Communication Disorders in a Multicultural and Global Society
Introducing a Multicultural and Global Society
Culture:
Origin: Latin word "colere," meaning to cultivate or improve.
Evolution: Originally referred to agriculture, but evolved in the 18th century to encompass the study of learned human behavior and experiences globally.
Definition (Sir Edward Burnett Tylor): "that complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society."
Focus: Behavior, beliefs, and values of a group connected by commonalities.
Function: Acts as a lens through which individuals perceive and interpret the world.
Components: Religion, language, customs, traditions, and values.
Anthropological View: A set of interacting systems perpetuating practices and systems through generations. These include:
Kinship systems: Mate choice, marriage customs, family relationships/obligations, household composition.
Nonkinship relations: Voluntary associations, religions/belief systems, economic and political systems.
Culture and Communication:
Language Systems: Bind communities, shape social life and communication, form social identity and group membership, and organize cultural beliefs and ideologies (Durant, 2010).
Universal Traits: All cultures have ways of communicating, classifying people, raising children, and establishing leadership roles.
Cultural Specificity: Different cultures express universal traits differently (e.g., sign language in Deaf cultures).
Interrelation of Speech, Language, and Communication:
Embedded in culture.
Edward T. Hall: "Culture is communication. Communication is culture."
Culture as Competencies: A system of shared competencies with varying individual specificities.
Culture as Knowledge: A theory of what one believes his or her fellows know, believe, and mean.
Function of Culture: Provides a system of knowledge for communication within a cultural group; system of knowledge that allows people of a cultural group to know how to communicate with one another.
Reciprocal Relationship: Culture and communication influence each other (Keesling, 1974).
Understanding Communication: Requires understanding ethnographic and cultural factors, intricately embedded in historical, geographic, social, and political histories.
Communication Roots: Embedded in culture, necessitating reference to cultural, historical, and societal bases when studying communication or communication disorders.
Social Rules: Determined by culture (e.g., topic selection, conversation initiation/termination, eye gaze).
Clinical Determination: Requires understanding the cultural context of communication to accurately assess the presence or absence of a communication disorder.
Cultural Influence: Communication behavior and perception of communication disorders are products of cultural values, perceptions, attitudes, and history.
Cultural Competence: Essential for determining communication competence within a group.
Terminology
Race vs. Ethnicity:
Ethnicity: Shared culture forming a sense of peoplehood based on a common past (e.g., Hispanic).
Race: Biologic and anatomic attributes (e.g., skin color) (e.g., Black).
Expressions of Ethnicity: Race, language, and ancestral customs.
Construction: Ethnicity is constructed and reconstructed in response to historical circumstances and changes.
Ethnic Group: People identifying with each other through a common heritage and shared cultural characteristics.
Shared Heritage: Common ancestry, history, kinship, religion, language, shared territory, nationality, or physical appearance.
Ethnic Identity: Marked by the consciousness of belonging and recognition from others.
Ethnography: Fully developed sense of the meaning of a culture, understood through complex webs of meanings, perceptions, actions, symbols, and adaptations.
Race:
Biologic and anatomic attributes such as skin color, facial features, and hair texture.
Cultural Variance: People of the same race can differ widely in cultural identity (e.g., transracial adoption).
U.S. Census 2010:
Categories: Represent social-political constructs for race, reflecting social definitions.
Racial Groups: White, American Indian/Alaska Native, African American or black, Asian, and Native Hawaiian/other Pacific Islander.
Ethnicities: Hispanic or Latino and Not Hispanic or Latino.
Definition of Hispanic or Latino: Person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
Language Note: The term does not refer exclusively to Spanish speakers.
Preference for Latino: Many Hispanic persons prefer "Latino" to refer to origin in Central and South America.
Culture: Term that connotes implicit and explicit behavior in a variety of areas.
Explicit Cultural Behaviors: Observable features like dress, language, food preferences, customs, and lifestyle.
Visibility: Readily visible and often used to identify cultural groups.
