Establishing a pedagogical framework for the multicultural course in communication sciences and disorders

Pedagogical Approaches to Cultural and Linguistic Diversity in Communication Sciences and Disorders Programs: A Nationwide Survey

PURPOSE

This study investigates how instructors in communication sciences and disorders (CSD) programs teach about cultural and linguistic diversity (CLD) in general-content courses as well as those dedicated to CLD content with the goal of identifying ways of improving training of preservice clinicians to provide culturally responsive service delivery.

METHOD

A survey was sent to 4,192 instructors in CSD programs at 295 institutions in the United States and Puerto Rico, of which 565 responded. The survey contained choice response questions and open-ended questions.

RESULTS

Curricular infusion as the sole strategy of CLD training has decreased since a similar survey was published by Stockman et al. (2008), while the number of programs that offer courses dedicated to CLD or use both strategies has increased. Dedicated CLD courses offer broader training in CLD issues and are considered more effective at preparing students to work with CLD populations. A number of challenges were identified, such as a lack of available resources or time to cover CLD issues.

CONCLUSIONS

A combination of curricular infusion and dedicated CLD coursework is recommended to ensure sufficient training in CLD issues. The development of additional resources is needed to better support instructors in both general-content and CLD-dedicated courses. Finally, CLD training should engage students in challenging unjust systems and harmful ideologies and not just celebrate multiculturalism in order to provide culturally responsive service to all clients.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25587651.

The Impact of Treating Bilingual Clients on Speech-Language Pathology Students' Cultural Responsiveness

PURPOSE

Graduate programs often use practicum experience with clients from nonmajority cultures to improve students' cultural responsiveness. Yet, it is not clear whether simply working with a client from a nonmajority culture actually confers this benefit or whether students are thinking about how to include culturally responsive behaviors when they are considering how to address a clinical case.

METHOD

Twenty first-year speech-language pathology graduate students (10 Spanish-English bilinguals, 10 monolingual English speakers) were split into three groups: monolingual experimental (n = 4), bilingual experimental (n = 4), and control (n = 12). The experimental groups completed a structured practicum with bilingual Hispanic/Latino clients. They received a 1-hr training in cultural responsiveness and then implemented a systematic language intervention in English or Spanish. Changes to cultural responsiveness were measured via think-aloud cases, and changes to confidence were measured with published, self-report scales. Reflective journal entries revealed what aspects of the clinical practicum students found most salient.

RESULTS

Experience working with bilingual clients did not have a substantial effect on students' confidence in their cultural competence. No substantial change was found in cultural responsiveness on the think-aloud for any group. Cultural responsiveness did not appear to be top-of-mind for the students.

CONCLUSIONS

Simply working with clients from nonmajority cultures does not create a scenario where cultural responsiveness is likely to improve. Additional targeted, purposeful training in cultural responsiveness is necessary.

Focusing Our Attention on Socially Responsive Professional Education to Serve Ethnogeriatric Populations With Neurogenic Communication Disorders in the United States

PURPOSE

This viewpoint discusses a plausible framework to educate future speech-language pathologists (SLPs) as socially responsive practitioners who serve and advocate for the burgeoning vulnerable ethnogeriatric populations with neurogenic communication disorders.

METHOD

We provide an overview of the demographic, epidemiological, and biopsychosocial context that supports the implementation of equity-based, population-grounded educational approaches for speech-language pathology services in ethnogeriatric neurorehabilitation caseloads and discuss a plausible perspective based on the educational social determinants of health (SDOH) framework by the National Academies of Sciences, Engineering, and Medicine.

RESULTS

The NASEM's three-domain SDOH educational perspective integrates education, community, and organization to create a self-reinforcing pedagogical coproduction that, grounded in the synergized partnerships of educational institutions, engaged communities, and organizational leadership, aims to address systemic drivers of health perpetuating ethnoracial disparities in health, care, and outcomes.

CONCLUSION

Exponentially growing vulnerable ethnogeriatric populations with age-related neurogenic communication disorders warrant the implementation of health equity education strategies to train technically prepared, socially conscious SLPs as service providers and advocates.

