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| Shared beliefs, traditions, and value of a group of people |
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| Classification system that distinguishes groups of people from one another based on physical characteristics |
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| Social definition for groups of people based on shared ancestry and culture: including customs, nationality, language and heritage |
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Variety of a language spoken by a sub group within a larger speech community
Variation of a language used by all speakers of a language |
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Developed when individuals use a particular dialect and share knowledge about constraints and options for language use
Communities may differ in vocabulary, grammar, pronunciation, rate of speech, rhythm of speech, communication topics, body posture, pragmatic rules
Many people are bi-dialectal or multi-dialectal |
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| Person’s unique way of speaking based on the interactions of age, education, personality family and geographical background |
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| Who determines that a communication disorder exists? |
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| Your culture helps your outlook on speech and language disorders |
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| Asian and Native American beliefs |
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| Speech and language disorders are a result of an emotional disturbance |
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| Believe that having a disorder is considered a persons fate and any recommendation for therapy is futile |
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| Parents feel personally responsible for the child’s disability |
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| Hindu and Native Americans |
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Disability may be seen as a spiritual gift or punishment
Client may be opposed to intervention that would change the disability |
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| Culture free testing- no such thing |
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Standardized assessments
Presentations of structural activities
Observation in naturalistic environments |
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| How many people can currently be identified as having a communication disorder |
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| Number of new cases of condition over a specific period of time |
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About 10% of Americans have a communication disorder
% in US will increase to about 13% by year 2050 |
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Attributed to
Aging population: people are living longer with sickness
Growing minority population: with limited access to health services
New diseases: new challenges including in speech pathology |
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Low income populations
Greater risk for many disease and disorders
Higher incidence of lead poising
Can lead to decreased cognitive abilities and speech and language delays |
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High uninsured rates among the poor
Diabetes: 8.3% of US population
Complication: heart disease and stroke, hypertension, blindness and eye problems, kidney disease, nervous system disease, amputation, dental disease, complication of pregnancy |
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Comprised of 12% of US population
Exhibit most significant incidences of diabetes, high blood pressure, sickle cell animia
High prevalence of hypertension, which lead to stroke, which may cause aphasia
Underutilize therapy for aphasia |
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Diabetes- 2X likely as whites
AIDS: children-46% of all people living with diagnosis in 37 states
90% develop disabilities that lead to global developmental delays, cognitive deficits, motor function abnormalities, loss of motor skills previously acquired, and mental retardation
Deafness: 14% of population |
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Hispanic Americans
15.75% of US population |
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AIDS: Hispanic children-17% of new infections
Hearing impairments: significant increase within diverse group
Deafness: 6.8% of population
Diabetes/stroke: Puerto Rican American highest
Down syndrome: high rate due to maternal age |
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Native Americans
.9% of US population |
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Heart disease and cancer leading cause of death
Diabetes: 2X all US adults
Cleft Palate: .79 to 3. 74 per 1000
Higher incidence of ottits media and fetal alcohol syndrome
Hearing Impairments: 16.2% of population |
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Asian/Pacific Islanders
Most rapidly growing group
4.2% of US population |
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Cleft Palate:
Chinese-1 per 492
Japanese- .85 to 2.68 per 1000
Asian males outnumber females |
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| Identification of a disorder or problem when none exists-false positive |
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| Communication disorder exists but is not identified false negative |
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| Non-verbal considerations |
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Use of time-testing is time sensitive
Learning
Group vs. Individual Achievements- |
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Language function- lots of questions-some cultures do not like this
Pseudoquestions-person asking already knows answer-silly to ask
Native Americans-may not respond in order to avoid embarrassment for the person asking |
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| Verbal Considerations continued |
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African American, Hispanics, Native Americans-children learn by observation
Questioning-causes cultural challenges
Language content- assessments presented without family |
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| Language organization structure |
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| Testing involves asymmetrical communicative interaction-speaker must remember topic-more language organization skills are warranted |
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| Variations in a language used by racial, ethic, geographical or social economic groups |
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Client’s ability to comprehend and produce language
PEP-potentially English proficient
LEP-limited English proficient |
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Language in which person us most fluent and proficient
Person can lose one language when acquiring another-may be conscious choice |
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Basic interpersonal communication skills
Linguistic code used in familiar social interactions
Sometimes hard to pick up delay because persons are proficient in BICS |
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Cognitive academic language proficiency
Formal language system used in the schools-use language to talk about language |
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| Child proficient in CALP as L1 can develop CALP in L2 easier than child proficient in BICS as L1 acquiring CALP as L2 |
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Use of standardized tests alone is insufficient when testing individuals from culturally and linguistically diverse backgrounds
Cannot be determined whether responses to tasks are delayed or different
Unable to determine if responses are due to lack or experience
Difficult to determine if true language impairment is present |
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Ethnography
Ethnographic interview
Unobtrusive observations
Observations
Dynamic assessment |
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| Find out values, norms, attitudes regarding language development, disorders, important considerations within culture, interactions, topics, roles of boy/girls, definition of a disability |
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| See the world through the eyes of the client or family |
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In the clients natural environment
Attitude of clinician “ I don’t know much about this persons point of view so I will let him set the agenda” |
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Takes longer but obtain valuable information
“Does not readily demonstrate whether a mismatch between communication abilities and expectations result from a lack of experience, lack of language learning abilities, or a combination of both |
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Interested in the process of learning
A test-teach-retest protocol for observing and evaluating the learning process
Able to make inferences about the individual’s language learning and use by purposefully teaching some skill during the assessment
Take time to learn about this person learning style and preferences |
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| Dynamic Assessment 3 phases |
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Test-assess a particular area
Mediation-teach the client something
Retest- repeat testing phase to determine if learning has taking place |
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| Suggestions for dynamic assessment |
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Narrative assessment
Assess grammar, fluency, story structure, and pragmatics
A functional tool when assessing language learning potential |
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| Be aware of cultural rules |
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Always include the family
Some families are extended by nature
Cultural groups have different views about family authority
In some Middle Eastern, Hispanic and Asian cultures the father is usually the spokesperson for the family and the highest authority
Be aware of differences in communication |
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Communication may breakdown and client is not aware
Parents say ‘yes’ but does not understand or agree
Cultural groups express disapproval differently
Asian cultures view it inappropriate to contradict others. Caregivers may appear to agree but may be saving face or showing courteous respect while having no intentions of following through
African Americans may perceive certain questions rude and highly personal |
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Families may have negative experiences with clinician’s culture
Sometimes there are political hostilities that the clinician would need to be aware of |
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Arabic cultures-client/caregiver may not regard female pand t may not listen suggestions
socially inappropriate for a female to make physical contacts with a male client
Female caregivers may experiences difficulty respecting suggestions of femal who is not also a mother
Asian culture-more appropriate to address an individual based upon their relationship in the family rather than by name |
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| Cultrual groups have varying expectations for a childs behavior in the company of adults |
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Hispanic- does not initiate conversation
Others-high level of conversational participation from children
African America/Hispanic-child who demonstrates sustained/prolonges eye contact with adult is disrespectful |
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Asian- adults avoid prolonged eye contact with other adults
Hispanic- distance between speaker and listener is close
Japanese- wants distance between speaker and listener
African Americans-express approval by physical contact |
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