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Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families
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Cultural Considerations when working with Culturally and Linguistically Diverse Populations: Working with bilingual children and families

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This presentation reviews the importance of culture and identifies nine parameters of culture. You will learn how to facilitate culturally familiar environments to maximize success in treatment.

This presentation reviews the importance of culture and identifies nine parameters of culture. You will learn how to facilitate culturally familiar environments to maximize success in treatment.

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  • Clients from culturally and linguistically diverse backgrounds comprise almost 35% of speech-language pathologists’ caseloads across employment settings (ASHAsurvey, 2000). Among this group of individuals, Latinos are the fastest growing racial/ethnic minority group in the United States (Salas-Provance, Erickson, and Reed, 2002). Between 1990 and 2000 the Latino population increased by 57.9 percent, compared with an increase of 13.2 percent for the total population of the United States. In 2000, 12.5 percent of US residents were Latino and more than three-quarters lived in the West or South, with half of all Latinos in California and Texas. In the fall of 2000, approximately 16 percent of students enrolled in elementary and secondary schools were Latino. Of these children, 17.3 percent were identified as having speech or language impairment during the 2000-2001 school-year.
  • Clients from culturally and linguistically diverse backgrounds comprise almost 35% of speech-language pathologists’ caseloads across employment settings (ASHAsurvey, 2000). Among this group of individuals, Latinos are the fastest growing racial/ethnic minority group in the United States (Salas-Provance, Erickson, and Reed, 2002). Between 1990 and 2000 the Latino population increased by 57.9 percent, compared with an increase of 13.2 percent for the total population of the United States. In 2000, 12.5 percent of US residents were Latino and more than three-quarters lived in the West or South, with half of all Latinos in California and Texas. In the fall of 2000, approximately 16 percent of students enrolled in elementary and secondary schools were Latino. Of these children, 17.3 percent were identified as having speech or language impairment during the 2000-2001 school-year.
  • The American Speech-Language-Hearing Association (ASHA) maintains that clinicians must recognize how a client’s cultural and linguistic characteristics will influence the clinical decision-making process and determine how communicative competence and impairment are evaluated (Tomoeda & Bayles, 2002).
  • ASHA’s position on the importance of culture is based on the assumption A client’s cultural beliefs will influence how they describe their health problems, the manner in which they communicate their symptoms, who they seek for health care, how long they remain in care, and how they assess the care provided. Culturally familiar environments facilitate success in treatment as clients are more secure and responsive in these settings. If clients feel the security of a culturally familiar environment, these clients may be more likely to respond freely and may also be further motivated to attend therapy. For these reasons, ASHA stresses the importance of clinicians developing their intercultural knowledge and skills in order to optimize patient outcomes (Tomoeda & Bayles, 2002; Mahendra et al., 2006).
  • As Latino families are most often served by non-Latino speech-language pathologists, misunderstandings may frequently occur. Knowledge of common cultural characteristics may reduce these misunderstandings. Latinos certainly identify to different degrees with the characteristics discussed in this paper so it is important to consider the individual. These are presented in order to provide parameters for the clinician to consider in the treatment of speech and language disorders when working with Latino families.
