DEIJAB word bank

The Center for Disease Control and Prevention defines accessibility as the specific consideration of needs for people with disabilities and the modification of products, services, and facilities that can be used by people of all abilities.

The CDC cites the following examples of accessibility:

• "Parking spaces are close to entrances
• Floor spaces and hallways are free of equipment and other barriers
• Staff and healthcare professionals can use sign language or have access to someone who can use sign language" (Disability and Health Inclusion Strategies, CDC, 2020)

Belonging supports the value of diversity. The idea of belonging allows individuals to show up as their authentic selves to work and school. Where inclusion, support, and acceptance are fostered in an organization, individuals have a sense of belonging.

Additional resource

Sense of Belonging (Sense of Belonging | Cornell University Diversity and Inclusion, n.d.)

A cisgender person's gender identity (and often gender expression) matches the sex they were assigned at birth (American Psychological Association, 2019).

Class is determined by the amount of wealth a person has access to through family support, inheritance, property, investments and is not limited to wage-earning (Louisiana State University, 2020).

Additional resources

• Social class & poverty in the U.S.: Crash course sociology #24 [Video] (Crash Course, 2017b).

Code switching is defined as modifying an individual’s "speech, appearance, behavior, and expression," that provides an ease of comfort for others in return for fair treatment, a high standard of service, and potential employment opportunities (The Costs of Code-Switching, 2021). It typically involves suppressing one’s first language and culture to fit into a dominant and acceptable language and culture (What Is Code Switching?, 2022).

Colorblindness is defined as the process by which a person attempts to ignore the existence of race or skin color in service of seeing past race and just seeing the person (Apfelbaum et al., 2012).

• Race is a component intertwined with everyday life, and it would be naïve to assume it doesn't play a major part.
• However, this deemphasizing of race ignores the actual lived experience of people of color in the U.S.

Additional resource

Being "color blind" doesn't make you not racist―In fact, it can mean the opposite (Vincenty, 2021).

Culture is a set of shared languages, ideas, customs, traditions, beliefs, and practices shared by a group of people (American Sociological Association, 2021).

What are culture and individual identity?

Client-centered practice dictates that we treat each client as a unique being. Some important ideas to keep in mind in cross-cultural interactions are the following:

• Culture is dynamic and complex and is influenced by outside forces such as technology and globalization.
• Culture influences one’s identity, but identity is multilayered and is derived from multiple sources. A client typically holds multiple identities based on life circumstances and experiences. These identities stem from affiliations to family, community, profession, religion, nation, and others.
• A client’s identity is a product of intersections of race/ethnicity, education, socioeconomic class, sex, age, sexual orientation, (dis)ability, religion, etc.

What are terms and definitions that represent multicultural responsiveness?

Cultural humility 
Cultural humility is an attitude and process by which providers strive to address issues of power differences between professionals and clients, value and respect clients by continuous engagement in self-reflection, and self-critique as life-long learners and reflective practitioners. (Penn State College of Medicine, 2021)

Cultural intelligence
Cultural intelligence is the ability to interact effectively with culturally different clients, and it relies on cultural metacognition—knowledge of your own attitudes, values, and skills, and those of the clients, makes for an effective encounter. (Mangla, 2021)

Cultural responsiveness
Cultural responsiveness is about reciprocity, respect, and mutuality. It involves exploring differences, being open to valuing clients’ knowledge and expertise, and recognizing the unique cultural identity of each individual client. (Fong, 2017)

Culture safety
Cultural safety recognizes the barriers to clinical effectiveness that occurs from a power imbalance between provider and patient. Cultural safety is a sociopolitical idea about the unconscious and unspoken assumptions of power held by health providers of groups that have been historically marginalized. It is about the trust and safety experienced by a client when treated with respect and understanding and is included in the decision-making process.

Cultural safety requires that as health practitioners we examine ourselves and the potential impact of our own culture on clinical interactions. This requires that we question what we bring to the table that could decrease the quality of healthcare for our patients and exam our own personal biases, attitudes, beliefs, stereotypes, and prejudices to reduce bias and achieve healthcare equity. (Jones & Tipene-Leach, 2019)

What are the influential theories relevant to culture?

The familiar image of culture as an iceberg shows that the important and deeper meanings of culture are hidden from view. Culture shapes our beliefs and world view. Values are at the core of differences in cultural beliefs, attitudes, and behaviors. The following are some dominant and influential theories.

