We’ve talked about the role of the SLP as it relates to cultural competence, cultural humility, and white supremacy. So what’s next? How do you take action? JNBASLH recently published a series of papers for a special issue titled “Removing the Stranglehold of Racism in CSD.” The title itself might leave you speechless.  But you if you are uncomfortable, you need to get comfortable being uncomfortable. 

“The professionals that serve these populations must change to meet the needs of their clients. This change is achieved primarily through education.

 

– Toliver-Smith & Robinson, 2020

So, what can you do? 

• Be aware of your own implicit biases. These are attitudes or stereotypes that a clinician might hold against others that impact their decision-making. Lecointe (2020) discusses the importance of increased awareness about these internalized beliefs, and Jessie (2020) discusses helping to educate our peers and provide them with the tools they need to be accountable. Remember that implicit bias, prejudice, and racism can often be intertwined. Admitting that we all have biases is the first step to working on how you interact with others. Two useful resources for next steps are the Harvard University Implicit Bias Test on Race and the article by Harley (2021) entitled “My crash course in cultural differences in home health.” 
• It is important to continue to take professional development centered on multicultural and multilingual infusion (MMI). Toliver-Smith and Robinson (2020) outlined key components of MMI curriculum, examining clients’ needs, and the skills and knowledge required that can lead clinicians toward cultural humility, responsiveness, and competence. 
• Understand the different types of microaggressions. For a basic understanding see our #AmIQualified series. Davis (2020) discusses microinsults (interpersonal communication that conveys rudeness, insensitivity, or stereotypes that provide a negative attitude about a particular group), microinvalidations (communication that excludes, negates, or excludes the realities of specific groups), and microassaults (biased attitudes, beliefs, or behaviors that are communicated to a specific group). For specific micro-intervention strategies refer to Sue et al. (2019). 
• Participate in sustained efforts towards racial transformation according to Butterfield & Robinson (2020) by participating in comprehensive continuing education focused on equity, racial awareness, and recognition. 
• Examine how culture and language use has a profound impact on various learning styles. Davis & Stanford (2020) discuss the importance of being aware of varying learning styles to mitigate bias. 
• Expose high school students from culturally and linguistically diverse populations to the professions of communication sciences and disorders (CSD). Wyatt & Mayo (2020) discussed the UNCG Chance program that exposes LatinX high school students to an intensive five-day college program and the academic major of CSD. Active recruitment at the high school level serves as a pipeline and pathway to this profession. As an SLP you could serve as that guide. 
• Remember your role in advocacy. Hoyns (2020) tells us that SLPs can collaborate with local police departments and funds could be reallocated to provide training on how to work with individuals that have disabilities and concurrent cognitive disabilities. This encompasses our caseload of clients with communication disorders that include but are not limited to clients who are neurodiverse (autistic, ADHD, etc.) or intellectually disabled. We can train law enforcement officers to quickly identify characteristics of different disabilities and then utilize these strategies to respond to a situation during an interaction and deescalate the situation. 
• So maybe, you are thinking what does this have to do with racism…..well Black individuals are less likely to receive an ASD diagnosis and may remain undiagnosed. Rava, Shattuck, Rast, and Roux (2017) indicate that by the age of 21, approximately 20% of autistic youth have been questioned by the police and 5% have been arrested. According to the National Alliance on Mental Illness individuals with disabilities make up a third to a half of all people killed by law enforcement officers. 
• Stowe (2020) tells us we must recognize that systemic racism goes beyond physical violence and overt discrimination but is also represented by the lack of diversity in leadership within this profession. Visibility is definitely a statement. The voices in leadership must reflect the diverse demographics of our nation. 
• Watch the documentary Pushout: The Criminalization of Black Girls in Schools (Morris, 2020). According to Vaughan-Robinson & Jessie (2020), they utilized this video at their university to highlight systemic racism in the public schools, specifically focusing on Black female students. For many school-based SLPs this can offer an opportunity some of the systemic challenges in the school system that impact children that we serve. 
• Include dynamic assessment as a crucial part of language sampling. Moses et. al (2020) asks clinicians to consider the potential influence of cultural and linguistic history on children’s responses to various tasks. This article highlights the role of spontaneous language sampling and our obligation to research the language domains of the communities that we serve in a variety of observation contexts. 