  • http://speechpathologyceus.net/courses/cultural-considerations-for-speech-therapy/These factors can profoundly influence the interactions between clinicians and their clients and, therefore, can significantly affect the practice of speech-language pathology (Tomoeda & Bayles, 2002). Individualism versus Collectivism.A culture is termed individualistic when great value is placed on individuals and their rights and decisions. Members of individualistic societies may tend to have more casual relationships. By comparison, a culture is collectivistic when great value is placed on the group and membership in the group.Views of time and spaceThis parameter refers to how strictly a culture adheres to a schedule. Some cultures emphasize punctuality, while others are more event-oriented. For the latter group, beginning a new event is determined by the completion of the previous event, rather than by a schedule. This parameter also refers to personal space and how much distance between conversational partners is required for individuals to feel comfortableRoles of men and womenGender roles vary across cultures and influence many areas, including education, ownership, choice of profession, and decision-making authority in the familyConcepts of class and statusWhat determines an individual’s societal position and place of respect varies across cultures (Tomoeda & Bayles, 2002). Wealth often plays a large part in the determination of class in Latino culture. Socioeconomic class may result in even greater group dissimilarities than country of originValuesA cultural group’s values are manifested in its view of the relationship of man to nature and of human beings to other human beings, the importance of ancestors and of the environment, and the degree of materialism (Tomoeda & Bayles, 2002). Values in the Latino culture include (1) “familismo,” or the ultimate importance of the family relationship; (2) “respeto,” treating authority figures such as parents, elders, and priests with respect; and (3) “personalismo,” a personal (vs. impersonal) interest in a relationshipLanguage This parameter involves the influence that the pragmatics of a language have oninterpersonal communication. One principle factor affecting communication is the degree to which context is necessary to derive meaning. The amount of information conveyed through setting or context differs among cultures, ranging from high to low context. For example, in high-context cultures, context is crucial to communicate meaning. In interacting with these cultures, a culturally competent clinician would be especially aware of nonverbal aspects of communication, such as eye contact, gestures, space, use of silence, and touch. In contrast, in low-context cultures the actual words are critical and should be the focus of communication.RitualsRituals or ceremonies are conventional ways of commemorating significant historical events or life changes and renewing commitment to shared values. Weddings, births, deaths, and religious worship are associated with rituals in most cultures and many rituals are based on religionSignificance of workThis parameter refers to the importance of work in a culture and how it is defined by the members of the culture. For example, Americans are defined by their work, but people in many other cultures are defined by the groups they are members of and their role in the community.Beliefs about healthIllness and disabilities are viewed differently across cultures. In many cultures, someone with a disability may be seen as special or holy, or they may be seen as bewitched. Illness may be thought to occur when an individual is out of harmony with nature or the universe, and a spiritualist, folk healer, herbalist, or witch doctor may be chosen over Western medical professionals to provide health care. A close relationship between religion and illness is common in Latino families.
  • Latino parents encourage positive emotions in their children, but discourage negative feelings such as anger and aggression in order to maintain the stability of the group (Torres-Matrullo, 1982, as cited in Lynch & Hanson, 2004). Because Latino families placate children and do not push achievement of developmental milestones (Roland, 1988, as cited in Lynch & Hanson, 2004), Latino families may be hesitant to seek treatment for children that exhibit disorders, believing that the child will develop speech and language in his or her own time. Furthermore, the general lack of acceptance of negative feelings in Latino families (Torres-Matrullo, 1982, as cited in Lynch & Hanson, 2004) could make it difficult to face and deal with the emotions that frequently accompany speech and language disorders. Latino children with speech and language disorders may be hesitant to acknowledge their emotions, or even deny them.
  • This parameter refers to how strictly a culture adheres to a schedule. Some cultures emphasize punctuality, while others are more event-oriented. For the latter group, beginning a new event is determined by the completion of the previous event, rather than by a schedule. This parameter also refers to personal space and how much distance between conversational partners is required for individuals to feel comfortable (Tomoeda & Bayles, 2002).
  • Latinos are typically event-oriented and not overly concerned with time. Being late is not considered rude or disrespectful, but instead means that a person is giving priority to a more urgent situation. Many Latinos are less rigid with time and appointments than are European Americans (Robayo, 2003). Latinos also frequently require less personal space to feel comfortable. A European American may require two to three feet of personal space. Latinos may interpret that great of a distance as cold, unfriendly, or as a method to demonstrate superiority (Bennett, 1993).
  • In the clinical setting, this parameter influences clients’ timely arrival for scheduled appointments, their comfort with pre-specified duration of sessions, and their expectation to be accommodated if they miss or cancel a session (Moxley, Mahendra, and Vega-Barachowitz, 2004). Clinicians need to be aware that many Latinos do not consider arriving late to be rude or disrespectful. Thus, tardiness should not be taken as a personal offense nor should it be interpreted as a lack of interest in treatment. Clinicians who are more event-oriented could possibly choose to schedule their Latino clients to arrive 15 minutes earlier than the actual appointment times in order to reduce the amount of time the clinician must wait for the client (Leith, 1986). The clinician should also consider their clients’ modes of transportation and how that may affect punctuality (Robayo, 2003). Given the tight schedule of most SLPs, however, it might be necessary to outwardly discuss why promptness is important in the clinical setting.In addition, it would benefit clinicians to realize the possibility of reduced personal space with Latino clients in order to not be alarmed when family members position themselves closer to each other or to the clinician than he or she is accustomed. Typically in the Latino community, a handshake is appropriate when one is introduced to a new person, but women may choose to kiss one another on the cheek (Robayo, 2003). Therefore, it would be most appropriate for a clinician to begin by greeting their Latino clients with a handshake. However, the clinician should be aware that with increased familiarity this greeting may change.
