CULTURAL INFLUENCESIN DISABILITY & I/DD

Alya Reeve, MD, MPHDDMI-TUG 7-14-14

WHAT IS CULTURE?

Culture can be defined as the ways people live with each other, differentiating themselves from other groups of people. Culture reflects an integrated system of learned

behavior patterns characteristic of a society that are not a result of biological inheritance.

It is often expressed by customary beliefs and social forms of a group.

Can you cite examples of culture?...

WE ARE INFLUENCED BY CULTURE(S)

All people are affected by and reflect their culture.

Attitudes about I/DD differ in Hispanic, Native-American, African-American, Mid-Eastern, Asian, and European cultural groups in the US.

Disabilities can create their own subcultures. Cultural differences affect attitudes toward

disability and even acceptance of services

CULTURES WITHIN CULTURES

Habits and attitudes are learned as part of socialization. Attitudes affect expectations of and

opportunities provided to people with I/DD.

Assessment of adaptive behavior functioning needs must take into account some biases of current assessment tools.

CULTURAL ASSUMPTIONS

People with disability all have low IQ If people do not talk, they do not

understand Sensory problems often form sub-

cultures, with short-hands of communication and self-identification

Religious and regional variations

FACTORS AFFECTING BEHAVIOR

Attitudes toward Disability

Family Structure Urban – Rural Family Training &

Disciplinary Practices Gender Inclusion – Protection

SES & Education Communication Styles Acculturation Mental Health Issues Language Barriers Religion

ASSESSMENT OF ADAPTIVE BEHAVIOR

Informant Selection Cultural Communication Styles Informant Interviews Evaluation of Opportunity vs. Ability Norm-based Assessment vs. Service

Planning Information

ADAPTIVE BEHAVIOR ASSESSMENT

Adaptive behavior expectations: The training in how to apply existing assessment

tools needs to include specific attention to influences of culture on opportunities and missed opportunities for people with I/DD and other disabilities.

The biases of current assessment tools have to be part of the developing awareness in using these tools and the push to develop more appropriate and attuned tools in the future.

IMPORTANCE

Inclusion Interpretation of attitude

Professionals Clients

Adaptation of tests Making sure real problems are identified Strengths be properly assessed and

supported

INCREASE AWARENESS

Discussions For teams concerning challenging situations Guardians, teachers, other professionals

Case-sharing Clinical review; Mentoring; Supervision; Training

INCREASE AWARENESS

Direct teaching Professional training classes Informal mentoring in public settings

Biographies People with disabilities telling their experiences

Oral and written formats Validation of struggles and successes in overcoming

barriers

LANGUAGE OF INCLUSION

People First “person” with “conditions”…

Having respect for traditions Eye gaze Greetings; names

An open-ness about disability v. challenges in functioning

CONCLUSIONS

Culture is all around us. If we do not talk about how we are

individually and collectively influenced by culture we do ourselves disservice.

We will commit unnecessary errors of judgment and assessment that will not produce the intended supports for people with I/DD.