‘It’s not what you say, but how you say it’: The art of communication with non-native English speakers

The goal of the Cribs for Kids program is to reduce the risk of SUID (sudden unexpected infant death) through its National Infant Safe Sleep Initiative.  SUID is any type of unexpected death occurring before the age of one and is typically due to asphyxia, accidental suffocation, infections, poisonings, or other undetermined causes. SIDS (sudden infant death syndrome) is a specific subset of SUID cases (1).  A national initiative with over 600 partners, the Cribs for Kids program has distributed over 300,000 safe sleep survival kits since it started in 1998 (1). Cribs for Kids in Philadelphia is partnered with the Maternity Care Coalition and provides a portable crib and safe sleep education to families in need in the greater Philadelphia area.

As the National Health Corps - Philadelphia member serving as the Cribs for Kids Advocate at the Maternity Care Coalition, I interact with clients from the city of Philadelphia and the surrounding region through phone scheduling, workshops, and home visits. Since Pennsylvania is the fourth largest destination for refugees in the United States(3) and boasts a large immigrant population this means that I often deal with non-native English speakers who have a wide range of English proficiency levels - from bilingual to very limited proficiency. Unfortunately my host site does not have access to interpreters on a regular basis, so myself and the other advocates are responsible for communicating with non-native English speakers via phone. The NHC training that has had the most positive impact on my ability to successfully serve at my host site focused on learning how to communicate effectively with non-native English speakers. Whether it is being aware of the words that I use when communicating with a neighbor or family member of a potential client to ensure there are no misunderstandings, to being aware of cultural differences and how those affect a family dynamic, communication can always be a challenge. When scheduling over the phone I have learned to be very conscious of my tone, my register, and how loud I am speaking.

Often people start to raise their voices and talk really slowly when interacting with people who have a different native language, but this is not the most effective way to facilitate meaningful communication with clients. Speaking to someone in that way does not help them understand better, but it can lead to feelings of belittlement. It may also influence the client to be less trusting and less willing to offer the information that is necessary to assess the client’s eligibility and schedule them to receive our safe sleep education and a safe place for their infant to sleep.

A de-escalation training that NHC offered us also focused on how to interact with clients in a way that is welcoming and non-threatening and very applicable when communicating via phone. I learned once again to be mindful of my tone, volume, and cadence when speaking to clients because ‘it’s not about what you say, but how you say it’ (2). The biggest thing that I have learned from National Health Corps training so far is to always remain upbeat and positive, speak clearly, and QTIP (quit taking it personally). We can never be fully aware of all the extraneous factors that influence how someone else’s day has been going, and I learned that it is not the client’s reaction (either positive or negative) that matters most, but the fact that I and the other advocates are able to deliver possibly life saving sleep environments and education to families throughout the Philadelphia area.

(1) Eileen Tyrala, MD. “A Brief History of Sudden And Unexpected Deaths in Infants.” Safe Sleep Symposium 09/21/2015, Philadelphia, PA.
(2) Kim Glodeck. “Non-Violent Crisis Intervention: De-Escalation Training.” National Health Corps Training 10/09/2015, Philadelphia, PA.
(3) Claire Jones. “Language Access for Helping Professionals.” National Health Corps Training 10/09/2015, Philadelphia, PA.

This blog post was written by NHC Philadelphia member Kelly Carey.
Kelly serves as a Cribs for Kids Advocate at Maternity Care Coalition.