Chapter 1 Communication disorders in a multicultural and global society

Introducing a multicultural and global society

The term culture originated from the Latin colere meaning to cultivate or improve. Although the term originally referred to agriculture, in the 18th century when the diversity of persons around the world became globally apparent through increased European and world exploration, the term culture evolved to refer to the study of the full range of learned human behavior patterns and experiences. Sir Edward Burnett Tylor (1832-1917), considered the founder of modern anthropology and one of the first scholars to use the term culture in a universal or human sense, defined culture as “that complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society” (Tylor, 1871, p. 1). Culture is about the behavior, beliefs, and values of a group of people who are brought together by their commonality. More important, culture is the lens through which one perceives and interprets the world (Vecoli, 1995). It is the filter through which all that one does must pass before entering the collective conscience. Religion, language, customs, traditions, and values are but some of the components of culture. Anthropologists describe culture as a set of interacting systems that perpetuate certain practices and systems through generations. The practices may involve kinship systems, which may encompass mate choice, marriage customs, family relationships and obligations, and household composition, as well as nonkinship relations in various voluntary associations. Religions or belief systems, economic systems, and political systems extend relationships beyond the family and household.

A culture also includes language or communication systems. According to Durant (2010), language systems and speaking behaviors bind communities and shape social life and communication. They help form social identity and group membership and help to organize cultural beliefs and ideologies. All cultures have ways of communicating using a verbal language; classify people according to age and gender (e.g., woman, man, girl, boy) and descent relationships (e.g., wife, mother, uncle, cousin); raise children in some sort of family setting; and have leadership roles for the implementation of community and family decisions. Although all cultures have these and possibly many other universal traits, different cultures have developed their own specific ways of carrying out or expressing them. For instance, people in Deaf cultures frequently use their hands to communicate with sign language instead of verbal language. However, sign languages have grammatical rules just as verbal ones do.

Speech, language, and communication are embedded in culture. Edward T. Hall (1959) said, “Culture is communication. Communication is culture.” Culture can be viewed as a system of competencies shared in broad design and deeper principles and varying among individuals. Its specificities are what an individual knows, believes, and thinks about his or her world. Culture is a theory of what one believes his or her fellows know, believe, and mean. It is more than a collection of symbols fit together by the analyst. It is a system of knowledge sharpened and constrained by the way the human brain acquires, organizes, and creates internal models of reality (Keesling, 1974). Culture provides a system of knowledge that allows people of a cultural group to know how to communicate with one another.

The relationship between communication and culture is reciprocal: culture and communication influence each other (Keesling, 1974). Therefore, one cannot understand communication by a group of individuals without a thorough understanding of the ethnographic and cultural factors related to communication in that group. These factors are intricately embedded in the historical, geographic, social, and political histories, which bind a group, give it a sense of peoplehood, and give it ethnic identity.

Because the roots of communication are embedded in culture, it is logical to assume that one cannot study communication or communication disorders without reference to the cultural, historical, or societal basis for the communication style or language used by the members of the ethnic or cultural group. The social rules of discourse and narratives (e.g., topic selection, who selects the topic, who initiates the conversation, who ends the conversation, distancing, eye gaze, and sense making) are culturally determined. Who speaks to whom, when, where, and about what must be understood in the context of the culture of both partners in the communicative event if the clinician is to determine the presence or absence of a communication disorder.

Communication behavior and the perception of what constitutes a communication disorder within a particular group are the products of cultural values, perceptions, attitudes, and history. These factors must be considered when determining the communication competence of a particular person within a group. For example, reluctance to speak and failure to initiate a conversation or use a particular narrative style can be appropriate to one culture but inappropriate to another. The impact of a voice disorder can be different for speakers of tonal languages than for speakers of nontonal languages. Expectations of the benefits of rehabilitation for the effects of stroke or traumatic brain injury can also differ across cultural groups.

