Hello everybody and welcome to your lecture today on bilingualism and culture and communication disorders. Back before COVID-19, some of you may have seen me around the department and core. I am Melissa Pierce.
I'm a rising third year PhD student in speech and hearing science and I'm also a bilingual speech language pathologist. And before coming back for graduate school, I worked for about 10 years in the field. So I'm going to be using some of my past experience to inform your lecture today. Before we really get going though, I also want to thank Dr. Restrepo, who's my advisor, and some of you may know her as well. She's in our department and for undergraduates she typically mentors people for specific research projects, like those of you who are doing ARIES or any of the Honors College things, and also she teaches classes in the Master's program.
So if you decide to continue on here at ASU. toward becoming a speech-language pathologist, you may end up in one of her classes someday. All right, so before we get into the topic, I'll tell you a little bit about my background. You can probably tell from this slide that I'm from Massachusetts. I got a bachelor's degree in Spanish back in 2005, so I've been bilingual actually for a while, and then went on to get my master's at BU in speech-language pathology.
After that, I started working in the Boston Public Schools for a few years, but I worked through an agency called Bilingual Therapies, which you see there. And through them, I actually learned a lot more than I think I would have in a typical just first job because my supervisor was bilingual as well and had a lot of background in the area of assessment and treatment with bilingual children. So I learned from her quite a bit.
And as I was working there, I started realizing that the evidence base that we were using was often just borrowed from what we had for our monolingual kids. And, you know, we really didn't know that much about what should work or could work with bilingual kids or even monolingual kids who were recent arrivals in the U.S. So that sort of got me interested in research questions, although I didn't end up coming back for research for quite a while. After that, I moved to Peru for two years as a Peace Corps volunteer, and I worked at a special education school.
And this was a very unique and wonderful experience. If any of you are thinking about doing the Peace Corps, by the way, feel free to send me an email. I love talking about it.
But there I really started to grasp a little more of the experience of being somebody who moves to a different country and, you know, just doesn't know all of the systems, isn't a first language speaker of the language of that country. It gave me a lot more empathy and understanding for some of my future students and clients when I ended up coming back to the U.S. From there, though, I didn't directly come back to the U.S. I moved to China for another two years. And there I lived in Beijing and worked with a lot of children of diplomats.
So I had quite a few cultures on my caseload. It was not just Chinese children or American children. It was a really large variety.
Through that experience, I saw more and more that our research base was a bit lacking, and also developed even more understanding for, you know, that experience of just not knowing what's up and maybe being misunderstood quite a bit of the time because your culture does not align with the one you're living in sometimes. So after a few years abroad, I ended up moving back to Massachusetts once again, and I worked at an outpatient pediatric facility. So you will notice throughout this lecture that a lot of my examples and experience is in pediatrics and with bilingual children. But I did try to bring in some examples from audiology and also from working with adults, for those of you who are interested in those populations in the future. So that's a little bit about me.
And now, as I told you, I'm a student in the PhD program here. And my research is on effective interventions for bilingual children. and I'm also still interested in assessments as well.
So that's what brought me back. That's a little about me and even though this is not a live recording, I still want to learn a little about you. So even if you are on Canvas or if you're on Zoom watching this, you can either enter in the chat function or if you're on Canvas maybe we can get a discussion board post going, just telling me a little bit about your background.
And I plan to be sort of live while this is going on in your normal class time and just hanging out in there to see what you say. So, usually when I've done this lecture in the past, it's a pretty good mix. We do have probably a majority who are thinking about speech-language pathology, but there's always a handful of audiology people too.
And we often have a lot of bilingual people in the class, so I am curious always about what the language backgrounds are. You know, people always think of Arizona as like the Spanish-English state, but we definitely have more variety than that here. So if you have a moment, you can sort of just type in, you know, hi, I'm majoring in communication disorders. Or maybe you're just taking this class for fun and you're majoring in something else.
Whether you're planning on graduate school, what your plans are in the future. Would you like to work with bilingual clients and students in the future? And if so, that would be great. So instead of raise your hand at the bottom here, just type in your response. Okay, so we have a lot of topics to cover for today.
We're going to start with just discussing some definitions of what culture is, what language is, some things that might influence your language development, and not just speaking more than one language, because we have to consider sociolinguistics a lot too, right? Dialects, all kinds of things. Then we'll discuss in detail the types of bilingualism, things that affect your bilingualism or multilingualism, and...
In the second half, we'll move more toward really communication disorder-specific things, such as clinical issues in our fields that relate to this population, some language policies that you're going to run into when you're out in the working world in the future. And lastly, I'm going to leave you with some recommended reading and also a short story that I think is really apt for describing some of the cultural issues that people come across. So the main question we're trying to answer here today is what might happen in the clinical or educational world as an SLP or audiologist if you have a mismatch between your culture and the language, culture, and dialect socialization practices of the children and adults that you're working with.
So here it tells you a little, right? Sometimes people are over-identified, which means that people who do not actually have a communication disorder are diagnosed as having one. Some students especially are under-identified where, you know, school staff will think, oh, they just need more time and they really do have a language disorder that needs treatment, but they're kind of like, pish posh, just give them more time to learn English. Or maybe they get diagnosed, but the treatment is really not appropriate for what's going on.
So these are all things that can and do happen out in the real world. Unfortunately, I've seen it myself many times. So that's why, as a rule, we want to keep expanding classes.
that really teach our future SLPs and audiologists about cultural issues because that is one way we can help avoid this practice of over and under identification in the future. Okay, so I want you to think about what might happen if this were you, and this can be on both sides of the story, right? Whether you're the SLP or the person in a professional position. Maybe it's happened to you before at a job that you had.
Or if you were the client or student, maybe you moved to the United States as a young child and got put into a certain class because somebody underestimated your language skills because they were basing them only on English. Okay, so that brings me to our next slide, right? Have you ever experienced something like this? How did you feel if you used a different dialect or a different language and you were put into speech therapy because of the way you speak? Is that a real language disorder?
Is that a real speech disorder? Hopefully you agree that the answer is no. That would be a difference, not a disorder.
But we really need to take care to distinguish these carefully. So, remember, these things can be due to more than just bilingualism, right? You can have an accent or a different dialect.
due to geography, maybe you are an English language learner, or many other factors. So I'm going to give you a personal example. Before college, I used to have a very heavy Boston accent when I was in kindergarten all the way through my senior year in high school. I mean very heavy. Very heavy.
I mean, I sounded like Mark Wahlberg. Mac. So do you think I should have been referred to speech therapy back then because I pack my car instead of parking my car?
Well, the answer is no, of course. That's a difference in dialect or a difference in accent, not a disorder. So had I been in an area of the country that was not familiar with that accent, maybe I would have had a mismatch with the school therapist or my teacher who thought that something else was going on.
These are the kinds of mismatches we need to keep an eye out and ear out for while we're working, right? Okay, so now I want you to think about a personal example. Just take a minute.
Think about it. If you are in the chat function, put it there. If we have a discussion post, we can put it there.
But how did you feel, or how did you think, if you were in the professional role, how do you think that the child or the family felt if you ran into this? So, and I'd love to hear both sides of that story, like whether you're working at, say you worked at a school, for example, if you were in the classroom, or if you were the child, or even as an adult, if this happened to some member of your family, or if you had some kind of mismatch with a professional who either misjudged your communication skills, or you were the professional and maybe some team members or even you yourself misjudged the skills of somebody that you were trying to evaluate or treat. So just take a minute and add in some examples there. Okay, so I want you to keep those in mind as we go through the rest of the lecture, as we talk about different ways to reconsider situations like that and how we really should be addressing them moving forward. So, now that you've got culture on the brain, or differences in dialects and cultures and mismatch, Let's talk more about it.
