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The Intelligibility in Context Scale, a screening tool available in English with accompanying translations in many of the languages spoken by Australian families: http://www. csu.edu.au/research/multilingual-speech/ics Collaborating with other key people Professional collaboration is important for providing holistic services to culturally and linguistically diverse families. If the family is not fluent or confident in English, it is important to collaborate with interpreters to ensure that families are fully informed at all times (Campinha-Bacote, 2002). Additionally, cultural brokers – that is support workers from the family’s cultural background – can be used to create a bridge of understanding, familiarity, and trust between SLPs and families from different cultural backgrounds (McElroy & Jezewski, 2000). If a cultural broker is not available, it may be worthwhile consulting a trusted member of the community to build trust and mutual understanding so that families feel comfortable and safe when accessing services. When working with children, collaboration with teachers and parents during assessment is important to gain a holistic picture of children’s communication and interactions as these are the people who spend the most time with the children and see them in everyday settings. Collaboration with parents and teachers is also important during intervention with all children to ensure follow-through between the home, school, and clinical contexts. It is also important to consider whether families would benefit from the input of other professionals (such as physiotherapists, occupational therapists, social workers, dieticians or psychologists, etc.). Once a trusting relationship has been established with a professional, that professional can act as a bridge for the family to learn about and access other services. Additionally, the knowledge and skills of colleagues and co-workers may be useful if they speak other languages or have experience in diverse cultures that could be drawn upon to support practice. Collaborating with more knowledgeable others is a vital component of ongoing professional development and developing cultural competence. Being flexible: one size does not fit all A dilemma in health practice is that often a generalisable “one size fits all” approach to practice can be sought and applied. In contrast, the most important component of culturally competent practice is recognising that each individual is different and therefore will require a unique approach to practice. This approach will be based on the individual’s language, culture, beliefs, interests, and goals. Engaging in culturally competent practice does not require SLPs to do away with current practice and start again; rather by using the principles described in this article SLPs can adapt existing practice to ensure that it is culturally responsive and meets the needs of families from culturally and linguistically diverse backgrounds. Applying these principles to individual contexts The application of the six principles described above will be different depending on the context in which SLPs practice and on the backgrounds and individual perspectives of the families they serve. Services based in settings such as schools, hospitals, universities, community health services, and private practice will each have their own barriers and facilitators to adapting aspects of practice to ensure that services are culturally competent. A key starting point is to

reflect upon current practices both at the individual and organisational level at the stages of referral, assessment, intervention, collaboration, and discharge to identify possibilities for incorporating aspects of cultural competence into existing practices (Verdon, McLeod & Wong, 2014). Once these possibilities have been identified, achievable changes can be implemented to enhance practice with culturally and linguistically diverse families. Larger changes may challenge the existing practice of an organisation and thus require more planning, thinking, and negotiation. Be a boundary pusher: Challenge existing practices SLPs can play a key role in enacting both bottom-up changes to practice through their daily activities, and advocating for top-down changes at the organisational level. Individual SLPs have the power to make small changes in their own practice which can have positive flow-on effects for larger changes to practice in their workplace. It is important for SLPs to have a vision of ideal practice and to actively take steps towards achieving this ideal by taking an activist stance towards promoting and enacting culturally competent practice. Oftentimes creating positive change requires SLPs to push the boundaries of existing practices when new evidence or more efficient approaches to practice are identified. SLPs can use the principles outlined in this article to think outside of existing practice and identify opportunities to enhance their current practice. If every professional incorporated these principles into their individual practice with culturally and linguistically diverse families, positive steps could be taken towards supporting all people with speech, language, and communication needs to reach their potential as competent communicators and active participants in society. Acknowledgments Sarah acknowledges support from a scholarship from the Australian Department of Education, the Research Institute for Professional Practice, Learning and Education (RIPPLE), and an Excellence in Research in Early Years Education Collaborative Research Network scholarship from Charles Sturt University. Sarah would like to thank the professionals in the Embracing Diversity, Creating Equality study for their hospitability, generosity of ideas, and for the contribution they have made to the profession by sharing their experiences of multilingual and multicultural practice. References Australian Bureau of Statistics (ABS). (2012). Reflecting a nation: Stories from the 2011 census, 2012–2013 . Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/lo okup/2071.0main+features902012-2013 Australian Bureau of Statistics (2013). Estimates of Aboriginal and Torres Strait Islander Australians, June 2011. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/ mf/3238.0.55.001 Bedford, J., Mackey, S., Parvin, A., Muhit, M., & Murthy, G. V. S. (2013). Reasons for non-uptake of referral: Children with disabilities identified through the Key informant method in Bangladesh. Disability and Rehabilitation , 35 (25), 2164–2170. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh- Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports , 118 (4), 293–302.

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JCPSLP Volume 17, Number 1 2015

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