Common Use: Focus of "culture-of-the-month" activities.
Implicit Cultural Variables: Factors not easily depicted and observed.
Examples: Age and gender roles, child-rearing practices, religious and spiritual beliefs, educational values, fears and attitudes, values and perceptions, adoption of other cultural norms.
Characteristics: Beneath the surface, relatively invisible yet shape the fiber of cultural group members.
Multicultural
Emergence: Term arose in the 1960s with recognition of racial and ethnic groups in English-speaking countries.
Initial Use: Referred to cultures by race and ethnicity (e.g., blacks in the U.S.).
Evolution: Describes a society with diverse cultures, religions, languages, customs, traditions, and values.
Group and Individual Identity: All individuals have both.
Definition: Society where diverse racial/ethnic backgrounds, socioeconomic groups, age groups, geographic areas, and other variables create a mosaic of individuals forming a rich whole.
Inclusions: Cultures defined by socioeconomic class, gender, sexual orientation, ability level vs. disability.
Value: Each individual is respected and valued for their contribution.
Additional Cultural Identities: Identification with deaf culture, disability culture, or LGBTQ+ culture.
Multicultural Society: Diverse society of individuals belonging to different cultural groups or subgroups.
Subculture: Group with a culture that differentiates them from the larger culture.
Examples: Chinese Americans (subculture of Asian Americans), Cuban Americans (subculture of Hispanic/Latino Americans).
Multiple Cultural Identities: Due to immigration, emigration, intermarriage, and relocation, many identify with multiple cultures/subcultures.
Individual Multiculturalism: Each person belongs to a unique set of cultures and subcultures.
Multicultural Relationships: Include clinician-client and client's family members.
Clinical Competence: Clinician works to harmonize individuals in the clinical situation to provide appropriate services.
Stereotype
Definition: Popular belief about specific social groups or individuals.
Cause: Overestimation of association between group membership and individual behavior (Gudykunst & Nishida, 1984).
Mechanism: Ascribing collective characteristics to every group member, discounting individual characteristics.
Nature: Can be negative or positive.
Examples: Stereotypes about Africans, Latinos, and Asians.
Cultural Competency: Requires avoiding stereotypes and focusing on the individual in clinical encounters.
Immigrant
Definition: Person migrating to another country, usually for permanent residence.
Global Numbers: By the end of 2005, 191 million immigrants lived outside their country of birth (United Nations, 2005).
Distribution: Approximately 75% live in 28 countries, with 20% in the United States.
Destination: 39% migrated to less developed countries, and 61% to developed countries (North America and Europe).
Leading Countries: Include Saudi Arabia, India, United Kingdom, Australia, and China.
Becoming a Multicultural Society: History of World Immigration and Migration Immigration
Ancient Movements: Peoples moving since ancient Greeks, Phoenicians, and Romans colonized uninhabited lands.
Modern Colonialism: Started in the 15th century with European sailors discovering new lands and seeking trading routes.
Colonial Powers: France, Spain, the United Kingdom, the Netherlands, and Portugal dominated world trade from 1500 to 1800.
17th Century: Creation of British, French, Dutch, and Swedish colonial empires, including the international slave trade.
English Colonies in America: Established framework for the future United States.
Decline of Colonial Empires: Reduced in the late 18th and early 19th centuries due to the American Revolutionary War and Latin American wars for independence.
Pre-Colonial Diversity in America: Original American Indians migrated from Siberia thousands of years ago.
American Indian Population in 1500: Over 4.5 million divided into numerous tribes with distinct cultures, religions, and languages.
Early U.S. Diversity: Already home to American Indians, Spanish, French, Mexican, and other groups.
First U.S. Census (1790): The United States was already a nation of many cultures.
Demographics: Almost 19% of Americans were of African ancestry, 12% Scottish and Scotch-Irish, with fewer German, French, Irish, Welsh, and Sephardic Jews.
Exclusions: Did not include American Indians or Hispanics.
Naturalization Act of 1790: Citizenship open to "any alien, being a free white person."