First, I would like to know what your definition of culture is. So let's take a step back here. What is culture? This is something else that you can share in a chat box or in a discussion post. And I'd like to see all your responses too, because they're quite interesting to me.
So I'm going to give you just a few seconds to do that. And then since this is recorded, I'll just tell you some of the answers that I usually get during this, which you may be typing right now. So a lot of people, for example, bring up food, religion, holidays, these sorts of traditions that are, you know, exclusive or common in a certain culture.
Right now, we just had recently Memorial Day, Memorial Day weekend in the United States at the beginning of summer. So these are all things that are cultural sort of traditions, right? I know this year might be a little different, but often people have a barbecue of a Memorial Day. And that's something that's...
culturally something we do. So lots of cultures have these sorts of things, right? These are really good examples. And we also know that there's a lot of overlap sometimes between some cultures.
So it's important not to overgeneralize. Even if some two cultures have one thing in common, that does not mean they have everything in common, right? And, you know, I saw this quite a bit at my old job. Some people would, you know, kind of overgeneralize that like all Hispanic cultures are the same, which is really not true at all.
There are so many different countries within or that fall under that umbrella. But, you know, if most of the people you knew are from like Puerto Rico, for example, sometimes people assume that Mexican folks have the same sorts of traditions, which is really not true. So beware of overgeneralizing is the message.
So there are so many cultures in our world, even in your own city that you live in. And cities, especially urban areas, get more diverse all the time. So overgeneralizing might cause you problems, especially in a clinical or educational environment, and that's what we want to avoid. So, even though there are distinctions between cultures and we don't want to overgeneralize, there are some universal principles that do apply when it comes to language especially. So, for example, we use language to transmit some of our cultural values, right?
And an example that's kind of recent with that is being from a collectivist culture versus an individualist culture. So take a second and think about what you think the United States is. And I think most of you probably came up with pretty quickly that we are more individualist, right? So these collective versus individual traits can be reflected in language and behavior. And a current example might be that pandemic response that's going on across the world right now, right?
We have the United States where we have people complaining about wearing masks, etc. in our individualistic culture. But then you look to other cultures, for example, South Korea, where people are quite willing to stay home in quarantine and wear the masks all the time. So these are some examples of cultural differences that manifest in behavior. So we also want to remember that there are variations within cultures. So think, for example, about just the label American.
Do you think a New Yorker has the same speaking style or the same culture and same traditions as somebody from rural Alabama or rural Texas? Probably not, right? Though there are a lot of similarities, people do have their individual differences too.
So the last principle you see in the list relates to language development. Language milestones are universal across cultures. Babies do typically start talking around one year old and combining words around two years old and so on and so forth. These milestones should be met regardless of the culture that the child belongs to.
If they're not, it might be a red flag. So, even though we do have differences, especially that become apparent later in life, the language development process is pretty universal. And just again, before I go to the next slide, be careful not to overgeneralize.
Okay, so, what does culture have to do with language? This is another big question. So we talked about our definitions of culture, right?
Let's talk more about the relationship between culture and language. So in a general sense, how you're socialized is a part of your culture. And socialization occurs through language. Language is a major part of it.
It's critical. It's how you learn to speak and how others speak to you and how it should be in different situations that you come across. So let's give a really concrete example, which could be the use of different dialects. Right.
So what is a dialect? I need to take a minute for this one to type out your definition either in the chat or discussion post. What do you think a dialect is? So most of you are probably describing the pronunciation, choice of words, things like that that are used by a group of people.
So let's remember that this refers to a group and not an individual. If it were an individual and they had some unique style of speaking, we would call that an idiolect. But since we're referring to groups, it's a dialect.
Is there such a thing as a standard dialect? that everybody uses or should use? Think about that for a minute. And if there is, who speaks it?
So if any of you have experience with sociolinguistics, this might be ringing a bell. So there's a question here of whether we should go for a descriptivist approach to language and dialect or a prescriptivist, right? So descriptivist would mean more that we are... allowing or recognizing any non-standard dialect in schools and clinics and different places we come across clients and communication disorders. Prescriptivist is more that we expect a certain standard dialect to be spoken in all those places.
So when we're assessing children and adults, are we making sure to consider that they might use a non-standard dialect? That's a really good question when you're doing an evaluation. Nowadays, it's 2020, and I think most therapists out there, audiologists too, whatever they're doing in an assessment, are not going to kind of ding someone on points or think that they have a language disorder if it's really just a dialect.
But there's a lot of details that go into differences between dialects, differences between language, one language influencing the other. So even though it seems obvious that, you know... people will speak different things and that doesn't mean they have a disorder.
We do have to get into the nitty gritty and take our time to do research on the home culture of the patient or student. So one last thought to remember on this is that everybody has an accent. So you might work in the same city your whole life and new students and patients come to you when you become an SLP or audiologist.
And Even though you think they all have an accent, well, you have one too. If you travel to certain places, say you go to Australia tomorrow, you're speaking English, but they will know you're American. So just remember, everybody has an accent, not just your patient or student. Everybody, including you. Okay, so we just talked about some variations in dialects and style of speaking.
So let's expand it a little bit to talk about cultural practices. and expectations and how these can play a role in when you're evaluating or treating a client or a student. So we talked a little bit a minute ago about collective versus individual socialization and how that's lately sort of manifesting in our response to COVID-19, right? But we can expand it a little further and get into some of these other examples.
So let's consider indirect or direct communication styles. In Western cultures, we tend to expect people to be very direct, to ask the questions that they want to know. When they are asked a question, we expect them to respond very directly and, you know, say what we asked and not kind of beat around the bush about it.
So if you're doing an evaluation, like say I am meeting with a parent who brought their child in for the first time for a speech therapy evaluation, and I say, all right, well, what brings you in today? What are your concerns? Some moms don't respond to that right away.
Sometimes you need a few sessions of them coming back to build that rapport, and then they start telling you more details about what's really going on. At first, they might beat around the bush, as I said. And that may just be a result of having a culture with an indirect communication style. And that's fine.
We really just need to show patience, because not everybody is, you know, a bold, direct American who's going to list out exactly what's going on with no qualms. at the beginning of an evaluation. Sometimes people need time and that's okay. It's your job as a professional to give it to them. So You've got to keep this in mind, especially during an initial interview with a patient, with their family members, or parents.
Avoid making assumptions right away. So let's look at another example here. Below it says time given versus time measured.
So this is something I wasn't really sure what the label was for it until I came to ASU, actually. I experienced it, but I didn't have a label. So this is referring to how in some cultures More value is placed on the amount of time that you spend talking to somebody and, you know, really hearing them out, especially if you're a professional and they're coming to you with a problem they want help solving.
So that's what's valuable in those cultures, and that's what's respected. Time measured would be more like the United States, where, though we do care about that, we also really care about sticking to the schedule. And if your appointment is at 9 a.m., well, we think you should be there at 8.50 to fill your paperwork, right?
So this can cause some conflict sometimes. So I'll give you a personal example from my last job. I worked at an outpatient clinic, so we did have a schedule that patients were expected to come at a certain time, certain day of the week.
