Table Of ContentDolores E. Battle, Ph.D.
Professor Emeritus of Speech-Language Pathology
Buffalo State College (State University of New York)
Buffalo, New York
With 16 Contributing Authors
3251 Riverport Lane
St. Louis, Missouri 63043
COMMUNICATION DISORDERS IN MULTICULTURAL
AND INTERNATIONAL POPULATIONS ISBN:978-0-323-06699-0
Copyright © 2012 by Mosby, an imprint of Elsevier Inc.
Copyright © 2002 by Butterworth-Heinemann, an imprint of Elsevier Inc.
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Library of Congress Cataloging-in-Publication Data or Control Number
Communication disorders in multicultural and international populations / [edited by] Dolores E. Battle ; with
16 contributing authors. — 4th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-323-06699-0 (hardcover : alk. paper) 1. Communicative disorders—United States. 2. Transcultural
medical care—United States. 3. Multiculturalism—United States. I. Battle, Dolores E.
[DNLM: 1. Communication Disorders—ethnology. 2. Cultural Diversity. 3. Linguistics. 4. Speech-Language
Pathology—methods. WL 340.2]
RC423.C6425 2012
616.8595—dc23
2011021819
Vice President and Publisher: Linda Duncan
Executive Editor: Kathy Falk
Managing Editor: Jolynn Gower
Developmental Editor: Lindsay Westbrook
Publishing Services Manager: Hemamalini Rajendrababu
Project Manager: Anitha Sivaraj
Design Direction: Margaret Reid
Printed in United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To my family, especially my husband Charles and my children Leslie
and Clark, and to the many individuals with communication disabilities
and their families, and the families of mankind that connect us all and
remind us that effective communication is both a responsibility and a
right for all.
Contributors
Zenobia Bagli, Ph.D. Sharynne McLeod, Ph.D.
Audiologist Professor
Gaithersburg, Maryland Research Institute for Professional Practice, Learning
and Education (RIPPLE)
Tachelle Banks, Ph.D. Charles Stuart University
Assistant Professor Bathurst, New South Wales, Australia
Special Education
Cleveland State University Thomas Murry, Ph.D.
Cleveland, Ohio Professor of Speech Pathology and Supervisor of Speech
Therapy
Dolores E. Battle, Ph.D. Department of Otolaryngology–Neck Surgery
Professor Emeritus of Speech-Language Pathology Weill-Cornell Medical College
Buffalo State College (State University of New York) Cornell University
Buffalo, New York Adjunct Professor of Biobehavioral Sciences
Teachers College
Mara Behlau, Ph.D. Columbia University
Permanent Professor, Graduate Program in Human New York, New York
Communicative Disorders
Universidade Federal de São Paulo–UNIFESP Constance Dean Qualls, Ph.D.
(Federal University of São Paulo) and Centro de Estudos Chair and Professor of Speech-Language Pathology
da Voz-CEV (Center for Voice Studies) State University of New York College at Buffalo
São Paulo, Brazil Buffalo, New York
Li-Rong Lilly Cheng, Ph.D. Tommie L. Robinson, Jr., Ph.D.
Professor Scottish Rite Center
School of Speech, Language and Hearing Sciences Children’s Hearing and Speech Center
San Diego State University Children’s National Medical Center
San Diego, California Washington, D.C.
Priscilla Nellum Davis, Ph.D. Carol Westby, Ph.D.
Professor Bilingual Multicultural Services
Communicative Disorders Albuquerque, New Mexico
The University of Alabama
Tuscaloosa, Alabama Freda Campbell-Wilson, Ph.D.
Head of Speech Language Pathology
Helen Grech, Ph.D. King Faisal Specialty Hospital
Co-ordinator, Communication Therapy Division Saudi Arabia
Institute of Health Care
University of Malta, Malta Toya Wyatt, Ph.D.
Professor
Ella Inglebret, Ph.D. Department of Human Communication Studies
Associate Professor California State University Fullerton
Department of Speech and Hearing Fullerton, California
Washington State University
Pullman, Washington
Hortencia Kayser
Director of EBS International
EBS Healthcare
St. Louis, Missouri
v
Preface
When the first edition of this textbook was published in United States were born in another country. Nearly 96%
1992, the United States and the world were different places of residents of the United States speak English well or very
than what they are today. We have all become more aware well, yet nearly 18% of residents older than 5 years speak a
of the world around us. In the past 20 years, we have seen language other than English at home. According to the 2010
wars in faraway places, such as the Persian Gulf, Iraq, and Census, although Spanish is by far the most common home
Afghanistan, being broadcast into our living rooms. We language of residents, there are more than 150 languages
have watched conflict as Bosnia and Herzegovina seceded spoken in the homes of residents.