Exclusions: Excluded non-whites and enslaved individuals.
Citizen Representation: Citizens represented only 48% of the total population.
Origin of the Term Immigrant: Refers to a person who voluntarily moved from their own country to another established nation Population Bulletin, 2003
First Wave of Immigration: 1820-1880
Immigration Patterns: Population growth primarily through three waves of immigration starting in the 19th century.
Immigration Numbers: Between 1820 and 1860, over 15 million immigrants arrived in the United States.
Major Groups:
Germans: 4 million after the failure of social reform.
Irish and British: 3 million each due to the potato famine of 1847.
Scandinavians: 1 million seeking land through the Homestead Act.
Asians: First major surge during the gold rush in the early 1850s and railroad construction.
Chinese Immigration: Increased from 63,000 to nearly 180,000 between the 1870s and early 1880s (Morrison & Zabusky, 1980; Vecoli, 1995).
Nativist Concerns: By 1882, some Americans worried about newcomers threatening "American" values.
Immigration Policy: Slow evolution of laws progressively restricting immigration or reducing rights.
Chinese Exclusion Act of 1882: Denied immigration to Chinese laborers and barred Chinese from citizenship.
Effect: Chinese population in the United States dropped to 1870 levels.
Second Wave of Immigration: 1880-1920
Start and End: Began in 1880 with the industrial revolution and ended with World War I.
Immigrant Numbers: 1.2 million at first, then an additional 18 million immigrants arrived.
Major Groups:
Italians: More than 4 million.
Austrians-Hungarians: 3.6 million.
Russians: 3 million (Vecoli, 1995).
Scandinavians: Overpopulation and unemployment led to increased immigration from Sweden and Norway, settling in the Midwest.
Asian and Middle Eastern Immigration: Large numbers from China, Japan, Greece, Lebanon, Turkey, and Syria.
Cultural Differences: Immigrants had language, culture, social institutions, customs, and experiences differing from European groups.
Immigration Acts of 1921 and 1924: Denied entry to aliens ineligible for citizenship and established national quota systems.
Purpose: Reduce Southern and Eastern European immigration and bar Asians entirely.
Goal: Freeze the biologic and ethnic identity of the American people.
Immigration Pause 1920-1964
Reasons for Hiatus: Restrictive policies, economic depression, and world wars.
Post-World War II Immigration: Reflected political unrest in Europe and the Middle East.
Migrant Farm Workers: Need for workers encouraged over 1 million Mexicans to come to the United States.
Impact: Mexicans have been the largest group of immigrants for the past 60 years.
Russian Immigration: Approximately 20,000 Russians and displaced individuals immigrated after World War II (Magocsi, 1995).
Numbers: By 1985, nearly 300,000 Russian Jews settled in major cities of the Northeast.
Turkish, Croatian, and Serbian: Immigration also increased, including professionals seeking better job opportunities.
Third Wave of Immigration: 1965 to Present
Motivations: Abhorrence of racism and recognition of Asian Americans' and African Americans' valor during wartime.
Policy Changes: A combination of international politics and democratic idealism, including the Civil Rights Act of 1964, eliminated racial restrictions.
Immigration and Nationality Act of 1965: Removed national origin quotas and opened the United States to immigration from throughout the world by regional quotas.
Unexpected Consequence: Beginning of the third wave of immigration.
Global Migration Increase: In 1965, 75 million people lived outside their country of birth; by 1985, that number increased to 105 million.
Numbers: An estimated 214 million international migrants in 2000, representing an increase of almost 40 million in the first decade of the 21st century and more than double the number of international migrants in 1980 (Hatton & Williamson, 2006; Kent & Mather, 2002).
Shift in Origin Countries: The major countries of origin changed from primarily European to Asia and Latin America.
Historical Comparison: During the first two waves, almost 90% of immigrants originated from Europe.
Recent Figures: During the 1980s, only 12% of the 7.3 million immigrants to the United States originated from European countries.