And very, very often the families came late and didn't think it was a very big deal at all. So this clinic, most of the families that I worked with were either Puerto Rican or from the Dominican Republic. And in those cultures, they are definitely time-given focused, not time-measured. So being late is really expected. And another personal example, my husband is Puerto Rican, and when we go to his family events and someone says, yeah, we'll start at six, we show up at 730, maybe even eight.
And it's no big deal. We're still not the last ones to arrive. So it really is like a genuine, obvious cultural difference.
But you know, we ran into problems with this when I got a new manager, and she just like did not get why people were arriving late. And it it resulted in a lot of kind of debates and trying to figure out what to do. So unfortunately, I don't think we ever came to a great resolution on that. But what happened often is that we would see the first client of the day a little late, but keep them for the full time. And the next one was late too.
And it just kind of like became a cycle. So. Being late was not considered rude to them though because that's not what they valued.
They valued that they got to do their entire session with the therapist and got to learn and spend that time talking to us therapists and figure out what was going on with their child. So another consideration is that last question on the slide you see, which is who does the communicating? So in some cultures, it's really the husband or the father of the child that typically communicates with schools and healthcare professionals.
So In other cultures, it might be the mother or the oldest person. So maybe it's a grandparent that's coming into the evaluation with you or into the session even every week. And in some parent families, you might have a single parent who is there with their child, but they're not really accustomed to being the one to communicate in those situations. And now they've been thrust into this role by the circumstances that they're in.
So these are all things to think about when you're scheduling interviews, especially during an interview when you're asking direct questions. who do you want to direct them to? We want to be respectful of the other culture.
And we also don't want to make people feel awkward at all, right? And in some cultures where there's a real deference to medical and educational professionals, we need to consider that as well, which is something you don't always see here in the United States. So the point really is that we need to just be aware that these may be differences, and because of them, it may take a few sessions to really get to the bottom of what's going on, and that that's okay. We really just need to show patience.
So lastly, I want you to consider a culture where children are sort of seen and not heard. So is the culture encouraging the kids to be outspoken, independent, or are they encouraged to kind of, you know, stay off to the side? If you're doing an assessment on a child who is from such a culture where they've been seen and not heard for most of their life, maybe now they're five years old and they show up at your office, And part of your assessment is to ask them, hey, look at this picture and tell me a story about it. Tell me about your last birthday party. Tell me about your favorite movie.
We're going to do this test. We're going to look at this book. And you need to tell me what you see in every single picture.
Is that child going to be comfortable in an activity like that? Maybe not. Maybe they don't have any experience in that type of an activity. So once you are trying to calculate the result of that test, is it really accurate?
And the answer is, you know, probably not. That's why we need a really thorough global assessment. We need to consider lots of different things and not just a test score. I'll get into test scores at a later slide. So we talked a bit here about, sorry, we just talked a little bit about different types of cultures and some contrasts that you might come across.
Now let's think about within the child or the patient that you're working with. So there's context to consider here too. What was their socioeconomic status?
Were they a speaker of a language minority or a language majority? This comes up a lot in the United States, right? So, and it depends on geography and numerous other things.
You know, a Spanish speaker here in Phoenix area maybe is not going to feel awkward at all speaking Spanish with their doctor if they know the doctor speaks it. But in rural Idaho, it's unlikely their medical professional is going to be fluent. Or maybe it's not unlikely, but it's less likely than it would be in an area like Phoenix.
So that's something to consider. We have to think about the variations in their language skill level that might be due to language input. What kind of quality of input are they getting?
Is it really just like only TV in English up until they get to the age where they go to school? Is it like once a week just for a couple hours when grandma comes over that they're speaking the home language and the rest of the time it's English? You know, there are a lot of differences that could result in higher or lower proficiency in one of the languages or the other. So these are all things to consider.
You know, some child who's only using their home language for a couple hours a week, we probably don't expect them to be really fluent in that. They'll probably have a stronger level in English. And the opposite is sometimes true as well. So we really have to be cognizant of those differences when we're evaluating, especially, because we don't want to assume that a child has a language disorder when really it's just a limited input, so they never developed that language to its full extent. A couple of other things are the age of acquisition of the second language.
So here I've written L2 and L1 and these refer to first and second language. So age of acquisition also matters. Suppose you get a middle school student who just shows up in your caseload one day and the teacher was worried about their English skills, but they just started learning English last month.
You know, I don't know that that happens too often anymore. I hope not. But it's something to consider, right?
We're not going to assume this child has a language disorder in English when really it's just lack of experience. Differences between the L1 and the L2 also need to be considered. If the two languages are quite different, for example, if you're looking at English versus Cantonese, those are quite different languages, especially phonologically.
You know, Cantonese is tonal, English isn't. If the child's trying to learn both of those and they're having some interference or one language is affecting the other, that's totally normal. And in certain areas, aspects of language, it may be harder for them to get something because the contrast is really great. If the word order is totally different, for example, I can't speak personally to that one because I don't speak Cantonese, but there are many examples of other languages where the sentence word order might be different.
Maybe that's affecting the child's English. And these things are really typical in bilingualism. So we can't really knock the child or think that there's something wrong with their language skills just because of that. Okay, so.
Before we get into definitions of the types of bilingualism, this is a short overview. We have first sequential language acquisition. This is acquisition of the L2 after the L1 is acquired. So remember L2 is second language, L1 is first. Usually the age around three or four is the cutoff that we consider.
So if a child is learning both languages up until before they turn four, usually we can consider that. simultaneous, oh sorry, a sequential, excuse me, a simultaneous bilingual. And if they start the second language after that age, they are sequential, as it says. Please refer to the slide and not my goofed up sentence that I said.
There's also early versus late, right? So if the child is learning their second language later in life, like I did, for example, I didn't start learning Spanish until high school, so I would be considered a late sequential bilingual. And this also refers to adult learners of a second language.
more definitely sequential. Simultaneous language acquisition on the other hand refers to when kids learn the languages before they are three or four years old. So they start at a very young age getting input and using output in both. So both languages are really required simultaneously. So at the bottom here you see a few more and you can probably kind of figure out what they mean from looking at them but we'll go over them pretty quickly here.
So a circumstantial bilingual is basically when the person is acquiring a second language due to their life circumstances. So, you know, maybe they moved at whatever age, their parents moved them to a new country, and they were just kind of thrust into a new environment and had to learn the language. due to their circumstances.
An elective bilingual, on the other hand, really chose to learn and went out of their way to learn. And maybe they chose to move to another country when they were a little older and were able to do that. At the bottom you also see here that we have broad or narrow views of bilingualism. So I think everyone might remember some kid in their high school foreign language class who claimed to be bilingual if he knew just a few vocabulary words. Was he really though?
Do you think so? If you have a really broad view of bilingualism, maybe you do. If you have a very narrow view, though, you might really expect a certain minimum level of fluency before someone can call themselves bilingual, or multilingual for that matter.
So there's a lot of discussion in linguistics and, you know, second language learning literature about what the definition should be, and people have different standpoints. So just consider what yours is. Is somebody bilingual if they know a few words, or do they really need to be fluent? Or does the real definition of bilingual fall somewhere in the middle? So we'll go into more detail right now about simultaneous versus sequential bilinguals because especially if you end up working in the schools one day, either as a speech pathologist assistant or an SLP, these are something you might run into.
