Southeast TACE Center: Region IV - Technical Assistance & Continuing Education

TACE IV Newsletter - Spring 2009

Providing Culturally and Linguistically Based Services to Diverse Persons with Disabilities in the Southeast Region

by Lucy Wong Hernandez

Pages: 1 (Article) - 2 (Resources & References)


Introduction

Research findings indicate that by the year 2050, people from culturally and linguistically diverse backgrounds are expected to comprise nearly 50 percent of the United States population. This trend is of utmost importance to disability service providers, such as vocational rehabilitation professionals, because racial, cultural and ethnic minorities, who often suffer from poverty, high unemployment, lack of health insurance, substance abuse, and poor education, have significantly higher rates of disability than those of the majority Caucasian population.

Disability researchers, practitioners, instructors, and service support personnel have not adequately understood the unique issues related to disability in culturally and linguistically diverse communities in the past and, as a result, have had a difficult time building relationships with culturally diverse persons with disabilities. The purpose of this brief article is to examine the barriers to these relationships, which fall into three main categories:

  1. Lack of cultural sensitivity and knowledge regarding culturally and linguistically diverse persons with disabilities;
  2. Failure to account for environmental influences that contribute to disability, including natural, social, cultural, and man-made environments; and
  3. Inadequate research methods and approaches by human service and education systems regarding diverse populations with disabilities.

In addition to examining these barriers, recommendations to better relate to the needs of persons with disabilities in cultural and ethnic communities are provided by expanding on the TACE Center: Region IV online training from March 4 and 18, 2009: Webinar: Demographic Changes: Serving Consumers from Diverse Cultural and Ethnic Backgrounds (Part I & Part II).

Need to Identify Diverse Cultural Values

Cultural values are essential parts of an individual’s characteristics, which can strongly influence the impact of outreach efforts (NIDRR, 2001). Of particular importance is recognizing the heterogeneity of culturally and linguistically diverse persons, such as African Americans, Hispanic Americans, Asian Americans and Pacific Islanders among other groups.

African Americans have been traditionally known as the largest minority group with a unique culture typical of their ancestry, accounting in 2006 for 40.7 million or 13.5% of the total American population.  Due to the diversity in cultures in the American society, this does not hold true any longer.

In 2006, there were 44.3 million Hispanic Americans or 14.8% of the total population. Between 2000 and 2006 Hispanics accounted for one-half of the nation’s growth and Hispanic growth rate (24.3%) was more than three times the growth rate of the total population (6.1%). The Hispanic culture is a very diverse culture which, for the most part, have a unified common language, Spanish, and numerous sub-cultural groups from different regions in the Americas. Among the Hispanic Americans, we have the largest group from Mexican descent, Puerto Ricans, Cubans and all countries in the Caribbean, and Central and South America.  These subgroups have their own regional characteristics, local language variations, and worldviews as they relate to life events such as the challenges presented by disabilities.

Asian Americans include, for example, Chinese, Japanese, Korean, Vietnamese, Thai, Hmong, Laotian, Filipino, and at least 35 other cultures. The major Asian groups are Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese and other Asian groups including Burmese, Cambodian, Hmong, Laotian, Thai, and Tongan.

Pacific Islanders include those with ancestral ties to the peoples of the Hawaiian Islands and other U.S. af­filiated Pacific Territories, including American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Territory of Guam, Republic of Palau, and Republic of the Marshall Islands. The major Pacific Islander groups are Native Hawaiian, Samoan, Guamanian or Chamorro, and other Pacific Island groups (Pi, 2001; U.S. Census Bureau, 2001).

Clearly, these communities contain extremely heterogeneous groups comprised of many different ethnici­ties (both new immigrants and persons whose families have been in the U.S. for generations), languages, cultures, and persons of all socioeconomic classes. Consequently, the need to identify the cultural values of individual communities is paramount to successfully developing effective working relationships with diverse persons with disabilities and their families.

While many cultures share common characteristics, each subculture possesses its own language, history, and customs (Sanderson, 1995; Hong, 1999, Wong & Wong Hernandez, 2009). The significance of culture in the understanding of disability and the rehabilitation process cannot be overemphasized. It has been shown to serve as both a barrier to recovery as well as a facilitator for recovery (Cuellar & Arnold, 1988, Wong Hernandez, 1997). Where there has been ideologi­cal congruence related to the rehabilitation approach, there has been a greater likelihood of adherence and successful outcomes. However, agencies and other bureaucratic organizations generally reflect the culture from which they have evolved. Thus, the bureaucracy of disability research organizations, vocational rehabilitation services, and educational settings, which are extensions of the cultures of industrialized, urban, European-American, English-speaking societies, have often been in conflict with the people of different cultures they serve (Lowery 1996). As a result, communication and collaboration between the research, service provision and minority disability communities have been inhibited and services have been ineffective.