Post-Korean and Vietnam War Era: Significant increase from Southeast Asian countries, Pacific Islands, Asia, Central and South America, and the Caribbean.
Recent Statistics: Nearly 85% of the 7.6 million immigrants since the 1980s have come from Asia, Latin America, and Africa, with Mexico and China having the largest numbers of immigrants, respectively (U.S. Census Bureau, 1996).
Hispanic Population Growth: Between 1980 and 1990, the Hispanic population grew by 36%, with major countries of origin being Mexico, Haiti, the Dominican Republic, and Cuba (U.S. Census Bureau, 1996).
Mexican and Caribbean Immigration: More than 2.7 million immigrants came to the United States from the Caribbean, and nearly 2 million came from Mexico alone in 2000 (U.S. Census Bureau, 2000).
Foreign-Born Residents Increase: Between 1990 and 2010, the number of foreign-born residents increased from 20 million to 40 million.
U.S. Population Growth: The entire U.S. population grew from 250 million to 310 million.
Immigration Contribution: Immigration contributed to a third of the U.S. population growth, and the U.S.-born children and grandchildren of immigrants contributed to nearly half of the entire U.S. population growth (Martin & Midgley, 2010).
Racial and Ethnic Diversity:
U.S. Population Increase: Increased by 9.7% between 2000 and 2010 (U.S. Census Bureau, 2011).
White Population Growth: Only 3.4%.
Hispanic Population Growth: 37.1%.
Asian Population Growth: 36.6%.
Cause: Largely due to significant increases in immigration of nonwhite racial and ethnic minority groups.
Undocumented Immigrants:
Estimates: Approximately 11.2 million illegal immigrants lived in the United States in 2010 (Passel, 2010).
Major Countries of Origin: More than 6 million from Mexico and more than 1 million from Guatemala, Honduras, and El Salvador.
Other Origins: Canada, Haiti, Poland, and the Philippines.
Settlement Patterns: Most legal immigrants settled in California, New York, Texas, Washington, Illinois, Florida, Pennsylvania, Massachusetts, Georgia, and Michigan (U.S. Census Bureau, 2011).
Visa Overstays: Undocumented persons enter as students, tourists, or temporary workers and remain after their visas expire.
Example: More than 250,000 Chinese intellectuals, scientists, and engineers stayed after their visas expired.
Result: Dramatic increase in immigration leading to diversity in the demographic makeup of America.
Global Migration
North America: World's largest immigration destination.
Mexican Migration to the U.S.: Nearly one half million persons migrate each year, about one third of whom are undocumented (Passel, 2004).
Numbers in 2006: More than 11.5 million Mexican immigrants resided in the United States, accounting for 30.7% of all U.S. immigrants and one-tenth of the population born in Mexico (Batalova, 2008).
Canada and the U.S.: Include only 5% of the world's population but receive more than one half of the world's immigrant population.
Asian Immigration to Canada: China, India, Pakistan, and the Philippines account for about 30% of all immigrants to Canada.
Caribbean Immigration: The 15 independent Caribbean nations have some of the highest immigration rates in the world.
Major Countries: Cuba, the Dominican Republic, Haiti, and Jamaica have sent large numbers of immigrants to the United States since 1980.
Colombian Emigration: Since 1996, 1.1 million of Colombia's 40 million people have left the country for the United States, Ecuador, Australia, Canada, Spain, and Costa Rica.
Colombians in Venezuela: There are more than 2 million Colombians in Venezuela.
Brazil: Largest recipient of immigrants in South America for many years.
Early Immigrants: Slaves from Nigeria, Angola, and Benin brought to work in sugar plantations.
Salvador Bahia: Remains the largest black city outside of Africa.
20th-Century Immigrants: Mostly from Italy, Germany, Spain, Portugal, and Poland to support farming and mining.
Post-1920 Immigrants: Lebanon, Syria, and Japan.
Linguistic Diversity: 99% speak Portuguese, but approximately 210 other languages are spoken or signed.