So some considerations when you're talking about simultaneous bilinguals. kids are whether we have two linguistic systems or one. Like is this child just like two monolinguals in one?
And the answer you'll see later is really no. But there are some things that are similar. So the milestones that we talked about a few slides ago should be the same. That child should still start talking around age one with their single words, start combining words a little later around age two. They should still be acquiring.
a certain number of vocabulary words as the years go on. And if they're not, that is a red flag. It's not because they're just confused, because they're bilingual. That's a good reason for that child to have an evaluation.
So, this sort of mixing of the two systems, mixing of the languages of the early stages, sometimes parents are a little concerned about that, and they think the child is confused, and they may bring them in for that reason, for an evaluation. So, it's up to you to inform them, you know? It's pretty normal for bilingual kids to switch back and forth, even at a very young age, and even in the early stages.
The most difference you might see is in the phonological systems, because those are considered kind of separate, so those are a little less likely to be affected by this code-switching type of thing. Okay, so for a sequential bilingual acquisition, or a second language acquisition, also known as. There are some stages that children go through and this is something to really keep in mind especially with students or patients that you're seeing who are coming a little later to start learning English.
So they weren't learning English from day one. They're a little older maybe they're five and now they're in kindergarten and they're learning or even older than that depending on their background. So they do go through a series of stages.
The first one which you might have heard of is the silent period. This though There's a little bit of a question currently in the research about whether this actually exists. Uh, so it's something to consider.
That's why I have a question mark next to it there. So, not every child goes through this, and I don't think it should be an expectation. And if the child is silent, maybe there's more to look at than just, oh, it's because they're learning the other language.
Um, the rest though... Usually do, each child does usually pass through them. So you go through kind of a telegraphic period where your sentences might be kind of basic, like, too basic for your age, but that's okay because you're still just learning those words. So, you know, a kindergartner saying like, read book me.
I want you to read the book to me. That's okay because they're really just trying out their new language and their new vocabulary. They might make sentences later that have mistakes and their fluency might not be very good.
So you know those kind of sentences with like uh, um in them, that's okay and it's perfectly normal. Later they're going to get more fluent and maybe have some minor differences. And then lastly they end up fluent and possibly have an accent. This kind of depends on the person and depends on you know different factors.
Not everybody does develop a native-like accent and age has a lot to do with that too, the age at which they were exposed to the L2. So these are some phases that most kids, or most people I should say, can go through when they're learning a second language. We also want to consider though down at the bottom here what happens in a school context because what if the teacher in the classroom is not really aware of these stages or if the parents aren't aware and they're hearings from the teacher that the kids doing this or that. It could be a cause for concern for them. So it's your job as the language expert to go in and explain.
So these stages might be even more apparent in an academic context, right? We need to remember that, you know, language skills manifest differently depending on what kind of programming the child is enrolled into. So I'm not sure if everyone knows this.
Maybe you do. But Arizona is still an English-only education state. So there are several types of sheltered English instruction. There's different types of programs.
But the ultimate goal of all of them here in Arizona is that the child eventually phases out into English only. And that's not true in other states. It used to be the law in Massachusetts and California as well, but it was voted out and hopefully we're voting on this in 2020 and you know the virus hasn't delayed anything too much with that.
But in a fully dual language program for example, the students will have opportunities all day long to show their skills in both of the languages. So you may be less likely to think, oh you know is that a red flag? Does that child have a problem? Because they're able to show you that they're fluent in one of the languages if not. both and eventually the goal is both.
But if they're thrust into an English-only environment where they're really not using the home language at all or maybe the only input they're really getting in that home language is kind of behavior management from the classroom aid who's telling them, you know, go sit down or be quiet in their home language, but it's not really curriculum language, you know, that child might have more difficulty expressing themselves. So we have to consider the context here. Below that bullet point you see Bix versus Calp. So these are two types of language which are introduced by a researcher named Jim, was it Jim?
named Cummins, this was a couple of decades ago and they sort of come under fire recently and I don't know that I ascribed to them but I want to at least tell you what they are because you may hear about this in the future. So Bix is basic interpersonal communication skills and Calp is cognitive academic language proficiency. So researchers question the validity of this and whether there's really a difference or if it's more of a continuum because, you know, can you really say that CALP is a completely separate thing from conversational English, for example?
As you're learning, you continue to develop the language that's going to let you understand academic concepts. But, you know, this researcher a few decades ago said that these are two separate things and CALP might take up to seven years to develop. So.
This is where people are getting a little critical and thinking maybe it is a myth, because, you know, if you're enrolling this child in school and you think there's a seven-year wait period before they're able to do academics in English, well, that's a pretty long wait, and that can have some actual real tangible consequences for that kid. So we are questioning the validity of that, but now you know what it is. And the question there at the end is, you know, can we agree that there is an academic language, and can you learn it?
Because in some of these contexts, especially in sheltered English instruction, maybe the focus is more on conversational and basic vocabulary, and they don't get to that academic vocabulary like they should. So, I want you to think about how this sort of thing might affect the students and how they're evaluated on their language skills. And I don't just mean in a speech and language evaluation, I mean just in general.
So, you know, kids have to take tests in class, they have to do writing, they have to take statewide exams. All those things may be affected. Okay. So lastly for this slide, let's remember adults, right? So we've been talking about kids in school a lot with the sequential versus simultaneous difference.
But we also, you know, we want to talk about an example of an adult. So if somebody had an accident that affected their language skills or if they had a stroke and now they need to be administered a language or a cognitive assessment, we need to think about what stage of acquisition they might be in, whether they... or fluent in that second language before because otherwise we may be misinterpreting the results entirely. Think about how this stage might manifest, right?
And how that's going to affect the evaluator's opinion of how they actually did and what their skills are right now. This is like interviewing families too. It was so, so important.
You've got to know where that person was before the incident occurred in order to accurately evaluate them. So, let's talk about some bilingual effects, because this can really happen to adults or children who are learning a second language, or third or fourth language for that matter. So we talked about those considerations a minute ago for simultaneous and sequential bilinguals.
So let's think about situations when, as the second language is increasing in use, the first language is affected. And sometimes both languages can be affected. So we're going to define some of these terms that you see here.
Language transfer, which seems kind of obvious, but I'll give you a couple of examples. This occurs when the characteristics of one language are affecting the other. And this can occur in simultaneous and sequential bilinguals, adults and children, right?
So here are a couple of examples. Negative transfer is when you're leaving something out. So, for example, if somebody is a native Spanish speaker and they're learning English, and they're trying to say that it's raining today, they might say, Today is raining. Why?
Because in Spanish, está, it is, is just one word. So, you might say, hoy está lloviendo. Today it is raining. So, that transfers over to English, where they might think there's only one word there instead of two. This is an example of the negative transfer, because they're leaving out a word.
Now, another example would be in Russian. There is no such thing as these copulary verbs that end in"-ing", in Russian. So, sometimes a Russian speaker who's learning English might say, you know, I walk to the store.
Whereas a native speaker of English might phrase it as, I'm walking to the store. And that's because these ing verbs just don't exist in the Russian language. So, those are two examples of negative transfer.
Positive transfer occurs when sentence structure or other characteristics of the two languages are similar. So, one is sort of boosting your use in the other. So another example from Spanish would be if you're using a cognate vocabulary word. So someone's saying, you know, we went to the restaurante or we went to the restaurante and they're using that, you know, knowledge that the word restaurant means restaurante and it's helping them express themselves more clearly because, you know, you're getting a positive transfer of that vocabulary word from one language to the other.