Teaching Queer Concepts to Graduate Students in Communication Sciences and Disorders: Culturally Responsive Pedagogy to Foster Affirmative Clinical Practice

There is a growing body of literature informing pedagogical content and strategies of diversity, equity, and inclusion in the education of speech-language pathologists. However, little discussion has included content related to LGBTQ+ people, even though LGBTQ+ people exist across all racial/ethnic groups. This article seeks to fill that void and provide instructors of speech-language pathology with practical information to educate their graduate students. The discussion uses a critical epistemology and invokes theoretical models, such as Queer/Quare theory, DisCrit, the Minority Stress Model, the Ethics of Care, and Culturally Responsive Pedagogy. Information is organized according to developing graduate students' awareness, knowledge, and skills and challenges instructors to modify current course content to disrupt systemic oppression.

A picture with a caption: Using photovoice as cultural self-reflection in communication sciences and disorders

PURPOSE

Self-reflection is an essential component of developing cultural competence. However, there is a paucity of research on how to best accomplish cultural self-reflection in CSD courses. Therefore, the purpose of this research study is to examine the teaching and learning practice of using Photovoice as a means of cultural self-reflection in a foundational, multicultural course in CSD.

METHOD

This qualitative investigation employed a phenomenological approach with emphasis on the scholarship of teaching and learning. Data gathering involved completion of a Photovoice assignment and a prompted reflection of the assignment. The Photovoice assignment entailed the students reflecting and examining their culture. Then, the students submitted two photographs, one that represents a strength of a culture they identify with and one that represents a challenge of a culture they identify with. The students presented their cultural strength and challenges in small and large group discussions. The prompted reflection required the students to address questions in a written or video-recorded response. When the course was completed, the researcher commenced line-by-line focused coding to cluster frequently used terms and common experiences into specific themes.

RESULTS

The student participants shared photos of cultural strengths and challenges, discussed these photos in small and large groups, and completed a prompted reflection of the Photovoice assignment. While each student's project and reflection were unique, common themes prevailed. The themes of safety, privilege, and mental health emerged from the Photovoice projects and the themes of learning and formating arose from the reflections on use of the project toward cultural competence.

CONCLUSIONS

The results of this study suggests that Photovoice is a valuable tool for cultural self-reflection and learning in all courses in CSD programs. In this way cultural self-reflection and the progression toward cultural competence is an on-going process where students are better prepared to provide client-centered, culturally competent care for all people.

Perceptions of African American English by Students in Speech-Language Pathology Programs

Purpose Despite the increased awareness that all dialects are valid linguistic forms, perceptions of African American English (AAE) use are often negative in the general population. Students training for careers as speech-language pathologists (SLPs) are required to have coursework relating to cultural and linguistic diversity. However, little is known about the perceptions of AAE among students in SLP programs. Method Seventy-three students from 46 randomly selected university programs in the United States completed an online survey including explicit statements regarding the validity of AAE and a matched-guide task assessing participants' implicit perceptions of AAE. Participants were randomly assigned to one of four audio pairings that differed in terms of the dialect spoken and the formality of the conversational context. Participants rated the speaker on 11 attributes (e.g., literate/illiterate, rich/poor) using the Revised Speech Dialect Attitudinal Scale. Results Participants indicated positive opinions of statements on the validity of AAE. However, across three categories of personal attributes-sociointellectual, aesthetic, and dynamism-participants who heard the Mainstream American English recordings rated the speaker differently than recordings including AAE. Conclusions Students in SLP programs express positive opinions regarding AAE, and yet, they rate speakers who speak AAE lower in personal attributes. The results highlight the importance of expanding training for future SLPs to include not only explicit statements about the value of AAE but also activities addressing implicit perceptions of dialect use. We provide a brief discussion of how the current data can be implemented for such an activity. Lesson plans and materials are provided as supplemental materials. Supplemental Material https://doi.org/10.23641/asha.15241638.

