The increasing diversity of clients with communication disorders requires speech-language pathologists (SLPs) to acquire greater cultural intelligence-the understanding of a client's values, social structure, and linguistic heritage.
Cultural intelligence is particularly important when assessing the client who is bilingual: It contributes to understanding the true meaning of messages and the communicative intents of individuals.
Three types of support
To improve our assessment of bilingual clients, we need three types of support:
Best practices. When working with bilingual or multicultural clients and families, we must be inquisitive diagnosticians, adopting methods that have proven effective and creating innovative strategies to solve our problems. We need to use a range of tools to decode the meaning of verbal, nonverbal, and sociocultural messages.
Cultural competency. We must go beyond interpreting the superficial linguistic meaning of the messages we receive from culturally and linguistically diverse clients and decode the cultural implications embedded in the meaning of the messages. Information on cultural competency can be found at the American Speech-Language-Hearing Association (ASHA) Web site (http://www.asha.org/about/Leadership-projects/multicultural) and the National Faculty Center at The University of Arizona (http://nfc.arizona.edu).
Knowledge of bilingualism. SLPs must understand the nature of bilingualism. Goldstein (2004), Grosjean (1982), and others have provided useful information about living with two languages and the development of bilingualism in children. Another important issue in bilingualism is the use of interpreters.
A protocol for clinical practice
The following protocol can help you better assess linguistically diverse clients and develop effective interventions.
Step 1. Use the SWOT method to assess strengths, weaknesses, opportunities, and threats:
Strengths. Find a client's cognitive, social, and communication strengths.
Weaknesses. Locate the weak points in the client's overall cognitive development and communication patterns and in her natural and social support system.
Opportunities. Check on optimal learning opportunities.
Threats. Find ways to prevent further challenges and make certain there's an accurate diagnosis, thus avoiding the threat of an incorrect or untimely diagnosis.
Step 2. Use the RIOT approach to assess the client:
Review all relevant background information, including family history.
Interview individuals who are close to the client.
Observe patterns of behavior and interactions in multiple settings.
Test the client using culturally fair methods.
Step 3. Analyze the data collected.
Step 4. Develop intervention strategies based on the data, as well as a plan to evaluate their effectiveness.
Learning from cultures
The United States is a nation with many immigrants, migrants, and refugees. As SLPs, we need to be knowledgeable about different cultures and open to learning from our diverse populations.
Cheng L. Lessons from The Da Vinci Code: Working with bilingual/multicultural children and families. The ASHA Leader Online. September 26, 2006.
Goldstein BA, ed. Bilingual Language Development & Disorders in Spanish-English Speakers. Baltimore, Md., Brookes Publishing Co., 2004. [Context Link]
Grosjean F. Life with Two Languages: An Introduction to Bilingualism. Cambridge, Mass., Harvard University Press, 1982. [Context Link]