Okay, so some of these are a little less familiar, the rest of the list. Nonlinear growth, for example, just refers to when the development and the advancement of the second language doesn't happen in a linear, always increasing way. Growth for kids especially, but actually for everybody depending on what context you're living in, can be affected by the circumstances you're in. So let's think about a child who goes to their home country or their parents'home country for summer vacation.
And during that period of time, they are not using English at all. They are only using the home. country language.
Then when they return in the fall, their English growth picks up again. So in this scenario, they sort of went, you know, learning English, learning English, summer, learning English, learning English. It was not just one straight shot increasing. And, you know, this happens in both directions. So attrition, for example, is when the first language atrophies.
So in this case, the speaker might lose some of their proficiency. And this also can happen in the context I just described. So somebody, for example, like me, when I moved back to the United States from abroad, my skills in Chinese, which I was trying to learn, and Spanish did get a little rough around the edges because of lack of use.
This happens with children, too. You know, skills that they once had, if they were falling into disuse, might atrophy. So that's language attrition.
Protracted development is similar but not exactly the same because in protracted development you're assuming that eventually they will develop the skill. It'll just be at a later or different pace or sequence than they would have. So this is when the skills in one of the languages don't develop on the expected timeline.
So for example, if a Spanish-speaking child goes to the United States at the age of four and begins English, but doesn't develop the use of the subjunctive form of verbs, for example, until sixth grade, We really expect them to do that earlier if they were in, you know, using Spanish all the time and developing completely like at a normal rate. There are no interruptions. But they do develop it eventually and maybe that's because over the years they cumulatively had enough input in Spanish.
So this would be an example of a protracted development. So it just happened a bit later, but it still happened eventually. Incomplete acquisition sort of similar to protracted development except they never do reach that milestone.
So they don't fully acquire the subjunctive. You know, for whatever reason they were not using Spanish or they were not having those conversations that require the subjunctive very often and that skill, that grammatical skill, just did not quite fully develop. So the most important thing to remember from this slide is that none of these things signal a language disorder. So the characteristics though often do overlap with those of language disorders. So these are just some of the considerations you're going to learn about more specifically if you do end up pursuing a career in speech-language pathology especially.
Especially with a Grado 2 assessment. So, you know, somebody might have skills or deficits in their skills, but it's not really because they have a disorder. It's because of one of these things occurring on this slide. So we really have to be considerate, cognizant of those when evaluating.
So a final question for you on this slide is if a child is referred for an evaluation at your school or clinic for the limited language skills, do you think it could be one of these issues? And if so, do they really have a disorder? So hopefully you'll agree with me that they probably don't, but we're going to do an assessment anyway and just make sure.
Okay, so let's talk about levels of proficiency a little bit. This is the last thing we're going to talk about before we dive into clinical issues. But language proficiency, just like the things we talked about on the previous slide, is really important for assessment and when we're trying to distinguish between a difference and a disorder.
We have to know that person's proficiency level. This is especially true for adults who may have had a certain proficiency level before they had a stroke, for example, but afterwards you've really got to interview their family and interview the people they know to find out what it was. It's also important for children. This should always be considered during an assessment of language and hearing, too, because remember, when you're assessing hearing, you might be giving someone directions, assuming they're fully proficient in English, and if they don't notify you, oh, I'm not sure what you said.
then how can you know that your results are accurate if they weren't sure what the directions were in the first place? If you were supposed to be raising my hand when I heard the beep, or was I supposed to be doing this or that? Maybe they don't know. So, here you see a few definitions that are related to proficiency, and proficiency is synonymous with fluency in speaking and understanding the other language. So, the idea of dominance is kind of falling out of favor, but it really just refers to the language that's more accessible, and it varies a lot by context.
Especially with adults. So I'll give you an example from Dr. Estrapo actually in our department. She said many times that she's much more readily able to discuss speech-language pathology topics in English and that's because she was educated in the field in English and her research career has been in English for the most part. So that's the language she used to learn about those topics and for that reason it's a little more accessible when she's just discussing them.
Whereas Spanish is actually her first language that she grew up with. So, this sort of relates to the next bullet, which refers to the fact that bilinguals have strengths and weaknesses in the different components of languages. So, it's really rare to find someone with perfectly equal fluency or perfectly equal skills in all areas, such as grammar, vocabulary, pronunciation.
I mean, it's a quite rare thing if you meet someone who's exactly the same in both. I think it's a lot more common for people to have varying levels in different things. And they're really all individual and just relate to that person's personal experience learning the two languages. So, this actually brings me to code switching, the next thing on our list here, because this is something very normal, and it doesn't always mean that the person didn't know the vocabulary word or lacked that skill in the one language but not the other.
It's actually a very rule-governed system that bilingual people use. We can even use it sometimes as part of an assessment because if somebody is breaking the rules of that rule system it's a bit of a red flag actually. So it's something we need to remember though, it's very normal and for those of you who are listening today who are bilingual I'm sure you've done it many times. Code switching within the same sentence or same conversation with your friends, going back and forth between either dialects or languages.
And it's a very typical thing, and it doesn't always mean that you don't know that word, how to use it in that situation. Sometimes it's just the natural thing to do in that conversation. So, like I said a moment ago, though, we can actually use it as a red flag in some cases.
So speaking of those, we have to consider the ability level and the characteristics of the language system of the child or adult that we're meeting and evaluating. So for example, somebody with a language disorder is going to have difficulty with proficiency, but in both of the languages. That's really the key. If it's only one and not the other, they're completely fluent and fine in one, then that's not really a language disorder, right?
It just means that they haven't fully reached a proficient or fluent level in the other language. So for example, if a person's communication is impacted by a hearing loss or a developmental language disorder or by aphasia, which is what might happen if you have a stroke, These all must be considered when you're making a judgment about that person's proficiency, because you're discussing an intact system versus an impaired system, so your expectations might be different. So just to wrap up the previous few slides, we can say that bilingualisms are not two monolinguals in one.
We cannot take a test score or look at only one of the languages or look at both and expect that child or adult to be perfectly fluent just like a monolingual in both of them at the same time. They are not two monolinguals in one. That's really key to remember.
And for that reason, we really can't take... test scores and things like that at face value, we have to consider the context of the whole person. But believe me, some people will still try to use only that test score to make a judgment. So this is most important in diagnosis, right? We can't use a score from an English standardized test, even if a child is bilingual, because it really doesn't reflect...
that child's skills are not going to be the same as a monolingual English-speaking child who was speaking English since day one. different things go into that score. So taking their score in an English test is not appropriate because that child does not match the sample of kids that the test was normed on. And also, it's something we need to think about ongoing, not just on the day of that first assessment.
Proficiency levels can change over time depending on what's going on, right? Earlier we talked about when kids go back to, you know, Mexico or wherever for the summer vacation. And after the summer of visiting family, maybe their Spanish skills are now like, woohoo, doing great.
and are more fluent than English, but then by May, after nine months in school, English is now a little bit more fluent than Spanish. Does that mean this child has a disorder? No, but it is something to consider for assessing their language skills.
So you can see here that there are real practical implications about how we describe, how we recognize bilingualism in the field of communication disorders, and it might have real tangible effects on a student or a patient's life. Okay, so time to get a little more clinical here. This slide doesn't really have a title, but it's about assessment.
