Cultural Competency in Professional Service

What is cultural competence?

a continuum of behaviors and attitudes relative to cultural and linguistic differences

What does a long term orientation favor?

a long-term orientation fosters virtues oriented toward future rewards, in particular, perseverance and thrift

What is a low-context communication style and who uses it?

a low-context tens to be direct and explicit used by individualistic cultures-the US educational system uses a low context communication style

What does a short term orientation favor?

a short-term orientation fosters virtues related to the past and present-in particular, respect for tradition, preservation of "face", and fulfilling social obligations

What are 11 cultural variables(differences)?

age, ability, race, ethnicity, experience, gender, gender identity, sexual orientation, linguistic background, national origin, religion, and SES

Which implicit behaviors affect everyone's culture?

age, gender roles within families, child-rearing practices, religious and spiritual beliefs, educational values, fears, and attitudes

What is the uncertainty avoidance dimension of culture?

the uncertainty avoidance dimension encompasses the degree to which a culture tolerates ambiguity or lack of specificity

What 2 elements combine to provide the most effective individualized assessment and intervention?

their findings and culturally sensitive approaches

What are 4 ways an SLP can gather information about another culture?

(a) learning through books, the arts, and technology; (b) talking and working with individuals who can act as cultural guides and mediators; (c) participating in the daily life of another culture; and (d) learning the language of another culture

How do the 5 dimensions of culture relate to the SLP?

-Child-rearing practices influence how children learn language, what they learn, and when they learn it -Knowledge of the nature of cultural variations can give SLPs and audiologists insight into the behaviors and traits clients and families value, thereby facilitating cross-cultural interaction and minimizing opportunities for miscommunication and misunderstanding

What are 3 areas for research?

-Future research should focus on topics such as efficacious assessment and treatment strategies as well as the effectiveness of culturally competent care in the field of speech-language pathology and audiology -There also continues to be a need for the collection of normative data of speech and language development in culturally and linguistically diverse populations -Research must rapidly expand in this area to find evidence that supports best practice that is culturally and linguistically appropriate.

What influences some immigrant families not seeking health care and speech therapy for their children?

-Immigrant populations may have limited access to speech and language services in their native countries prior to immigration. Specific communities may also have their own traditional ways of caring for individuals with disabilities -When families hold such beliefs, they may be unlikely to seek or access educational, medical or other health care services provided in the United States

What are goals of Special Education and Headstart and how can they conflict with cultures of families served?

-The goal of special education is to increase children's abilities to function as independently as possible by acknowledging individual differences and promoting individual strengths -This philosophy may clash with the cultural values and beliefs of the families enrolled in special education programs. For example, it was reported that Head Start programs tend to use developmentally based practices with individualized child-directed activities. However, Southeast Asian parents' goals for their children who attended a Head Start program were not oriented toward developing independence and self-esteem. A primary goal for the parents was that their children develop obedience and respect. As children developed more independent behaviors in preschool, parents reported greater difficulties in disciplining them

What 2 federal laws or orders prohibit discrimination and ensure equal access to programs receiving federal funding?

-Title VI of the 1964 Civil Rights Act -Executive Order 13166

Describe child rearing expectations in an individualist culture.

-child rearing styles in individualist cultures value and support autonomy, emotional independence, and individual initiative -tend to follow the child's lead -tend to direct and manipulate the child's learning and thus enhance verb learning

What are the 6 stages along the cultural continuum?

-cultural destructiveness -cultural incapacity -cultural blindness -cultural pre-competence -cultural competency -cultural proficiency

According to WHO, what factors influence the ability of individuals with impairments to participate in life activities?

-environmental factors -culture, language, race, and ethnicity

What are 3 key points to consider regarding culture?

-everyone has culture -culture is as dynamic as people are -implicit versus explicit behaviors

How is "friendliness" (trust and distrust) interpreted differently in cultures at variance along the 5 dimensions of culture?

-friendliness is conveyed by polite listening in a high power distance culture, by formal and specific language in a strong uncertainty avoidance culture, by verbal disclosure of information in an individualistic culture, and by loud talk in a highly masculine culture. Failure to recognize these variations in interactions can result in crucial miscommunications -what they interpret as friendly, unfriendly, interested, or bored behaviors may vary

How has the Office of Minority Health helped health care settings explained cultural competence?

