The Importance of Cultural Competence in Speech-Language Pathology

In order to be culturally competent, practicing speech language pathologists, it is important to consider the differences that exist among and between culturally and linguistically diverse groups. Taking cultural differences in to consideration when servicing diverse groups allows for professionals to create stronger relationships between clients and their family members. Providers establish a sensitive, safe place that factors in the values of a culture that allows for better goal creation and functionality is increased.

There are many culturally and linguistically diverse groups that comprise the population of the United States. However, there is a pre-established “mainstream” US culture that does not account for the differences of the culturally and linguistically diverse groups that must not be assumed to function for all clients. For example, belief systems that create a groundwork of a culture’s world views differ drastically between cultures. While the mainstream US culture believes in the power of science and cognitive processes, other groups, such as Native American cultures, value long-practiced traditions. For example, Native American cultures use traditional songs and stories as methods of teaching (Robinson-Zañartu, 375). In addition, while sequence of events and cause-and-effect are embedded within the stories shared, greater emphasis is placed on a “bigger idea” rather than specific details. This should be taken in to consideration when speech-language pathologists evaluate narrative abilities, as this is a difference rather than a disorder in terms of story-telling style and interpretation. Another cultural difference between mainstream US culture and Native American peoples is the appropriateness of linguistic timing. For example, in mainstream US culture, question-and-answer in order to interview or assess is completely appropriate. However, in Native American culture, quick timing of questions in succession may be means for retreat or closing off. This style of questioning to gain information should not be used for Native American clients or their families (Robinson-Zañartu, 375). Speech language pathologists should also not misinterpret the cultural practices of respect for elders that differ between Native American culture and mainstream US culture. In particular, in school settings, a Native American student may demonstrate respect for authority and elders by not looking their teachers in the eye or not engaging in reciprocal conversations by refraining from asking direct questions. An uneducated clinician may erroneously assume the child is shy, withdrawn, or not self-confident (Robinson-Zañartu, 377). Instead, a speech language pathologist should acknowledge that a lack of eye contact is not socially awkward in a Native American culture, but instead is a sign of respect and should not be forced.

An incredibly important factor to consider as a speech language pathologist is a culture’s view of disability. For example, families of Vietnamese culture may feel that a family member with a disability may not be able to improve or overcome their disability, and the focus is rather placed on the family finding harmony with the disability. This should be taken in to consideration when choosing treatments and goals for the client with regards to how it affects their family’s harmony (Davis-McFarland, 205). Cultural view of the disability may affect how willing a family may be in seeking treatment or interventions.  Similarly, there may be more factors that influence a family’s treatment and intervention decisions, based on their cultural values that they associate with health. For example, in mainstream US culture, the gender or ethnicity of the service provider is not taken in to as much consideration as it may be for other cultures, such as Arab cultures. In addition, in some cultures, the male-counterpart may be the sole decision maker. In these circumstances, the speech language pathologist should not force a particular provider or treatment plan if it is not suitable for a family based on their personal, cultural opinions (Davis-McFarland, 206). It is best to give the family the freedom to seek other options that are more harmonious for the lifestyle and culture.

Written By: Taylor Viggers, MS, CF-SLP

References:

Robinson-Zañartu, C., Butler-Byrd, N., Cook-Morales, V. et al. Contemp School Psychol (2011) 15: 103. doi:10.1007/BF03340967

Davis-Mcfarland, Elise. “Family and Cultural Issues in a School Swallowing and Feeding Program.” Language Speech and Hearing Services in Schools 39.2 (2008): 199. Web.

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