Sense of Belonging

Clinicians should be at the forefront in addressing ethnic issues and cultural bias

By Barbara A. Ellicott, EdD, CCC-SLP

Have you ever felt ostracized, isolated or deprived socially, academically, spiritually and economically from the society in which you live? Many multicultural students know what it feels like to be misunderstood and misplaced.

But there are constructive strategies that speech-language pathologists can employ as a means of off-setting breaches of human rights and prejudicial treatment that continue to occur.

Having worked in a variety of geographical settings over the past 27 years, I have come to realize how much individuals in highly provincial areas need to be educated about people whose cultural beliefs differ from their own. Ignorance together with isolated negative experiences are among the greatest causes of prejudice.

In conjunction with various colleagues, I have developed a number of interventions for dealing with prejudice, from subtle traces to extreme incidents.

The first professional situation I encountered involving prejudice occurred in a rural community, a highly provincial environment. Working in a public school, I was assigned to provide language development in two kindergarten classes.

Enthusiastic about displaying a newly-acquired flipchart, which included people of color, I invited verbal expression about a snow scene. Pointing to the chart, a little boy called out a racial slur. The first response from my colleague and I was to remind the boy that he wait for his turn before speaking.

We then proceeded to tell the children how lucky they were to have friends from many different countries. We structured subsequent lessons to include the contributions of the various ethnic and cultural groups depicted.

In still another rural school district, I was employed as a learning consultant and assistant to the school psychologist. According to the teachers in that school, the students had not been exposed to persons of color and/or different cultures. Many projected racial elitism.

When a black kindergarten student began attending the school after moving from an urban area, her teacher reported that she was belligerent, aggressive and hostile and assaulted students in class and in the hall. In addition, numerous parents complained that the student was threatening to their children and obstructed the learning process. They threatened to sue the school if the girl was not removed.

The school psychologist and I decided to observe the girl in class. She sat silently with her head down and appeared to have difficulty understanding directions, such as folding paper and coloring. During free play, she was ostracized by the other children. When we interviewed the teacher, we were told that the girl was shunned by her classmates because she pushed them in the hall on her first day.

We then spoke with the superintendent/principal, whose own background in-cluded being the daughter of immigrants and coordinating programs for English as a Second Language. She inform-ed us that the little girl's grandparents had recently been awarded custody of the child, whose mother was a drug addict and father an alcoholic. The administrator attributed the girl's behavior to
her past experiences of living in the inner city, where it is survival of the fittest. Children learn early that they must assert themselves by nudging others they pass in a new environment as a means of communicating the message that they are not an easy target. Therefore, when the young girl began attending the school, she brushed against a few other children in the hall on her first day. In addition to being ostracized, she was subjected to racist remarks. With the encouragement of the administrator, we began discussing the possibility of hosting a multicultural open house, which had been successful in other school settings. Such an event includes observational and participatory stations; music, food and talented student entertainers from other communities; and travelogues and information on different religious customs.

Before we could organize the event, however, the situation involving the little girl worsened, despite our attempts to educate the parents and students. The girl's grandparents removed her from the school.

Body tracings of children were displayed in the hall, but the one that was colored brown had been removed and placed on the desk in the office I shared with the school psychologist. We submitted our resignations soon afterward.

I also have observed incidents of social noninclusion at the secondary level. In one provincially tight-knit school district, I recall a ninth grader from another country who spoke little English. He was subjected to ridicule, imitative mockery and physical threats. The student sought refuge with the school nurse, who referred the boy to me. Relieved by the fact that I was able to comprehend some of his native tongue, he proceeded to tell me of his misery and loneliness.

Inspired by this need by limited English-speaking (LES) students to feel a sense of belonging and acceptance, I proposed the formation of an International Club. Such a club could be open to immigrants as well as students of multicultural descent. The purpose of this club would be two-fold: to help LES students find a niche, and to encourage other students to discover or rediscover their own ancestry.

Speech-language pathologists often serve in the capacity of both confidante and advocate. Students typically see us as "safe ones" with whom to speak. As we continue to gain the respect of our colleagues, our advocacy potential increases as well.

In another secondary school, a student from a European country became discouraged after his numerous attempts to be accepted into different social groups were rejected and a female student declined to date him. In spite of the teacher's attempts to cheer him up, the student began to withdraw.

A summer visit to his native country appeared to have a therapeutic effect on him, however; and he began the fall semester with a brighter outlook. Then one of my speech students informed me that the boy was assaulted. He had endured threats and verbal attacks during the school day and then was followed and taunted when he left school. He was shoved and thrown face down on the pavement.

When he arrived for speech class, I told him that I had heard about the assault, and he shared the experience with me. After I intervened, disciplinary action was taken against his attackers; but it may take some time for his psychological wounds to heal. The student and I continue to have a bonded relationship that is helpful in the healing process.

About midway in my professional career, I accepted a part-time position in a school district that appeared to shimmer with kindness and goodwill. However, as the years progressed, I gradually came to realize that this appearance was largely superficial.

Some of the students in the speech program began to openly discuss the "weirdness" of the students from other countries. Determined to demonstrate the beauty of our American melting pot, I set out to familiarize the students with the geography, cultures and languages of our LES students. This provided the context in which speech and language therapy took place.

I wanted LES students to play an active role in the educational process. Excited about being acknowledged, they brought in photos of families, schools and cities.