Terminology

The terms race and ethnicity are often used interchangeably; however, they have different meanings. Ethnicity refers to a shared culture that forms the basis for a sense of peoplehood based on the consciousness of a common past. For example, Black is considered a race, but Hispanic is considered an ethnicity. Hispanics can be of any race. Race, language, and ancestral customs constitute the major expressions of ethnicity in the United States. Ethnicity is not passed genetically from generation to generation. Rather, ethnicity is constructed and reconstructed in response to particular historical circumstances and changes. In its most intimate form, an ethnic group can be based on face-to-face relationships and political realities that mobilize its members into political self-determination. Joined by the aspirations for political self-determination, ethnicity is used to identify groups or communities that are differentiated by religious, racial, or cultural characteristics and that possess a sense of peoplehood.

An ethnic group is a group of people whose members identify with each other, through a common heritage that is real or assumed, and share cultural characteristics. This shared heritage may be based on putative common ancestry, history, kinship, religion, language, shared territory, nationality, or physical appearance. Members of an ethnic group are conscious of belonging to an ethnic group; moreover, ethnic identity is further marked by the recognition from others of a group’s distinctiveness.

Ethnography refers to the fully developed sense of the meaning of a culture and the complex manner in which one comes to understand the intricacies of the culture. The ethnographic understanding of a culture implies a fully developed sense of the complex web of meanings, perceptions, actions, symbols, and adaptations that make a people who they are.

Race refers to the biologic and anatomic attributes and functions, such as skin color, facial features, and hair texture. Two people can be of the same race but differ widely in cultural identity, personal history, and their view of the world. For example, a Korean child reared in a Korean family will have Korean cultural values; however, a transracially adopted Korean child adopted at birth by an African American family has the biologic and genetic characteristics attributed to his or her genetic ancestors but has the cultural values imparted by the adoptive parents.

The 2010 U.S. Census employed categories representing a social-political construct for the race or races that generally reflect a social definition of race recognized in this country. The concept of race took into account social and cultural characteristics as well as ancestry. The race categories included both racial and national-origin groups. The racial groups were identified as white, American Indian/Alaska Native, African American or black, Asian, and Native Hawaiian/other Pacific Islander. Persons were also given the option of identifying as “two or more races.” Race and ethnicity were considered separate and distinct identities. Thus, in addition to their race or races, all respondents are categorized by membership in one of two ethnicities, which are “Hispanic or Latino” and “Not Hispanic or Latino.” For example, an African American could be identified as “black (Not Hispanic).”

“Hispanic or Latino” was used to refer to “a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race.” The term does not refer to those who speak Spanish. For example, many people from the largest country in South America, Brazil, speak Portuguese. Persons in Spain are considered European and are not considered Hispanic. Many Hispanic persons prefer the use of the term Latino to refer to their origin in the countries of Central and South America. This distinguished them from persons who are identified only by the language that they speak. Although both terms are used, the term Latino is preferred.

Culture is a term that connotes the implicit and explicit behavior in a variety of areas. Explicit cultural behaviors are visible to the world and include observable features of dress, language, food preferences, customs, and lifestyle. Explicit behaviors are readily visible and are often used to identify the cultural group to observers. These behaviors are the focus of “culture-of-the-month” activities and programs. Implicit cultural variables are those factors that are not easily depicted and observed. They include such factors as age and gender roles within families, child-rearing practices, religious and spiritual beliefs, educational values, fears and attitudes, values and perceptions, and exposure to and adoption of other cultural norms. Implicit cultural values are beneath the surface, relatively invisible; however, they shape the fiber of those who identify as a member of a cultural group.

Multicultural

The term multiculturalism emerged in the 1960s in response to recognition of the varieties of racial and ethnic groups that were emerging as educational and political entities in English-speaking countries. It was at first used to refer to cultures by race and ethnicity, particularly blacks in the United States who were gaining political recognition in response to the civil rights movement. Because “culture” has many dimensions, the term multicultural is not to be restricted to describe only racial and ethnic minorities. The term has evolved to describe a society characterized by a diversity of cultures with varieties of religions, language, customs, traditions, and values. All individuals have a group identity and an individual identity. The term multicultural is used to describe a society in which people from diverse racial and ethnic backgrounds, socioeconomic groups, age groups, geographic areas, and other variables come together to create a mosaic composed of individuals that form a rich whole. It also includes the cultures defined by socioeconomic class, gender, sexual orientation, ability level versus disability, and other variables that define persons as individuals. The term is used to describe a society in which each individual is respected and valued for his or her contribution to the whole.