So I've mentioned a couple of times that we can't really use standardized tests with bilingual people if they were normed on monolingual groups. So here I just have a few examples of some tests that are available in other languages. You see in the bottom left, we have the BESA. This is actually one of the few tests that are truly bilingual, like the child answers in both languages. is allowed to answer in both languages for certain parts of the test.
So this stands for the Bilingual English-Spanish Assessment, and that's a really good tool to have available. It's one of a very small group of tools. We also have standardized tests that are, you know, in one language or the other. So in the bottom right here you see this CELF, which is the Clinical Evaluation of Language Fundamentals. This is the preschool Spanish edition.
However, we have to remember that this edition was actually normed on a group of monolingual Spanish-speaking kids, not bilingual. So when we administer this to a bilingual preschool student, we can't really compare those scores to the normative sample because our child is bilingual and the normative sample is monolingual. So these are all things to remember. So though a test like that can give us some information, you should never stand alone. On the upper right you see one of the aphasia tests that's also available in Spanish, but the same reasoning applies here.
If it was normed on monolingual speakers, you really have to reconsider whether you even want to report that score. And really you shouldn't. So you might get some information, but it will never ever be a standalone evaluation. You have to do more. So in the top left, I have a couple of other alternatives that are not standardized tests, but they're methods that we use.
So language sample analysis is a great one that can be used with children and adults. And this is a really useful, although time-consuming thing, where you're really getting either a conversational or a storytelling language sample from the child or the adult. And that's going to give you a little more information about what they are able to come up with and how their language skills sound at kind of a more of a global level than on a really static skill that's looked at on a test.
Dynamic assessment, the second one you see there, is another method. This one is typically used with children and the format is kind of a test teach test format. So you're testing a skill, teaching it, and then retesting it to see if the child learned it.
So this is really useful because you're actually looking at their ability to pick something up rather than their skills at a static point in time. And a lot of these things have been found quite useful with bilingual children especially. So the main point is, and as you continue your education in this field, you will learn this more and more, but no test really stands alone.
We need to use a variety of methods to evaluate patients and students, and we have to look at converging evidence before making a diagnosis. So stuff like this can help you, but you also need to be interviewing. You need to be, you know, listening to that person talk and communicate in a natural setting, too. Okay. So what about language policy?
I mentioned a little while ago about how Arizona is one of the English-only states in the education system here. We're going to talk about this at a societal level too, not just schools. So we talked about how policies might affect bilingual speakers and we're going to dive a little deeper.
So there is some research out there showing that dual language programs in schools are as successful as English only. But as I mentioned, Arizona, we're still an English-only state. And there are states who had this policy in the past but voted it out, and I believe I mentioned California and Massachusetts as examples.
So here in Arizona, ELL students, or English language learners, though they might be placed in more of a 50-50 setting with the two languages, the ultimate goal is always to phase them out of that and get them to English-only within a few years of when they start school. this is really the key difference. So parents who want a true dual language program have to find a private school in Arizona to do that.
So if you yourself were bilingual back in elementary school, middle school, or high school, I want you to think back to then and think about how this policy might have affected your trajectory. Did you grow up in Arizona? Were you put into English only right away?
And what was that like? So if anyone would like to share, maybe we can get a Zoom chat or a discussion post going about that too. Because personal experience can really tell us a lot. So think about how that affected your school life, what you thought about school even.
And think about whether if a more comprehensive dual language program was available, would you have wanted to do it? And if you did one of those such programs, did you like it? What did you think? So let's hear from some people in class here. We also want to consider when talking about this.
The attitude toward the home language that kind of manifests when a policy like this is in place. So, the schools are kind of showing, like, the home language is not a priority for us, English is. But then, when you get to high school, you're typically required to take a foreign language class, right, as part of your curriculum.
So, isn't this a bit contradictory? You have to admit, this sends a bit of a mixed message about which languages are really worth learning in the schools, right? So...
For adults, this kind of prescriptivist attitude exists as well. So the United States doesn't actually have an official language, but English is the assumed official language, and I think we can all sort of agree that this assumes that it is. So think about what happens for people in a job interview or when writing a paper for a college class. If English isn't the person's first language and they make some transfer errors or something like that, or if they have an accent, how does this affect them in the real world? These are all things that...
happen to people on a daily basis. And if you're more interested in this topic, I really do encourage you to look into sociolinguistics courses and, you know, more research in that area because it comes up a lot. So this is just an old podcast from a while back, from October, but it's just kind of an overview of the English-only policy here in Arizona, so I won't talk about this too much.
This is supposed to be up for voting again in 2020, so you know keep your ears and eyes open on the news and see we'll see what happens and hopefully they actually do the vote and it's not delayed by the pandemic. Okay so what are the effects of policies like this? Well we just talked about the kind of message it's sending right, but for students you know we see a little summary here of the effects that we've been talking about. So It can affect their language development. If you're thrust into English only, now you have less time in the day to be using your home language.
Well, we talked about protracted development and language attrition before. These are some things that can happen. All these things can affect academic achievement, cultural identity because of those mixed messages about which languages are worth learning, and also just resources within the individual. The second part for adults in the workforce, just a little summary as well.
Think about how this affects people with customer-facing roles and job interviews, promotions. If you have an accent, maybe you have personal experience in this area, and it's really too bad. So again, if this is something that interests you, I really do encourage you to look into sociolinguistics coursework. And also, if you continue in communication disorders, really make sure you take these multicultural and bilingualism classes, because they can really... dive deep into these matters when it comes to assessing and treating our patients and students.
Okay, so let's kind of come back to our main purpose here, right? So why are we studying these topics? And we talked a lot about sociolinguistic topics today, but why do we study these in SLP and audiology?
Well, we have to define what's normal across languages, dialects, and cultures, right? This improves our differential diagnosis. The more we know about different languages, different dialects. The more we will know when something is happening that's typical, something expected, that's an interference or just, you know, the usual code switching versus an actual language disorder.
Next, we need to understand cultural and socialization practices so that we can assess people better, design intervention better, and, you know, really grasp what's going on. That's when we need to consider those factors and interviews and who we're talking to and how many times might we have to have a meeting before the person really opens up, all that sort of stuff. And last, our main goal really, which is to reduce the over-identification and under-identification of people with communication disorders.
And this really does apply to both. So I know I'm very focused on the SLP, but for audiologists, you know, we don't want kids to start in school who have a hearing loss and they remain undiagnosed because teachers and school staff just thought, oh, it's just taking them a little longer to learn English. It's no big deal.
But really, it was because they couldn't fully hear. So these things happen and it's really unfortunate. So we're trying to teach the next generation of therapists and audiologists so that we can avoid it.
Okay, so again, why are we studying these topics? Difference or disorder? So a lot of things come into play here. With Spanish speakers in schools, for example, we need to talk to the families, know what's going on.
That way we can recommend bilingual programs or therapy or the appropriate language for therapy and so on. We also need to think about the role of culture in our clinical decisions. So if you're working with adults, you have a dysphagia patient, you know, you have to talk to the family about diet before you're recommending something. Even the word list when you're doing an audiology exam, maybe you are having them identify words, but one of the words could be offensive in their culture, or you're using a word that you think they'll understand, but really it's, you know. Mexican Spanish, not Ecuadorian Spanish, which is what they speak.
