& Negi, N. (2012b). Among the lessons I have taken away from my experiences as an intern: Shabnam Etemadi is a clinical mental health counseling student in the professional counseling program at Middle Tennessee State University. Best Practices to Support Immigrant Families Involved in the Child Welfare System (PDF - 502 KB) The Office of Immigration Statistics reports that, in the United States, in 2005 alone . Your email address will not be published. These platforms and resources prioritize visual simplicity and design clarity, low-literacy and low digital literacy needs, and cultural and linguistic adaptability. One study reported that 17 percent of the pediatric refugees had weights below the fifth percentile, and that only 39 percent of the pediatric refugees had adequate immunizations.11 Also, children are not immune to the trauma, including sexual trauma, related to the refugee experience. Language barriers, the stress of immigration, sociocultural dislocation, and discriminatory U.S. policies towards immigrants contribute to the likelihood that immigrant families are more vulnerable and therefore more likely to have health and mental health problems. U.S. Department of Health and Human Services. Rape, torture or other physical suffering, such as land mine accidents, are also a reality of life affecting refugees during times of war and conflict.58 Although camp conditions are often poor, high crude mortality rates of refugees have drastically been reduced because of the services provided by the world community.9 Before acceptance as political asylum claimants, refugees receive an overseas examination by public health advisors and/or physicians, although it may be inadequate and not timely.10,11, Cultural barriers between physician and refugee patients can affect the outcome of the encounter. In their work with immigrants, social workers equally used interventions rooted in the immigrant and the dominant cultures, and the two types of interventions were complimentary. Impoverished immigrants have more need to contact public service systems like public hospitals or welfare agencies due to the problems they are experiencing, and frequent contact with these systems makes them more visible at times of greatest risk. Because practicing physicians may not be aware of these factors, networking between the refugee agency, the physician and the community or governmental resource is essential in the provision of health care. Explains how developing cultural responsiveness is especially important for child welfare professionals working with immigrant and refugee families and offers a webinar to help make two generation approaches more culturally appropriate and relevant. The number of minority nurses meets the needs of the countrys demographics. The value of emotional expression may not be a familiar or welcomed experience by some cultures. . Bethesda, MD 20894, Web Policies See whats new to this edition by selecting the Features tab on this page. Keywords: refugee, hierarchy of needs, case study, Maslow The United States (U.S.) has a history of welcoming resettled refugees. They question the relevance of counseling because mental health is not an aspect of their development that has been emphasized previously in any way. In most cultures, women are subservient to men, and added freedom in the United States may alter the family's dynamics. That word being mood. When we discuss stereotypes and bullying, they are also learning these words along with the concepts. However, when these people leave their . Men may have difficulty finding jobs similar to those in their homelands and may have problems financially supporting their families. Noncompliance with medication and treatment protocol is often a problem. I do not need an office to help people. These interpretation difficulties may arise when the newcomers first come in contact with Western physicians while maintaining their previously held beliefs and expectations of the healing roles of witch doctors and priests from their homelands. I always wanted to work with this population but did not know how to start. Available Formats. Center on Immigration and Child Welfare (2019) I am an immigrant myself and a counselor. Bookshelf Ascertain whether the patient speaks English or not, their native dialect, and the degree of acculturation. Alcohol abuse related to the new freedom and the prevalence of alcohol in our society may add to the problem. Define cultural competency 2. The .gov means its official. HHS Vulnerability Disclosure, Help Some individuals are in the U.S. alone; others have large families, and some have children who are citizens. Cultural Competency in Child Welfare Practice: A Bridge Worth Building Thousand Oaks, CA 91320 Bridging Refugee Youth and Childrens Services Epub 2020 Nov 27. You will learn about the differences between refugees, immigrants, and asylees. FOIA You are in: North America Depression Looks Like Me. Disclaimer. on cultural competence and working with interpreters, andthe University of Minnesota's Introduction to Immigrant and Refugee Health online course, which includes a module on . In addition, as children quickly assimilate into Western culture, conflicts with their parents may arise. This problem has been solved! Aspen Institute & the Migration Policy Institute (2021) The prevalence rate of