F-2: Identify and integrate relevant cultural variables in the assessment process ©
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Target Terms: cultural variables in assessment, cultural humility, cultural competence
Definition: Culture is basically a word that describes a way of life for a group of people.
Cultures can have to do with values (like what it means to work hard or how elderly people should be cared for), beliefs (like religion or spiritual beliefs), rules (like unwritten or written societal rules), expression (like art and music), daily living characteristics (like sleep schedules), food and drink, leisure time, work characteristics, child rearing, and so on. A culture can apply broadly to a huge group of people, but it also applies to a small group, like a household.
As you can imagine, cultural influences are pretty darn important when we’re talking about meaningful behavior change. During assessment, it is important to consider the entire learning history of the individual in front of you. It is crucial that we de-center our experience and center the experience of the person we’re working with.
It is not enough to look past cultural differences. Being “culture blind” makes no sense, and it’s the opposite of what we should be doing as responsible clinicians. To gain a full understanding of our clients, we must acknowledge important cultural variables related to things such as: daily routines, communication, social dynamics, norms around work and leisure, and much more.
Important steps behavior analysts can take to integrate a client’s cultural experience into assessment:
- Really take the time to listen to what people are telling you – with their words and their actions
- Cultural competency- take time to understand a client’s culture in order to interact effectively
- Cultural humility- self reflect on our own assumptions about others’ cultures
- Cultural responsiveness- once you have an understanding of a client’s cultural experience, use that to make decisions
Clinical example: Jose lives in the USA and has been referred for early intervention to help him with social skills and language development. Jose comes to the initial intake appointment with his mom, who speaks fluent English. However, the clinician makes sure to ask about cultural aspects of Jose’s family, and finds out that Jose’s dad (who also lives in the household full time) does not speak English at all! Jose is being raised in a bilingual household. Imagine if Jose’s clinician had not asked about language – Jose could have been taught to mand and tact exclusively in English, which would have potentially added a huge strain within his family. Jose’s clinician makes sure to include both of Jose’s parents and designs a language acquisition program that includes the languages Jose’s family speaks.
Clinical example: Daphne is a client in a school. Every day, she brings her own lunch to school. It is usually a large piece of cooked chicken. Daphne’s family expects her to be able to eat this meal without help and without utensils. Instead of telling Daphne’s parents that they are being ridiculous, or pulling out the “template” meal skills task analysis and teaching Daphne to cut her food into tiny bites with a plastic knife and fork from the cafeteria, Daphne’s clinician accepts that Daphne needs intervention in how to eat her meals in a way that’s consistent with her cultural norms.
Clinical example: Sara is a behavior analyst who is doing a parent interview as part of an FBA. During the interview, the parent mentions that the child, who is 5 years old, is still occasionally breastfed in the home. Sara accepts this and moves on with her work, regardless of whether she would personally want to breastfeed a child that age. Sara knows that it is not her job to comment or criticize other people’s cultural child rearing choices unless (1) someone is in danger, or (2) they ask for her help.