As it becomes increasingly easy to download “no prep” or “print and go” materials from a variety of online resources, many new—and experienced—clinicians might not realize the materials they plan to use don’t align with their clients’ values, beliefs and background knowledge.
Even with a conscious awareness of the importance of cultural competence, I’ve made mistakes in material selections, as both a clinician and clinical supervisor.
As a new clinician, I once gasped in embarrassment as the “Santa” articulation card fell out of my deck and on to the table during a group session with students who didn’t celebrate Christmas. As a clinical supervisor, I’ll never forget the time I sprinted from the observation room to the treatment room when a student clinician introduced a “haunted house” activity to a client who didn’t celebrate Halloween. I knew this family didn’t celebrate this holiday, but I failed to mention it to the student clinician and misinterpreted the activity description on the lesson plan I reviewed before the session. The student was understandably disappointed she couldn’t use the elaborate house and paper ghosts she spent hours preparing.
That’s when I knew I needed to find a way to help new clinicians develop skills in cultural competence as they select and modify clinical materials. Even as an experienced clinician, I find it helpful to use a checklist to make sure I avoid using materials that might not align with my clients’ culture or background.
First, consider the various cultural facets playing a role in the selection of the clinical materials. Examples include the clients’ race, ethnicity, languages or dialects, age, gender identity, religion, family composition and socioeconomic status.
Then, review all text and images depicted on materials. Some specific items to look for include:
- Do materials and stories include depictions showing only one culture, language and/or type of family?
- Do they depict themes of magic or fantasy, including images of leprechauns, vampires, witches or wizards?
- Do they depict themes of religion or spirituality, including ghosts, angels or places of worship?
- Do they depict images typically associated with specific holidays, including candy canes, colored eggs or even hearts associated with Valentine’s Day?
- Do they depict images of or descriptions of meals or foods—pork or beef depicted as hot dogs or burgers, for example—that might be restricted based on religion? (This is particularly important to consider if using food during sessions.)
If the answer to any of the above questions is “yes,” clinicians should then determine if those themes align with the client’s background experience and cultural preferences.
To better understand my clients’ cultural preferences and background knowledge, I ask families open-ended questions such as: “Could you tell me about holidays or events—if any—you celebrate during winter months?”
I suggest avoiding closed-ended questions such as, “Is it OK if we do a Christmas craft today?” The family might feel pressure to respond, “yes,” and while it might actually be OK if the child pastes ornaments to a Christmas tree during one treatment session, the family might not prefer it.
Finally, I also suggest clinicians examine materials to ensure they avoid stereotypical representations of cultures. For example, on a set of slightly dated articulation cards I saw the target word “chief” depicted by a cartoon image of a Native American.
Examining materials might take more time when creating, selecting or modifying resources for session activities, but it’s an important step in the ongoing process of becoming a more competent clinician.
Cara Hammond, MA, CCC-SLP, is a clinical supervisor at the Freedlander Speech & Hearing Clinic at the College of Wooster. firstname.lastname@example.org.