  • In the clinical setting, this parameter influences clients’ timely arrival for scheduled appointments, their comfort with pre-specified duration of sessions, and their expectation to be accommodated if they miss or cancel a session (Moxley, Mahendra, and Vega-Barachowitz, 2004). Clinicians need to be aware that many Latinos do not consider arriving late to be rude or disrespectful. Thus, tardiness should not be taken as a personal offense nor should it be interpreted as a lack of interest in treatment. Clinicians who are more event-oriented could possibly choose to schedule their Latino clients to arrive 15 minutes earlier than the actual appointment times in order to reduce the amount of time the clinician must wait for the client (Leith, 1986). The clinician should also consider their clients’ modes of transportation and how that may affect punctuality (Robayo, 2003). Given the tight schedule of most SLPs, however, it might be necessary to outwardly discuss why promptness is important in the clinical setting.In addition, it would benefit clinicians to realize the possibility of reduced personal space with Latino clients in order to not be alarmed when family members position themselves closer to each other or to the clinician than he or she is accustomed. Typically in the Latino community, a handshake is appropriate when one is introduced to a new person, but women may choose to kiss one another on the cheek (Robayo, 2003). Therefore, it would be most appropriate for a clinician to begin by greeting their Latino clients with a handshake. However, the clinician should be aware that with increased familiarity this greeting may change.
  • What determines an individual’s societal position and place of respect varies across cultures (Tomoeda & Bayles, 2002). Wealth often plays a large part in the determination of class in Latino culture. Socioeconomic class may result in even greater group dissimilarities than country of origin. For example, a person from Mexico of low socioeconomic status could share more in common with a poor Peruvian farmer than a member from the Mexican middle class. Formal education and higher education degrees are also sources of respect in the Latino community (Robayo, 2003).
  • At the beginning of the year (i.e., January 6th), Latinos may celebrate Dia de los Reyes. For this holiday, children leave their shoes out to be filled with treats to commemorate the visit of the three kings, or Magi, to the Christ child shortly after His birth. Dia de los Muertos (Day of the Dead, All Souls Day for Catholics) is celebrated by Mexican-Americans and many other Latinos, and combines aspects of Indian ancestor worship with Catholic prayer rites for the deceased. Held on November 1st for all children who have died and November 2nd for all adults who have died, families may build altars to commemorate the dead on which are placed statues, pictures of the dead, food offerings, decorations of skeletons, candied skulls with the names of the deceased, candles, and so forth. On December 12th, in the Feast of Our Lady of Guadalupe, the parish churches of Latino communities hold a mass of extensive celebration, often with parades, to commemorate the apparition of Our Lady to Juan Diego, an Indian peasant in the 1500s who lived in what is now Mexico City. Finally, on December 24th, Noche Buena, or the eve of Christ’s birth, is celebrated by preparing traditional foods, such as tamales for Mexican-Americans, and then attending midnight mass. In addition, another traditional festivity in the Latino community that may occur at any point during the year is the Quinceañera, or coming-out celebration for a 15-year-old girl (Lynch & Hanson, 2004.)
  • A close relationship between religion and illness is common in Latino families. Because of this relationship, a disability may be seen as a divine punishment for sin, and the family may believe they should not interfere with God’s will. However, many of the studies on Latino health beliefs have centered on rural and/or low socio-economic status Mexican-Americans. Thus, it is possible that the religion/illness relationship is more related to socioeconomic factors, rather than cultural (Zaldivar, 1994; Slesinger, 1981, as cited in Salas-Provance et al., 2002). For many Latinos, medical folk beliefs include mal ojo (i.e., evil eye,
  • Parents’ beliefs about the cause(s) of speech and language disorders can determine their thoughts on the extent to which their child’s developmental course can be modified by treatment, and/or their thoughts regarding which type of intervention would be most effective. How modifiable parents believe the stuttering to be influences how active a role they will take in facilitating the child’s progress. Latino parents may attribute the cause to uncontrollable factors such as those discussed in the assessment of disorders, such as mal ojo/evil eye, susto/fright, or mal puesto/evil hex, making these parents less likely to take an active role in intervention. Therefore, a parent-implemented intervention program would be an inappropriate and ineffective treatment option for this family (Rodriguez & Olswang, 2003).