-include access to interpreter services in health care settings -consideration of individual health and illness experiences -the rights to respectful and nondiscriminatory care

What are 5 dimensions of cultural variability reflected across all aspects of life?

-individualism-collectivism -power distance -masculinity-femininity -uncertainty avoidance -long-term orientation

How does individualist-collectivism affect one's perception of disability?

-individualist cultures tend to view disability more favorably and want to open up opportunities for the child; will place them in special education programs and give them many more opportunities -collectivist cultures, the family will care of the child and feel they need to protect and do things for the child; may not end up in any special education programs

What 5 policy changes are in the Joint Commissions Roadmap for Hospitals designed to lessen healthcare disparities?

-officers guidance on establishing qualifications for language interpreters -identifying the patient's oral and written communication needs -providing language interpreting and translation services -respecting cultural, spiritual, and religious beliefs as they relate to health care needs -accommodating the needs of patients with disabilities

How does power distance influence parent-child interactions?

-parent-child interactions are different based on what kind of culture the child comes from -in high power-distance societies, mothers were less likely to talk with their child because that would mean they were an equal conversation partner; also they viewed the responsibility of educating the child as solely the schools; this society values social interdependence and does not foster active exploration of the child -in low power-distance societies, the mother would often prompt the child for narratives, share events about what happened during the day, and encouraged active exploration for the environment and followed the child's lead

In 2010, what are 2 factors compelling the need for cultural competence?

-projected growth in the cultural and linguistic diversity of the US population -the increased demand for accountability

What are 5 elements essential to improving an organization's cultural competence?

-the importance of culture -assessment of cross-cultural relations -vigilance towards the dynamics that result from cultural differences -the expansion of cultural knowledge -adaptation of services to meet culturally unique needs

What are 6 reasons to become culturally competent according to the National Center?

-to respond to current projected demographic changes in the US -to eliminate long-standing disparities in the health status of people or diverse racial, ethnic, and cultural backgrounds -to improve the quality of services and health outcomes -to meet legislative, regulatory, and accreditation mandates -to gain a competitive edge in the marketplace -to decrease the likelihood of liability/malpractice claims

What cultures are examples of collectivist communities?

African American and Mexican American

In 2007, what percentage of enrollment in US schools are English Language Learners in pre K-12?

11%

In 2007, of students 6-21 served by IDEA 2004, what percentage had a speech or language impairment?

19%

What percentage of Americans are non-hispanic white in the US?

64%

What is a high-context communication style and who uses it?

A high-context message tends to be vague, indirect, implicit; used by families from collectivist cultures (many immigrants to the US are from collectivist cultures)

What will foster effective cross-cultural exchange?

Continued development of cultural competence

How can culture influence a family with a deaf child that is similar to how culture influences the larger community of typical families, according to Bagli, 2002?

Culture may affect the way a family accepts a diagnosis, copes with the emotional impact of having a deaf child, interacts with the professional, implements treatment, allows clinicians to participate with the family in early intervention, and tolerates what may be perceived as intrusion from the clinician

What laws apply to schools ensuring non-discrimination?

Equal Educational Opportunities Act of 1974

Referring to the Cultural Dimensions table, apply the 5 dimensions to your perceptions of the CSUN Department of Communication Disorders and Sciences.

Individualistic, feminine, low power distance, low uncertainty avoidance, long term orientation

How long should one strive for cultural competence?

It is a career-long journey

Describe the US educational System in terms of the Hofstedes' 5 dimensions of culture.

The US educational system leans toward an individualistic, low power distance, low uncertainty avoidance, masculine orientation, and long-term orientation

What cultures are examples of individualist communities?

US, German, Scandinavian, and Swiss cultures

Why should one avoid stereotyping?

because he or she may have adopted some values and behaviors of other groups that have influenced his or her level of assimilation and acculturation

What are expectations for children in high power distance society?

children are expected to be obedient toward their parents; independent behavior on the part of a child is not encouraged; respect for parents and other elders is seen as a basic virtue; young children are looked after and are not expected to experiment for themselves

What are expectations for children in low power distance society?

children are more or less treated as equals; the goal of child socialization is to encourage children to take control of their own affairs as soon as they can; active experimentation is encouraged

Describe how families may be in conflict with the US educational system.

children with disabilities from culturally diverse backgrounds were typically referred to special education programs by mainstream staff who viewed special services as a right of children living in a literate, highly technological society that values independent functioning. Many of these children, however, came from nonliterate, nontechnological backgrounds where the children were socialized to be dependent on their families and communities for all of their needs. Thus, children were displaced, were denied services, or received services that were not valued or wanted by the family because of these misunderstandings and lack of cultural knowledge.