from Yugoslavia and as Cairo and other nations in the Middle The U.S. Census Bureau recognized the increasing
East and Northern Africa underwent political change. We have diversity of the country by the realignment of racial and
witnessed genocide in Rwanda and Somalia. The way we ethnic groups on the 2000 Census. The realignment recog-
travel has been changed by threats of terrorism and the need nizes that people are either Hispanic or non-Hispanic by
for security screening at airports. And yet we celebrated global ethnicity and that they may be of one or more racial groups:
harmony in the Olympic Games in Beijing, Sidney, Calgary, black or African American, white, Asian, American Indian,
and Vancouver. Alaskan Native, Native Hawaiian, or Pacific Islander. When
The past two decades have also brought changes in one adds to this other dimensions of cultural diversity, such
health care as we know it. When the first edition of this as religion, socioeconomic status, and geographic diversity,
textbook was published, AIDS and HIV were only whis- the complexity of culture affecting communication and
pered about. Dysphagia had only 1457 records on PubMed, communication disorders is far greater than race and
as opposed to the 457,000 records today. The laws for ethnicity.
ensuring nondiscrimination of children and adults with So, as we began to consider a textbook that would be
disabilities have become a part of our everyday lives with more consistent with the view of the world that we live in
the ADA, NCLB, IDEIA, and RIT. Twenty years ago, today, it became obvious that the concept of multicultural
cochlear implants and genetic mapping of the human populations had to be considered more broadly than race
genome were in their infancy. Technology, the Internet, and ethnicity in the United States. This edition provides not
online telepractice, and Skype have connected people only a view of communication disorders in the traditional
around the world in ways well beyond our imagination in racial and ethnic populations in the United States but also a
previous years. And Thomas L. Friedman wrote a book broader view of populations around the world, including
called The World Is Flat to bring to our awareness that we Central and South America, the indigenous peoples of the
cannot think about the world today without thinking about United States as well as those of Australia, the African dia-
how we are all related and intertwined. sporas including the peoples of the Caribbean nations, and
International migration—people moving across national peoples of Europe and the Middle East. The authors are
borders—has become one of the challenges and realities of the themselves multicultural and international—they are white,
21st century. More than 170 million people, about 3% of all black, Asian, Native American, and Hispanic and come
humans alive today, live outside their country of birth, up from from the United States, Brazil, Australia, Malta, Taiwan,
the estimated 120 million in 1990. If all the world’s migrants and Saudi Arabia.
were in one place, they would create the world’s sixth Hortencia Kayser looks at bilingual language development
most populous country (after China, India, the United States, in Latino populations in the United States but also at the con-
Indonesia, and Brazil.) This international migration affects the cepts of disability and development in Central and South
people living in the major regions of the world, including America. Carol Westby and Ella Inglebret expand their presen-
North and South America, Europe, the Middle East, Asia, and tation of Native Americans in America to include indigenous
Oceania. Approximately 95,000 people from non-U.S. coun- populations in Canada, Australia, and New Zealand. Recog-
tries arrive in the United States each day. Although most are nizing that many of the children of persons who were new
nonimmigrant tourists, students, and temporary workers, about immigrants to this country at the time of the first edition of this
3000 are immigrants or refugees who have been invited to book have assimilated to varying degrees and are now second-
the country to become permanent residents. Another 1000 or and even third-generation immigrants, Li-Rong Lilly Cheng
more are unauthorized immigrants who enter the country by traces the differences in language and concept of disability in
evading border controls. Regardless of how these people have first-, second-, and third-generation immigrants from Asian
entered this country or other countries around the world, it is and Pacific Island countries. Freda Campbell Wilson discusses
no longer appropriate to consider cultural diversity by histori- the challenges of providing service to persons from the Middle
cal racial and ethnic groups. More than 11% of residents of the East, which has under gone significant political changes in
vii
viii Preface
the past 20 years. Because the immigration of persons from comprehensive international review of the advancements
the African diasporas as well as the Caribbean nations has made in the identification and treatment of hearing impair-
increased, particularly in the cities of the South and Northeast, ments. In this edition, the ICF, IDEIA, NCLB, and RTI
the discussion of African American or black English is present new issues in providing assessment and interven-
expanded to include consideration of persons from the African tion for children with communication impairments. Toya
diasporas as well. Wyatt approaches the complexities of assessment of com-
As in previous editions, the text contains several chapters munication disorders involving international multicultural
that focus on specific disorders. Sharynne McLeod and Helen clients and families. Priscilla Davis and Tachelle Banks
Grech, well known for their work in language development focus on issues to be considered in providing intervention
and international perspectives of phonologic disorders, pro- with culturally and linguistically diverse and international
vide a comprehensive overview of phonology, language, and clients and families. The text concludes with a review of the
literacy in English-speaking countries as well as of European issues to be considered in conducting and reading research
languages. Tom Murry and Mara Behlau provide a compre- on international populations.