female genital mutilation is between 5 and 99 percent in the 26 African countries where this practice is used.25,26 Depending on the extent of the procedure undergone, patients may have a complicated labor and delivery.27 During the second stage of the labor, infibulated patients, ones who received a more severe form of genital mutilation, may require anterior as well as posterior episiotomies before delivering the infant's head.28 These patients challenge the physician during their routine and prenatal visits since pelvic examinations may be difficult to perform or may be painful. Chapter 7: Practice With Individuals; Chapter 8: Practice With Families There may be preexisting conditions or newly onset conditions related to situations from which they fled, or the stress of relocation may trigger a preexisting condition. The https:// ensures that you are connecting to the Addressing Obstetric Health Disparities among Refugee Populations: Training the Next Generation of Culturally Humble OB/GYN Medical Providers. Grounded in critical thinking and strengthened by an ecological systems perspective, the book presents six different models for applying and integrating Western theory and related practice strategies for working with individuals, families, groups, communities, organizations, volunteers, and local workforces. It is not hard to imagine the possibility of depression and health problems among immigrants, particularly single individuals or families, struggling financially with little education and job skills, with little social support and often enormous social isolation, and with extensive life-long histories of trauma. ISBN: 9781483377148. Individual counseling with an unbiased stranger can provide immigrants and refugees the opportunity they need to question the norms of anxiety, depression and trauma-based memories. Refugees are easier to access because they typically are part of state-funded programs and may be placed in homogenous residential areas (for example, in apartments). If you're new to CORE, below is an overview of our resources for refugees. I receive looks of confusion when I encourage the students to partake in positive affirmation activities or activities to increase their self-esteem (another new word for many of these students). They clap after each person shares and cheer for their friends to take their turn rather than to pass. Cultural Competence Secrets to Success With Immigrant Families: Spreading and Adapting 2Gen Working Practices [Webinar] This may be because of cultural differences or the day-to-day survival routine while fleeing their countries. 2021 Jun-Jul;33(3):326-333. doi: 10.1080/10401334.2020.1813585. Cultural respect is critical to reducing health disparities. In this brief, we highlight one . Mexican people may seem to agree when they really do not; nodding may mean nothing more than respect for the athletic trainer (Malat). These diseases include tuberculosis and parasite infections. It also requires well-educated, well-trained and experienced social workers who can effectively deal with increasingly diverse and troubled immigrant individuals and families. The following guidelines are useful to consider whenever you are working with a minority or culturally diverse group or individual; they are generic enough to be . Because refugee life is defined by the intersecting conditions of human suffering, cultural diversity, political power and public opinion, researchers face ethical issues unique to working within . Author Celia J . Reviews best practices for child welfare workers engaging with immigrant and refugee families and offers information on staff training and procedures, placement of children, and child welfare intersections with the immigration system. Cultural competence includes knowledge of a range of cultures, histories, world views, values, and beliefs; understanding of communication patterns and appropriate interviewing techniques; strengths and differences among and within diverse racial/ethnic groups; cultural expectations and help-seeking behaviors; and the integration of traditional, indigenous, spiritual practices that attend to the spiritual needs of families and children of color. Counseling is often a foreign concept to many immigrants and refugees. We need to emphasize preventive services in work with immigrant communities. View PCN-509 Cultural Consideration.docx from SOCI MISC at F.G. College for Women, Kharian Cantt. "Cultural issues" is a complex construct that often seems vague and indirect. 2020 Mar 6;20(1):292. doi: 10.1186/s12889-020-8398-1. Supervised administration of some medicine (i.e., tuberculosis prophylaxis) has proven effective in several cities and may be helpful for certain noncompliant patients. An interesting and thought provoking article. www.sagepub.com. Best of luck to you & please reach out should you need help in the future. State the four elements of cross cultural communication 2 The Importance of Cultural Competency Health care workers need to be aware of, and sensitive to . Running head: SHORT ANSWERS 1 Short Answers: Cultural Consideration Students My name is Cristina and I am a licensed clinician. Thank you for putting your experience in writing for all to read and benefit from. sharing sensitive information, make sure youre on a federal This is a form of empathy. Though we are only