Even the most simple of daily tasks, such as shopping for food or asking for directions, can become challenges involving not only the language barrier, but also the potential for deep cultural misunderstanding. Generally, it is believed that injury resulting from accidents and natural disasters is less traumatic than injury resulting from willful acts by other human beings, such as torture. Teachers can learn to recognize symptoms of mental illness, or abrupt behavioral changes that disrupt the class. Signals teachers identify from observation may include absences, withdrawal from participation, lack of attention, sleeping in class, frequent crying, behavioral problems, and change in progress. Sometimes the signs are not obvious.
Teachers can discuss health and cultural content relevant to learners.
When refugees seek help from a medical doctor or a mental health professional, they often become uneasy when asked about details of their personal lives and backgrounds. In the ESL classroom, activities related to making appointments to see a doctor and then talking about health issues with the doctor, finding and keeping a job, negotiating transportation, and so forth are all natural components of the curriculum. These activities give learners opportunities to discuss issues of personal interest and concern with others and to solve problems related to survival, family, and employment. When viewed as part of the process of developing needed competencies using the English language, they are usually not considered invasive or out of context by either students or teachers. Some suggestions for activities are listed below.