These are all things we have to be considering. So when I initially gave this lecture live, we did a word cloud for this one, but again I'm just going to have you either stick some ideas in the Zoom chat or in a discussion post here. So what are some of the considerations that SLPs and audiologists should have when working with bilingual and multicultural clients?
So this is just kind of a check. to see if you've been listening so far, some of the things that we need to consider. And I'm just going to give a couple of minutes for people to fill this out, and then we can go over what the usual responses are that I get. Okay, so hopefully people are chiming in a little bit now. And some of the things that I often hear in this one is, you know, Knowing the type of culture that the person comes from.
For example, is it time given versus time spent? We need to know the proficiency level in the language and that's for language clients and audiology clients. We need to know cultural values because that's going to inform your treatment objectives and treatment activities, for example. So these are all some things that we need to consider.
We also need to consider proficiency levels in the languages and how those have been affected by a context and changes in that person's life. We need to take all of these under consideration when doing an assessment but also when developing a treatment plan because that's more long term. So to summarize yet again, we need to determine whether the person has a language difference or a language disorder. If it's a language difference, we're not referring them.
That's not something that we work with. We are in the land of communication disorders, not differences. We need to determine the appropriate services if there is a disability identified. We need to set appropriate treatment goals. We need to work with family members and include them in the treatment process in a culturally responsive way.
And this is really important with children and with pediatric clients especially. And lastly, we need to value the goals and the input of the patient or the student and their family. We can't just go sticking to our usual goals on with...
No regard. We need to learn about their culture and learn what they want to work on. Learn what's going to motivate them to really progress in therapy.
So, that last one, I just want to comment again because it really is so important. And this really applies to adults and children. I know my experience is in pediatric, but when you're working with an adult who has had a stroke, for example, or who even has a hearing loss, you know, you really have to get the family involved.
Even though in the United States, as adults, we tend to kind of go off and do these things on our own. If a person is really, you know, in a rehab and trying to achieve their prior level, The family has got to be involved in a big way. The family members are going to come to you with their concerns. You know, maybe someone had a stroke and they were starting to learn English, but they kind of like gave up or they're not that fluent yet. They're going to ask you, is it going to confuse him to keep doing that if he's just trying to get regular language skills back?
These are the sort of questions that come up for therapists, for language therapists, and maybe for, you know, mental health therapists too. But you need to be able to answer, especially with parents. You often get people asking if their child is going to be confused because they're hearing two languages.
And the answer is no. The child's having a problem in both languages. That may be a red flag, and it's not the bilingualism that's causing it. So your job is really to, you know, be an information giver in a culturally appropriate way.
But you need to share that information with them. And that means you need to know that information. We'll talk in a couple minutes about judging your cultural competence and some resources to improve that. But that's really important as you're going out into the field.
And that's true in any field. I know that you guys are undergrads, and some of you may continue in SLP or audiology, and some may go to some related profession, or not do this at all. But if you end up working with families in the future, these are really general topics that a lot of different professionals need and use.
Okay, so in service delivery, we have to consider what kind of services are linguistically and culturally appropriate, right? Are we providing services in the home language? Let's think about the age of the child, the school. In early intervention, it's different. We're going to their home.
So is that considered appropriate? Some families would rather bring their child to an office than have you go to their home or vice versa. Sometimes they don't want to go to the outpatient.
They'd rather have you come. So those are some things to think about when picking up new clients, uh, children. And if a child is going to English-only school, should we do therapy in the home language and English or just English? Some things to think about.
Think about in your past, too, if you ever knew anyone who was in speech therapy who was bilingual. What did they do back then? Um, you know, these are more questions.
Who should I talk to when I'm providing audiology services to adults? Depending on their home culture, should I be speaking directly to the wife or to her husband or to both? What if I'm a monolingual therapist or audiologist? And then what do I do? What if my new patient doesn't speak English?
What am I supposed to do? So these are things that come up a lot, too. And these are real-world questions that you will come across. It's not a question of if.
It's a question of when. So you need to know how to answer, right? A lot of these are really individualized and it depends on the family and what their goals are too. Remember, the family is always going to be part of the team with you, whether it's an IEP team or a rehab team or whatever.
Their input matters and you've got to consider it. So that can help you answer some of the questions here. But the big one that I get a lot from my peers, my therapist peers, is if I'm monolingual, what the heck am I supposed to do when I get this new patient or, you know, student who doesn't speak my language? So let's talk about that for a minute.
First, let's see what ASHA says. Is everyone familiar with ASHA? I think maybe some of you are familiar with NSHLA, which is the National Student Speech Language and Hearing Association, and ASHA is the American Speech Language and Hearing Association, which is kind of the umbrella. NSHLA is like our little sibling, I guess.
So ASHA, though, really sets the rules for practicing speech pathologists and audiologists. And they do have an entire section on the website that relates to providing services for bilingual clients. So I encourage you to look at that, especially after class when you have some downtime, if you're interested in what the answers are to these questions. So I just want to highlight one section of this here and kind of go over it.
So I do want to actually give you a moment just to read this to yourself, though. So just take a moment and read. the rest of the slide and see what you think and if you in the future might qualify as somebody who's a bilingual clinician or you know what you would do if you're not. And remember, if you're bilingual, it doesn't mean you're bilingual in every language that you'll come across, so you have to be able to answer that question either way. So take a moment.
Okay, so hopefully you've read through here, but I really want to draw your attention to one of the sentences at the bottom in that red square or red rectangle that I have, and that is that the clinicians are obligated to provide culturally and linguistically appropriate services to their clients and patients regardless of the clinician's personal culture, practice setting, or caseload demographics. So what does that really mean? Well, first of all, you need to know what culturally and linguistically appropriate services are.
appropriate services are, right? And second of all, you need to provide them. So if you're trying to refer out to another therapist that you know in your city, for example, who does speak the language, there's always a chance they won't have room on their caseload and can't take this kid.
And that means that you're going to have to step up, basically. So I was asked this question, you know, what to do many times, but my colleagues at my outpatient job in particular, So when a child would arrive in the clinic, the therapist didn't speak the home language. And the answer is you either refer them to another therapist who does. So at that job, I got these referrals a lot. But, you know, there were times when my caseload was completely maxed out and I could not take another kit on.
So in those cases, if we didn't have anyone in a different clinic to refer to, then my colleagues did end up doing the work with these families. They just had to, you know, use the interpreters or, you know. Talk to family members over the phone who did speak English, even though maybe the family member who brought the child didn't.
A lot of different things. The answer to the question, then, is you adapt. So if there's no one to refer to who does have the native-level language skill in the child's language or the patient's language, your job is to adapt, right? You are obligated to provide that service if this person has a communication disorder that you can treat.
So by adapt, I mean use whatever resources are at your disposal. So that includes interpreters, which I mentioned here on the slide, indirect strategies such as parent trainings, even including siblings in your sessions. If they come after school, that would be great. Oh, and especially if you do early intervention, because you are at home with them, and that's a perfect opportunity to include family members. So adapting can take a lot of forms.
The important thing, though, is that you don't leave a family hanging just because... you don't speak their language or come from the same culture as them. That is the real main takeaway here. So how do you know if you're culturally competent enough or fluent enough in the language that you can provide these direct services without needing outside support or indirect methods?
So ASHA does have some advice about this. They do have an entire section on the website on self-assessment for cultural competence. What's interesting about ASHA is they Don't actually have a language test for any languages that you need to pass in order to call yourself a bilingual therapist. Certain states do. I know New York does.