  • From www.kwintessential.co.uk/translation/articles/interpreter.htmlBy way of offering some tips on working with interpreters the following guidelines may be of some use:1 - Establish and agree ground rules with an interpreter. For example, try and communicate how you want a meeting run, the number of sentences to be translated at a time, the confirmation of jargon or idioms before they are translated, when breaks will be taken and seemingly trivial matters like seating arrangements.2 - Try and brief an interpreter prior to any face to face meetings. Familiarise them with the whos, whats and whys. If there is any specific terminology to be used ask them if they understand it. If you foresee any tricky issues or tense topics, prepare them for it.3 - If you plan to give a speech or read from a script, give the interpreter a copy. The more familiar they are with the subject matter, the better a job they will do.4 - While speaking through an interpreter always engage with your counterpart directly. Even though you cannot understand what is being said, show interest, keep eye contact and remain focused. If you start to converse through an interpreter you lose any chance of building trust, rapport or confidence.5 - Try and avoid humour. Most interpreters will agree that jokes do not translate well. If you are giving a speech and plan to start it off with a joke, it is advisable to consult the interpreter first to see if they think it will work.6 - Plan your time carefully. Conversing through an interpreter makes conversations twice as long. For example, if you are making a presentation remember that anything you say will first be translated, so the likelihood is that a one hour presentation will take two. Compensate for this by either cutting down your presentation or speaking in shorter, sharper sentences.7 - Do not rush. Interpreting is a taxing job and is mentally exhausting. To alleviate the pressure as much as possible, speak slowly and clearly. If you rush the interpreter is more likely to become stressed and the quality of the translation may drop.8 - Interpersonal communication, by its nature, involves emotion. An interpreter should never translate emotions. If the speaker is annoyed this will be obvious in their body language and tone. Never involve the interpreter at a personal level in any discussions and if you see an interpreter translating your emotions, ask them to stop. The interpreter is there to purely translate what is being said.9 - Make sure the interpreter is clear that they are never to answer questions on your behalf. Even if the answer is simple, the interpreter should still convey this to you. If an interpreter starts to speak on your behalf, this can have numerous negative consequences such as undermining your position or even losing face.10 - Ask interpreters not to change or alter what you say even if they think it may cause offense. If you plan to talk about a controversial issue let the interpreter know. Before discussing it with an audience announce that what will be said is not the opinion of the interpreter but your own. This then frees the interpreter of feeling uncomfortable and nervous.
These guidelines should enable you to get the best out of your interpreter and consequently your business meeting, presentation, conference or event.
  • From www.kwintessential.co.uk/translation/articles/interpreter.html– jokes don’t translate well
  • From www.kwintessential.co.uk/translation/articles/interpreter.html
  • Bias can be avoided simply by explaining bias to an interpreter. Empower them to do a good job by explaining how common bias is to all of us. This causes a person to monitor themselves to provide the best interpreting. Bias is dramatically increased the closer the interpreter is to the client. i.e immediate family.
  • The family: The family is the most accurate source for their language and dialect. Ask for a member of the family that is not immediate to limit biasProfessional CommunityAlso, inquire as to their community. They will be the first to tell you if there is a cultural center, religious center, or a medical professional such as a nurse that they know that speaks their language. The nursing/ nursing home professional community is incredibly diverse. If the family can direct you towards a medical professional that speaks their language you have a leg up on someone that is probably familiar with translating.Cultural Centers: Some of the greater populations have cultural centersReligious Groups:Synagogues, temples, mosques, churchesOn-line resources: These tend to be pricey but in dire circumstances, there are online interpreters that you can conference in to a meeting to translate. The hospital/post trauma situations conference in interpreters. It is also common when there is a lawsuit involved.
  • Talk to the family, not to the interpreter:Maintain proper eye-contact and maintain normal cultural interactionsSit across from client and interpreter takes a mediating positionUse yes-no questions:This controls the pace of the interview. The interpreter doesn’t independently question/investigate, you do.Provide pauses for interpreterJimmy Carter example
  • Transcript

    • 1. To take into consideration whenworking with bilingual childrenand families Bilingual Bootcamp Summer 2011
    • 2. Outline for Today • Understanding the Importance of Culture • The Nine Parameters, including: ▫ Individualism vs. Collectivism ▫ Views of Space and Time ▫ Roles of Men and Women ▫ Concepts of Class and Status ▫ Values ▫ Language ▫ Rituals ▫ Significance of Work ▫ Beliefs about Health • Use of an interpreter • How knowledge of culture changes our intervention
    • 3. Learner Objectives • Participants will list, identify, describe…: ▫ Common cultural characteristics of the Latino community ▫ The importance of developing knowledge about other cultures to optimize patient outcomes ▫ Nine parameters that can be used to characterize cultures ▫ Ways to facilitate culturally familiar environments to maximize success in treatment
    • 4. Why study culture?Demographics • In 2000, 12.5 percent of US residents were Latino and more than three quarters lived in the West or South, with half of all Latinos in California and Texas. • In 2000, approximately 16 percent of students enrolled in elementary and secondary schools were Latino. Of these children, 17.3 percent were identified as having speech or language impairment during the 2000-2001 school-year. (Salas-Provance, Erickson, and Reed, 2002).