European Migration in the 1990s: Movement of between 500,000 and 1 million persons a year made migration a major social and political issue.
Concentration: The four largest European countries—France, Germany, Italy, and the United Kingdom—include about 66% of European Union (EU) residents but received 88% of EU immigrants in 1995.
Foreign Workers: In 1998, foreign workers made up 6% of the population of the counties in Western Europe (Organization for Economic Cooperation and Development [OECD], 2000).
Cultural and Linguistic Diversity: Immigration brings diversity of cultures and languages.
Language Examples in Germany: Although most persons learn English, immigrant languages include Turkish, Russian, Arabic, Greek, Dutch, Italian, Polish, Serbo-Croatian, and Spanish.
Language Examples in France: Arabic, Armenian, Ababa, Berber, Cambodian, Chinese, Danish, and Dutch.
Asian Migration: Most migration is from one Asian country to another; however, many Asians have migrated to the United States, Canada, and Middle East Gulf nations seeking employment (OECD, 2000).
Refugees and Asylees: Some leave their country for fear of persecution.
Middle East: Accounts for 45% of the world's refugees, including 1.5 million Afghan refugees to Iran in 2000.
Largest Refugee Population: Lives in Gaza, Jordan, and neighboring countries.
Africa: Had nearly one-eighth of the world's population and nearly one-third of the world's 12 million refugees in 2000.
Reasons for Flight: Domestic turmoil in places such as Rwanda, Somalia, and Darfur.
Largest Source of Refugees (2005): Afghanistan, Iraq, Myanmar, Sudan, and the Palestinian territories.
Canada: Resettles more than 1 in 10 of the world's refugees.
Diversity: Home to persons born in more than 100 different countries, with 10 groups having more than 200,000 residents each.
Languages: English (59.3%) and French (23.2%), with at least 87 other unofficial languages (Lewis, 2009).
Global Linguistic Diversity: More than 7000 languages spoken in 196 countries (Lewis, 2009).
Ethnic Group Numbers: Largely unknown.
Asia: At least 71 ethnic groups, with 56 in China alone.
Africa: Hundreds of ethnic groups with at least 1500 languages and cultures.
Australia: Multiethnic country with descendants from England, Ireland, Scotland, Italy, Germany, and China.
Aboriginal Population: Nearly one-half million (2.3%) are of aboriginal descent or from the Torres Strait Islands.
Languages: At least 40 different languages spoken (Price, 1999).
Conclusion: National and worldwide immigration patterns have led to a multiethnic and multicultural world.
Acculturation and Assimilation
Models of Assimilation
Incorporation Process: Tens of millions of immigrants are incorporated into societies through acculturation and assimilation.
Acculturation: Newcomers assume cultural attributes of the receiving country, including language, norms, behaviors, and values.
Assimilation: Incorporation into social and cultural networks of the host society, including work, residence, leisure, and family.
Definition: Giving up one's culture and adopting characteristics of another.
Three Models: Conformity, Melting Pot, and Cultural Pluralism.
Conformity Model
Historical Preference: Favored throughout much of history.
Belief: Early Americans believed in their cultural and biologic superiority.
Laws: Restricted immigration and citizenship to persons from Western Europe.
Expectation: Nonwhite people were to abandon their distinctive values and conform to the American model.
Immigrant Motivation: Strove to adopt American culture for economic and political benefits.
Result: Rejection or alteration of family names, languages, and customs.
Melting Pot Model
Description: Elements of culture brought by immigrants are transmuted into a new American culture embodying cultural variants.
Outcome: An amalgam of varied cultures in which no single culture is dominant, blending into a rich whole.
Policy Justification: Provided rationale for more liberal immigration policies in the late 1960s.
Critiques: Attacked as ethnic groups sought to retain their individual identity, traditions, and customs.
Cultural-Pluralism Model
Emergence: Offered as an alternative to the melting pot model in the 1990s.
Recognition: Recognizes diversity within the nation.
Internal Attitude: Predisposes, but does not compel, the display of ethnic identification in interactions.
