and perhaps the most focal consideration of how cultural dimensions apply in clinical service provision, engages not only the cultural tendencies (characteristics/traits) of practitioners, clients and other involved groups (e.g., family members and immediate communities), but, more vitally, how all these people (either individually or in groups) interact with each other. The ultimate aim is working toward building SLP skills that enhance collaborative practice between provider and client, alongside culturally competent practice that is founded on shared knowledge, mutual understanding and respect—a practice that tackles disabilities across populations as well as individually (e.g., Reid, Secord, & Damico, 1993; Verdon, Blake, et al., 2016).
2.5.2 Language and Linguistic Diversity
As just stated, language is a fundamental cultural dimension, because it is not just symbols reflecting reality, but a means to understand that reality, which concurrently influences an individual’s views of the world—a concept reiterated in linguistic relativity theory (e.g., Boroditsky, 2006). Language includes oral, written, and signed forms, and belongs to the larger framework of human multimodal communication where both linguistic (spoken/non‐spoken) and nonlinguistic (nonverbal) (e.g., kinesthetics, proxemics, chronemics) modalities are at work. Linguistic, paralinguistic, and nonlinguistic modalities are very revealing for communicative disorders in general, and especially when minority communities (e.g., deaf, indigenous, transgender) are concerned; nevertheless, like culture, these modalities may sometimes surface as secondary in clinical practice. In the background of such constructs stands context, which is what stirs the course of everything, that is, cognitive learning processes and outcomes, type(s) and ultimate attainment in language acquisition, variability in language use and usage, how all these manifest underlyingly or overtly in SLDs, and the degree to which the influence of such factors are accounted for in clinical service provision.
Sociolinguistic variation is the norm (e.g., Babatsouli, 2019a; Ball, 2005). Context, whether geographic, social, ethnic, political, cultural, disability‐related, and so forth, generates diversity in language. Linguistic diversity takes many forms, which at a primary level surfaces as language families. There are more than 7,000 languages in six macro areas in the world, a number that will double if manual language is incorporated (Ethnologue, 2019). Language diversification results from dialectal variation when dialects cease to be mutually intelligible. A difference between a language and a dialect, though, is nowadays based on political considerations: “a language is a dialect with an army and a navy” (Weinreich in Anderson, 2019). There is currently no estimation of how many dialects there are in the world, while individual languages have numerous dialects. Another type of linguistic variation is diglossia, where a single language community has access to both a low/vernacular and a high/prestigious version of their language; Standard and African American English is an example of present‐day diglossia (Babatsouli, 2019a). A theoretically based understanding of the nature of specific SLDs in bidialectal and diglossic communities are very revealing for the learning processes that pertain within such disorders.
Regional (geographic) and social (cultural) variation affects all grammatical levels in language, but pronunciation (speech), which is less prone to standardization, is affected the most (Maclagan, 2005). In speech sound disorders (SSDs), speech production outputs are indications, or decisive manifestations, used to disentangle difference from disorder, in the same way that behaviorally (thus culturally) defined criteria guide diagnosis in SLDs at large (e.g., Bowen, 2014; Norbury & Sparks, 2013). Goldstein and Horton‐Ikard (2010 and refs therein) define: “language difference (i.e., expected variations in syntax, morphology, phonology, semantics, and pragmatics) and a language disorder (i.e., a disability affecting one’s underlying ability to learn a language)” (p. 54). Different dialects carry different cultural connotations in terms of class, gender, and ethnicity, and some of them are negative and lead to social disfavor or stigma. Such “linguistic subordination” tends also to have a negative effect in clinical practice, where the presence of dialect may bring about refusal of service provision to minorities (Wolfram & Forrest, 2019) or may be misinterpreted as disorder (Battle, 2012). ASHA policies and codes clearly state that no dialect is better than another, but the issue of dialect in SLDs remains intricate in that there is still some confusion that leads to inconsistent approaches in service delivery among professionals.
On a separate level, language also varies based on both the user (in terms of identity and group membership) and the use, referring to deviations in speech style (i.e., language register), as speakers shift registers within and between different social situations. Other gradations in language variation relate to age (e.g., slang, neologisms, vs. older people’s use/idiolects), globalization effects (e.g., lingua francas), gender and sexuality, and so forth. Identification and knowledge of the many faces of linguistic diversity is paramount because, first, normative is defined based on mainstream majority usage that tends to ignore the “correctness” of minority usage, and second, processes of standardization tend to be partial as they do not account for all the facets of typical language and for ascertaining all‐encompassing norms to guide the diagnosis and remediation of impairment.
2.5.3 Language and Diversity in Acquisition
Context, the main generator of linguistic diversity, is also an instigator of variation in language acquisition. Language may refer to any linguistic code, whether it is an actual spoken language, a dialect, a non‐spoken (manual/signed) language, or a communication modality. Acquisition refers to both implicit (unconscious) and explicit (conscious) learning; it may also involve naturalistic situations, instructional settings, or combination(s) of both. Acquisition may take place endogenously or exogenously in terms of whether the language(s) targeted is the ambient one or not (i.e., the language of the environment or the larger community), in monolingualism, bilingualism, multilingualism, bilectalism/bidialectalism (two dialects), multilectalism/multidialectalism (many dialects), heritage language (home language different from community language), or diglossia; among these one also finds passive use, that is, the speaker comprehends but purposely refrains from speaking. It is worth noting that the state of being bilingual (in the senses just delineated and irrespective of proficiency levels) incorporates aptitude (langue) and skill (parole) on both the linguistic and the cultural terrain since, as mentioned earlier, linguistic symbols are interpretations of cultural entities, often non‐translatable, as in the case of la Día de los Muertos, la quiche, yin‐yang or φιλότιμο .
Context may also affect language acquisition and its outcomes in terms of the age, timing, degree, and length of exposure to linguistic input, the quantity and quality of linguistic input, the number of languages, executive processing, the actual course of development, universals, and individual variation, patterns of interference, language status and dominance, social and affective factors, and in terms of the end result, sometimes referred to as ultimate attainment, with regard to nativeness or native‐likeness, fluency, proficiency, presence or absence of accent, language attrition and loss, and so on. These are all factors that give rise to a number of related terms and definitions in language acquisition research, the most predominant of which have already been mentioned, but there is also an abundance of them less cited, whose sheer enumeration serves as further evidence of the diversity witnessed in language acquisition patterns (see Babatsouli & Ball, 2020).
The acquisition of language is investigated by three to four main fields in applied linguistics, primarily distinguished into: first language (monolingual), bilingual and/or multilingual (terms with decisively overlapping semantics), and second language acquisition, that is, FLA, bilingualism, multilingualism, and SLA, respectively. Further convergence is identified across these fields in that bilingual and multilingual child development may also be considered relevant in the study of first language acquisition (as in simultaneous acquisition of languages) or second language acquisition (as in successive acquisition of languages), as well as in the fields of bilingualism/multilingualism. Similarly, the study of second (or third, fourth, etc.) language acquisition in adulthood (meaning post‐puberty) may still fall within the regimen of the study of bilingualism or multilingualism.