In addition to race and ethnicity, one may identify with the culture of deaf persons, persons with a disability, or with gay, lesbian, bisexual, or transgender culture. It is important to realize that the multicultural society is a diverse society of individuals who belong to many different cultural groups or subgroups. In sociology and anthropology, a subculture is a group of people with a culture (whether distinct or hidden) that differentiates them from the larger culture to which they belong. For example, Chinese Americans could be considered a subculture of Asian Americans; Cuban Americans could be a subculture of Hispanic or Latino Americans. Because of immigration, emigration, intermarriage, and geographic relocation, many persons identify with one or more cultures or subcultures. Consider a person who was born in Alabama to American parents: a father from Kuwait, Saudi Arabia, whose mother came from Isfahan, Iran; and a mother from Cleveland, Ohio, whose own mother came from a village in the mountains of Slovenia and whose father was a Serb immigrant from Zagreb, Croatia. The mother’s family was Baptist, and father’s family was Shi’a Muslim. In a sense, all persons are themselves multicultural. Each individual belongs to a unique set of cultures and subcultures that define who they are as individuals and which groups they identify with for a particular activity, practice, or belief.

Multicultural relationships also include the clinician and client and members of the client’s family. All persons seeking clinical services are to be considered as individuals with individual cultural values and as belonging to one or more subcultures. All persons providing clinical services are also individuals with individual cultural values. The clinically competent clinician works to bring the persons in the clinical situation into harmony with each other so that the most appropriate clinical services can be provided.

Stereotype

A stereotype is a held popular belief about specific social groups or types of individuals. Stereotyping results from the overestimation of association between group membership and individual behavior (Gudykunst & Nishida, 1984). Stereotyping occurs when a person ascribes the collective characteristics associated with a particular group to every member of that group, discounting individual characteristics. Stereotypes can be negative or positive. For example, persons living in Africa may be thought of as living in huts in jungles; Latinos, as poor illegal immigrants; and Asians, as gifted in mathematics and science. Cultural competency requires that clinicians avoid developing stereotypes and keep the individual at the forefront of any clinical encounter.

An immigrant is a person who migrates to another country, usually for permanent residence. According to the United Nation’s (2005) World Population Policies Report, by the end of 2005, the population of the immigrants that were born in a country and currently live in another country reached 191 million. Approximately 75% of international immigrants live in 28 countries, with 20% of the world’s immigrants living in the United States. According to the report, in 2005 approximately 39% of immigrants had migrated to less developed or developing countries and 61% had migrated to developed countries of North America and Europe such as Canada, Russia, Germany, Ukraine, France, and Spain. Other countries leading in world immigration include Saudi Arabia, India, United Kingdom, Australia, and China.

Becoming a multicultural society: history of world immigration and migration immigration

Peoples have been moving about the world since the days of ancient Greeks, Phoenicians, and Romans who “colonized” uninhabited lands for farming, hunting, and gathering in Europe and Northern Africa. Modern colonialism started with the Age of Discovery in the 15th century when sailors from Spain and Portugal discovered new lands across the oceans in the Americas and sought trading routes to Asia. The main European countries that were successful in the Colonial Era were France, Spain, the United Kingdom, the Netherlands, and Portugal. Each of these countries had almost complete power in the world trade from roughly 1500 to 1800. The 17th century saw the creation of the British, French, Dutch, and Swedish colonial empires throughout the world, including the international slave trade in Europe, the Caribbean, and other parts of the world. In the 17th and 18th centuries, English colonists established the framework for the society that would become the United States. They built the colonies in Massachusetts and Virginia and overran the early colonies that had been established by the French and Spanish. The spread of European colonial empires was reduced in the late 18th and early 19th centuries by the American Revolutionary War and the Latin American wars for independence.

The diversity of America was established long before the colonial period. The original American Indians are said to have walked across a land bridge from Siberia thousands of years ago. In 1500, the more than 4.5 million inhabitants of America were divided into hundreds of tribes, each with distinctive cultures, religions, and languages (Vecoli, 1995). The country already was home to American Indians, Spanish, French, Mexican, and other groups who occupied the land that became the United States as the country expanded west. When the first U.S. census was taken in 1790, the United States was already a nation of many cultures. Almost 19% of Americans were of African ancestry; 12% were Scottish and Scotch-Irish; and fewer were German, French, Irish, Welsh, and Sephardic Jews (Vecoli, 1995). The census did not include American Indians or Hispanics.