    • 5. Why study culture?Demographics • Clients from culturally and linguistically diverse backgrounds comprise almost 35% of speech-language pathologists’ caseloads across employment settings (ASHA survey, 2000). • Between 1990 and 2000 the Latino population increased by 57.9 percent. (Salas-Provance, Erickson, and Reed, 2002).
    • 6. Why study culture?Increased Accuracy of Decision Making • The American Speech-Language-Hearing Association (ASHA) maintains that clinicians must recognize how a client’s cultural and linguistic characteristics will influence the clinical decision-making process and determine how communicative competence and impairment are evaluated. (Tomoeda & Bayles, 2002).
    • 7. Why study culture?Improved Therapeutic Outcomes • A client’s cultural beliefs will influence how they describe their health problems, the manner in which they communicate their symptoms, who they seek for health care, how long they remain in care, and how they assess the care provided. • Culturally familiar environments facilitate success in treatment as clients are more secure and responsive in these settings. (Tomoeda & Bayles, 2002; Mahendra et al., 2006).
    • 8. Why study culture?Reduction in Misunderstanding ofClients and Families • As Latino families are most often served by non-Latino speech-language pathologists, misunderstandings may frequently occur. Knowledge of common cultural characteristics may reduce these misunderstandings.
    • 9. The Nine Parameters of CulturalConsideration
    • 10. Nine Cultural Parameters 1. Individualism versus collectivism 2. Views of time and space 3. Roles of men and women 4. Concepts of class and status 5. Values 6. Language 7. Rituals 8. Significance of work 9. Beliefs about health
    • 11. Cultural Parameters Checklist
    • 12. Individualism vs. Collectivism • A culture is termed individualistic when great 1. value is placed on individuals and their rights and decisions. ▫ Members of individualistic societies may tend to have more casual relationships. • A culture is collectivistic when great value is placed on the group and membership in the group. ▫ These societies form close ties between individuals and reinforce extended families.
    • 13. Individualism vs. CollectivismCultural Examples 1. • Interdependence is highly valued in some cultures and the well-being of the group is more important than that of the individual (Hofstede, 2001; Salas-Provance et al, 2002). • Cultures can have a tendency to placate and nurture children, not pushing the achievement and developmental milestones that are often valued in other cultures that concentrate on fostering independence and individualism (Roland, 1988, as cited in Lynch & Hanson, 2004).
    • 14. Individualism vs. CollectivismImplications for Treatment 1. • Latino parents encourage positive emotions and discourage negative feelings such as anger and aggression in order to maintain the stability of the group. • Latino families may be hesitant to seek treatment for children that exhibit disorders, believing that the child will develop speech and language in his or her own time. • A lack of acceptance of negative feelings in Latino families could make it difficult to face and deal with the emotions that frequently accompany speech and language disorders.
    • 15. View of Time and Space • How strictly a culture adheres to a schedule 2. • Some cultures emphasize punctuality, while others are more event-oriented. For the latter group, beginning a new event is determined by the completion of the previous event, rather than by a schedule. • This parameter also refers to personal space and how much distance between conversational partners is required for individuals to feel comfortable.
    • 16. View of Time and Space Cultural Examples 2. • Americans are typically event-oriented and are concerned with time. ▫ Being late can be considered rude or disrespectful. Whereas, other cultures can perceive tardiness as giving priority to a more urgent situation. • Some cultures require less personal space to feel comfortable. ▫ A European American may require two to three feet of personal space. This could be considered as cold, unfriendly, or as a method to demonstrate superiority.
