Hearing Loss and Diabetes in an African American Adult

Research has linked hearing loss to other medical conditions such as diabetes. Studies have shown that hearing loss is more common in individuals who have diabetes than in those who do not. Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and the blood vessels. Consequently, diabetes can affect the blood vessels of the inner ear and the vestibulocochlear (VIII cranial) nerve fibers. This case study examines the interrelationship between diabetes and hearing loss in an African American adult while examining the issues of the higher prevalence of diabetes in African Americans and the role of audiologists in the care of individuals with hearing loss and diabetes.

Dysphagia Management in Culturally-Linguistically Diverse Populations

Culturally competent management of adults with swallowing disorders involves more than simply including ethnically appropriate foods in dysphagia therapy. It requires an understanding of the client's health beliefs, challenges, and unique cultural perspective regarding all aspects of food to ensure unbiased and culturally appropriate services are provided. This chapter begins with an overview of dysphagia management followed by a closer look at cultural beliefs regarding food and ethical conflicts that may arise. The strategies for shared decision-making presented help create a culturally sensitive dynamic between the clinician and the patient/family that positively influence therapy outcomes. The chapter concludes with a case study that highlights the importance of ethnographic interviewing needed to establish understanding and trust between the clinician and an elderly Mexican woman and her family. The strategies and techniques presented here can be applied across all cultures to achieve successful management of dysphagia.

Systems-Based Approaches to Speech-Language Pathology Service Delivery for School Age Children

This chapter will provide readers with an overview of how a systems-based approach can be used to understand the relationship between culture, environment, language, and disability. It will identify a useful model of ecology, culture, and development that can and should be considered in conjunction with the WHO-ICF framework to guide service delivery in school-based settings. This chapter will also provide an overview of systems-based approaches that can be used when working with children from traditionally marginalized backgrounds. Finally, a case study example will be used to provide guidance on the application of systems-based approaches to service delivery for children in school-based settings.

Navajo Speech and Language Evaluation

The case study highlights the importance of culturally and linguistically appropriate assessment of young Navajo/American Indian children and the importance of alternative assessment procedures to support appropriate diagnoses and recommendations. The case also illustrates systemic issues that result in lack of coordinated care, appropriate diagnosis, and lack of American Indian speech-language pathologists who understand linguistic and cultural differences. The case is based on a typical experience when clinicians who are not familiar with the Navajo language perform speech-language evaluations in Navajo-speaking communities.

Traumatic Brain Injury in Culturally Diverse Populations

This chapter highlights traumatic brain injury (TBI) and various health disparities within this population, particularly gaps related to patients from culturally diverse backgrounds. A review of three main health disparities is included, related to increased risk for sustaining a TBI, intervention barriers related to TBI, and long-term outcome after TBI. This chapter also evaluates how culture influences aspects of TBI intervention by exploring cultural considerations apparent in diverse populations. The chapter concludes with an examination of a case study based on an actual patient who sustained a TBI and details how his Native American culture impacted his healthcare choices and how his healthcare providers adapted intervention strategies given cultural influences unique to his clinical presentation.

Working With Deaf and Hard-of-Hearing Children From Linguistically Diverse Backgrounds

An increasing number of deaf and hard-of-hearing (D/HH) children live in homes where languages other than English or American Sign Language (ASL) are used. This chapter reviews issues of culture and linguistic diversity when working with D/HH multilingual learners (DMLs) from identification and early intervention through school entry. The authors will provide two case studies to explore the issues of service delivery to DMLs and their families: 1) Ji-Hun, who appears to use several spoken languages, including Korean, Japanese, and English, and 2) Ana, who is a recent immigrant to the USA and appears to use ASL, spoken Spanish, and spoken English. The discussion of these two case studies will encompass some cultural differences, including 1) openness to engagement with providers, 2) cultural beliefs about hearing loss, 3) community systems and familiar support, 4) perceptions of systems and authorities. The case studies presented are not based on actual clients but are drawn from the clinical experiences of the authors.

Factors Influencing Aphasia Assessment for Bilingual Adults

This chapter provides a brief overview of stroke, aphasia, and aphasia assessment. Additionally, it considers various issues associated with the standardized assessment of aphasia, including problems related to cultural and linguistic biases. The chapter also includes information on working with people who are bilingual, as well as working with interpreters. A hypothetical case study is presented as a teaching avenue to discuss these topics in greater length. This section contains details regarding how both cultural and linguistic barriers associated with the assessment of the patient's aphasia may have influenced the intervention provided by the speech-language pathologist (SLP). Medical terminology and procedures related to stroke intervention are also discussed as it relates to the SLP's plan of care.

Sickle Cell Disease and Hidden Hearing Loss

Sickle cell disease (SCD) is an autosomal recessively inherited group of red blood cell disorders. It is more commonly found in African Americans and Hispanics in the United States. The sickle-shaped cells characteristic of the disease cause physiological problems, including hemolytic anemia and vaso-occlusion. Research has linked hearing loss to sickle cell disease. Studies have shown that children and adults with sickle cell disease may have higher rates of sensorineural and central auditory hearing impairment. This case study examines hidden hearing loss in an African American boy with SCD who presents with normal hearing thresholds. It also discusses the role of audiologists in the care of individuals with sickle cell disease and hearing loss.

A Bilingual Child Diagnosed With Autism Spectrum Disorder (ASD)

Silvia and Antonio Juarez described their 4-year-old son Emanuel as often happy. Emanuel came from a bilingual home and spoke both Spanish and English. His favorite activities were reading and playing with his iPad over-and-over again. Reading was a favorite pasttime and something that the Juarez's felt he did well. While he was described as “loving to engage people,” it was not clear that his efforts were successful nor was it clear that they were reciprocated. Briefly observing Emanuel's interaction with his parents, it was noted Emanuel used echolalic phrases and engaged in repetitive and restricted behaviors, toe walking, and finger flicking. These behaviors were noted to be unusual and warranted further evaluation. The Juarez's primary concern was regarding Emanuel's “talking and being able to hold a conversation.” Through speech and language therapy, the family expected that Emanuel's communication skills would improve, and he would be able to participate in conversations and talk in sentences.

Intervention Services for a Child With Multiple Disabilities

This chapter will focus on providing intervention services for an eight-year-old African-American female, Dawn, with multiple disabilities. Dawn has been diagnosed with Down syndrome, a comorbid diagnosis of an intellectual disability, and exhibits behavior problems at home and school. In this scenario, she has been evaluated within the school system to determine eligibility for services, and the speech-language pathologist needs to develop intervention goals and select therapy strategies to provide appropriate services. While both parents are involved in the child's care, the family does not have permanent housing and moves frequently. Information from actual cases has been incorporated into this chapter.