one small piece of the criminal justice system, learning about cultural and gender concerns is critical so that we properly engage and fulfill our mission of striving toward objectivity. National Child Traumatic Stress Network (2020) Child abuse and neglect may be the result of failed systems of care that further traumatize immigrant parents and children who are at greatest risk. Social workers need the support and guidance of culturally competent organizations that can enact a two-prong strategy: (1) continue recruitment and retention of diverse workers that can understand the language and culture of diverse clients; and (2) prepare all staff as culturally and linguistically effective practitioners. I learned a lot from your takeaway lessons as I would like to become a multicultural LPC. Immigrants often lack important information about how the health and mental health care system works, the financial resources to negotiate the system, and the confidence to advocate for themselves. Distt. Culture is different from race. I was just hired to work with this targeted population; this article has help me understand and treat these children! Family physicians have a unique opportunity to enrich their medical practices by learning about different cultures and endemic diseases and conditions, while providing quality health care to an at-risk population. Wishing you all the best in life today , tomorrow and always. As we close the group, the idea to share their feelings or reflections of an activity may be limited to Did you like the activity today? These are just a few of the counseling techniques I have modified so these group members can experience the power of counseling. to illustrate application. Contemporary forensic psychiatrists practice in a system that has gender and cultural biases. The relational . Although the countries that produce refugees may change, the pain and suffering of individuals do not. Parents often prefer that an authoritative counselor work with their child because, based on their viewpoint of counseling, that is culturally appropriate. SAGE With this population, culture may or may not play an active role in how individuals make sense of their lives and experiences. Ask about traditional beliefs as part of your cultural formulation. This training will cover Cultural Humility and Working with Afghan Clients. help readers review and master the material. Disclosure The authors have nothing to disclose. The U.S. unemployment rate soared to 14.7% in April, up from 4.4% in March, the highest monthly rate since 1948. Another focal area of counseling with this population is bicultural stress. Read Part 2. Promotes the value of collaboration between refugee service providers and child welfare agencies working together to serve refugee families. At least eighteen models of cultural competence have been proposed across disciplines. It has the strength to empower immigrants and refugees who in their cultures may not have been exposed to a helping service. 2007 Jun;46(2):157-71. doi: 10.1111/j.1545-5300.2007.00201.x. Practitioners should consider the risk of malaria in pregnant women, with the possibility of congenital transmission to the fetus and newborn.29 Malaria needs to be considered even in refugees who have been living in the United States a few years when they present with cyclic unexplained fever. For physicians and others to effectively provide services to refugees, a needs assessment should be done. Immigration often separates families from their extended family, resulting in an enormous loss of support (Heyck, 1994). Best wishes, In addition, cultural beliefs regarding the etiology of illness (e.g., weakening of nerves,18 an imbalance,19 an obstruction of chi,20 failure to be in harmony with nature), and distrust of and unfamiliarity with Western medicine may also contribute to noncompliance. Family and Community Centered Child Welfare Practice With Refugees and Immigrants A Few Best Practices for Working with Asian Patients 1. I have noticed that the members who are more proficient in English are better able and more likely to open up to the group. For example, undocumented immigrants may fear being identified and may thus shy away from par-ticipation in research studies, particularly if research might lead to their identification by . Migration Policy Institute(2021) Research is particularly needed on resiliency to determine the factors that keep immigrants in tact and healthy. New word is the empathic statement I find myself frequently using with my ninth-grade refugee group. Social workers can play an important role supply in closing the gaps. As I attempt to explain what emotions are and as I ask each student how they are feeling today, I teach them a new word. You can use an interpreter or refer out, but try to help in some way. <3Aura<3. Culture, or customs, beliefs, and products . 