What are explicit behaviors that affect everyone's culture?

clothing, external symbols, food, and language

What is the relationship between communication and culture?

communication is embedded in culture, therefore, communication by a group cannot be understood without a thorough understanding of the cultural factors that affect this communication

How is culture dynamic?

cultural norms are not stagnant, but instead change over time

What is the main problem that results from health care disparities?

delayed identification of and intervention for communication disorders

What expectations are seen in a feminine-culture?

emotional gender roles overlap; both men and women are expected to be modest, tender, and concerned with the quality of life; people, quality of life, nurturance, and equal sex roles prevail; feminine cultures assertive behavior and attempts at excelling are frowned upon; excellence is not something one displays

What expectations are seen in a masculine society?

emotional gender rules are distinct; men are expected to be assertive, tough, and focused on material success whereas women are expected to be modest,tender, and concerned with the quality of life; students try to make themselves visible in class and compete openly with each other; it is important to be the best in the class

What 4 actions are reflective of the proficiency level of cultural competence?

equivalent to advocacy stage, in which clinicians champion culturally competent practice by training others in cultural competence, recruiting personnel from diverse cultures, and conducting research that adds to the knowledge base of communication disorders and differences in diverse populations

What is the pre competence stage of cultural competence?

equivalent to an awareness stage in which clinicians are aware of perceptions, values, and other elements of their own cultures and those of cultures different from their own

What is the competence level of cultural competition?

equivalent to application level, in which clinicians effectively use their cultural knowledge during interviewing, assessment, and treatment

What sociocultural factors are less recognized aspects of culture in communication?

eye behavior, facial expressions, body language, rules of social interaction, child-rearing practices, perceptions of mental health, health, illness, and disability

What does a culture high in uncertainty avoidance exhibit?

have a greater need for rules and predictability; students in high uncertainty cultures favor structured learning situations with precise objectives, detailed assignments, and strict timetables; teachers are expected to be the experts

Collectivist cultures tend to use a...

high-context communication style

What factors provide commonality in a cultural group?

historical, geographic, social and political history

What keeps an SLP from overgeneralizing when regarding client's cultural differences?

individualization

What is the individualism-collectivism dimension of culture?

isomorphic with a dimension influencing communication style

When do SLP's learn to be culturally competent?

it is an ongoing learning process throughout their careers

What is cultural humility?

lifelong and critical self-assessment, admission of limits, and acquisition of knowledge

Individualist cultures tend to use...

low-context communication style

What does a culture low in uncertainty avoidance exhibit?

more tolerant of opinions different from what is expected; these students prefer open-ended learning situations with vague objectives, broad assignments, and no timetables; they accept a teacher who says"I don't know" and when parents are called in, they are expected to be active participants in the child's learning process

Culture definition

the integrated pattern of learned behavior, including thoughts, communications, knowledge, beliefs, and values of a group, that is passed on from one generation to the next

What is the long versus short term orientation in culture?

the long versus short term orientation refers to whether a society exhibits a pragmatic future-oriented perspective or a conventional historic point of view

What is the masculinity-femininity dimension of culture?

the masculinity and femininity dimension demonstrates the extent to which a society adheres to a male dominated model

What is the power distances dimension of culture?

the power distance dimension refers to how a society views the equality or lack thereof among its members

What is acculturation?

the process by which one group assimilates or adopts the cultural values and behaviors of another group

Describe how professionals who were educated in the US educational system are oriented in Hofstede's 5 dimensions?

typically value a lower power distance, and attempt to treat students, clients, and families as equals, encouraging them to participate in the development of therapeutic goals and objectives; persons from high include them in the development of the intervention

What cultural groups were found to receive disparity in their health care according to the Institute of Medicine study?

various racial/ethnic groups, individuals from low SES, and the lesbian, gay, bisexual, transgendered population