (Spector, 1985). Culture is not rigid and unchanging among distinct groups but varies among individuals (Gray & Thomas, 2005). Culture is an essential component of how explanatory models for illness, difficulties, and disabilities are formed. An explanatory model is a belief system by which a person or people from a cultural group explain, diagnose, and identify possible treatments for an illness or disability (Kleinman, Eisenberg & Good, 1978). From a western cultural standpoint, often the cause of illness or disability is deemed to be of an anatomical or physiological nature and therefore medical or professional intervention is needed to remediate the issue. Other cultural standpoints may identify the cause of illness or disability as being related to spirituality, religion, or family history, and therefore may identify other means of overcoming the issue (Nuckolls, 1991; Vukic, Gregory, Martin-Misener & Etowa, 2011). Differences in the cultural background of SLPs and the families they serve means that each party may approach the same situation from a very different viewpoint. A lack of cultural understanding can result in a communication breakdown between SLPs and families leading to ineffective and culturally inappropriate practice. To avoid such communication breakdowns, SLPs are encouraged to engage in culturally safe practice, a philosophy of practice that originated in nursing and is defined as practice with “a person or family from another culture, and is determined by that person or family” (Nursing Council of New Zealand, 2005, p.4). The challenges of cross-cultural practice have been well documented in the literature (Caesar & Kohler, 2007; Jordaan, 2008; Kritikos, 2003, Stow & Dodd, 2003; Williams & McLeod, 2012), with the major ones identified as a lack of culturally appropriate tools for assessment; limited developmental norms for linguistically diverse populations upon which to make a differential diagnosis; and insufficient professional support and training for working with families from different cultural backgrounds. The mismatch between the cultural diversity of Australian SLPs and the cultural diversity of the Australian population means that it is essential that all SLPs develop cultural competence in order to engage in culturally safe and competent practice (Verdon, McLeod & McDonald, 2014). Cultural competence Culturally competent practice is defined as practice that “acknowledges and incorporates, at all levels, the importance of culture, assessment of cross-cultural relations, vigilance toward the dynamics that result from cultural differences, expansion of cultural knowledge, and

KEYWORDS CHILDREN CULTURAL DIVERSITY MULTILINGUAL PRACTICE THIS ARTICLE HAS BEEN PEER- REVIEWED

Sarah Verdon

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JCPSLP Volume 17, Number 1 2015

Journal of Clinical Practice in Speech-Language Pathology