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Becoming culturally competent early intervention providers

Five key principles promote culturally competent practices in early intervention. Culturally competent early intervention providers:

1. Expect, and appreciate, that parenting and child development practices between culturally diverse families will often be different. One mother may nurse her child until 30 months of age and another weans her baby at age 6 months. One father places his child’s hands around a football during play and another considers play with infants something that only mothers do. One grandmother sees her role as “spoiling” the first born son of her own son and another takes great pleasure in teaching her grandson to feed himself.

A culturally competent early intervention provider understands that each of these examples is “right on”- for that particular parent and family. There is not one standard for judging a father’s play, how long for a mother to nurse, or how grandmother should prompt a grandson’s independence.

2. Look for and find ways to support the meaning an individual gives to specific behaviors (Landrine, 1995). In the example in the first principle, the mother who nursed her child for several years followed the examples of her mother, aunts and cousins, and would consider it a great disruption in raising her child if she could not do so. The second mother feels remorse in giving up breast feeding as she returns to work, but also is pleased that she could do so for 6 months since neither her mother or her grandmother nursed their babies. The nursing behavior of both mothers is rooted in their own culturally derived belief systems. If it happened that their children could not be adequately nourished through nursing, alternative recommendations from medical personnel and/or early intervention providers could be met with very different acceptances from each parent.

A culturally competent early intervention provider would explore multiple options, and their meanings and consequences, with each parent in order to help her select and embrace another way to feel good about feeding her child. This provider would recognize that suggestions that require big changes in behavior, or that do not complement each mother’s values, will require more support and exploration before they are accepted, if at all.

3. Recognize the potential for barriers when they interact with people from cultures different than their own because of the various meanings and values connected to family life and parenting. The discomfort and conflict which often arises among people from different backgrounds has been called a “cultural bump” (Archer, 1986). Cultural bumps signal the unfamiliar, and may result in minor discomfort (e.g., do I take my shoes off before entering this family’s home?) or major discomfort (e.g., family members relying on “folk” remedies rather than giving a child physician prescribed medication). Cultural bumps result from differences in how individuals view their:

  • Sense of self: learning who you are and how to act
    (e.g., how to address elders; acceptance of special physical or mental conditions; which personal characteristics are valued by family and community);
  • Funds of knowledge: access to information to guide important life events
    (e.g., who to go to for advice about relationships or money; how to find good medical care or the right herbs to treat specific symptoms);
  • Perceptions of power: behavior and skills associated with status and privilege (e.g., speaking English versus another language; speaking up in public or to authority figures)


4. Craft respectful, reciprocal and responsive relationships with people from cultures different from their own.

Being willing to create respectful, reciprocal and responsive relationships is just as important in becoming culturally competent than how much information one has about beliefs and mores of various cultures. Skilled dialogue promotes relationships between families and early intervention providers (and among providers) that are:

  • Respectful. Respect is demonstrated by acknowledging and accepting the boundaries that naturally exist between people. Physical boundaries (e.g., how close to stand to another person, always making eye contact with elders) and emotional boundaries (e.g., making small talk before discussing serious issues; whether to bring up family matters before strangers) both connect and distinguish people from one another.

    Understanding that many Cambodian families believe a person’s head is the most important part of the body because one’s spirit rests there, Dante was sure to ask Sooyen’s parents if he could touch Sooyen’s mouth and cheeks before beginning his feeding assessment.

  • Reciprocal. Helping others identify, and value, the contribution of each person restores the balance among family members and early intervention providers, or among providers. All people are equally valued and one person is not viewed (or acts as) an expert authority who has the “right” answers.

    During her home visit with Sam’s family, Leathia recognized that she was slipping into a nonproductive judgment about Sam’s mother (“She is more interested in watching TV than talking with me.”) Leathia consciously made an effort to switch her thinking to, “Here’s someone who may benefit from what I know about playing with toddlers, and from whom I can learn what Sam likes to do.”

  • Responsive to family values and beliefs. Responding to another person’s values and beliefs is not becoming responsible for someone else. Before focusing on answers and suggesting strategies, culturally competent early intervention providers consider a family’s life style and offer choices that may still need some “tinkering” to make the right fit. They avoid assumptions and instead, draft “lightly held hypotheses” about what others know and believe (Barrera & Corso, 2003, p.47).

    Listening to Mrs. Pena talk about how she wanted Mayra to sit at the table and eat “all by herself” during the family dinner each day, Silvia wondered how independent Mrs. Pena really wanted Mayra to be in 3 months. Silvia realized she needed to spend some more time understanding what the Pena dinner was like, and how this family viewed independence before offering suggestions that might be aligned more with her beliefs about independent feeding for young children with motor delays.

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