To preserve the ideals on which the nation was founded, the Naturalization Act of 1790 was passed. It specified that citizenship in the United States was open to “any alien, being a free white person,” thus excluding from citizenship of the country those who were not white and those who were enslaved. Those counted as citizens of the United States represented only 48% of the total population of the country. The term immigrant entered into the language to refer to a person who voluntarily moved from his or her own country to another established nation (Population Bulletin, 2003).

First wave of immigration: 1820-1880

Population growth in the United States, other than by natural increase, came primarily through three waves of immigration beginning in the 19th century. Between 1820 and 1860, more than 15 million immigrants arrived in the United States, including 4 million immigrants from Germany after the failure of social reform, 3 million each from Ireland and Britain as a result of the potato famine of 1847, and 1 million from Scandinavia who were seeking land available through the Homestead Act. During this period, there was the first major surge in immigration from Asia during the gold rush in the early 1850s and building the railroad. From the 1870s to the early 1880s, the number of persons from China increased from 63,000 to nearly 180,000. (Morrison & Zabusky, 1980; Vecoli, 1995).

By 1882, some Americans became concerned that the newcomers would pose a danger to “American” values and institutions. The slow evolution of a national policy on immigration resulted in a series of laws that progressively restricted immigration or reduced the rights of those who were new to the country (Morrison & Zabusky, 1980). For example, the Chinese Exclusion Act of 1882 denied immigration to Chinese laborers and barred Chinese from acquiring citizenship. As a result of these policies, the Chinese population in the United States had dropped to the 1870 levels.

Second wave of immigration: 1880-1920

The second wave of immigration began in 1880 with the beginning of the industrial revolution and ended with the beginning of World War I when 1.2 million immigrants arrived. Advances in transportation technology and the industrial revolutions enabled increasing numbers of people to set off for other parts of the world in search of a better life. This wave brought an additional 18 million immigrants to the United States, including more than 4 million from Italy, 3.6 million from Austria-Hungary, and 3 million from Russia (Vecoli, 1995). Overpopulation in Scandinavia, resulting unemployment, and a desire for freedom led to a significant increase in immigrants from Sweden and Norway, who often relocated to the states of the Midwest, especially Illinois, Minnesota, Michigan, Iowa, and Wisconsin.

In addition to the European immigration during this period, a large number of Asians, primarily from China and Japan, and persons from Greece and the Middle Eastern countries of Lebanon, Turkey, and Syria came. They had language, culture, social institutions, customs, and a collective experience that differed significantly from that of European immigrant groups. The concerns about the differences between Asians and Europeans culminated in the Immigration Acts of 1921 and 1924. These acts denied entry to aliens ineligible for citizenship (i.e., those who were not deemed white) and established national quota systems designed to reduce the number of Southern and Eastern Europeans entering the country and to bar Asians entirely. The laws attempted to freeze the biologic and ethnic identity of the American people by reducing the influence from those not like the early immigrants who had gained political and economic power in the country.

Immigration pause 1920-1964

The time between 1920 and 1964 marked a hiatus in immigration due to restrictive immigration policies, economic depression, and the effects of two world wars. Immigration after World War II reflected political unrest in Europe and the Middle East. The postwar era brought a renewed interest in immigration to parts of the world. It was followed by a new surge of subsequent changes in laws and immigration policy.

After World War II, the need for migrant farm workers encouraged more than 1 million persons from Mexico to come to the United States. This has continued such that persons from Mexico have been the largest group of immigrants to the United States for the past 60 years. In addition, approximately 20,000 Russians and other displaced individuals immigrated to the United States immediately after World War II (Magocsi, 1995). By 1985, nearly 300,000 Russian Jews had reached the United States and settled in the major cities of the Northeast (Magocsi, 1995). Turkish, Croatian, and Serbian immigration also increased after World War II, including professionals such as engineers and physicians seeking better job opportunities.