I think Arizona does, too, if I'm not mistaken. But basically, ASHA, as our national organization, does not require that. It's just recommended. But I do encourage you to get on the website.
The address is up here. ASHA.org slash practice slash multicultural slash self. And they've got some checklists, some awareness tools, and they also have links to professional development, which I know you may not be there quite yet in your career, but in the future I do encourage you to look at these things because not every graduate program offers coursework in this area, and ASHA may be able to make up for what your program lacks. So, this checklist that was just linked to on the previous slide, these are just some examples of the first half of the checklist.
I just couldn't fit it all here on the page. But I want to just take a minute and look at these and think about how you would rate yourself. So the ratings are up in the top left.
So one is you strongly agree all the way to five, which is strongly disagree. Three is neutral. So, you know, read through some of the ones, especially on the left, and see how you would answer. And then up at the top you see that there is no answer key, but you should review responses that you rated 5 for or even 3. Because this might indicate a lack of cultural awareness in that area or, you know, just some need for more personal reflection or need for more, you know, either awareness training or even just making a friend from that community to help you to help you open your mind a bit. So I have the link here on the slide and I encourage you to check that out if you have some spare time.
And this will just give you just a general sense of kind of where you stand when it comes to these issues. Okay, so we are nearing the end here. We've gone through a lot of topics today and now it's time to wrap up.
But one of the main takeaways today is that you as future SLPs and audiologists, you've really got to do your best to be culturally aware. And not let your personal biases or even just simple ignorance let you misdiagnose or improperly treat a patient or a student. So we don't have any evidence that bilingual intervention or education delay English development.
There's no evidence that simply being bilingual will confuse or cause problems for a child or adults. And what one really needs to maintain their bilingualism is enough input and opportunity to use the languages. So if this child's having problems or this adult's having problems in both languages, that's more of an indication that something is going on. Bilingualism in and of itself does not cause people to be confused.
So that's a bit of a wrap-up of the lecture, but I do have a couple more things for you before I let you sign off. This next slide just has some suggested readings. So in the top left you have some demographic information about ASHA members and I encourage you to check that out because we as a field are not very diverse.
I'll just be blunt about that. Most speech-language pathologists and audiologists are white middle class or upper middle class women, like myself. So we really are trying to diversify and ASHA does have some efforts going on to do that, but like anything it takes a long time. Check that out though, and if you are from a minority community, or if you're a guy or anything that's not that typical SLP, I really encourage you to pursue this career because we need diversity.
We need people who understand other cultures, and we also just need some variety in our lives, right? So I encourage you to check that out, and just the ASHA website in general. There's really a wealth of information on there.
You also have my email address here in the middle if you want to discuss any of this stuff. or even just like career, looking for opportunities that will let you work with families who are bilingual and multicultural, please shoot me an email. It's mpierc12 at ASU. And then below I have a couple other websites in addition to ASHA. This is Two Languages, Two Words world, excuse me, is actually a blog, but it's run by Elizabeth Pena and a few other researchers, and there's a lot of information on there that's really great, just about assessments and pros and cons of different things and strategies that we use in the field.
And also just posts about bilingualism in general. Leadersproject.org is another one that's kind of similar. There are a lot of resources about bilingual development on there. This is run out of Columbia University in New York by one of their faculty, and it's got some materials as well. And then the last one is Bilingualistics.com, which is actually a contract agency.
So they... you know, employee SLPs, and they have some information on the site as well. And then other than that, I have a few books over here.
So this one, Dual Language Development and Disorders, was a book I actually bought because I never took this class on this material when I was in grad school. It was actually not offered in my program at BU. And I ended up having to kind of self-teach and cobble together some program for myself through Continuing Ed.
So this is a book that I owned. It was one of the first ones I got on the topic. It's really helpful and it's also written in some nice plain language so even if you're not quite in a master's yet, it can still give you some great info if you're interested. The other two are less SLP related but more just about, you know, cultural differences and language differences in society. Unequal Childhoods relates a lot to the education system and home life, whereas the other one here, The Spirit Catches You and You Fall Down, is a story about a family dealing with the medical.
institution in the United States, and they're from the Hmong culture, and they ran into quite a lot of problems with the medical institutions. And that is pretty much it, but the very last thing, and I promise it's the last thing this time that I have for you, is actually a short story. So we're not going to discuss it since this is a recording, but you can always feel free to in either a Zoom chat or a discussion post on campus. But I'm just going to read it out loud, and I hope it gives you some final thoughts about things to consider as you're moving forward in your studies and in your career. Because you're only a student for so long, and soon these will be real-life problems for you, even if you go into a related field that's not SLP or audiology.
So the story is called The Sunglasses. And it's by a guy named Michael Mercil, whose info I have at the end. So I will just read it out loud for you. So, imagine that in your country, from the time of the first people, today and far into the future, everyone that has ever been born or will be born was born with two legs, two arms, two eyes, a nose, a mouth, and a pair of sunglasses. The color of the lens in the sunglasses is yellow.
No one has ever thought it strange that the sunglasses are there because they've always been there and they are part of the human body. Everyone has them. Take the yellow sunglasses off and look at them.
What makes them yellow are the values, attitudes, ideas, beliefs, and assumptions that people have in common. Everything that they've seen, learned, or experienced in the past, present, and future has entered into the brain through the yellow lens. Everything that has been filtered and interpreted through all these values and ideas that have made the lenses yellow.
The yellow lens thus represents our attitudes, beliefs, values, and represents our culture. Thousands of miles away in another country from the time of the first people today and far into the future, everyone that was ever born or will be born was born with two legs, two arms, two eyes, a nose, a mouth, and a pair of sunglasses. The color of their sunglasses is blue.
No one has ever thought it strange that the sunglasses are there, because they've always been there and they're a part of the human body. Everyone has them. Everything that the people see, learn, and experience is filtered through their blue lenses.
A traveler from the first country, of the people with the yellow lenses, who wants to go to that other country may have enough sense to realize that to learn about that country and its people more thoroughly, He will have to acquire some of those other sunglasses so that he can see and really experience life and culture there. When the traveler arrives, he wears the other sunglasses, stays for a few months, lives with the people, and feels he's really learning about the values, attitudes, and beliefs of the people of that country. He actually sees that country and the people as he is wearing their sunglasses. He comes to his own country and declares that he is now an expert on that country.
and that the culture of that country is green. He didn't remove his old filters of yellow. The moral of this fable is, before we are open and free to learn about another culture and put on their sunglasses, we have to remove our own, so that our interpretation of the new culture will not be colored or filtered by our own values, attitudes, and beliefs.
We are not there to judge another culture, but to learn about it. We need to develop double vision. or the ability to see more than one side of an idea. How do you remove the yellow sunglasses? By trying to understand and describe the values, attitudes, beliefs, ideas, and assumptions of your own culture.
The lighter the yellow color becomes, and the more blue the other culture becomes. The more we can verbalize and really understand what it is that makes us who we are, the easier it becomes to lighten the yellow filters, and put on the blue lens, and see a truer shade of blue. and accept that it will never be fully blue. So I'll leave you with that.
And I thank you for listening today and joining me for this recording. And I hope everyone was able to input some information into a chat box or discussion posts. And again, please feel free to email me if you have any questions at all.
And it was a pleasure joining you for your class today. Thank you.