ASHA shares that “No test can be completely culture free. Most formal testing is unfamiliar to individuals who have not had exposure to the mainstream educational context and to the culture of testing that includes both nonverbal and verbal components. Nonverbal aspects of the testing culture include: 

• perception of time;
• how one is expected to learn;
• how one is expected to respond—in a testing context—to the examiner, regardless of gender, culture, age, and/or socioeconomic background;
• attitudes toward display of abilities;
• attitudes toward guessing, using the process of elimination, storytelling, or conversing with an unfamiliar individual;
• test abstraction (e.g., naming protocols that require providing already shared information or situations in which the client/patient is required to assume a “make-believe” attitude in order to engage in an expected manner); and
• nonlinguistic aspects of pragmatics (DeJarnette, Rivers, & Hyter, 2015).

Verbal aspects of the testing culture include

• form of language;
• functions of language;
• content of language;
• organization of language; and
• pragmatic rules of social interaction.

ASHA recommendations using accommodations and modifications to testing material when possible:

• rewording and providing additional test instructions other than those allowed when presenting trial items;
• providing additional cues or repeating stimuli that may not be permitted on test or task items;
• allowing extra time for responses on timed subtests;
• skipping items that are inappropriate for the individual (e.g., items with which the client/patient has had no experience);
• asking the individual for an explanation of correct or incorrect responses (when not standard procedure); and
• using alternate scoring rubrics.