Cultural Competence Checklist:Personal Reflection
_____________________
*While several sources were consulted in the development of this checklist, the following document inspired its design:
Goode, T. D. (1989, revised 2002). Promoting cultural and linguistic competence self-assessment checklist for personnel
Providing services and supports in early intervention and childhood settings.
Reference this material as: American Speech-Language-Hearing Association. (2010). Cultural Competence Checklist: Personal reflection. Available
from http://www.asha.org/uploadedFiles/Cultural-Competence-Checklist-Personal-Reflection.pdf
.
© Copyright 2010 American Speech-Language-Hearing Association. All rights reserved.
This tool was developed to heighten your awareness of how you view clients/patients from
culturally and linguistically diverse (CLD) populations.
*There is no answer key; however, you should review responses that you rated 5, 4, and even 3.
___ I treat all of my clients with respect for their culture.
___ I do not impose my beliefs and value systems on
my clients, their family members, or their friends.
___ I believe that it is acceptable to use a language
other than English in the U.S.
___ I accept my clients’ decisions as to the degree to
which they choose to acculturate into the dominant
culture.
___ I provide services to clients who are GLBTQ (Gay,
Lesbian, Bisexual, Transgender, or Questioning).
___ I am driven to respond to others’ insensitive
comments or behaviors.
___ I do not participate in insensitive comments or
behaviors.
___ I am aware that the roles of family members may
differ within or across culture or families.
___ I recognize family members and other designees
as decision makers for services and support.
___ I respect non-traditional family structures (e.g.,
divorced parents, same gender parents,
grandparents as caretakers).
___ I understand the difference between a
communication disability and a communication
difference.
___ I understand that views of the aging process may
influence the clients’/families’ decision to seek
intervention.
___ I understand that there are several American
English dialects. I recognize that all English
speakers use a dialect of English.
I understand that the use of a foreign accent or
limited English skill is not a reflection of:
___ Reduced intellectual capacity
___ The ability to communicate clearly and effectively
in a native language
I understand how culture can affect child-rearing
practices such as:
___ Discipline
___ Dressing
___ Toileting
___ Feeding
___ Self-help skills
___ Expectations for the future
___ Communication
I understand the impact of culture on life activities,
such as:
___ Education
___ Family roles
___ Religion/faith-based practices
___ Gender roles
___ Alternative medicine
___ Customs or superstitions
___ Employment
___ Perception of time
___ Views of wellness
___ Views of disabilities
___ The value of Western medical treatment
I understand my clients’ cultural norms may
influence communication in many ways, including:
___ Eye contact
___ Interpersonal space
___ Use of gestures
___ Comfort with silence
___ Turn-taking
___ Topics of conversation
___ Asking and responding to questions
___ Greetings
___ Interruptions
___ Use of humor
___ Decision-making roles
Ratings:
1 Strongly Agree
2 Agree
3 Neutral
4 Disagree
5 Strongly Disagree
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