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Schools maintain a monocultural approach to teaching even with a growing CLD school population. Multiculturalism supports the idea that school curriculum should represent and reflect the cultural make-up of the school population. Multicultural education is democratic, and it promotes cultural differences as assets rather than liabilities.

Disorders of speech and language include myriad diagnoses that vary in incidence and prevalence across age span and cultures. Disorders can range from those that do not impinge upon general communication, learning or psychosocial function, such as a mild speech disturbance, like a lisp, to global aphasia with a complete lack of communication ability. The short- and long-term effects of these impairments are often directly related to the age at onset, duration, co-morbidities, access to intervention by qualified professionals, and the societal response to the disability. In cultures that take a dim view of any type of deviation from the norm, there may be less access to diagnosis and treatment, as well as a hesitancy to seek out available options for treatment. Additionally, for those countries in which there are larger issues of general health, economic support, and quality of care, the nature of the disability may receive little or no attention simply due to national priorities or limited access to resources. Although, globally, disorders of speech and language are not exclusively limited to those countries with poorer health outcomes, in general, speech and language services may be less accessible or absent in poverty-stricken nations of the world. In many cases, these countries are at greater risk for many of the disorders simply due to environmental and social conditions, such as lack of early access to health care and preventative interventions. This chapter explores Global Perspectives on Speech and Language Impairments.

Writings about language and speech impairments (SLI) have been present for many centuries (Smith, 2004). Unfortunately, early historical accounts tended to reflect negatively upon individuals with SLI. For example, Van Riper and Erickson (1996) related that during the Roman times, an individual who stuttered was placed into a cage for entertainment purposes. According to these authors, citizens passing would throw coins into the person's cage to get him to talk. During the late 1800s, the profession of speech-language pathology began as an avocation of certain professionals, notably doctors, educators, and elocutionists (public speakers), who were interested in helping others improve their speech. American doctors studied under the auspices of European doctors who treated people with communication disorders. The two most common disorders that were treated then were dysfluency (stuttering) and speech sound errors (articulation) (Duchan, 2002). Treatment was available for the above disorders, however, the programs were not in public schools and the results of intervention were mixed (Smith, 2004).

An increase (>150%) in the number of children experiencing learning difficulties is occurring due to changes influencing identification processes within our legislative mandates (Kavale, 2005; Kavale, Holdnack, & Mostert, 2005). There are also federal mandates that set the stage for our current practice changes, a specific learning disability (SLD) definition that has remained unchanged, and new initiatives steeped in older approaches that set the stage for complex interpretations (Kavale, 2005; Kavale & Forness, 2003). Can our current and past approaches foster the development of approaches which will better support our at-risk youth and their experience of learning disabilities? Pertinent questions are (a) who is this group of at-risk individuals? (b) what are the characteristics? (c) what approaches best support and deviate the path from a fully-fledged diagnoses of SLD? and (d) what approaches best support and identify the presence of SLD? This chapter will share the current landscape of practice for supporting students who are deemed at-risk for developing learning disabilities or school failure. The chapter explores the historical perspectives of identification and how they have influenced the change to the current initiative of response to intervention/instruction (RtI), its strengths, and its needs. Patterns across the pertinent issues are discussed.