Admissions Type and Cultural Competency in Graduate Speech-Language Pathology Curricula: A National Survey Study

Purpose This research describes the results of survey questions designed to establish how cultural competency is taught in graduate speech-language pathology programs with a view on how to increase cultural competency in practicing professionals. Method One hundred ten department chairs or designees of university programs with graduate speech-language pathology programs participated in this study. Participants were asked questions to better understand how programs included cultural competency content for teaching purposes in program curricula. Respondents were sorted into groups by admission practices (traditional admissions, some holistic measures, or holistic review). We provide a description of responses, including which cultural competency topics are included in curricula, and we compare programs' composite cultural competency by admission type. Results Programs that used some holistic measures or holistic review had had significantly more content that focused on cultural competency than the traditional group, and also used a wider range of pedagogical approaches used to teach this content. Programs that employed some holistic measures or holistic review also covered a wider range of topics, including learning the importance of listening nonjudgmentally to clients' disability/health beliefs and valuing curiosity, empathy, and respect for others. Less than 30% of the traditional admissions programs reported that students were taught about institutional biases or the value of eliminating disparities, and less than 40% reported that students are comfortable talking about culture openly or are able to discuss their own cultural backgrounds or biases. The authors discuss implications and recommendations for enhancing cultural competence in graduate speech-language pathology programs.

Speech-Language Pathologists' Perceptions of Nonnative Accent: A Pilot Study

Purpose

Considering the American Speech-Language-Hearing Association's (ASHA) global influence and continued emphasis on heightening multicultural receptivity, a major consideration for ASHA is to cultivate cultural sensitivity and competence in its largely female (95.30%), monolingual (93.46%), and White (92.10%) workforce. ASHA's 32-year transition from no formal multicultural education to mandatory multicultural education infusion provokes to enquire whether multicultural education in speech-language pathologists (SLPs) has modified SLPs' perceptions toward multicultural issues. In this article, we explored an aspect of such sensitivity. We want to know whether there exists a linear relationship between SLPs' age, as an index of their exposure to formal multicultural education, and SLPs' bias toward nonnative accent, as an index of their multicultural sensitivity.

Method

Two hundred sixty-eight SLP ASHA members completed a web-based pilot survey testing whether SLPs made biased associations based on personality traits, sociocultural factors, professional attire, and physical appearance of persons with nonnative accent and whether the SLPs thought they had an accent. Logistic regression tested whether age predicts explicit biased associations for these five outcomes.

Results

ASHA SLPs made biased associations with accent for all outcomes, but age only predicted the likelihood of explicit accent-based biases for physical appearance. The relationship was curvilinear, with 40- to 45-year-olds making the most biased associations and older SLPs making progressively fewer biased associations.

Conclusion

Clearly, the specific psychosocial attributes associated with perception of nonnative accent need to be explored from a dynamical systems perspective to discover potential variables that might directly or indirectly influence accent perception and potential biases.

Integrating Lesbian, Gay, Bisexual, Transgender, and Queer Issues Into the Multicultural Curriculum in Speech-Language Pathology: Instructional Strategies and Learner Perceptions

Purpose

Instructors teaching courses on diversity issues in communication sciences and disorders do not typically or uniformly teach about lesbian, gay, bisexual, transgender, and queer (LGBTQ) culture. The purpose of this article is to provide readers with a detailed description of the importance, historical context, and pedagogical methods for integrating LGBTQ content and history into courses on diversity issues for speech-language pathology and audiology students.

Conclusion

Content on LGBTQ culture and history merits inclusion in the curricula for future health care providers given the backdrop of historic and continuing discrimination as well as persistent health disparities among LGBTQ-identified persons. This article provides one example of the instructional design of an LGBTQ teaching module, embedded into a required course on cultural and linguistic diversity for speech-language pathology students. This preliminary investigation revealed that learners responded positively to this content module, demonstrating interest and engagement as well as improved awareness and knowledge for better serving LGBTQ clients.

Outcomes of an International Audiology Service-Learning Study-Abroad Program

PURPOSE

The purpose of this study was to evaluate students' academic and civic learning, with particular interest in cultural competence, gained through participation in the Speech, Language, and Hearing Sciences in Zambia study-abroad program.

METHOD

Twelve female students participated in the program. Quantitative data collected included pre- and postprogram administration of the Public Affairs Scale (Levesque-Bristol & Cornelius-White, 2012) to measure changes in participants' civic learning. Qualitative data included journals, end-of-program reflection papers, videos, and researcher field notes. Feedback was also obtained from community-partner organizations via a questionnaire and rating scale.

