Module 4: Building Conversations

4.6 The Multilingual Environment

MultilingualDo you speak the same language as your clients? If not, overcoming that language barrier may be a big challenge for both you and your clients.

Even if you do not speak the language of your clients, there are some things you can do. Learn a few key phrases to use with the client before the interpreter arrives. Your interest and caring will be evident despite the language barrier. You do not have to master a language to be an effective communicator.

Establish the language to be used: Find out which language people prefer to use with you; don’t assume that they will prefer their native language if they also speak English.

Introduce English words: If English is your clients’ second language, introduce basic words related to food and nutrition. Have them practice saying the new words. You can practice saying the words in their language at the same time. Ask your clients to teach you.

Be alert to subtleties: Consider subtle differences in usage of words, not just differences in language. For example, clients may use the terms “high blood” and “low blood” to refer to two unrelated conditions, hypertension and anemia.

Tips for Working with People Who Speak Another Language

  • Don’t think that people who are struggling with English are less intelligent. Applaud them for trying to make things easier for you. They are trying to learn your language instead of asking you to learn theirs.
  • Try learning a few words in their language. Learn greetings and titles of respect.
  • Write numbers down for the person — for example, with recipe amounts. People easily confuse numbers spoken in a new language.
  • Ask questions in several different ways. People may use only the words they know in English to answer your questions.
  • Learn the proper pronunciation of names. For example, in Spanish, say “ah” instead of “uh,” as in María.
  • Be friendly, accepting, and approachable.

A Picture Is Worth a Thousand Words

Many people learn first by listening and watching. Try to provide nutrition information without written words. Try pictures, food models, videos (especially those in the person’s native language), hands-on food demonstrations, flip charts, and games. Use several approaches.

Use recipes that can be memorized: Some people cannot read a recipe or do the math needed to measure or adjust to their family size. Try to make the recipes easy enough to memorize. Demonstrating helps. Tasting is essential. Many people cannot afford to buy foods their families might not like or accept.

Consider the needs of people who are hearing impaired: Try a visual or written approach when working with people who are hearing impaired, and try to use some signs, too. Don’t judge their intelligence based on their ability to speak or read lips (30 percent of words can be lip read).1 For many members of the Deaf community who use American Sign Language, English is a second language. Be aware that English differs from ASL in grammar and syntax.2 Voice, text, and video relay services and technologies help the deaf communicate by phone, although e-mail and text messaging may provide alternate means of communication, depending on client preference.


1 Hoang, L, LaHousse, SF, Nakaji, MC, & Sadler, GR. (2011). Assessing deaf cultural competency of physicians and medical students. Journal of cancer education, 26 (1), 175–182.
2 Meador, HE, & Zazove, P. (2005). Health care interactions with deaf culture. Journal of the American board of family practice, 18, 218-222.