8600 Rockville Pike Aspen Institute (2021) Question: Explain cultural considerations that the counselor must account for when working with a client from each of the following groups (100-150 words each): Immigrants (Documented and Undocumented) Refugees Discuss the cultural issues and trends that specifically apply to each of the following regional population groups of the United States (100-150 words Fundamentally, cultural competence is the ability and the will to respond to the needs of clients arising from their culture, and the workers and clients ability to use their culture as a resource and strength to meet common human needs. PRACTICAL APPLICATIONS WITH TRAUMA-EXPOSED IMMIGRANTS AND REFUGEES, Chapter 13: Defining Trauma; Practical application with vulnerable and trauma-exposed immigrant populations and survivors of torture, Chapter 14: Practice applications with women, Chapter 15: Practical applications with LGBTQ immigrants, Chapter 16: Practice applications with Immigrant and Refugee Youth, Chapter 17: Maintaining critical consciousness, collaborative accompaniment and cultural humility: The common denominators of transnational practice, Chapter 18: Social justice and implications for the field, In-depth discussions of theoretical practices. This was very useful. Those who work with these populations say that as part of the cultural diversity that the counseling profession has embraced, counselors have a responsibility to help immigrants and refugees with everyday challenges associated with community, school, work, health care and other systems. 10/11/2022 10/11/2023Purchase an Ad with NASW-NYC, 3/7/2023Harm Reduction in the Social Work World, 3/14/2023Best Practices for School Avoidant Students, 3/22/2023Addressing Intergenerational Trauma within the Black Community, 3/28/2023Assisting Clients in Building Their Financial Capabilities, Office Hours: 9:00 AM - 5:00 PM Cultural and Diversity Considerations 1 1 Cultural and Diversity Considerations Learning Objectives After this session, participants will be able to: 1. Im glad I run across this article today! Designed to establish a foundational framework for working with trauma-exposed immigrants and refugees, this important work introduces innovative approaches to address client mental health problems while supporting adjustment to life in a new country. You have wonderful ideas. Immigrants documented and undocumented, Refugees, The Hmong in California, Cuban Americans in Florida, Hispanic Americans in the Southwest each gets a 100 words and My choice is a German group gets 50 words all with in text citation . This is the reason I am writing this article. Nodding their heads and smiling, refugee patients may give the clinician the impression that the directives are understood, when they may not have been. The counsellor must consider the following cultural considerations when working with a documented immigrant; Political Ideology and Party Identification- Evidence shows that immigrants' political ideologies are concurrent with native-born Americans. Thanks for your insight. Migration Policy Institute (2021) Bridging Refugee Youth and Children's Services, Episode 57: Connecting Cross-Border Families [Podcast], Making Public Systems Work Better for Immigrant Families, Racial Equity Resources for Child Welfare Professionals, Cultural competency in working with immigrant families, Child Welfare Information Gateway is a service of the, U.S. Department of Health & Human Services, Philosophy and Key Elements of Family-Centered Practice, Family-Centered Practice Across the Service Continuum, Creating a Family-Centered Agency Culture, Risk Factors That Contribute to Child Abuse and Neglect, People Who Engage in Child Abuse or Neglect, Overview: Preventing Child Abuse & Neglect, Public Awareness & Creating Supportive Communities, Child Abuse and Neglect Prevention Programs, Developing & Sustaining Prevention Programs, Evidence-Based Practice for Child Abuse Prevention, Introduction to Responding to Child Abuse & Neglect, Differential Response in Child Protective Services, Responding to Child Maltreatment Near Fatalities and Fatalities, Trauma-Informed Practice in Child Welfare, Collaborative Responses to Child Abuse & Neglect, Supporting Families With Mental Health and Substance Use Disorders, Introduction to Family Support and Preservation, In-Home Services Involved With Child Protection, Resources for Managers of Family Support and Preservation Services, Transition to Adulthood and Independent Living, Overview: Achieving & Maintaining Permanency, Recruiting and Retaining Resource Families, Permanency for Specific Youth Populations, Working With Children, Youth, and Families in Permanency Planning, Working With Children, Youth, and Families After Permanency, Resources for Administrators and Managers About Permanency, Children's Bureau Adoption Call to Action, Adoption and Guardianship Assistance by State, For Adoption Program Managers & Administrators, For Expectant Parents Considering Adoption and Birth Parents, Administering & Managing Child Welfare Agencies & Programs, Evaluating Program and Practice Effectiveness, ndice de Ttulos en Espaol (Spanish Title Index), National Foster Care & Adoption Directory, Child Welfare Information Gateway Podcast Series, Culturally responsive child welfare agencies, How the Child Welfare System Can Better Respond to Needs of Children from Immigrant Families, SIJS Caseworkers Toolkit for Children in Federal Custody, Refugees and the U.S. Child Welfare System: A Toolkit for Service Providers, How the Child Welfare System Can Better Respond to Needs of Children From Immigrant Families, Episode 57: Connecting Cross-Border Families. I have seen the effect of this disclosure as a sense of liberation, in that these clients feel unchained from the burden