In addition, disability researchers, rehabilitation service providers, academic instructors and human service sup­port personnel have not been sufficiently cognizant of the cultural variables and environmental determi­nants that comprise disability across multiple communities to be able to implement effective and rigorous strategies to address them. Greater knowledge of, and respect for, culturally and linguistically diverse persons with disabilities and their immediate family members would facilitate the development of therapeutic alliances, medical and vocational rehabilitative efforts, appropriate and valid research methodology and other community supports. However, supporting this approach rarely goes beyond a few training sessions in cultural competence. Also, culturally and ethnically diverse persons, with or without disabilities, have not been recruited and retained in adequate numbers at institutions of higher learning, in rehabilitation counselor training programs, or in leadership positions (Douthitt, 1995) where, with appropriate support, they could have significant and meaningful roles in disability rehabilitation research and service provision within diverse communities. This is especially important because over 25 years of research has shown that people prefer being served by others of their own culture and, if possible, who speak their own native language.

Need for Cultural Competency

The need for cultural competency and cultural sensitivity is crucial for understanding the unique culture of each culturally and linguistically diverse group. For instance, professionals who attempt to reach out to diverse communities cannot underestimate the need to recognize the different values, beliefs, perceptions and practices of each culture regarding disability. Knowing this, we need to actively work towards understanding cultural differences and incor­porating strengths found within them to effectively work with diverse persons with disabilities. In addition, cultural competency also requires significant training of personnel in rehabilitation, disability research and human service support systems in the southeast region and nationwide.

Recommendations

To effectively work with culturally and linguistically diverse persons with disabilities, VR agencies need to:

Specific training, such as the ones provided by the TACE Center in the southeast region, can also prepare rehabilitation personnel to design and implement services that are effective in the following ways:

To make progress in these areas, we need not merely to understand, but also to document, the effectiveness of the new paradigms of disabil­ity in which the medical model alone is no longer effective for understanding disabilities but the social model of utilization and delivery of rehabilitation services is more inclusive and effective for all populations. Environmental determinants of disability must be explored, including attitudinal, cultural, environmental, and social bar­riers in society that contribute to mental and physical disabilities. This new paradigm requires that we do not simply shift the focus from the person to their environment but, instead, that we explore the dynamic interplay between the individual and environment, including architectural designs and communication systems that can be enhanced to support quality of  life for persons with disabilities from diverse cultural and ethnic backgrounds.

Need for Culturally Appropriate Methods

There is a need for appropriate approaches and methods to be used when addressing disabilities in culturally diverse communities that are both culturally grounded and sensitive to the needs of the group. Involving culturally and linguistically diverse persons with disabilities in research, education and training and service delivery has been critical to gaining understanding of their unique needs and cultures, but doing so has sometimes created more challenges and been more difficult than expected. Wong Hernandez (1995 & 2009) and Balcasar (2002) outlined and expanded a list of general principles and strategies for improving outreach activities to culturally diverse persons with disabilities for their involvement in service delivery and also as service recipients as in the case of vocational rehabilitation counseling. This list included:

  1. Effectively addressing the real needs of culturally and linguistically diverse persons with disabilities,
  2. Recruiting and employing a diverse research, education and training team to work with diverse populations,
  3. Establishing personal relationships with members of the community to gain understanding of their values and culture,
  4. Becoming part of the local network by having regular con­tacts from agencies,
  5. Focusing on and developing the strengths of culturally diverse persons with disabilities,
  6. Be­ing persistent and not letting diverse persons with disabilities have unsuccessful services outcomes when they fail to comply due to dissatisfaction with services,
  7. Being a good listener to build a reciprocal process of communication and trust,
  8. Utilizing members of the target community in outreach efforts,
  9. Meeting people where they live and work instead of having them come to you,
  10. Using different modes of communication to disseminate information to the community,
  11. Implementing appropriate and qualified language translators when needed, and
  12. Volunteer­ing time in the community to show your commitment.

Recommendations

In light of the barriers faced by culturally and linguistically diverse persons with disabilities, at the Southeast TACE Center: Region IV, we encourage taking proactive steps towards re-evaluating and changing the approaches and methods for working with diverse communi­ties to better fit specific culturally diverse groups. The challenges of providing services and equitable treatment for culturally diverse persons with disabilities by the human service provider’s field, vocational rehabilitation system and educational settings need continual attention and progress. Only when disability researchers, practitioners, instructors, and support personnel are able to adequately understand the unique issues related to culturally diverse persons with disabilities will they begin to effectively address their needs and obtain successful outcomes. This will require strategic plans that involve multiple stakeholders with experience and knowledge in the area of disabilities and culturally-based services for diverse populations and an on-going effort in the advancement and improvement of research and best practices for services delivery for culturally and linguistically diverse persons with disabilities.

The Southeast TACE Center: Region IV offers in-depth technical assistance for VR agencies in the Southeast region on cultural competency, including additional training and consultation.

For More Information:

Contact TACE Region IV at

Disclaimer

The TACE Center: Region IV Newsletter ©2009 was developed with funds from the U.S. Department of Education, Rehabilitation Services Administration (RAS) under the priority of Technical Assistance and Continuing Education (TACE) Projects - Grant# H264A080021. However, the contents of this Newsletter do not necessarily represent the policy of the Department of Education, Rehabilitation Services Administration (RSA), and you should not assume endorsement by the Federal Government [34 CFR 75.620 (b)].