• Schwartz’s Theory of Basic Values identifies ten core universal values that are common to all cultures, with defining goals and behaviors that are essential for human survival and existence as socially organized groups. (Australian National University, 2020) The differences between cultures lie in how these values are prioritized and the behaviors they elicit.
• Hofstede’s Cultural Dimensions Theory (2021) provides a systematic framework for six cultural dimensions shared by all cultures:
  1. Power Distance (equality versus hierarchy)
  2. Individualism (individual freedoms versus collective responsibilities)
  3. Uncertainty Avoidance (informal versus formal)
  4. Masculinity (competition versus collaboration)
  5. Time Orientation (short-term versus long-term)
  6. Indulgence (free gratification versus restraint)
• American anthropologist and cross-cultural researcher, Dr. Edward Hall classified cultures on the basis of communication as high-context (HC) cultures and low-context (LC) cultures. The communication style of HC culture is indirect and meaning is implicit. Communication in LC culture is direct and explicit. (Neuliep, 2017) The U.S. is a low-context culture.

It is best to view these cultural characteristics as lying along a continuum rather than as polar opposites. For example, it is the relative degrees of individualism versus collectivism that differentiates cultural groups. Individuals from a collectivist culture are still individuals, but the degree to which they factor others into their decisions is different from those from a strong individualistic perspective.

What are the implications for practice?

How do we use our knowledge, skills, and attitudes to provide culturally responsive and culturally effective care? 

Knowledge about key cultural characteristics is helpful, but it is important to know that over time people are acculturated and socialized to the larger context and dominant ways of doing and being. 

Acculturation is a process in which members of one cultural group adopt the beliefs and behaviors of another group. (Berry, 2019) The extent to which individuals become acculturated varies; social integration requires a certain degree of acculturation from diverse cultural groups as well as an inclusive attitude by the dominant social groups.

References

Australian National University. (2020). Values: Schwartz theory of basic values | ANU. ANU | Integration and implementation sciences (I2S) is a discipline providing concepts and methods for conducting research on complex real-world problems. https://i2s.anu.edu.au/resources/schwartz-theory-basic-values

Berry, J. (2019). Acculturation: A personal journey across cultures (elements in psychology and culture). Cambridge: Cambridge University Press. https://doi.org/10.1017/9781108589666

Curtis, E., Jones, R., Tipene-Leach, D. et al. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. Int J Equity Health 18, 174. https://doi.org/10.1186/s12939-019-1082-3

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113. https://dx.doi.org/10.1037/bar0000076

Hofstede Insights. (2021). National culture. https://hi.hofstede-insights.com/national-culture

Mangla N. (2021). Working in a pandemic and post-pandemic period–Cultural intelligence is the key. International Journal of Cross Cultural Management, 21(1), 53-69. https://doi.org/10.1177/14705958211002877

Neuliep, J. W. (2017). Intercultural communication: A contextual approach (7th ed., international student ed.). Sage.

Penn State College of Medicine Faculty and Staff Resources. (2021, June 15). Diversity, equity and belonging. Author. https://faculty.med.psu.edu/resources/diversity/#topic-diversityglossary

Additional resource

Video: What is culture? (SFU Co-operative Education. 2019.)

Cultural awareness is the recognition and conscious observation of the similarities and differences between cultures (National Center for Cultural Competence, n.d.).

Cultural humility emphasizes humble and empathetic communication with clients and reduces reliance on bias or implicit assumptions, and instead encourages intentional listening and openness to various cultures (AOTA, 2020).

Additional resource

Cultural competence or cultural humility? Moving beyond the debate (Green-Moton & Minkler, 2020)

Cultural sensitivity is understanding the needs and emotions of your own culture and the culture of others. (National Institute of Environmental Health Sciences, 2007)

Colonization is defined as discriminatory, oppressive, and unearned social privileges impacting Indigenous people. According to Community Psychology, decolonization is a “process of examining and undoing unearned privilege that is a result of these historical and present-day processes” (Simons-Rudolph, 2019).

The term reflects " 'cultural, psychological, and economic freedom' for Indigenous people with the goal of achieving Indigenous sovereignty — the right and ability of Indigenous people to practice self-determination over their land, cultures, and political and economic systems" (What Is Decolonization?, n.d.).

Additional resource

Decolonization Is for Everyone (TEDx Talks, 2019)

Disability culture represents a social identity of empowerment and awareness of mental and physical disabilities and challenges societal norms and medical and institutional oppression. Disability culture accepts human differences, vulnerability, and interdependence (AOTA, 2021).

Additional resources

• Disability and health overview (CDC, 2020)
• Disability impacts all of us infographic (CDC, 2020)

Diversity is broadly defined as the unique attributes, values, and beliefs that make up an individual (Taff & Blash, 2017) when compared with the context of a group or population. Diversity comes in many forms, including, but not limited to, socioeconomic status, race, sex, ethnicity, age, disability, sexual orientation, gender identity, and religious beliefs (AOTA, 2020).

Additional resource

Diversity and inclusion in occupational therapy: Where we are, where we must go (Taff & Blash, 2017)

Ethnicity is defined as a group of people that identify with one another based on shared culture (Ford & Kelly, 2005).