RESULTS

Comparison of the pre- and postprogram Public Affairs Scale data showed a significant increase in cultural competence and a marginal increase in community engagement at the conclusion of the program. Qualitative data showed that participants' cultural awareness was increased, they benefited from hands-on learning, and they experienced a variety of emotions and emotional and personal growth.

CONCLUSIONS

Results show that a short-term study-abroad program with a service-learning component can be a mechanism for students to enhance academic and civic learning, specifically cultural competence and clinical skills. Sustainability of programs is a challenge that needs to be addressed.

Assessing services with communicatively impaired bilingual adults in culturally and linguistically diverse neurorehabilitation programs

The combined effect of the steady increase in cultural and linguistic diversity and epidemiological factors in minority populations is estimated to continue having an impact on adult neurorehabilitation programs in the country, particularly in the number of bilingual individuals receiving clinical services. No comprehensive assessment of the present professional and clinical realities in service delivery to communicatively impaired adults in culturally and linguistically diverse (CLD) neurorehabilitation contexts has been conducted. The current survey research was undertaken to examine current professional training, clinical practices, and challenges in the services rendered to the steadily increasing numbers of communicatively disordered adults in CLD neurorehabilitation programs with a special focus on bilingual persons. A 36-question, 6-section survey was administered to health care-based SLPs working with adults to examine multiple factors regarding work setting and caseload, professional training, clinical tools and procedures, service delivery issues, and suggestions to improve clinical work with bilingual adults in CLD neurorehabilitation environments. Results support that SLPs presently make sensible decisions to serve communicatively disordered bilingual adults with neuropathologies despite training gaps and scant clinical resources. Responses additionally highlight critical areas to improve professional preparation and available resources. Results are discussed in terms of strengths and weaknesses as well as their implications to professional education and target research areas in order to minimize present gaps in service delivery with bilingual speakers in CLD adult neurorehabilitation programs.

LEARNING OUTCOMES

As a result of this activity, the reader will be able to: (1) Discuss the demographic and epidemiological factors that suggest a continued increase in the number of communicatively impaired bilingual adults in CLD neurorehabilitation programs. (2) Describe current strengths and weaknesses in the diagnostic and therapeutic practices employed by SLPs with bilingual clients in CLD adult neurorehabilitation programs. (3) Describe possible strategies to improve current limitations in professional training and clinical resources that would strengthen the current services given to bilingual adults in CLD neurorehabilitation programs.

Monolingual versus multilingual acquisition of English morphology: what can we expect at age 3?

BACKGROUND

At least two-thirds of the world's children grow up in environments where more than one language is spoken. Despite the global predominance of multilingualism, much remains unknown regarding the language acquisition of children acquiring multiple languages compared with monolingual children. A greater understanding of multilingualism is crucial for speech-language pathologists given the increasing number of children being raised in linguistically diverse environments.

AIMS

To investigate the expressive morphological abilities of multilingual children acquiring English, compared with monolingual children, at 3 years of age.

METHODS & PROCEDURES

Participants were 148 children (74 multilingual children; 74 matched monolingual children; mean age of 3 years 4 months) already participating in a larger prospective longitudinal cohort study of language development in Melbourne, Australia. Thirty-one languages in addition to English were represented within the embedded cohort. All participants completed a direct language assessment to measure their expressive abilities across a range of English morphemes. The parents of the multilingual participants completed an interview regarding the children's language backgrounds and experiences.

OUTCOMES & RESULTS

The Multilingual Group typically performed below the Monolingual Group in terms of their accurate use and mastery of English morphemes at 3 years of age, although variable expressive abilities were indicated within each group. The same morphemes were shown to be mastered by relatively higher proportions of each group. Likewise, the same forms were mastered by relatively lower proportions of each group. The results indicated similarities between the children's acquisition of English morphology, regardless of whether they were acquiring English only or in combination with another language(s) at 3 years of age.

CONCLUSIONS & IMPLICATIONS

This study found a range of similarities and differences between multilingual compared with monolingual children's acquisition of English morphology at 3 years of age. The findings have important implications for researchers and clinicians involved in the management of linguistically diverse populations by advancing knowledge of early multilingual English morpheme acquisition and building awareness of acquisition patterns among multilingual and monolingual English-speaking children at 3 years of age.