“We have a responsibility to take steps to avoid biases in our assessments of children who may not share our cultural and linguistic heritage.”

 

– Moses et al., 2020

Let’s consider integrating a client’s cultural history into therapy for individuals at risk for dementia. Postman and Slay (2020) discussed the use of reminiscence therapy for individuals with cognitive-communication decline. This type of therapy is designed to focus on past events and experiences of your clients while utilizing past artifacts. This type of therapy can also be done in a group to support collective memory recall. Postman and Slay (2020) describe their adaptation of reminiscence therapy when working with a group of Black elders who were at risk for dementia. The therapy session described in the article focused on the current socio-political climate to facilitate the participants’ community involvement in their communities’ racial justice efforts. The therapy sessions connected with a group of local community activists. This study resulted in a group reminiscence therapy protocol for a program called Senior Social Group for Brain Health as We Age. 

“We are at the beginning of a long, and at times, draining process, and this step of making the conversation critical and interwoven into all we do is essential to current and future change 

 

– Stowe, 2021

As a profession, we have the ability to contribute to making systemic changes. We recommend you read some of the articles that we highlighted or at least the articles that feel most relevant to your clinical practice. 

References

Butterfield, V. & Robinson, T.L. (2020). Sustained efforts in racial transformation: A call to action to train students in Communication Sciences and Disorders. Journal of the National Black Association for Speech-Language and Hearing.

Davis, K.C. (2020). Me and microaggressions: A Framework for overcoming microaggressions in Communication Sciences and Disorders Academic Programs. Journal of the National Black Association for Speech-Language and Hearing.

Davis, A.S. & Stanford, S. (2020). Shifting the mindset of racism through cognitive learning styles in communication sciences and disorders. Journal of the National Black Association for Speech-Language and Hearing.

Hoyns, H. (2020). The need for interdisciplinary collaboration and police training on how to interact with diverse individuals with autism and other cognitive-communication disabilities. Journal of the National Black Association for Speech-Language and Hearing.

Jessie, A.C. (2021). Coupling degrees, breaking the silence, and seeing what I can be. Journal of the National Black Association for Speech-Language and Hearing.

Lecointe, K. (2020). Strategic measures to reduce racism & prejudice in higher education. Journal of the National Black Association for Speech-Language and Hearing.

Moses, N., Reuterskiold, C., & Klein, H.B. (2020). Language sampling and semantics in dynamic assessment: Values, biases, solutions. Journal of the National Black Association for Speech-Language and Hearing.

Rava, J., Shattuck, P., Rast, J., & Roux, A. (2021). The prevalence and correlates of involvement in the criminal justice system among youth on the autism spectrum. Journal of Autism Developmental Disorders. https://doi.org/10.1007/s10803-016-2958-3

Stowe, K.D. (2020). Breaking the Silence: Action steps for eradicating racism in CSD. Journal of the National Black Association for Speech-Language and Hearing. 

Toliver-Smith, A. & Robinson, G.C. (2020). A phenomenological study of multicultural/ multilingual infusion in communication sciences and disorders. Journal of the National Black Association for Speech-Language and Hearing. 

Vaugh-Robinson, L. & Jessie, A. C. (2020). Addressing the Effects of Racism in SLP graduate students: The impact of dynamic response approach. National Black Association for Speech-Language and Hearing. 

Wyatt, J.R. & Mayo, R. (2020). Pathways to the Profession: The UNCG Campamento Hispano Abriendo Nuestro Camino A La Education (CHANCE) program. National Black Association for Speech-Language and Hearing.