Resisting Ableism in School-Based Speech-Language Therapy: An Invitation to Change

Moving Toward Anti-Ableist Practices in Aphasia Rehabilitation and Research: A Viewpoint

PURPOSE

Ableism is a pervasive set of beliefs that regard nondisabled bodies and minds as ideal and necessary to live a full life. Ableism manifests for people with aphasia as stigma and discrimination based on their language ability. We assert that ableism contributes to decreased quality of life for people with aphasia and should be actively challenged and disrupted by clinicians and researchers in the field.

METHOD

We applied the Health Stigma and Discrimination Framework (HSDF) to outline how stigma and discrimination are perpetuated against people with aphasia on the basis of language ability and their downstream health and social consequences. We presented this framework at the Clinical Aphasiology Conference in 2023 and share themes and challenges that arose from this discussion and from our ongoing learning.

DISCUSSION

Applying the HSDF to aphasia outlined potential sequelae of ableism. We identified preliminary foci of future initiatives aimed at challenging ableist beliefs and practices and means to monitor the effectiveness of such interventions. Furthermore, we draw attention to the seeming tension between anti-ableist practices and traditional language rehabilitation goals. We assert that this tension may be a catalyst for fruitful discourse on how clinicians and researchers can resist ableism while honoring the lived experiences of people with aphasia and their goals for language rehabilitation. These discussions may be facilitated by existing models in disability studies (e.g., the political/relational model).

CONCLUSIONS

Clinicians and researchers are well positioned to challenge ableism and minimize the resultant health and social impacts for people living with aphasia. Anti-ableist practices are not antithetical to aphasia rehabilitation and can be thoughtfully integrated into rehabilitation practices and discourse.

Using a Social Model to Guide Individualized Education Program Development and Change Educational Paradigms to Be Critically Inclusive

PURPOSE

The Individuals with Disabilities Education Act explicitly acknowledges disability as a natural part of the human experience. However, special education services, including speech-language services, often focus on remediating the characteristics of the individual with the disability rather than addressing the disabling conditions of the school environment or leveraging the supports and resources available or potentially available to the student. The purpose of this article is to provide a social model of disability framework to guide Individualized Education Program (IEP) development and change educational paradigms around language and communication.

METHOD

A discussion of a new theoretical framework, critical inclusion, is situated within the speech-language pathologist's role in the IEP process. An argument for adopting an integrative approach to service delivery through the social model of disability is provided. The Social Communication and Engagement Triad framework is then used to illustrate a social model of disability approach to assessment, IEP goal development, and service delivery case examples.

CONCLUSIONS

Speech-language pathologists and all educators have a responsibility for creating a space where all learners belong and diversity in all aspects is celebrated. Embracing a social model of disability approach to the IEP process can support practitioners in their work toward creating a more equitable and inclusive education system.

Ableism, Code-Switching, and Camouflaging: A Letter to the Editor on Gerlach-Houck and DeThorne (2023)

PURPOSE

This letter to the editor is in response to the Gerlach-Houck and DeThorne (2023) epilogue regarding their proposal for speech-language pathologists to offer Autistic code-switching (Autistic masking and camouflage) as a viable, non-ableist social communication tool that Autistic clients may choose to use in "high-stakes" social situations. In connection with Autistic code-switching, the authors reference "the debate" regarding code-switching in "African American Vernacular English speakers," specifically, whether "standard" English should be encouraged as a way to access "conventional forms of success."

CONCLUSION

Professionally training Autistic clients to "code-switch" with the goal of improving the client's chances of accessing conventional forms of success is essentially training Autistic masking and camouflaging. This type of therapy reinforces to both the Autistic client, as well as society, the position that hiding a person's Autistic traits is a pathway to acceptance and success. Autistic camouflaging has detrimental ramifications for mental health outcomes; perpetuates both internalized and societal stigma; hinders bias and discrimination deconstruction; reinforces ableist values; and fails to dismantle power inequities and social barriers that lead to marginalization, oppression, and exclusion.