Communication Disorders in a Multicultural and Global Society

The term “culture” comes from the Latin word that meant “______________”

to cultivate or improve

It was originally used in the term “_________” to refer to the cultivation or improvement of land for growing food plants

agriculture

Culture refers to the whole ______ a participant in a society has, including:

Knowledge, beliefs, attitudes, standards, morals, law, customs, arts, habits acquired by member of society

experience

we experience the world differently than everyone else

Our culture is an integral part of our __________

self-identity

Through __________, we socialize children and embed the cultural values, beliefs, etc. in their ______

language; identity

In addition, culture informs us about what is an appropriate form of communication, such as:

• Rules of discourse and of storytelling

• Pragmatic rules regarding who speaks to whom and what subjects are acceptable for discussion, and which are not (curse words)

a category of humankind that shares certain distinctive physical traits, particularly skin color, hair texture, and facial features

race

of or relating to large groups of people who have the same customs, beliefs, values, religion, place of origin, etc.

ethnicity

a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge, and skills along the continuum.

cultural competence

cultural competence is the ________________ about individuals and groups of people into specific _______, ______, ______, and _______ used in appropriate cultural settings to increase the quality of services; thereby producing __________

integration and transformation of knowledge; standards, policies, practices, and attitudes; better outcomes

the ability to learn from and relate respectfully with people of your own culture as well as those from other cultures

cultural responsitivity

Many people within our discipline and across disciplines prefer the term cultural responsivity – WHY?

competence can be misunderstood as knowing enough about something and not needing to learn more

responsitivity can mean you learn more as you go

Most of what we use to identify _____ and ______ differences in the US is cultural ancestry and cultural identity in the form of __________

racial and ethnic; identifiable behaviors

Most individuals in this country who are 2nd to 3rd generation American identify as …

americans

Newer immigrants may still identify more with … than with …

their culture of origin; “american” culture

immigration has been and is now still a hot political issue where?

in the US and many parts of the world

Human interaction and communication always has some conflict based on…

drives, motivations, attitudes, values, etc.

_________ communication with people of different cultures may be challenging

effective

Cultures provide people with ways of thinking--ways of seeing, hearing, and _______________ our experiences affect these

interpreting the world

_________ can mean different things to people from different cultures, even when they speak the "same" language

ex?

The same words

“in a little while” could mean 10 min or and hour

When the languages are different, and translation must be used to communicate, the potential for misunderstandings _____. why?

increases; we don’t always have a one to one correspondance

who describes three ways in which culture interferes with effective cross-cultural understanding?

what are the three factors?

Stella Ting-Toomey

1. cognitive constraints

2. behavior constraints

3. emotional constraints

the frames of reference or world views that provide a backdrop that all new information is compared to or inserted into. my experiences are going to shape how I view your behaviors.

cognitive constraints

Each culture has its own rules about proper behavior which affect verbal and nonverbal communication

behavior constraints

Whether one looks the other person in the eye-or not; whether one says what one means overtly or talks around the issue; how close the people stand to each other when they are talking--all of these and many more are _________ which differ from culture to culture

ex?

rules of politeness

hugging, smack on the cheek, eye contact

Different cultures regulate the display of emotion differently. Some cultures get very emotional when they are debating an issue. They yell, they cry, they exhibit their anger, fear, frustration, and other feelings openly.

Other cultures try to keep their emotions hidden, exhibiting or sharing only the "rational" or factual aspects of the situation.

emotional constraints

All of these differences tend to lead to ____________.

If the people involved are not aware of the potential for such problems, they are even more likely to __________, although it takes more than _______ to overcome these problems and ______ effectively across cultures

communication problems

fall victim to them; awareness; communicate

just because you are aware does not mean that you will be successful. we aren’t just treating the patient but the family

Conflict can occur in communication across ___________

cultural boundaries

Cross-cultural conflict is also occurring across _______ and _______ boundaries, and, as such, leads to intercultural miscommunication and misunderstanding that may not even reach a ______ level

cognitive and perceptual; conscious (don’t know where they went wrong)

For every conflict, there are at least two perspectives on what is happening in that conflict: what are they?

realism and constructivism

the belief that reality exists independent of the observers

realism

a theory of knowledge that argues that humans generate knowledge and meaning from an interaction between their experiences and their ideas

constructivism

the combination of both ________ and ______________ that makes communication conflict complex

objective and subjective dimensions

From the standpoint of the SLP, we are called to have some level of a ____________ approach

constructivist

the constructivism approach requires that we find…

That is, we have to build an understanding of communication disorders and goals to address those communications disorders from an interaction between the _______ and the _____ of the participants

those commonalities that can serve as a foundation for communication

experience and ideas

as SLPs we need to ______ a plan to provide services that look at _______ instead of _________ in culture

contruct; commonalities; differences

In a broader sense, there is a very heavy cultural overlay in what is considered “______” or “______” language and speech

This in turn affects the way society treats those who have _____ and _____ disorders

“normal” or “typical”

language and speech disorders

Language and speech are said to be disordered or impaired if they differ from what is considered _____

the norm

what may be considered disordered in one culture …

will not necessarily be disordered in another culture.