    • 17. View of Time and SpaceImplications for Treatment 2. • In the clinical setting, this parameter influences clients’ timely arrival for scheduled appointments, their comfort with pre-specified duration of sessions, and their expectation to be accommodated if they miss or cancel a session. • Thus, tardiness should not be taken as a personal offense nor should it be interpreted as a lack of interest in treatment. • Schedule 15 minutes earlier if you are schedule- oriented.
    • 18. View of Time and SpaceImplications for Treatment 2. • It would benefit clinicians to realize the possibility of reduced personal space with Latino clients. • Family members may position themselves closer to each other or to the clinician than he or she is accustomed. • Start with a handshake and be aware that with increased familiarity this greeting may change.
    • 19. Roles of Men and Women 3. • Gender roles vary across cultures and influence many areas, including education, ownership, choice of profession, and decision-making authority in the family. (Tomoeda & Bayles, 2002)
    • 20. Roles of Men and Women Cultural Examples 3. • An example of one dynamic is: male supremacy (machismo) with maternal submissiveness (marianismo). • In these roles, the male is the head of the household and the figure that makes the final family decisions. The female may put family needs ahead of her own personal desires and often has exclusive domain over child rearing. • Higher education and increased immigration are affecting these roles.
    • 21. Roles of Men and WomenImplications for Treatment 3. • A clinician will most often interact with a mother when meeting to discuss a child’s evaluation, progress, or attend therapy. • However, in meetings where a decision needs to be made that will affect a course of treatment, it is suggested that both parents be encouraged to attend.
    • 22. Concepts on Class and Status • What determines an individual’s societal 4. position and place of respect varies across cultures (Tomoeda & Bayles, 2002). • Wealth often plays a large part in the determination of class. • Socioeconomic class may result in even greater group dissimilarities than country of origin.
    • 23. Concepts on Class and StatusCultural Examples 4. • If a culture is class conscious, members of different social classes may not socialize together. • Because of this concern with class and status, individuals may be particularly attentive to good hygiene and physical appearance. • Many cultures are concerned with maintaining, and ultimately improving, their social class status. (i.e. immigration) (Robayo, 2003).
    • 24. Concepts on Class and StatusImplications for Treatment 4. • It is important for clinicians to consider the sensitivity that many people of that culture have toward social class and status and their concern with maintaining and/or improving their status. • The Latino culture is typically more formal than that of mainstream American culture. ▫ Latino clients may be more concerned with titles and mannerisms that denote different class levels. For example, it may be particularly important to Latino clients that “Dr.”, “Mr.”, or “Mrs.” be used in addressing others
    • 25. Values • A cultural group’s values are manifested in it’s 5. view of the relationship of man to nature and of human beings to other human beings, the importance of ancestors and of the environment, and the degree of materialism (Tomoeda & Bayles, 2002).
    • 26. Values Cultural Examples 5. • Latino culture may include: ▫ (1) “familismo,” or the ultimate importance of the family relationship ▫ (2) “respeto,” treating authority figures such as parents, elders, and priests with respect ▫ (3) “personalismo,” a personal (vs. impersonal) interest in a relationship (Tomoeda & Bayles, 2002).
    • 27. ValuesImplications for Treatment 5. • One way that children are expected to exhibit respect is by generally remaining quiet in the presence of adults. • By including Latino parents’ values in the intervention planning process, clinicians can build collaborative relationships with the parents that are positive and effective. • These values can be included in the treatment programs through the development and implementation of mutually agreed upon goals.
    • 28. Language • This parameter involves the influence that the 6. pragmatics of a language have on interpersonal communication. • The amount of information conveyed through setting or context differs among cultures, ranging from high to low context. ▫ For example, in high-context cultures, context is crucial to communicate meaning. In interacting with these cultures, a culturally competent clinician would be especially aware of nonverbal aspects of communication, such as eye contact, gestures, space, use of silence, and touch. In contrast, in low-context cultures the actual words are critical and should be the focus of communication.
    • 29. Language Cultural Examples 6. • The Latino Spanish-speaking culture is a high- context culture, while the American English- speaking culture is a low-context culture (Tomoeda & Bayles, 2002). ▫ For example, a study of Latino children found that, compared to other ethnic groups, these children had a higher sensitivity to nonverbal communication and indicators of feelings. • Communication is focused more on the relationship and interaction, rather than being task-oriented.