We do a considerable amount of world map work and discuss seasonal and climatic differences and how the latter influences culture, employment, etc. We discuss various religions, emphasizing their commonalty rather than their differences.

Above all, we discuss the importance of feeling pride in one's religion and culture and of understanding and respecting others. I particularly enjoy teaching--and learning--about the influence other cultures of the world have on our so-called American culture. Living provincially rather than interculturally, I tell my students, is comparable to limiting themselves to hearing just one instrument their entire life and never a full orchestra.

Since initiating this strategy, the provincial students have grown, not only in speech-language development but in their understanding of people from other cultures.

All too frequently students are misunderstood or misdiagnosed, especially in schools that do not have ESL and LES programs. They are sometimes thought to be disinterested or not trying hard enough. This is another opportunity for the speech-language pathologist to serve in the advocacy role after getting to know these students.

For example, I remember a student from a Spanish-speaking country who only knew the English words "yes" and "no." No ESL teachers were on staff in his school district. He was labeled a slow learner and placed in basic classes in an undesirable social environment, where lower functioning students and those with special needs acted out and chided him. Some teachers reprimanded him for not paying attention or following directions.

After several months a teacher referred him to me for a speech-language evaluation. I explained to my colleague that any evaluation in English would not be valid; but I agreed to informally assess the student's language ability, because of my familiarity with Spanish, and to search the field to determine whether Spanish language instruments were available at his grade level.

My informal assessment revealed that the student was highly motivated but extremely anxious and not functioning up to par in language development in his native language. His formal vocabulary was limited, and it became obvious that he had an auditory processing deficit.

Because of the breadth and depth of our training, speech-language pathologists are in a rather unique position to be of great assistance in the area of differential diagnosis. We can serve in a counseling, tutorial and advocacy capacity in those situations when students are misunderstood.

For example, LES and ESL students all too often are placed in classes for students who are low functioning and at grade levels below their cognitive abilities. Sometimes this occurs devoid of any LES/ESL instruction or tutorials. This results in negative consequences by ad-versely affecting the student's self-esteem, morale and socialization.

An indirect way in which the speech-language pathologist can be of help to LES/ESL students is by serving as a testing consultant. In certain schools there appears to be a dearth of knowledge as to what tests measure, whether there is a problem with construct validity, and whether cultural bias exists in the content of tests.

The clinician can be an active informant by helping faculty members who lack an understanding of cultural communication differences--especially those dealing with etiquette and respect issues--that often result in misdiagnoses in the special services-evaluation area.

For example, a psychologist wrote in an evaluation report that a student was extremely shy and had difficulty with emotional intimacy. When queried as to how she reached that conclusion, she responded, "He does not initiate a conversation and never makes eye contact."

The psychologist did not know that in the student's culture a child is only permitted to respond to an authority figure when given explicit permission to do so. Further, eye contact with a person of authority is considered to be disrespectful.

The same psychologist wrote in a report about a student of a different ethnic background, "This student tends to be aggressive and make sexual innuendoes." When asked how she came to the latter conclusion, she reported, "He violated my personal space. He goes around hugging his peers." In fact, the student was a recent immigrant from Italy, where personal warmth and affection is routinely displayed through being physically close, embracing and kissing.

In addition to academic and psychosocial misinterpretations that may occur, social biases exist that are related to cultural bias. The speech-language pathologist may be in a position to come to a student's assistance in such situations.

Biases have been witnessed in school disciplinary programs. For example, a Spanish student called out "Jesus" when one of his peers sneezed. The teacher stated, "How dare you use the Lord's name in vain!" The confused student was escorted to the school disciplinarian, who strongly reprimanded him and issued a detention summons. However, in the student's culture people say "Jesus" rather than "God Bless You!" when someone sneezes.

As another example, an elementary school student pinched a female classmate he admired on his first day in public school. The unsuspecting little girl screamed and informed her teacher, who informed the principal, who informed the superintendent.

The boy's non-English-speaking parents were asked to leave work and attend an emergency meeting. The parents, who eventually had to seek the assistance of an interpreter, learned that they would have to keep their son home from school for the next several days; and, if such "misbehavior" continued, their son would face suspension. Anyone who took the time to learn about the child's native customs would have found that pinching was an acceptable and encouraged flirtatious behavior practiced openly among family members and friends.

By no means are the above prejudices and biases restricted to schools. Blatant and insidious prejudices exist in hospitals and nursing home settings. The speech-language pathologist can play a key role in helping to eliminate some of the prevailing prejudice and negativity directed toward patients and students from different cultures. The extent of our success will depend on the degree of diplomacy we employ in the intervention process.

We should take an active role in serving as consultants to teachers, administrators and other health care professionals by doing the following:

* informing them what tests are biased and/or not likely to produce valid responses;

* familiarizing them with the unique communication customs of the multicultural groups represented in their setting;

* helping arrange for interpreters when appropriate;

* encouraging the formation of a Wel-come Wagon group in an effort to help our multicultural people feel more welcome and accepted;

* developing a Big Brother/Big Sister program to shadow new members during the first few weeks and months of their adjustment process; and

* encouraging the formation of a multicultural orientation program for the general population of the school or hospital, complete with stimulating guest speakers, films, multicultural performers, and book, tape and CD exhibits.

Dr. Barbara A. Ellicott is a speech-language pathologist, learning consultant, child development specialist and state-certified school psychologist in New Jersey.