ASHA’s Strategic Pathway and You: Focus on Objective 8 ASHA’s Strategic Pathway to Excellence is designed as a basis for transformation in the way audiologists and speech-language pathologists provide services, the way others perceive and value those services, the science underlying service delivery, and the composition of ASHA membership. ASHA staff are guiding work on eight strategic objectives toward ... ASHA News
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ASHA News  |   April 01, 2016
ASHA’s Strategic Pathway and You: Focus on Objective 8
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Cultural & Linguistic Diversity / ASHA News & Member Stories / ASHA News
ASHA News   |   April 01, 2016
ASHA’s Strategic Pathway and You: Focus on Objective 8
The ASHA Leader, April 2016, Vol. 21, 56-57. doi:10.1044/leader.AN1.21042016.56
The ASHA Leader, April 2016, Vol. 21, 56-57. doi:10.1044/leader.AN1.21042016.56
ASHA’s Strategic Pathway to Excellence is designed as a basis for transformation in the way audiologists and speech-language pathologists provide services, the way others perceive and value those services, the science underlying service delivery, and the composition of ASHA membership. ASHA staff are guiding work on eight strategic objectives toward ASHA’s Envisioned Future, to be achieved by 2025, when ASHA turns 100. Each month, the Leader examines one of the objectives and how members are addressing it.
Objective 8: Increase cultural competence
Vicki Deal-Williams, chief staff officer for multicultural affairs, leads the staff effort to achieve a transformational increase in ASHA members’ cultural competence. According to Deal-Williams, “ASHA members are ultimately responsible for whether we accomplish this objective. Our success is completely dependent on every ASHA member’s ability to appropriately address the influence of language and culture for everyone they serve.
“ASHA members have long persisted in providing services in a manner that’s based on a norm that does not exist,” she adds. “Each individual we serve holds a unique key to unlocking their specific outcomes based on their experiences, environment, exposure, ability and aspirations. It is the responsibility of every ASHA member to find and use that key as they interact with all of their clients, not just those they think have cultural or linguistic differences. At each encounter, every ASHA member should be asking, ‘What do I need to know?’ and ‘How do I go about working with this individual and their family or caregivers, to best identify and meet their needs?’”
ASHA staff are working to create and disseminate information and new tools to meet the challenges associated with recognizing that everyone has an individual, cultural composition that directly impacts communication and related functions. The focus is to proactively engage members to learn to address culture and language as a matter of routine, whether they are practitioners, faculty members, clinical educators or administrators.
Here are examples of an audiologist and an SLP who are well on their way to increased cultural competence.
Rosa A. Abreu, MBA, MA, CCC-A, manager/audiologist, Newark (New Jersey) Beth Israel Medical Center, an affiliate of Barnabas Health
Language and culture are interrelated and have a reciprocal relationship. Patients who share a common native language may not necessarily share the same culture and may have very distinct slang/dialects.
As a bilingual audiologist (English and Spanish), I have developed a sensitivity to the various dialects of the Spanish language: Castilian (Spain) versus Latin (South America) and to the nuances of their culture. For example, in Columbia “¿Qué más?” is how they say, “How are you?” It’s confusing when you consider that this is also how they ask, “What else?” In addition, “cola” isn’t always a soft drink and “bicho” doesn’t always mean a bug. Audiological terms are not immune: Mild hearing loss is translated as “pérdida de audición leve” but the word “leve” can also mean moderate.
As I prepare and translate simple patient education handouts and counsel patients and parents on hearing loss, it is paramount that the words I use adhere to the intended meaning throughout the various Spanish dialects. One of the ways I do this is to regularly browse through informative websites related to Spanish dialect and culture (SpeakingLatino.com; AlwaysSpanish.com) and online Spanish synonym dictionaries (dirae.es; bit.ly/spanish-dialects).
As a way of validating the dialect or slang words I use with bilingual patients and parents, I encourage them to make sure prior to leaving our center that they can restate to me the main problem/issue, what to do next and why it’s important to do so—as they see it.
Alicia Fleming Hamilton, MS, CCC-SLP, Saint Paul Public Schools, St. Paul, Minnesota
Last year, a mother requested an evaluation for her daughter Lena (a pseudonym). The family was from Mexico and spoke Spanish as their home language. Lena’s mother said her daughter had been diagnosed with autism and needed one-on-one assistance in the classroom. While our school requested her medical records, I researched her language background. I gathered a case history in Spanish, where her mom reported that Lena had minimal verbal skills, but spoke English to her brothers and sisters. She didn’t use much Spanish, except at school.
Her mom was concerned that learning two languages was confusing Lena and delaying her language. I assured her that learning two languages was beneficial for Lena, and that speaking to Lena in her native language, Spanish, would strengthen her language base. Being bilingual was not delaying her language skills. Lena’s medical records revealed a diagnosis of Fragile X syndrome. After researching the syndrome on ASHA’s website, I completed informal and formal testing in both languages, using conceptual scoring, and I compared phonemes present in Spanish and English, consulting ASHA’s Multicultural Affairs and Resources page.
Lena was absent many times that winter, and when I asked her mother why, she told me that she believed the cold air made Lena’s learning difficulties worse. I thought maybe her mom didn’t want to drive in the cold. When Lena was at school, her mother was often with her—taking off her coat, feeding her breakfast and finishing her assignments. From my perspective, Lena was being “babied” and it was impeding her progress. When I asked her mother to let Lena complete tasks independently, she became upset and told me it was her job to take care of her daughter and my job to teach her.
Our school team diagnosed Lena with a severe developmental/cognitive delay and a severe language disorder. Lena was finally receiving the help she needed in school, but her mother still appeared frustrated. When I asked if she had anything to share, she quietly mentioned she felt responsible for her daughter’s disability—that she had failed to keep her daughter healthy.
A month after this meeting, I had my first child: a perfect little boy with a clubfoot. As I sat through evaluations and pursued treatments for him, I came to see Lena’s mother’s experience through my own. I understood her desire to help her child in any way possible and I, too, felt responsible for my child’s disability.
Reflecting on this experience, I see that I took the right steps in researching Lena’s language and using valid evaluation practices. However, I should have given her mother the opportunity to share her culture and beliefs instead of making a judgment about her parenting style. I learned that cultural competence isn’t gained solely from research; it’s cultivated across experiences and rooted in the belief that each person’s culture is unique and valuable.
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April 2016
Volume 21, Issue 4