    • 30. LanguageImplications for Treatment 6. • Clinicians should resist any urge to immediately begin tasks and recognize the role that informal and relaxed exchanges play in the intervention process of Latino clients. • Similarly with assessment, clinicians should consider that Latinos are part of a high-context culture, meaning information is frequently conveyed through setting or context in addition to or even in place of verbal communication.
    • 31. Rituals • Rituals or ceremonies are conventional ways of 7. commemorating significant historical events or life changes and renewing commitment to shared values. Weddings, births, deaths, and religious worship are associated with rituals in most cultures and many rituals are based on religion (Tomoeda & Bayles, 2002).
    • 32. Rituals Cultural Examples 7. • January 6th, Día de los Reyes ▫ Children leave their shoes out to be filled with treats by the 3 kings • November 1st, Día de los muertos ▫ Prayers given to people who have died • December 12th, Feast of Our Lady of Guadalupe ▫ Celebrate the appearance of Our Lady to Juan Diego in Mexico • December 24th, Noche Buena ▫ Celebrated by preparing traditional foods, such as tamales for Mexican-Americans, and then attending midnight mass.
    • 33. RitualsImplications for Treatment 7. • Clinicians should consider Latino holidays and celebrations identified during assessment when scheduling treatment sessions to avoid conflicts. • Festivities can also be included in treatment activities and discussions to make them more meaningful and motivational for the child. • The family will appreciate the clinician incorporating the Latino culture into therapy activities, thereby strengthening the clinician- family relationship.
    • 34. Significance of Work 8. • This parameter refers to the importance of work in a culture and how it is defined by the members of the culture (Lynch & Hanson, 2004).
    • 35. Significance of Work Cultural Examples 8. • Americans are largely defined by their work, but people in many other cultures are defined by the groups they are members of and their role in the community. • In some families, there is an expectation that children will take up work roles within the family, such as childcare, helping with chores, or actually working with other family members. These responsibilities may stem from economic necessity.
    • 36. Significance of WorkImplications for Treatment 8. • Latino children are often expected to work within or outside of the home. • This requirement may involve these children in activities and settings that clinicians do not usually associate with their young clients. • It is important for clinicians to inquire about and be aware of their young clients’ activities in order to decide on appropriate treatment goals, stimuli, and functional activities for that client’s communicative needs.
    • 37. Beliefs about Health • Illness and disabilities are viewed differently 9. across cultures. • In many cultures, someone with a disability may be seen as special or holy, or they may be seen as bewitched. • Illness may be thought to occur when an individual is out of harmony with nature or the universe, and a spiritualist, folk healer, herbalist, or witch doctor may be chosen over Western medical professionals to provide health care.
    • 38. Beliefs about Health Cultural Examples 9. • A close relationship between religion and illness can be common. • A disability may be seen as related to God’s will and might affect a family’s motivation to address change. • However, many of the studies on health beliefs have centered on rural and/or low socio- economic status. Thus, it is possible that the religion/illness relationship is more related to socioeconomic factors, rather than cultural.
    • 39. Beliefs about HealthImplications for Treatment 9. • Parents’ beliefs about the cause(s) of speech and language disorders can determine their thoughts on the extent to which their child’s developmental course can be modified by treatment. • Therefore, a parent-implemented/assisted intervention program may be difficult to initially begin (Rodriguez & Olswang, 2003).
    • 40. Questions?
    • 41. Culture Activity Using our own culture to establish awareness The importance of cultural awareness is to identify what might influence a person’s thinking and actions, not to list or memorize what specific characteristics a person is likely to express or maintain.
    • 42. Individualism vs. Collectivism 1. • Do you feel that your family more greatly values a. independence or b. care and concern for others? • If your son were receiving a speech evaluation, would you be more offended if you were told that he should interact more with other children or that he is too “clingy” with the family? • If you were to be inadvertently insulted by someone based on your own cultural beliefs, what would it sound like?
    • 43. View of Time and Space • Do you consider yourself punctual? 2. • Is this at odds with your family’s habits? (Are you always late/early for Thanksgiving dinner?) • Does punctuality or the lack of it in your family/coworkers/yourself bother you? • How do you successfully deal with this difference?
    • 44. Roles of Men and Women • Did your parents/grandparents have definite 3. roles at home? • Do you believe in these roles or reject them? • Would/do/did these roles influence your impression of people when working together or dating? • How would you respond to a parent who compliments your evaluation because they didn’t “know a man/woman could do this job?”