Value: Individual cultural identity is valued and accepted.
Ethnic Identity: Individuals choose to maintain their ethnic identity.
Common Citizenship: Sharing common American citizenship and loyalty.
Cultural Maintenance: Ethnic groups maintain and foster their languages, customs, and cultural values.
Homeland Connection: Maintaining features of their home culture that identify them with their homeland.
Examples: New immigrants may prefer to retain the identity of their homeland and be recognized for example, as Nigerian or Jamaican.
Levels of Adaptation and Assimilation
Variable Factor: Determination or willingness of immigrants to assume the culture of America.
Variation: Degree of adaptation and assimilation varies.
Historical Influence: Early immigrants made great efforts to acculturate and assimilate.
Cheng and Butler (1993): Describe six levels of adaptation and assimilation:
Reaffirmation: Reject the new culture and attempt to maintain or revive native cultural traditions.
Synthesization: Attempt to synthesize a selective combination of cultural aspects of both cultures.
Withdrawal: Reject and withdraw from native culture or the new culture due to cultural conflict.
Constructive-Marginality: Tentatively accept the two cultures but do not fully integrate into either one.
Biculturalism: Full involvement of both cultures.
Compensatory Adaptation: Become thoroughly integrated into the new culture, rejecting identification with the native culture.
Barriers to Assimilation and Acculturation
Limited Acculturation: Many experience limited acculturation and practically no assimilation in their lifetimes.
Factors Affecting: Circumstances of immigration, race and ethnicity, class, gender, and character of community.
Immigration circumstances:
Voluntary immigrants: Prepared for the move and willing to accept changes.
Involuntary immigrants: May be resistant and suffer social and political isolation.
Refugees: Forced to leave their country and may lack knowledge of the language or culture of the receiving country.
Vigdor (2008) Study:
Assimilation difficult to define; used various factors.
Immigrants assimilate just as quickly as in 1990.
Economic and civic assimilation can occur without cultural assimilation.
Immigrants from developed countries are not necessarily more assimilated.
Mexican immigrants experience low rates of economic and civic assimilation but normal rates of cultural assimilation.
Race Impact: Skin color has been a dominant factor for Asians, Hispanics, African Americans, and Native Americans.
Cultural Acceptance: Willingness of the dominant culture also affects this.
Additional Factors: Religious practices, social class, traditional gender roles.
Community Density: The density of the population and the location of the immigrant communities influence the rate.
Children's Assimilation: Children and grandchildren retain fewer ancestral cultural values.
Questioning Models: As the United States enters the 21st century, its future as an ethnically plural society is questioned.
Cultural Diversity in a New America
Outcome of Immigration: Culturally and linguistically diverse America.
U.S. Census (2010): Identified more than 207 ancestral groups.
Largest Ancestral Groups: German, Irish, Italian, and countries of the United Kingdom.
Other Groups: Sub-Saharan Africa, African countries, West Indies, and Middle East.
Smaller Groups: Malta, Carpatho-Rusyns, Cyprus, Kenya, Uganda, Estonia, and New Zealand.
Religious Diversity
Importance: Shown in the guarantee of religious freedom in the First Amendment.
Early Settlers: Primarily Protestants and Roman Catholics.
Other Immigrants: Slavic Christian and Jewish immigrants established Judaism and orthodoxy.
Recent Trends: Due to Middle East and African immigration, the number of Muslims has doubled since 1990.
Asian Immigration: The number of Hindus and Buddhists has doubled since 1990.
Other Religions: Several million persons practice as many as 60 other religions.
Impact: Each religion affects the identification of communication disorders and delivery of services.
Cultural Groups: Have definable implicit characteristics in universal categories of behavior (e.g., views toward education and health care).
Western/European Cultures: Based on germ theory.
Non-European/Eastern Views: See a connection between illness and internal forces.
Religious Practices: Disease viewed as punishment for a specific ill deed or religious failing.