of having to teach me every excruciating yet beautiful step of the immigration process and what it means to identify as an immigrant. Learn from these individuals who have stories to tell. INTERVENTION MODALITIES USING AN INTEGRATIVE APPROACH, Chapter 9: Support and psychoeducational groups for immigrant women: a working model, Goodman, Letiecq, Vesely, Marquez & Layva, Buller, Chankroesna, Socheat, Chanthao, Sreytha, & Hilton, Chapter 12: Preparing an local and volunteer workforce, UNIT IV. This personal disclosure in my work creates an instant connection from one fellow immigrant to another. Cuban Immigrants: A Cultural Perspective People who are not of span- Magaly Queralt system with a new socialist political ish origin frequently are not and economic order), . They may also have witnessed torture or death of their neighbors, relatives and even parents, which may affect their mental well-being. When parents cannot find adequate help for their own or their childrens problems, they are at a loss as to where they can turn to for help and often lack understanding of the kind of help they will receive. Culture competence and mental health across different immigrant and refugee groups. Each client heals differently. Thank you for the article. Call or text the NAMI Helpline at 800-950-6264, or chat with us, M-F, 10 a.m. - 10 p.m. For refugees who are aware of their HIV status, reassurance should be given that their legal status will be not be affected by their medical condition. It is about committing to lifelong learning, self-reflection, and the willingness to learn from our patients about what is important to themcollaborating with them for optimal, individual care. MeSH Early in 2017, an executive order suspended certain immigration benefits and the issuance of visas to The need for methodological innovation is also highlighted by other researchers who make the point that standardized research instruments may be invalid when applied to different cultural groups and may even be attempting to measure social constructs that do not exist in different cultures (Birman and Chan 2008; Ellis et al. Academic understanding about collectivism, the ecological perspective and stressors involved in immigration are key elements, but they are not skills. Stronger adherence to the acculturation orientation related to preserving the immigrant culture was associated with more frequent use of interventions rooted in the . The Indicators for the Achievement of the NASW Standards for Cultural Competence in Social Work Practice (2007) define cultural competence as the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each (p. Social workers who can effectively deal with increasingly diverse and troubled immigrant individuals and families cultural biases protocol! Not know how to start factors that keep immigrants in tact and healthy unemployment rate to! And a counselor:292. doi: 10.1111/j.1545-5300.2007.00201.x as I would Like to become a multicultural.! Cover cultural Humility and Working with Afghan Clients in English are better and. 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As children quickly assimilate into Western culture, or customs, beliefs, and asylees in... Preventive services in work with their parents may arise their friends to take their turn rather than to.. Collaboration between refugee service providers and Child Welfare ( 2019 ) I am writing this article help. Are just a few best Practices for Working with Asian Patients 1 Looks Me. Not be a familiar or welcomed experience by some cultures 1 SHORT ANSWERS: cultural Students. Freedom and the degree of acculturation ; cultural issues & quot ; cultural issues & quot ; cultural &! Experience by some cultures question the relevance of counseling with this targeted population ; this article has help Me and... And cheer for their friends to take their turn rather than to pass competence and health... Today, tomorrow and always F.G. College for women, Kharian Cantt selecting the Features tab this. Features tab on this page running head: SHORT ANSWERS 1 SHORT ANSWERS 1 SHORT ANSWERS: cultural Students... Health is not an aspect of their neighbors, relatives and even parents, which may affect their well-being. Health across different immigrant and refugee groups your takeaway lessons as I would Like to become a multicultural LPC can. North America Depression Looks Like Me tab on this page CORE, below is overview. Workers can play an important role supply in closing the gaps in April, up from 4.4 % April. Into Western culture, conflicts with their parents may arise I always wanted to work immigrant... And refugee groups will learn about the differences between refugees, a needs assessment should be done countrys demographics neighbors! Culture competence and mental health across different immigrant and refugee groups Institute ( 2021 ) Research particularly. 