    • 45. Concepts on Class and Status • What value do you give to education? 4. • What value do you give to wealth? • Are these two concepts connected for you? • Do these ideas influence your thoughts of another person? • How do you think a therapist’s beliefs about class and status could affect the degree to which they feel that a child is impaired?
    • 46. Values • In one word, what would your mother and/or 5. father put the most value on (e.g., respect)? • How would you react during an evaluation if your client told you that this value (e.g., respecting adults) was “the dumbest thing she ever heard of?”
    • 47. Language • Do your family members talk with their hands? 6. • Are you more clear or less clear in an email rather than in person? • With a low-verbal client, do you focus on increasing his words more, increasing his gestures more, or relying on both equally? • Have you ever thought during an evaluation that a child may be more communicative because she is using one strategy over another?
    • 48. Rituals • What traditional holidays did you grow up 7. celebrating (e.g., Easter, Ramadan, Yom Kippur)? • What would your family’s reaction have been if one of your parents’ bosses demanded that they work that day? • Example: Assuming you had an Islamic client, what may be the repercussions of scheduling evening therapy or a food activity during Ramadan?
    • 49. Significance of Work • When you meet someone new, what do you ask 8. them? • If you are talking with someone new about their job, would you ask how much money they make? • If someone were to ask you to describe yourself, would you include what you do for a living? • If you asked someone to describe himself and he did not mention a job, would you question whether there are difficulties or if he was unemployed?
    • 50. Beliefs about Health • How closely have you followed suggestions from your 9. doctor, physical therapist, dentist, etc? • Should every disease have an explanation, even if not yet known, or are there some things we just can’t understand? • Do you routinely believe medical professionals or do you seek second opinions? • How could you get a family that has never been compliant to follow through with take-home therapy? • Are you offended if a family does not follow through with your suggestions?
    • 51. Questions?
    • 52. Accessing clients and familiesthrough their home language.
    • 53. 3Selecting Personnel to Conduct theEvaluation and Intervention Source: ASHA • Level 1: trained (in CLD issues) bilingual speech- language pathologist fluent in the native language • Level 2: trained (in CLD issues) monolingual speech-language pathologist assisted by trained bilingual ancillary examiner. • Level 3: trained (in CLD issues) monolingual speech-language pathologist assisted by trained interpreter
    • 54. The Top Ten Tips • Establish and agree to ground rules ▫ How to run the session ▫ Number of sentences at a time ▫ Confirmation of jargon/idioms – Avoid it! ▫ When to take breaks • Brief the interpreter prior to the session ▫ Who, what, why ▫ Specific terminology ▫ Format ▫ Your job and what you are looking for
    • 55. The Top Ten Tips (continued) • Familiarize them with the topic ▫ Best if your interpreter has some experience in education, special education, speech-language ▫ Important for interpreter to know what you need • Avoid humor • Plan your time carefully (twice the time) • Do not rush, speak slowly and clearly and provide pauses for the interpreter
    • 56. The Top Ten Tips (continued) • An interpreter should never translate emotions, body language works for that • An interpreter should never answer questions on your behalf. • Ask them their opinion after the session • An interpreter should never alter what you say.
    • 57. Interpreter bias• It is human nature to want a member of your culture to perform well• An interpreter should: ▫ Maintain Neutrality ▫ Translate statements verbatim ▫ Maintain confidentiality
    • 58. Types of Interpretation • Consecutive Interpreting ▫ The interpreter listens to a section and then the speaker pauses to give time to interpret ▫ Used in one-to-one and small group meetings • Simultaneous Interpreting ▫ The interpreter attempts to relay the meaning in real time. ▫ Used more for conferences and speeches to large groups
    • 59. How to find an interpreter • On-line resources ▫ www.professionalinterpreters.com • The Professional Community ▫ Nurses, healthcare professionals • Community Volunteers ▫ Cultural centers ▫ Religious groups • The family ▫ Extended members preferred
    • 60. How to work with an interpreter • Talk to the family, not to the interpreter • Sit across from client and interpreter takes a mediating position Note: An inexperienced interpreter may talk more or less than you do.
    • 61. Debriefing and writing the report • Debriefing ▫ Ask the interpreter their impressions of the interaction and client after the interaction • Reporting ▫ Annotate that an interpreter was used ▫ Supplement testing with other data  Observations  Teacher/family input
    • 62. Questions?
    • 63. Visit us at bilinguistics.com
    • 64. For more great resources visit our resourcelibrary at SpeechPathologyCEUs.net
    • 65. Thank you!

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