Third wave of immigration: 1965 to present

Abhorring the racism of Nazism and stirred by the valor that the Asian Americans and African Americans showed in the fight to protect the freedom of America during World War II and the Korean War, the nation changed the way it thought about race and equality. A combination of international politics and democratic idealism, including the Civil Rights Act of 1964, resulted in the elimination of racial restrictions from American immigration and naturalization policies. The Immigration and Nationality Act of 1965 removed the national origin quotas and opened the United States to immigration from throughout the world by regional quotas. The unexpected consequence of the 1965 Act was the beginning of the third wave of immigration. In 1965, an estimated 75 million people, or less than 3% of the world population, were living outside their country of birth. By 1985, that number had increased to 105 million. There were an estimated 214 million international migrants in the world in 2000, representing an increase of almost 40 million in the first decade of the 21st century and more than double the number of international migrants in 1980 (Hatton & Williamson, 2006; Kent & Mather, 2002).

The third wave of immigration in the United States differs from the previous two waves because the major countries of origin of the immigrants changed. Not only did the total number of immigrants increase steadily to 1 million or more arriving each year, but also the countries of origin changed from being primarily European countries to those of Asia and Latin America (Vecoli, 1995). During the first two waves of immigration, almost 90% of the immigrants originated from Europe. During the 1980s, however, only 12% of the 7.3 million immigrants to the United States originated from European countries.

In the post–Korean War era of the 1970s and the post–Vietnam War era of the early 1980s, there was a significant increase of people immigrating to the United States from the Southeast Asian countries and Pacific Islands, Asia, Central and South America, and the Caribbean. Nearly 85% of the 7.6 million immigrants since the 1980s have come from Asia, Latin America, and Africa, with Mexico and China having the largest numbers of immigrants, respectively (U.S. Census Bureau, 1996). Between 1980 and 1990, the Hispanic population in the United States grew by 36% with major countries of origin being Mexico, Haiti, the Dominican Republic, and Cuba (U.S. Census Bureau, 1996). More than 2.7 million immigrants came to the United States from the Caribbean, and nearly 2 million came from Mexico alone in 2000 (U.S. Census Bureau, 2000). Between 1990 and 2010, the number of foreign-born residents in the United States increased from 20 million to 40 million while the entire U.S. population grew from 250 million to 310 million. Immigration contributed to a third of the U.S. population growth, and the U.S.-born children and grandchildren of immigrants contributed to nearly half of the entire U.S. population growth (Martin & Midgley, 2010).

The U.S. population increased by 9.7% between 2000 and 2010 (U.S. Census Bureau, 2011). As shown in Table 1-1, the growth in the white population was only 3.4%, whereas the growth in Hispanic population was 37.1% and that in the Asian populations was 36.6%. The growth in the U.S. population was largely due to significant increases in immigration of nonwhite racial and ethnic minority groups.

In addition to the documented legal immigrants to the United States, there are many undocumented or illegal immigrants. Immigration Services estimates that approximately 11.2 million illegal immigrants lived in the United States in 2010 (Passel, 2010). More than 6 million illegal immigrants were from Mexico and more than 1 million from Guatemala, Honduras, and El Salvador. However, many undocumented immigrants also have origins in Canada, Haiti, Poland, and the Philippines. The overwhelming majority of legal immigrants settled in California, New York, Texas, Washington, Illinois, Florida, Pennsylvania, Massachusetts, Georgia, and Michigan (U.S. Census Bureau, 2011). In addition to those illegally crossing the borders, a number of undocumented persons enter the country as students, tourists, or temporary workers and remain in the country after their visas have expired. For example, more than 250,000 Chinese intellectuals, scientists, and engineers came to the United States for advanced degrees and stayed after their visas expired or applied for alien resident status. The result of the dramatic increase in immigration is the diversity in the demographic makeup of America.

Global migration

North America is the world’s largest immigration destination. Nearly one-half million persons from Mexico migrate to the United States each year, about one third of whom are undocumented (Passel, 2004). In 2006, more than 11.5 million Mexican immigrants resided in the United States, accounting for 30.7% of all U.S. immigrants and one tenth of the entire population born in Mexico (Batalova, 2008). Canada and the United States include only 5% of the world’s population, but they receive more than one half of the world’s immigrant population. China, India, Pakistan, and the Philippines account for about 30% of all immigrants to Canada. The 15 independent Caribbean nations have some of the highest immigration rates in the world. Cuba, the Dominican Republic, Haiti, and Jamaica have sent large numbers of immigrants to the United States since 1980. Since 1996, 1.1 million of Colombia’s 40 million people have left the country for the United States as well as for Ecuador, Australia, Canada, Spain, and Costa Rica. There are more than 2 million Colombians in Venezuela.