hensive and innovative overview of cultural and linguistic This fourth edition of Communication Disorders in
aspects of voice and voice disorders based on data from coun- Multicultural and International Populations provides up-
tries around the world. Tommie Robinson looks at international dated information as well as a new broad perspective
cultural issues in identification and treatment of fluency disor- of communication impairments in cultural and linguistic
ders, particularly among persons from the African diasporas. diversity around the world. Speech-language pathologists
Constance D. Qualls reviews issues involved in assessment and audiologists providing clinical services will continue to
and treatment when persons from culturally and linguistically serve growing numbers of clients from a variety of cultural
diverse populations, including new immigrants, have neuro- and linguistic backgrounds. Increasing diversity in its many
logic impairments such as dysphagia. dimensions will shape traditional approaches to assessment
Hearing impairment and hearing aids and rehabilitation and intervention. It is in this spirit that this edition of this
services in developing countries have received worldwide textbook is offered.
attention through special projects of the World Health Dolores E. Battle, Ph. D.
Organization and WWHearing. Zenobia Bagli provides a Editor
Part I
Cultural Diversity: Implications
for Speech-Language
Pathologists and Audiologists
Chapter 1
Communication Disorders
in a Multicultural and Global
Society
Dolores E. Battle
using a verbal language; classify people according to age
INTRODUCING A MULTICULTURAL
and gender (e.g., woman, man, girl, boy) and descent
AND GLOBAL SOCIETY
relationships (e.g., wife, mother, uncle, cousin); raise chil-
The term culture originated from the Latin colere meaning dren in some sort of family setting; and have leadership
to cultivate or improve. Although the term originally re- roles for the implementation of community and family
ferred to agriculture, in the 18th century when the diversity decisions. Although all cultures have these and possibly
of persons around the world became globally apparent many other universal traits, different cultures have devel-
through increased European and world exploration, the oped their own specific ways of carrying out or expressing
term culture evolved to refer to the study of the full range them. For instance, people in Deaf cultures frequently use
of learned human behavior patterns and experiences. Sir their hands to communicate with sign language instead of
Edward Burnett Tylor (1832-1917), considered the founder verbal language. However, sign languages have grammati-
of modern anthropology and one of the first scholars to use cal rules just as verbal ones do.
the term culture in a universal or human sense, defined Speech, language, and communication are embedded in
culture as “that complex whole which includes knowledge, culture. Edward T. Hall (1959) said, “Culture is communi-
belief, art, morals, law, custom, and any other capabilities cation. Communication is culture.” Culture can be viewed
and habits acquired by man as a member of society” (Tylor, as a system of competencies shared in broad design and
1871, p. 1). Culture is about the behavior, beliefs, and values deeper principles and varying among individuals. Its speci-
of a group of people who are brought together by their com- ficities are what an individual knows, believes, and thinks
monality. More important, culture is the lens through which about his or her world. Culture is a theory of what one be-
one perceives and interprets the world (Vecoli, 1995). It is lieves his or her fellows know, believe, and mean. It is more
the filter through which all that one does must pass before than a collection of symbols fit together by the analyst. It is
entering the collective conscience. Religion, language, cus- a system of knowledge sharpened and constrained by the
toms, traditions, and values are but some of the components way the human brain acquires, organizes, and creates inter-
of culture. Anthropologists describe culture as a set of inter- nal models of reality (Keesling, 1974). Culture provides a
acting systems that perpetuate certain practices and systems system of knowledge that allows people of a cultural group
through generations. The practices may involve kinship to know how to communicate with one another.
systems, which may encompass mate choice, marriage cus- The relationship between communication and culture is
toms, family relationships and obligations, and household reciprocal: culture and communication influence each other
composition, as well as nonkinship relations in various (Keesling, 1974). Therefore, one cannot understand com-
voluntary associations. Religions or belief systems, eco- munication by a group of individuals without a thorough
nomic systems, and political systems extend relationships understanding of the ethnographic and cultural factors
beyond the family and household. related to communication in that group. These factors are
A culture also includes language or communication intricately embedded in the historical, geographic, social,
systems. According to Durant (2010), language systems and political histories, which bind a group, give it a sense
and speaking behaviors bind communities and shape social of peoplehood, and give it ethnic identity.
life and communication. They help form social identity and Because the roots of communication are embedded in
group membership and help to organize cultural beliefs culture, it is logical to assume that one cannot study com-
and ideologies. All cultures have ways of communicating munication or communication disorders without reference to
2
Copyright © 2012 by Mosby, an imprint of Elsevier Inc.
