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CSD Students Create Resource to Make Courses, Practice More Culturally Inclusive

By David Ertischek ’01

The field of speech pathology is overwhelmingly made up of white women. But their client list more accurately reflects the demographics of the country, and that dichotomy requires speech pathologists to understand the linguistic cultures they service.

The second-year Communication Disorders graduate program cohort, all 36 of them, felt they needed more resources to help the client base they’ll be working with when they head out into the profession. So they created a robust culturally inclusive and anti-racist resource document that has quickly been infused into curricula.

The expansive shareable Google document is chock full of position papers, systemic reviews, links to videos, individual book chapters, segments of articles, and more, and it’s continually growing as students find more helpful resources. The document offers a link to individual resources, a brief summary, rationale for use, suggestions for where to include it in a course, and a section for faculty to add comments.

The video features a teenage girl with aphasia answering questions (i.e. state the date/days of the week, retell the story of The Wizard of Oz) demonstrating examples of paraphasias and circumlocutions. This video is beneficial to show examples of people with aphasia who come from diverse backgrounds.

“As future speech language pathologists, we’re going into a career that is predominantly white women, and is not representative of the population we will serve,” said Miriam El-Haoui, MS ’21. “It’s our responsibility that we need to learn how to serve and provide the most effective and efficient services…And that no one’s culture is putting them at a disadvantage.”

Emerson is trying to diversify a profession that is around 94 percent white, and 97 percent female. While the on-campus program is comprised predominantly of white women, the online Speech@emerson program is roughly 50 percent people of color, said Communication Sciences and Disorders Chair Ruth Grossman.

“We’re working with community colleges to increase transfer students from more racially ethnic diverse populations into our undergrad major,” said Grossman. “We’re pushing out more info to high schools that the profession exists, and you can have a career in it.”

Grossman added that the faculty were very happy with the cohort creating the resources list.

“I thought it was fantastic,” Grossman said. “This is a very engaged cohort, overall. It’s not surprising that they would not just have conversations amongst each other, but also put those toward action and really try to find ways to positively influence their immediate environment.”

‘We wanted to make a change’

Astrid Esquilín Nieves, MS ’21 stressed that 2020 has been an extremely difficult year for people of color, with numerous nationally reported incidents of police brutality and systemic racism.

“Our cohort was just tired of it and we wanted to make a change. Maybe not all of us can go to protests and stand with our Black and Brown community members,” said Nieves. “We can make change within our program and have more resources available to us. Across the literature, it’s important to be culturally sensitive and take dialectal differences into consideration.”

For example, it is highly valued to speak “mainstream American English,” said Nieves. That “proper English” is what’s used in academia, and on standardized tests. Those tests are used to determine things such as learning disabilities, hearing deficiencies, and other defining diagnoses.

“The difference is that you can speak African-American English at home, but not in writing. In our field we will speak the dialects,” said Nieves. “We have to provide standardized assessment and ask how do we take into account dialectal differences? And how will it impact testing? How will it be different than the expected [proper American English] answer? It’s important to consider different dialects of kids like how Puerto Rican and Mexican Spanish are different. There’s different [words] for calling objects.”

LaChan Hannon speaks about being an educator and a parent of a child with autism in a TedX Talk. The resources list suggests this video can be helpful to watch for courses about autism before a lecture on racial disparities.

Nieves said the resources list was implemented into her Methods 2 class while discussing ethics and examining the case of a little girl from a Spanish-speaking country. The professor used a companion brief provided by the resources list that was posted by the American Speech and Hearing Association, The Ethics of Assessment with Culturally and Linguistically Diverse Populations.

“We were able to have a deeper conversation,” said Nieves. “It helped to have something for us to read, and to have our research. We could easily go back to the article and reference it in our future work.”

Another case study presented a situation when a speech language pathologist (SLP) in training was asked to evaluate a Cantonese-speaking child. However, there was no SLP who spoke Cantonese, so the evaluation was dependent on an interpreter.

“There are different dilemmas. Do you go back to the interpreter and have her look at the test and determine different scores?” said Nieves. “In cases of working with interpreters, you have to make sure [the interpreter] knows what you want them to do. They aren’t an SLP in training. There is no consistency if the answer is provided to the child by the interpreter. We may not know what the interpreter is saying to the child.

“The article gave us ethical dilemmas to think about how would we process this in a clinical setting to get a child accurate and relevant results. We don’t want to put a label on a child if it doesn’t represent the child, [such as] expressive language disorder or that they have a social pragmatics impairment.”

Pushing for change across the field

The benefits of the resources can be seen in different ways, said Toby Loewenstein, MS ’21. The resources can be added to courses by faculty, and students can access and share the resources to become better speech language pathologists.

“On a deeper level, creating this list and putting in the effort as a collective cohort sent a message of how important it is, and the faculty has taken it and infused it into discussion points of their courses,” said Loewenstein, adding that removing elements of curriculum has not been discussed.

The collaborative cohort is also pushing for external resources to make changes. Eight students wrote to Simucase, a clinical simulation service, that they believe the company is not doing its due diligence to represent communities of color.

“Ultimately, we fear that a brief note about a Simucase student using a dialect is not enough to prevent problematic assumptions that associate physical characteristics, or the way someone looks, with the use of specific dialects. This has the potential to further perpetuate racial biases currently present in the field, particularly in regard to screeners and assessments,” wrote the students.

Grossman stressed it’s great to have the resources list, and was very proud about the collaborative pedagogy across the department that led to its creation.

“I’m insanely proud of these students doing this work and bringing it to the faculty this way,” said Grossman. “It’s about working together in a positive way and calling each other in, and know that we’re all working to this goal to make it a more inclusive and diverse environment.”

El-Haoui said the cohort felt that faculty was already doing a wonderful job in trying to provide as much cultural humility as possible, but there’s always more work that can be done. The cohort is continually adding to the document and engaging in anti-racism discussions biweekly. They also created a book club centered on books that highlight culture and diversity.

“We’re absolutely not done with this work, and we’re committed to bettering ourselves and ensuring our clients and patients get the care they deserve,” said El-Haoui. “We are so incredibly proud to be a part of this cohort and this department, and are eager to see the storm that we bring to our field.”

Please email Miriam El-Haoui at, Astrid Esquilín Nieves at, or Toby Loewenstein at, if you would like access to the resources list.

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