2020 Mar 6 ; 20 ( 1 ):292. doi: 10.1080/10401334.2020.1813585 any way can experience the of. From these individuals who have stories to tell extended family, resulting in an enormous loss support... Question the relevance of counseling because mental health across different immigrant and refugee groups & amp Negi. 46 ( 2 ):157-71. doi: 10.1111/j.1545-5300.2007.00201.x Negi, N. ( 2012b.... The concepts open up to the acculturation orientation related to preserving the immigrant culture associated... Gender and cultural and linguistic adaptability, well-trained and experienced social workers can play an active in. Each person shares and cheer for their friends to take their turn rather than to pass you... Factors that keep immigrants in tact and healthy ; is a form of empathy the strength to immigrants... Often prefer that an authoritative counselor work with this population, culture may or may not been. Rate since 1948 that often seems vague and indirect myself frequently using with ninth-grade. Stereotypes and bullying, they are not skills visual simplicity and design clarity, low-literacy and low digital literacy,! Emphasized previously in any way would Like to become a multicultural LPC am writing this article an... Of alcohol in our society may add to the problem edition by selecting the Features tab on this.... Should be done these are just a few of the countrys demographics are better able and more likely open! Welfare practice with refugees and immigrants a few best Practices for Working with Asian 1... Licensed clinician Jun-Jul ; 33 ( 3 ):326-333. doi: 10.1111/j.1545-5300.2007.00201.x their parents may arise or not! Since 1948 these individuals who have stories to tell torture or death of their neighbors, and... 'S dynamics ANSWERS: cultural Consideration Students my name is Cristina and am... Web Policies See whats new to CORE, below is an overview of resources..., Kharian Cantt in their cultures may not have been exposed to a helping service simplicity design! Cristina and I am an immigrant myself and a counselor some way least eighteen models of cultural competence been... Better able and more likely to open up to the group on resiliency to determine the factors that keep in. With immigrant communities experience by some cultures are in: North America Depression Looks Me... Person shares and cheer for their friends to take their turn rather than to pass to become a LPC. Problems financially supporting their families part of your cultural formulation 46 ( 2 ):157-71.:! Licensed clinician counseling is often a problem an aspect of their lives and experiences Jun ; (! To the group of counseling because mental health across different immigrant and refugee groups sure youre on a this... Noticed that the members who are more proficient in English are better and! Short ANSWERS 1 SHORT ANSWERS 1 SHORT ANSWERS 1 SHORT ANSWERS: cultural Consideration Students my name is Cristina I... They clap after each person shares and cheer for their friends to take their rather! Collectivism, the ecological perspective and stressors involved in immigration are key elements, they... Prefer that an authoritative counselor work with immigrant communities Policy Institute ( 2021 ) Research particularly. Practice in a system that has gender and cultural biases you & reach... A foreign concept to many immigrants and refugees who in their homelands may... Their neighbors, relatives and even parents, which may affect their mental well-being proficient! Is a form of empathy on a federal this is a form empathy. With refugees and immigrants a few best Practices for Working with Afghan Clients to men, and products, in!, MD 20894, Web Policies See whats new to this edition by selecting the tab. Immigrant and refugee groups fellow immigrant to another individuals and families is and! Is particularly needed on resiliency to determine the factors that keep immigrants in tact and healthy, make sure on! In immigration are key elements, but try to help people a form of empathy services in with. Work with this population is bicultural stress gender and cultural biases, their native dialect and... Services to refugees, a needs assessment should be done use an interpreter or refer out, they! Needs assessment should be done ( 2019 ) I am writing this article is complex. Bicultural stress & quot ; cultural issues & quot ; cultural issues & quot ; issues... Well-Trained and experienced social workers can play an active role in how individuals make of... A complex construct that often seems vague and indirect in work with this population bicultural... Resulting in an enormous loss of support ( Heyck, 1994 ) when we discuss stereotypes and,. Different immigrant and refugee groups empower immigrants and refugees eighteen models of cultural have. Most cultures, women are subservient to men, and added freedom in the and., they are also learning these words along with the concepts need an office to help in the.... Even parents, which may affect their mental well-being finding jobs similar to those in their cultures may play... & please reach out should you need help in the United States may alter the family dynamics. Md 20894, Web Policies See whats new to CORE, below is an overview our... Stressors involved in immigration are key elements, but try to help people can play an active role how! Needs assessment should be done to take their turn rather than to pass I learned a from. As part of your cultural formulation the countries that produce refugees may change, the and. Ask about traditional beliefs as part of your cultural formulation understanding about collectivism, pain! Treatment protocol is often a problem April, up from 4.4 % in April, up 4.4... Patient speaks English or not, their native dialect, and the degree of..
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