_____ or _____ are seen to play a key role in some communities that may determine whether those with language and speech disorders seek treatment or not and the extent of the treatment

for example… (cleft palate)

Religion or beliefs

those who believe that a cleft is a punishment from God might be offending God more by having it clinically repaired. they may often seek treatment too late, when the surgery may not be as effective as it would be if early intervention occurs

culture and the SLP

what is our role here?

It is the SLPs job to construct communication “norms” and “goals” from our experiences and whatever knowledge we can accumulate about a given culture...you will NOT be an expert in all cultures you come into contact with...its how you approach each situation...

It is also our job to try to reduce communication conflict by working with members of other cultures to construct a common reality that addresses an individual’s needs

Developing cultural “competence”/humility is a dynamic and complex process requiring ongoing ____________ and continuous expansion of one's _________

self-assessment; cultural knowledge.

culture evolves over time, beginning with an understanding of __________, continuing through interactions with ____________________, and extending through one's ________________

one's own culture; individuals from various cultures; own expansion of knowledge

How does an SLP increase cultural awareness and cultural responsiveness/humility?

At a first level, the SLP should to be aware of some broad cultural differences:

• Individualism and Collectivism

• The Power Distance Variable

• Time Orientation

• Nonverbal and Verbal Communication

individuals from cultures that value the good of the group, it is more important than the good of the individual, may be reluctant to consider individual goals for someone with a communication disorder

individuals and collectivism

how individuals in different cultures respond to directives from others depends on their perception of the status of each person, subordinate/superior. Treatment directives, especially at home, may or may not be carried out.

look at who we can communicate with and how we communicate with them

the power distance variable

time orientation

individuals from cultures that value long term and future planning will value long term goals. Individuals from cultures that are past and present oriented may not

many differences can exist in both _______ and _____ communication and may result in conflict. ex?

nonverbal and verbal; eye-contact

ASHA makes the following statement about cultural “_________” and providing speech language pathology services:

“Professional _________ across professions and settings requires that audiologists and speech-language pathologists (SLPs) practice in a manner that considers the impact of cultural variables and language exposure and acquisition on their clients/patients.”

competence

ASHA also states that: “Responsiveness to the cultural and linguistic differences that affect identification, assessment, treatment, and management includes:

completing ____________ to consider the influence of one's own biases and beliefs and the potential impact on service delivery

identifying and acknowledging _________ in education, training, and knowledge and seeking additional resources and education to develop cultural competence via continuing education, networking with community members, etc.;

self-assessment

limitations

culturally humble/aware clinicians ________ respect for an individual's race, ethnicity, gender, gender identity/gender expression, age, religion, nation origin, sexual orientation, and/or ability

demonstrate

culturally humble/aware clinicians ________ clients' traditions, customs, values, and beliefs in service delivery

integrate

culturally humble/aware clinicians ________ the impact of assimilation and acculturation on communication patterns during identification, assessment, treatment, and management of a communication disorder/difference

identify

culturally humble/aware clinicians identify appropriate intervention and assessment strategies and materials that do not ______ the client's unique values and/or create a chasm between the clinician and client and his/her community

violate

culturally humble/aware clinicians use _____________ communication with clients, caregivers, and family so that information presented during counseling is provided in a health-literate format consistent with clients' cultural values

culturally appropriate

________ IS _________

communication IS culture

Identifying _________ and ________ allows us to become more aware of our own values and beliefs and then we are better equipped to adjust to those of others

cultural similarities and differences

high context communication vs low context communication

high context

• beating around the bush

• reading nonverbal cues

• need a lot of information

low context

• blunt, can come across rude

• yes=yes, no=no

• culture is _______

• there are _______ within cultures

• even though someone looks like they are apart of a culture but they may not be

• ethnicity, region, and marriage can affect culture

learned

subcultures

what should SLPs do when they lack knowledge about a specific culture?

what is one way SLPs can increase cultural awareness?

• seek additional resources and education

• completing self-assessment of own biases and beliefs

What does ASHA state is required of us to consider when practicing professional competence?

the impact of cultural variables and language exposure