Linguistic Diversity
Result of Diversity: Racial and ethnic diversity has resulted in linguistic diversity.
Census Data (2010): More than 55 million persons speak a language other than English at home.
Spanish Speakers: More than 34 million people in the United States speak Spanish or Creole only at home.
Percentage: 61% of all languages other than English.
Other Languages: Chinese, French, German, Tagalog, Vietnamese, and Italian are spoken by more than 1 million persons at home.
Additional Languages: Arabic, African languages, Greek, Hindi, Persian, Urdu, and Gujarathi.
Language Use in Schools: Higher percentage of Hispanic and Asian students speak a language other than English.
English Proficiency: More than 5.4% of Americans speak English less than very well.
States with Low Proficiency: California, Texas, and New York.
Groups with Low Proficiency: Hispanic, Asian, Native Hawaiian/other Pacific Islanders, and American Indian/Native Alaskans.
Communication Disorders in a Multicultural Society
Recognition of Need: Soon after the Civil Rights Act in 1964.
Growing Concern: African American children were being inappropriately classified as having disorders.
Study of Communication Disorders: Speech-language pathologists and sociolinguists began studying communication disorders in multicultural populations.
ASHA Position: Adopted a position paper on social dialects in 1983, recognizing dialects as legitimate forms of English.
Increased Immigration: Need to study grew with the third wave of immigration.
Diverse Immigrants: The new immigrants were also more diverse than before, arriving from a broad spectrum of countries encompassing a range of linguistic variables and a diversity of cultural backgrounds.
Communication Disorders grew Concerns: Directed at immigrants from Spanish-speaking and other non-English-speaking countries.
ASHA Publication: Published Clinical Management of Communicatively Handicapped Minority Language Populations in 1985.
Communication Disorders in Culturally Diverse Populations
General Demographics
Worldwide Prevalence: Approximately 10% of the world's population live with disabilities (WHO, 2010).
Poverty: 80% of disabled individuals live in low-income countries with limited access to basic services.
Increasing Numbers: Rise of communicable diseases, injuries, falls, violence, and aging.
No Reliable Data: On the prevalence of speech impairment around the world.
Hearing Impairment: About 278 million people had moderate to profound hearing impairment in 2005 (WHO, 2005).
Prevalence: 80% of these live in low and middle-income countries (WHO, 2005).
Demography of Disability: Difficult to define due to varied cultural definitions.
WHO Strategy: International Classification of Functioning, Disability and Health (ICF).
Reviews of Disability Literature : Disability rates from to . Low quality of life from disability rates of to . (Barbotte and associates, 2001
Diversity among Children in Special Education
Children Receiving Special Education: Difficult to obtain reliable data around the world.
Developing Countries: Jonsson and Wiman (2001) and Savolainen (2000) estimate between and percent of children with disabilities enrolled in school.
The Philippines: of the million school-aged children with disabilities were actually enrolled in schools.
Mozambique: of children attending school were children with a disability.
Ethiopia: The enrollment rate of children with disabilities was less than . The World Bank (Filmer, 2005) reported on the education of persons with a disability, Surveys included Jamaica, Cambodia, Mozambique, Sierra Leone, Pakistan, Spain, and Burundi.
Disability rates of enrollment to school: There were gaps of from to between the enrollment of students with a disability and those without a disability in these countries.
Indonesia: of the children aged to years without a disability were enrolled in school; however, only of children with a disability were enrolled in school. Across the 11 surveys, the median gap between the school enrollment for those with a disability and those without was for children aged 6 to 11 years and 31% for those aged to years.
In the United States: Since 1975, students with a disability have been guaranteed a free appropriate public education, IDEA.
Becoming a Culturally Competent Clinician
Continuous Process: Understanding another culture is a continuous, not discrete, process.
Cultural Conflict: Identifying sources involves more than learning about implicit and explicit variables.
Monocultural Assumptions: Not relevant as most literature assumes the clinician is a member of the majority culture.
Broad View: Clinician and client may differ by culture, racial and ethnic group, sex, age, socioeconomic class, gender, or religion.
