Cultural Competence in Bilingual Social Communication Assessment: A Case Study The purpose of this article is to highlight how cultural considerations impact assessment and diagnostic decision making. This article addresses the steps involved in conducting a culturally sensitive, comprehensive evaluation of social communication skills using the Autism Diagnostic Observation Schedule-2nd Edition (ADOS-2). This evaluation was conducted with a 13-year-old, bilingual ... Article
Article  |   April 26, 2016
Cultural Competence in Bilingual Social Communication Assessment: A Case Study
Author Affiliations & Notes
  • Shirley Huang
    Architects for Learning, Needham, MA
  • Disclosures
    Disclosures ×
  • Financial: The author has no relevant financial interests to disclose.
    Financial: The author has no relevant financial interests to disclose.×
  • Nonfinancial: The author has no relevant nonfinancial interests to disclose.
    Nonfinancial: The author has no relevant nonfinancial interests to disclose.×
Article Information
Special Populations / Cultural & Linguistic Diversity / Autism Spectrum / Language Disorders / Social Communication & Pragmatics Disorders / Part 1
Article   |   April 26, 2016
Cultural Competence in Bilingual Social Communication Assessment: A Case Study
Perspectives of the ASHA Special Interest Groups, April 2016, Vol. 1, 29-41. doi:10.1044/persp1.SIG14.29
History: Received January 22, 2016 , Revised March 22, 2016 , Accepted March 22, 2016
Perspectives of the ASHA Special Interest Groups, April 2016, Vol. 1, 29-41. doi:10.1044/persp1.SIG14.29
History: Received January 22, 2016; Revised March 22, 2016; Accepted March 22, 2016

The purpose of this article is to highlight how cultural considerations impact assessment and diagnostic decision making. This article addresses the steps involved in conducting a culturally sensitive, comprehensive evaluation of social communication skills using the Autism Diagnostic Observation Schedule-2nd Edition (ADOS-2). This evaluation was conducted with a 13-year-old, bilingual Cantonese-English speaking teenage girl. She had a history of atypical social behaviors and language disorder, diagnosed at age two. Her complex social difficulties were previously overlooked by professionals and misunderstood as related to her Chinese culture and/or prior history of language disorder. Conducting a culturally appropriate assessment was further complicated by the family's lack of English proficiency and low socioeconomic status, and related challenges they experienced with accessing and navigating the healthcare and special education system. Lisa was referred to a multidisciplinary team, which included a native Cantonese-speaking speech-language pathologist (SLP), to determine the nature of this teenager's social challenges. The team's understanding of the layers of cultural influence on social development—overarching Chinese values, local Chinese community, and the family environment—played a key role in determining whether this teenager's social behaviors were acceptable in either the Chinese or mainstream American culture. Evaluation results shed light on this teenager's long-standing social interaction difficulties, and were consistent with a diagnosis of autism spectrum disorder (ASD). With this newly understood diagnosis, the family reported they felt relief in knowing how to best support their daughter.

Acknowledgements
The author wishes to extend special thanks to all the professionals at the Center for Children with Special Needs who were involved in this diagnostic evaluation.
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