Additional resources

• Video: What is ethnicity? (PBS, 2019)
• What's the difference between race and ethnicity? (Bryce, 2020)

Equity is an approach that ensures everyone is given an equal opportunity; this means that resources may be divided and shared unequally to make sure that each person can access an opportunity. Equity considers that people have different access to resources because of a system of oppression and privilege. Equity seeks to balance that disparity. "Equity is often confused with equality; however, they are significantly different. Equality ensures that everyone receives the same benefit or consequence" (AOTA, 2020).

Additional resources

• Video: Equity and equality (University of Maine, 2019)
• In Focus: Reducing racial disparities in health care by confronting racism (Hostetter & Klein, 2018)

Genderqueer can be categorized in three ways:

1. Personal identity exists outside of the gender binary
2. Refers or rejects the identity of masculine and feminine traits
3. Embraces gender fluidity (Otis, 2015).

Additional resource

Video: The gender tag: Authentic gender expression (Skyler, 2019)

Gender expression is the way that someone outwardly presents their gender through style, demeanor, and social behavior (Boskey, 2021).

Additional resource

Video: What is gender expression? (The Advocate, 2018)

Gender identity refers to the internal perception of one's gender and how a person labels oneself. It can correlate with or differ from a person's assigned sex at birth (HRC, 2020).

Additional resource

Video: Range of gender identities (AMAZE, 2019a)

Generalizations are defined as "statements about common trends within a group, but with the recognition that further information is needed to ascertain whether the generalization applies to a particular person" (Galanti, 2000).

• These statements are not necessarily negative and can be helpful and intended to guide people in their actions. ​
• Usually qualified by words such as "often," "sometimes," and "may."

Identity-first language places the disability or condition first when describing a person, e.g., autistic person, blind or deaf person, making the condition a part of the person’s identity. Person-first language puts the person first and the disability or condition as the descriptor, e.g., person with autism, person who has vision or hearing loss. It is important to note that many self-advocates in the autistic community prefer identity-first language (Lei, Jones, Brosnan, 2021).

Imposter syndrome is defined as an experience in which a high achieving and qualified person has a fear of being revealed as a fraud or not qualified enough in the workplace or university setting (Pandika, 2020).

Feelings of insecurity and self-doubt are common characteristics of imposter syndrome (IP). Contributing factors of IP include family environment, generational status, race, socioeconomic, sexism, ageism, etc. (Ahmed et al., 2018)

Imposter syndrome can be common in environments that are biased and promote toxic cultures. (Stop Telling Women They Have Imposter Syndrome, 2022)

"Inclusion is the acceptance and support of diversity wherein the uniqueness of beliefs, values, and attributes is welcomed, valued, and leveraged for maximum engagement" (Taff & Blash, 2017).

"Inclusion is not simply tolerance. [It] inherently embraces the value of all individuals and is the active response to diversity by fostering acceptance, respect, belonging, and value for everyone. To support diversity, inclusion must be actively pursued" (AOTA, 2020).

Additional resources

• Video: What is inclusion? (Down Syndrome Queensland, 2019)
• Diversity and inclusion in occupational therapy: Where we are, where we must go (Taff & Blash, 2017)

Intersectionality is defined as the interconnected nature of identities such as race, class, and gender and the interdependent systems of power and privilege that result from the interconnectedness (Perlman, 2018).

For example, a heterosexual black female-identified person may experience power and privilege differently than a queer black female-identified person or a heterosexual white female-identified person.

Additional resources

• Video: What is Intersectionality?  (Hopkins, 2018)
• Video: Intersectionality and health explained  (Sociological Studies Sheffield, 2020)

Indigenous refers to a person or group of people whose culture, identity, and often spirituality is rooted in a particular place.

Additional resource

Video: What does being indigenous mean? (CBS News, 2017)

As a part of diversity, equity, and inclusion, justice breaks down barriers to both opportunities and resources for every individual and community to have equitable and equal access for a “full and dignified life.” Examples of barriers can include, but are not limited to societal obstacles, such as racism, classism, sexism, etc. (Public Lands Alliance, 2020).

Microaggressions are defined as often unconscious everyday behaviors that denigrate someone from a historically marginalized or non-dominant group (Sue et al., 2007).

They are small, but if experienced chronically, a person can feel "death by a thousand tiny cuts."

Additional resource

Microaggressions are a big deal: How to talk them out and when to walk away (Limbong, 2020)

Neurodiversity is the “belief that differences in thinking and processing should be considered an integral part of one’s personhood” (Dallman, William, Villa, 2022). The movement emphasizes that all ways of learning and thinking are This principal of neurodiversity requires the respect of an individual’s traits and behavior as part of their natural neurological makeup and emphasizes that all thinking and learning types are a part of the core diversity characteristics, such as race, ethnicity, gender and gender identity, and sexual orientation (Kornblau, Robertson, 2021).

