Cultural Differences in Speech Therapy and Assessment

Cultural Differences

Every good debate starts with a better disclaimer, so here it goes:

When you talk about cultural differences or cultural parameters you risk stereotyping whole groups and individuals.

So why risk it? Why take up your time writing about it? Why risk angering people who respect us, our writing, and have been reading our essays for years? Why take the chance that someone reading this, who is not in a good place, will see this as discriminatory?

Three Reasons to Talk about Cultural Differences

#1 SLPs are over-identifying students at disproportional rates and have not been given the tools to deal with it.

Here’s the simple math:

If your district has 1000 students, 500 of whom are Caucasian, 300 of whom are African American, and 200 of whom are Hispanic-surnamed, your special education caseload should be approximately 50%/30%/20% respectively. If your school looks like 30%/35%/35%, that’s over-representation or more commonly; disproportionality. How do you think SLPs are doing on that front?

Nationally, year-after-year, over-identification of minority students continues to be a problem. This indicates that we, the laypeople, are not being given the time, tools, or knowledge to correct the trends.

#2 Your caseload does not match your culture.

A student’s language, culture, and experience (exposure) can influence how robust their communication is. If we don’t take these differences into consideration, we risk seeing their differences as a disorder. This means pulling kids who don’t need services and using up more of your already precious time. So, if we learn about what research has told us about cultural differences, this can help us account for the difference and feel better about our diagnoses.

The Old Trope We Can’t Use Anymore

When professionals make broad statements about cultural differences they often tack on some off-the-beaten-path locale onto the end of their statement to qualify how they are generalizing. They say something like:

“Chances are, the students you serve come from a different culture…unless you work in Montana or South Dakota.”

Well, I spoke with an SLP in Montana who was seeking information to serve their large population from Micronesia.

Also, we are putting together a presentation for the school district in Anchorage, Alaska so they can better serve their 100+ languages. (Yes, you read that right).  So the old trope is dead. If your therapy group looks, sounds, and acts like you, just wait 30 minutes, or wait until next semester.

#3 I haven’t been sleeping well

I just finished my umpteenth school year and this “problem of diversity” isn’t going anywhere. And to be honest, I don’t want it to. I love the worlds, languages, and culture that my caseload exposes me to. I crave it to stave off boredom. Yet, some speech pathologists can’t revel in these beautiful differences that make us human because the unfamiliar leads to questions about what we should focus on in therapy and if we should be qualifying or not. Healthcare professionals generally err on the side of generosity. It’s in our genes. If we are not 100% sure whether a child qualifies or not, it’s better to give her some help than risk denying services, right? Enter stage left–over-identification.

Are you tired of feeling badly just for having a child’s best interest in mind? Are you exhausted from bearing the burden of large caseloads? Me, too. Research on cultural differences has made me more confident and enjoy my job more. I want that for you, too. But in sharing this information, I risk being misunderstood. I will bear that if it means one less child enters special education or one more speech pathologist welcomes diversity.  End of disclaimer (tirade maybe?)…

So let’s do this! I am writing to you, dear reader, in an attempt to be brave, in an attempt to make us better professionals, and with the hopes that our 20+ years of serving diverse children earns us an ounce of trust, that we are not stereotyping. I am writing this because an understanding of cultural differences can help your therapy progress at a faster rate and can make you more confident in your diagnostic decisions.

Here’s how we are going to talk about cultural differences.  The next 10 posts are short, fast, intriguing reads on different parameters of culture.

cultural differences

  • Why Understanding Cultural Differences is Important to SLPs
  • Cultural Parameter #1: Individualism versus Collectivism
  • Cultural Parameter #2: Views of Time and Space
  • Cultural Parameter #3: Roles of Men and Women
  • Cultural Parameter #4: Concepts of Class Status
  • Cultural Parameter #5: Cultural Values
  • Cultural Parameter #6: Home Language Use
  • Cultural Parameter #7: Cultural Rituals
  • Cultural Parameter #8: Significance of Work
  • Cultural Parameter #9: Beliefs about Health

These posts are heavy cited so that the researchers can tell the story of where they got their information and how they have done their best to account for bias. I hope you see a little bit of yourself and your students in each of the parameters that are highlighted.

We begin our next essay by: Understanding Cultural Parameters is Important to SLPs


Want to read about all the cultural parameters in one place, get ASHA CEUs and a helpful chart? Check it out.

Understanding Cultural Parameters when Assessing and Treating Diverse Children

Cultural Competence: Overview – ASHA

Written by: Scott Prath

4 Comments on “Cultural Differences in Speech Therapy and Assessment”

  1. May 24, 2019 at 6:44 am #

    I wish that all health and education professions emphasized the importance of cultural literacy as SLP does. Obviously its a “work in progress” to go from learning about these concepts in undergrad and then translating it to competence in clinical practice, but I find myself CONSTANTLY frustrated on this topic. I find that most people completely overlook the minutiae and nuance of cultural diversity; it’s so much more than traditional dress and cuisine! I would also love for more professionals to discuss openly the intersection of socioeconomic status. We throw that word around a lot, but are we taking into consideration the influence of “poverty culture” on our students/client? There is QUITE a bit of research and information on the psychological, social, and physiological effects of poverty on an individual and their family AND their community; why do we ignore this? I wish I had a dollar for every time a social worker or principal chalked up a students’ shortcomings to “bad parenting” or believed that a desperate parents emotional confessions in a meeting were “alligator tears.”

    • May 24, 2019 at 11:18 am #

      Thank you for your comment. This is the exactly the conversation we hope to add to and begin with these posts.

  2. June 14, 2019 at 9:15 am #

    I have found this book to be helpful in my understanding of families of a low socioeconomic means: A Framework for Understanding Poverty by Ruby Payne
    A Framework for Understanding Poverty – A Cognitive Approach (Sixth Edition)

    • June 14, 2019 at 2:19 pm #

      I hadn’t seen that before and will have to add it to my list. It seems like it is really popular among other educators. I like this quote about it: It reveals the daily struggles and indignities the poor face and how to help.

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