Cultural Advocacy in Speech-Language Pathology
Necessity for Cultural Advocacy
Cultural competency in Speech-Language Pathology is the ability to provide services that are in the best long-term interests of individuals with suspected or confirmed communication disorders, in a manner that is understood and accepted by those receiving these clinical services. For clinicians providing assessment and intervention services to bilingual individuals with suspected language disorders, professional cultural competency is built on three fundamental knowledge domains: knowledge of self, knowledge of others, and knowledge of the theoretical and emperical literature on dual-language development, use, and disorders (Kohnert, 2008).
Providing culturally competent speech and language services are required under ASHA’s Code of Ethics. On occasion, professionals may consider cultural competence a personal choice involving their professional service; however, it is a mandatory element to be integrated in all speech and language services. This page explores cultural advocacy topics to support the reader in providing services to individuals in a culturally sensitive manner.
Assessments of Personal Cultural Competence
Cultural Competence Awareness Assessment
An interactive web-based tool, was designed to help you evaluate your cultural competence. Percentages and scores are provided in each subtest in order to help you determine your level of knowledge of specific topics. They should not be used as absolutes. They should be used to determine which areas may need some further development. Your ASHA name and password will not work. You will need to use the following name and password to enter this site.
Name: MATtester
Password: Pilot
The above information can be found at: http://www.asha.org/practice/multicultural/self.htm
Student Review of Website Tool The pretest was interesting because it forced me to think of concepts I have not recently defined for myself or thought about. The policies and procedures took some thought and to be honest, had I not attended a recent lecture which covered pivotal legislation, I would not have done as well. Some questions could be answered successfully with a little deductive reasoning. One thing I would like to note, this section really just tests your knowledge on when ASHA as addressed cultural issues. While important to understand we have legal requirements and we are a part of an organization addressing cultural aspects- Testing on dates may not deepen a personal reflection of cultural competence. It DOES deepen a clinician’s knowledge on resources and expectations held for SLP professionals by ASHA. I proceeded to do the test and it was not just a simple quick test. I would recommend doing one section at a time when you have time to spend a couple minutes thinking about the questions being asked.
Scenarios When Cultural Advocacy is Necessary
Examples of conversations that may need some cultural advocacy
VIDEO“They are in America, they need to learn English.” This video demonstrates clarification; restate what the speaker has just said in a natural way, but be cautious and avoid shifting the speaker's meaning to your reality and perspective.
VIDEO“I send home paperwork, I make phone calls, how hard is it for the parent to contact me! They are so irresponsible.” This video demonstrates reflection; showing understanding of the person's feelings or frame of reference.
VIDEO“This school used to be a good school until they built those apartment complexes- now the kids are wild and don’t care”. This video is an example of how you can clarify and reflect and help guide the conversation towards a solution focused discussion
Respectful Listening Tools to Facilitate Conversations About Culture
Building open lines of communication begins with effective listening. Often, SLP’s begin their professional careers addressing cultural competency when they take multicultural curriculum required in their Masters programs. This provides opportunity for clinicians to focus on incorporating culture competency in their assessment and treatment of individuals with communication disorders. When clinicians graduate and get into professional work environments, they often find themselves in positions to be cultural advocates with peers and colleagues. Talking about culture and bias is often an uncomfortable conversation. In an SLP’s career, it is highly likely that there will be situations that require cultural advocacy which may lead to challenging discussions. Cultural error involving clients may be perpetuated because culturally insensitive comments and decisions are not called out and discussed. There are several reasons these comments may not be getting attention; all parties involved may not realize the comments’ limiting effects and/or a listener may not know how to discuss it in a helpful way. While SLP’s are not trained to be social justice counselors, we are required to be culturally competent. Advocating for cultural best practice is under our scope of practice and there are numerous programs and trainings to better gain skills at directly creating and pushing these conversations.
Trainings, education on cultural knowledge, and self evaluation of biases will help clinicians continue to grow in the professional and personal practice. While trainings and self education are highly encouraged, they are not mandatory for SLP’s to be culturally competent.
One of the pivotal elements that contribute to being culturally competent is an individual’s motivation and attempt to truly understand different perspectives and values. As an individual understands their own values and biases, they can also appreciate and respect others; even if the values conflict. Respectful and effective listening provides an individual the opportunity to gain insight to the speaker’s perspective.
Strategies for Effective Listening
Andrews & Andrews work involving family counseling focuses on 3 aspects that help create respectful and effective listening:
Listen with curiosity
Listen non-judgmentally
Stay focused on the speaker
All SLP’s can begin their careers as cultural advocates by using their skills as respectful and effective listeners. We can advocate for our clients and create professional dialogue by truly listening to where others are coming from then creating a relationship where we can provide information and promote culturally appropriate decisions. Being a respectful and effective listener does not imply you are supporting or adopting another person’s stratifying or stereotyping understanding of others. It implies that you are taking action in creating a dialogue with another person. When you convey respect for the speaker and your goal is to gain an understanding of where they are coming from- often the speaker is more open to hear a different perspective than their own. The conversation can develop into a discussion where different perspectives can be introduced and discussed.
Avoid: Asking irrelevant or poorly timed questions, Self-disclosure, Giving advice too early
Respectful Listening
Andrews & Andrews research has shown listening techniques which facilitate open dialogue. Respectful listening often results in empathy.
Clarification- Paraphrase – restate what the client has just said in a natural way
Reflection- Showing understanding of the person’s feelings or frame of reference
Affirm but not confirm-You hear them, you are not judging, you are providing them a place to share their experience and perspective
Outcome of Empathic Listening
Your communicative partner feels accepted
Their feelings and perspectives are validated
Start to feel more empathic themselves
You begin to hear exceptions