Diversity, Equity, and Inclusion in Language Intervention

Image courtesy of Pixabay.com

Did you know kittens born in the same litter can have different fathers? That’s one evolutionary strategy to ensure genetic diversity!

If you’ve been following the last several weeks (months, really) of posts, then you know that DEI in the evaluation and treatment of language disorders has been on my mind a lot lately.

Different is not disordered. Different is not less than. Different is simply different – just like the colors and patterns of the kittens’ fur in the image above.

Why is that we humans are so quick to judge others by the way they speak or how parents interact with children? Let’s leave abuse and neglect issues aside here in this discussion. I think we can all agree that there are situations and adult choices that cross the line regardless of the language, or culture, or income level (e.g., verbal/physical/sexual/emotional abuse, financial abuse, intimate partner violence, substance abuse in the home, etc). These are not the issues I’m talking about.

I’m talking about differences like the use of child-directed speech (CDS) and child-directed activities versus simplified language, but not CDS and adult-directed activities. I’m talking about communities valuing the needs of the many over the needs of the individual. I’m talking about how these different cultural practices affect language use and form.

Mainstream American parenting practices generally favor using child-directed activities where the child sets the pace. The child’s lead is followed. Adults ask children questions both the adults and children know the answer to (display questions). The child is an acknowledged participant in these interactions, although they may not be considered fully equal to the adult. The adult tends to use simplified language and CDS with very young children. CDS is characterized by exaggerated prosody, lengthened vowels, and body/facial expressions. It also tends to place prominent nouns in phrase final position so that it is easier for adults to stress the word. Adults who use CDS tend to use more diminutive forms (e.g., Look at the doggie. Do you see the doggie? Where’s the doggie?) There is little evidence to support the use of CDS as an effective intervention strategy on its own merits.

CDS is a cultural parenting practice. It should be recognized as such and not as an intervention strategy. It most definitely should not be recommended as a blanket strategy for every single family seeking EI services. Reading to children is another strategy that is blanketly recommended. There are even programs to send books home with parents of newborns. But, no one ever asks families from CLD populations about whether adults reading to children is a preferred parenting practice. Maybe the community and the family place more emphasis on orally told stories. No one ever ensures that the adults in the community and the family have the reading skills to be able to to read the books that are sent home. There’s very little effort spent on suggesting books that feature the culture of the family or the community. There’s very little recognition that not all families and cultures use display questions in their interactions with children. Mainstream culture professionals just assume.

And, therein lies the problem. You know what they say about assumptions…

So, what’s an SLP to do? There is substantial evidence to support that more talking and more interactions between older children/adults and young children supports the long-term language outcomes of young children ( cf. Greenwood et al., 1994; Hart & Risley, 1995). This is one area where becoming more culturally responsive is critical to making sure that SLPs are providing appropriate strategies for families who come from a different culture or who practice parenting differently than mainstream culture. In many cultures where multi-generational families are the norm, it may not be the parents who provide the most interactive opportunities for young children. It may be grandparents, older children, or extended family members who may or may not live in the family home. The only way to know (and to be more inclusive) is to ask. Asking questions like, “Who does the child spend the most time with?” or “Who would you like the child to be able to communicate with?” What would you like your child to be able to tell you?” or “How do children in your family ask for things they want?” will go a long way in breaking down some of the communication barriers between the family and the SLP.

In many families from CLD backgrounds, individuals with disabilities are who they are. There is a recognition that the person may have issues which need to be accommodated, but the person doesn’t need to be ‘fixed.’ (Personally, I think this is a much healthier attitude and something we would all do well to adopt!) But, this viewpoint can be in conflict with the viewpoint of the mainstream culture SLP or special education team, which can place a lot of emphasis and effort into trying to ‘fix’ the problems they see. This mismatch can lead to a lot of frustration on everyone’s part. Ask questions. If there are certain challenges in the school environment that the team needs to address, make sure the family understands why the school needs to address them (e.g., interactions with other students/teachers especially during puberty; toileting habits; aggressive behaviors; expectation that students will help in the classroom; etc.)

In many Latinx families, parents are parents. Parents are not teachers in the sense that they believe it is their responsibility to teach school-based concepts. Parents are responsible for teaching the skills that boys and girls need to learn to contribute to the needs of the family unit. So, maybe SLP shouldn’t recommend working with flash cards or sending ‘homework’ when these suggestions and strategies go against the family’s parenting values. Maybe it would be better to ask the parents what they would like their children to be able to do or do more independently. Whereas it might be appropriate to suggest playing “Simon Says” to a mainstream culture family to work on following directions, other families might prefer that we provide suggestions for helping children follow recipes or complete household chores. How will you know? Ask!

In many cultures, the needs of the many outweigh the needs of the one. This may mean that children learn to work cooperatively for everyone’s good from a young age. And, providing the answers when your friend is clearly struggling is not ‘cheating.’ It also may mean that calling attention to one student performing better than their peers is culturally insensitive. This can be a difficult concept for some people from mainstream culture, where great value is placed on individual achievement. Find out. Ask. What does the community value? How are children praised and reprimanded? Maybe, just maybe, you’ll learn some new ways of thinking and some new strategies, too!

I could have written a much shorter post by simply saying, “Hey, SLPs, don’t want to be considered a ‘Karen’ by the families and clients you serve? Then don’t be one. Don’t assume. Ask. Listen. Remember that you have as much to learn from the families and communities you serve as they do from you.” At the end of the day, what matters is that we improve the lives of our clients. And, we need to make sure we use the client’s definition of “improve.”

As always, thank you for reading and I look forward to reading your comments!

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