Recognizing that we all have and represent a culture is an important step. It's important to be aware of the many cultural variables that can impact assessment and intervention. ASHA has produced a variety of statements and guidelines concerning cultural and linguistic diversity (ASHA, 2013, 2014).
Some of the cultural variables that may influence the perceptions and behaviors of both individuals and clinicians are age, gender, occupation, sexual orientation, disability, socioeconomic status, religious beliefs, and ethnicity.
Rules for verbal and nonverbal communication may vary across cultures. For example, gestures and their meaning may vary from culture to culture. A gesture indicating a positive behavior for one culture, such as a "thumbs up," may be viewed as inappropriate in another culture. The communication roles that partners play also may vary with cultural expectations. For example, helping a child to initiate communication more often may not be valued by some cultures. Silence may be perceived as a sign of respect for a communication partner, rather than a failure to respond or understand. The linguistic diversity of individuals may affect aspects of communication, such as vocabulary, dialect, and beginning literacy.
Individuals vary across cultures, but they also vary within a culture.
Service providers should attempt to be as knowledgeable as possible about individuals' cultural backgrounds. Perhaps the most important consideration for practicing clinicians is that culturally based differences in communication may not necessarily be considered deficiencies or disorders.
With an increasingly diverse population, it is necessary that individuals providing for the communication needs of persons with severe disabilities become sensitive to cultural influences.
Family preferences regarding cultural priorities should be reflected in the service provision (ASHA, 2013, 2014). Issues of respecting cultural and linguistic heritage in all communication services have received attention recently, with emerging inclusion of parental perspectives on language use (Yu, 2013).
Although guidelines suggest that instruction in an individual’s first language helps build a strong base for further language instruction, including AAC, there is limited research supporting the specific strategies involved in teaching AAC (Harrison-Harris, 2002) to individuals from multilingual backgrounds. Therefore, we recommend working closely with the family and other members of the team to provide the child with opportunities to communicate both at home and at school in the language that will be most effective within those contexts.
This may mean using different systems or a different set of vocabulary across settings at some time during the course of instruction. Careful data collection will help guide the team regarding the use of multiple systems. For example, if an individual using AAC is using symbols and text in his or her first language, data are needed to evaluate how well school personnel respond to the individual's first language. Similarly, if two different systems are used, the team may consider whether the individual responds less often (perhaps due to confusion). The clinician and team members will need to create their own data set to make decisions that are best for the individual.
For persons who live with families that speak another language, multiple language factors need to be taken into consideration. The individual must have access to opportunities to communicate both at home and at school in the language that will be most effective within those contexts.