Analysis: Look to differences as well as similarities.
Self-Awareness: Clinicians must understand their own culture and assumptions, continuously assessing cultural differences.
Importance of Knowledge: The clinician needs knowledge and resources
Importance of knowledge: The clinician must be aware, protect, and respect the beliefs and values in order to ensure there are no miss-diagnosis
In becoming a culturally competent clinician, it is important to consider culture-bound variables and language-communication-bound variables
Importance of Individualism and Groups: People from cultures of collectivism look after the needs of the entire group in their social network. People from Cultures in which collectivism are predominant include:
Arab
African
Asian
Hispanic cultures
Power-Distance and Variables: The power-distance variable focuses on the social relationships between people of different statuses (i.e., superiors and subordinates
People from high power-distance cultures do not question the orders or suggestions of superiors.
People in low power-distance cultures do not necessarily accept superiors' orders.
Time Orientation: Differs Across cultures. When the culture is long-term and future oriented, the establishing of long-term goals and priorities are highly valued. Different cultures place different emphasis on whether the focus of establishing short term goals or long term goals.
Nonverbal and Verbal Communication Styles
Nonverbal Communication
Information Transmittal: Information transmitted without words.
Proxemics: Use of personal space and conversational distance.
Kinesics: The use of body movements body language, facial expressions.
Paralanguage: Variables such as silence, loudness, inflection, and stress. Social Distance
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Culture: Encompasses knowledge, beliefs, arts, morals, laws, customs, and acquired habits, shaping world perception and consisting of religion, language, customs, traditions, and values. Anthropologically, it's a system perpetuating kinship and nonkinship practices.
Culture and Communication: Language binds communities, shaping social life, identity, and beliefs. Cultures universally communicate, classify, nurture, and lead, but express these traits uniquely. Culture is communication and a system of shared knowledge, influencing and being influenced by communication.
Terminology: Ethnicity is a shared culture, while race involves biologic traits. Ethnicity is constructed historically, forming ethnic groups with common heritage and identity. Ethnography is a deep understanding of a culture's meanings. The U.S. Census categorizes race and ethnicity, defining Hispanic/Latino origins.
Multicultural: Emerged in the 1960s, describing diverse societies respecting each individual's contribution, including additional identities like deaf, disability, or LGBTQ+ cultures. Many have multiple cultural identities due to various factors, requiring clinical competence to harmonize individuals.
Stereotype: Popular beliefs about groups, overestimating associations between membership and behavior. Cultural competency requires avoiding stereotypes and focusing on individuals.
Immigrant: Migrants to another country, with most residing in developed nations. Colonialism and immigration waves have shaped multicultural societies, influencing demographics and policies.
Becoming a Multicultural Society: Immigration waves from 1820 to the present have diversified the U.S., with policy changes impacting origin countries and demographics. Global migration patterns show North America as a major destination, with diverse immigration and emigration trends worldwide.
Acculturation and Assimilation: Immigrants incorporate into societies through acculturation and assimilation, with models like conformity, melting pot, and cultural pluralism. Adaptation levels vary, influenced by circumstances, race, class, and community. Barriers exist, questioning future ethnic plurality.
Cultural Diversity in a New America: Immigration leads to cultural and linguistic diversity, with various ancestral groups, religions, and languages spoken. This diversity impacts communication disorders and service delivery.
Communication Disorders in a Multicultural Society: Awareness of communication disorders in diverse populations grew post-Civil Rights Act. ASHA recognized dialects, addressing concerns in Spanish-speaking and non-English-speaking communities. Demographics of disability worldwide vary, with challenges in data collection and special education access.
Becoming a Culturally Competent Clinician: Requires continuous understanding, self-awareness, and respect for beliefs/values. Considers cultural and language-communication-bound variables, individualism, group dynamics, power distance, and time orientation.
Nonverbal and Verbal Communication Styles: Includes proxemics, kinesics, paralanguage, and social distance.