The following list offers some of the conditions most common among those who describe themselves as neurodivergent:

• Autism spectrum disorder (this includes what was once known as Asperger’s syndrome)
• Attention-deficit hyperactivity disorder (ADHD)
• Down syndrome
• Dyscalculia (difficulty with math)
• Dysgraphia (difficulty with writing)
• Dyslexia (difficulty with reading)
• Dyspraxia (difficulty with coordination)
• Intellectual disabilities
• Mental health conditions like bipolar disorder, obsessive-compulsive disorder and more
• Prader-Willi syndrome
• Sensory processing disorders
• Social anxiety (a specific type of anxiety disorder)
• Tourette syndrome
• Williams syndrome

Source: Cleveland Clinic, 2023

As developed and defined by Ramugondo (2015), occupational consciousness is the "ongoing awareness of the dynamics of hegemony [the social, cultural, ideological, or economic influence exerted by a dominant group], and recognition that dominant practices are sustained through what people do every day, with​ implications for personal and collective health" (p. 488).

Occupational alienation — When people lack control over their occupations and experience meaninglessness or purposelessness (Hocking et al., 2011).

Occupational deprivation — When people are denied access to occupation over an extended time, with negative consequences for health & well-being (Hocking et al., 2011).

Occupational marginalization — When people's need to exert choices and decision-making power as they participate in occupations is hindered (Adapted from Townsend & Wilcock, 2004).

Occupational imbalance — Imbalance speaks to being occupied too much or too little to experience meaning and empowerment (Townsend & Wilcock, 2004).

Occupational apartheid — Depriving individuals, groups, and communities of meaningful and purposeful activity through segregation due to social, political, and economic factors and social status reasons (Simo-Algado et al., 2002).

Occupational justice refers to the right of all individuals to participate and have equity in occupational choice to increase their well-being (AOTA, 2020).

People of color include U.S. citizens who do not identify only as White under the current U.S. Census ethnicity categories (Raypole, 2020).

Additional resource

Video: Let's talk about "BIPOC" (Black, indigenous, people of color) (Pacific Lutheran University, 2020)

Privilege is access to resources (social power) that are only readily available to some people because of their social group membership; it is an advantage or immunity granted to or enjoyed by one societal group above and beyond the common advantage of all other groups (National Conference for Community and Justice [NCCJ], 2021).

Additional resources

• What is privilege? (NCCJ, 2021).
• Video: Privilege explained (Shetty, 2020)

The term race has many definitions (Zevallos, 2017).

• Many individuals believe that race is physical and biological differences between other groups and cultures (e.g., skin color).
• Other individuals, such as sociologists, define race as a false construct that historically and currently conflates skin color and ancestry with behavior and culture.
• This concept and perspective of race illustrate that the term evolved from an intent to create division.
• Race, and its social existence, is widely held assumption and has real consequences for all people.

Additional resources

• Video: The origin of race in the USA (PBS, 2018)

Romantic orientation is an affinity for someone that evokes the desire to engage in an emotionally intimate relationship.​

Sex is a term used to refer to the chromosomal, hormonal, and anatomical characteristics used to classify individuals as male, female, or intersex. ​

Sexual orientation is the type of attraction one feels for others, often labeled based on the gender relationship between the person and the people to whom they are attracted.

Additional resource

Video: Sexual orientation: A spectrum of attraction (AMAZE, 2019b)

Socioeconomic status is the amount of money one earns in wages each month or year. This can change rapidly.

Additional resources

• Video: The impacts of social class: Crash course sociology #25 (Crash Course, 2017a)
• Socioeconomic status (American Psychological Association, 2021)

Stereotypes are defined as oversimplified ideas we hold about a person based on their identity (Galanti, 2000).

Usually, stereotypes are based on assumptions, popular opinion, or misinformation, are generally negative, are sweeping and simple, and are often characterized by "always" and "never."

Additional resource

Video: Stereotypes (SFU, 2019)

Defined as systems of power in a society that advantage certain groups over others and include ideologies such as racism, sexism, heterosexism, etc. (collectively "the isms") (Shlasko, 2015).

Additional resources

• Video: Power, privilege, and oppression (University of Denver, 2018)
• Social identities and systems of oppression (NMAAHC, 2021)

A transgender person's gender identity (and sometimes expression) does not align with the sex they were assigned at birth. "Trans" is an umbrella term that refers to various ways people transgress gender norms (University of Florida, 2017) .

Additional resource

Video: Gender assigned to us at birth should not dictate who we are (McBride, 2016)