Brazil has been the largest recipient of immigrants in South America for many years. Early immigrants were slaves from Nigeria, Angola, and Benin who were brought to work in the sugar plantations in the northeast region of Salvador. Salvador Bahia remains the largest black city outside of Africa. In the early part of the 20th century, immigrants to Brazil were mostly from countries such as Italy, Germany, Spain, Portugal, and Poland to support farming and mining. After 1920, Brazil attracted more immigrants from Lebanon, Syria, and Japan. As a result, Brazil is a multiethnic country where 99% of the inhabitants speak Portuguese; however, approximately 210 other languages are spoken or signed by the inhabitants.

The movement of between 500,000 and 1 million persons a year in Europe during the 1990s has made migration a major social and political issue in many European countries. The four largest European countries—France, Germany, Italy, and the United Kingdom—include about 66% of European Union (EU) residents but received 88% of EU immigrants in 1995. In 1998, foreign workers made up 6% of the population of the counties in Western Europe (Organization for Economic Cooperation and Development [OECD], 2000). With immigration comes diversity of cultures and languages. In Germany, for example, although most persons learn English as a second language, immigrant languages spoken by sizable communities of first and second generation persons of Eastern European, African, Asian, and Latin American origins include Turkish, Russian, Arabic (by immigrants from Africa and the Middle East), Greek, Dutch, Italian, Polish, Serbo-Croatian (by persons from the former Yugoslavia), and Spanish. In France, as a result of immigration, a number of nonindigenous languages are spoken, including Arabic, Armenian (by recent immigrants arriving from Armenia, Azerbaijan, and Iran), Ababa, Berber, Cambodian, Chinese, Danish, and Dutch. In Asia, most migration is from one Asian country to another; however, many Asians have migrated not only to the United States and Canada but also to the Middle East Gulf nations seeking employment in the oil industry (OECD, 2000).

Although most immigrants leave their country of origin for reunification with their families or to seek a better life through employment of education, some leave their country of origin for fear of being persecuted for reasons of race, religion, nationality, or membership of a particular social group. They become refugees or asylees. The Middle East, which includes Western Asia and Northern Africa, has had major immigration to other parts of the world. Although it makes up only 6% of the world population, it accounts for 45% of the world’s refugees, including 1.5 million Afghan refugees to Iran in 2000. The world’s largest refugee population lives in Gaza, Jordan, and neighboring countries. In 2000, Africa had nearly one eighth of the world’s population and nearly one third of the world’s 12 million refugees. The refugees were fleeing domestic turmoil in places such as Rwanda, Somalia, and Darfur. As of December 31, 2005, the countries with the largest source of refugees were Afghanistan, Iraq, Myanmar, Sudan, and the Palestinian territories.

Canada resettles more than 1 in 10 of the world’s refugees and is home to persons born in more 100 different countries around the world, with 10 groups having more than 200,000 residents each, including English, French, Scottish, Irish, German, Italian, Chinese, North American Indians, Ukraine, and Dutch (Statistics Canada, 2006). Although Canada is a bilingual country, with English spoken by 59.3% and French spoken by 23.2% of the residents, there are at least 87 other unofficial languages spoken in the country, including North American Indian, aboriginal, and hybrid languages (Lewis, 2009).

Because of colonization and global migration, there are more than 7000 languages spoken in the 196 countries in the world today (Lewis, 2009). The number of ethnic groups is largely unknown. In Asia, there are at least 71 ethnic groups, with 56 ethnic groups in China alone. In Africa, ethnic groups number in the hundreds, with at least 1500 languages and cultures. Australia is also multiethnic country. Although its inhabitants are largely descendants from England, Ireland, Scotland, Italy, Germany, and China, nearly one-half million (2.3%) are of aboriginal descent or from the Torres Strait Islands, and there are at least 40 different languages spoken in the country (Price, 1999).

It is clear that national and worldwide immigration patterns have led to a multiethnic and multicultural world.

Only gold members can continue reading. Log In or Register to continue