JCPSLP Vol 17 No 1 2015_lores

Getting to know yourself The important starting point for culturally competent practice is for SLPs to engage in self-reflection (Tervalon & Murray-Garcia, 1998). It is necessary that SLPs know who they are, what they believe, and how this impacts upon the way they view the world and engage in practice. To facilitate self-reflection, SLPs can ask themselves some key questions such as: • What is my culture? • What are my beliefs, values, and attitudes? • Why do I have these beliefs, values, and attitudes? • What are my attitudes towards people of different gender, race, language background, sexual orientation, and level of ability? • What biases do I bring to my practice? Through self-reflection comes self-awareness. Such awareness can help SLPs to understand when a barrier between themselves and a family is present and what may be the cause of this barrier. An important part of overcoming barriers is cultural humility, whereby all cultures, belief systems and explanatory models are valued in clinical decision-making, rather than simply adopting the cultural approach to practice valued by the professional or dominant society (Tervalon & Murray-Garcia, 1998). Resources: The American Speech-Language-Hearing Association website provides resources to facilitate reflection on professional practice, service delivery, and policies and procedures. These can be accessed at http:// www.asha.org/practice/multicultural/ and include: Personal reflection activity for professionals: http://www. asha.org/uploadedFiles/Cultural-Competence-Checklist- Personal-Reflection.pdf Activity for reflecting on organisational policies and procedures: http://www.asha.org/uploadedFiles/Cultural- Competence-Checklist-Policies-Procedures.pdf Activity for reflecting on service delivery with culturally and linguistically diverse clients: http://www.asha.org/ uploadedFiles/Cultural-Competence-Checklist-Service- Delivery.pdf Knowing and forming relationships with families and communities Taking time to get to know and build trusting relationships with families is key to engaging in culturally competent practice. By taking time to get to know families, SLPs are better informed to make decisions about diagnosis and appropriate ways to proceed with intervention if necessary. It is important that SLPs gain an understanding of the home environment; for example, what the main language used in the home is, what other languages are spoken, when and where these languages are used, and what languages the family wants to work in (De Houwer, 2007). This will help with understanding the linguistic influences upon speech and language when planning assessment. A complete case history of the family’s cultural and linguistic diversity will assist in making an accurate and well-informed diagnosis. Knowledge of the languages spoken is also important for planning intervention as multilingual speakers have been found to benefit most from intervention provided in their primary language, with the potential for positive generalisation of effects to occur in their additional language(s) depending on the nature of the communication need (Gutiérrez-Clellen, 1999; Kohnert, Yim, Nett, Kan, & Duran, 2005). Engaging in western health practices may be an unfamiliar concept for culturally and linguistically diverse

adaptation of services to meet culturally unique needs” (Betancourt, Green, Carrillo & Ananeh-Firempong, 2003, p. 294). Culturally competent practice demonstrates an understanding of, and respect for, cultural and linguistic differences among individuals and responds to these differences in a culturally sensitive and appropriate manner. Developing cultural competence is an ongoing process that requires SLPs to actively seek new knowledge about the families they work with and to reflect upon their own practice to ensure it is respectful and inclusive so that services are effective, useful, and relevant to the needs of the families they serve (International Expert Panel on Multilingual Children’s Speech, 2012; Verdon, McLeod & Wong, 2014). SLPs need strategies to support their practice with culturally and linguistically diverse families to ensure the effective communication of purpose, ideas, beliefs, and desired outcomes. To identify practical pathways for supporting culturally and linguistically diverse families, this article draws upon research undertaken in the Embracing Diversity, Creating Equality study (see Verdon, 2014 for more information). The Embracing Diversity, Creating Equality study investigated international practices with culturally and linguistically diverse children in 14 sites on four continents in five countries including Brazil, Italy, Hong Kong, Canada, and the USA. The sites were based in many different settings including private practice, preschools, schools, hospitals, universities, and community-based settings, representing the diversity of SLPs’ practice around the world. From the vast amount of data collected and analysed regarding practice with culturally and linguistically diverse families, six key principles for SLPs to translate these findings into practice were identified. These were: 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 (see Figure 1). As every individual has their own unique culture, these six principles are useful in guiding practice with all families. The importance of each of these key principles, their application in individual contexts and resources to support enactment of these principles (where appropriate) are explored below.

Knowing and forming relationships with families and communities

Being-flexible: One size does not fit all

Getting to know yourself

Culturally competent practice

Setting mutually motivating goals

Collaborating with other key people

Using appropriate tools and resources

Figure 1. Six key principles for culturally competent practice

3

JCPSLP Volume 17, Number 1 2015

www.speechpathologyaustralia.org.au