Communicate your way: De-pathologising the speech pathology profession

This week is 2024 Speech Pathology Australia week. The theme of this year’s event is “communicate your way”. Reflecting on this theme I realised that helping people to “communicate their way” is the whole point of what we are working towards with the people we support. Our purpose as speech pathologists is to enable them to communicate in a way that is authentic and meaningful to them. This might seem like a straightforward concept, but in a profession that has the word “pathology” in its name, historically we have been very good at identifying what is “wrong” with a person’s communication, rather that what is amazing, unique and special.

The speech pathology profession is going through a slow but beautiful transformation where were are realising that the goal of speech therapy is not a homogenising one, where every person is required to speak “correctly” (as has traditionally been the goal) but rather a process to embrace the diversity of different forms, styles and cultures of communication.

One example of this is in the area of speech production. It has long been upheld that there is a correct way to say things and that if people pronounce words and sounds differently this needed to be fixed. But what this approach actually does is covertly foster bias and enable marginalisation of speakers of “non-standard” dialects, namely those who are multilingual or speak a dialect that is considered a lower status (e.g., rural dialects or dialects spoken by those of lower socioeconomic status). In the age of social media, people are subverting these old stereotypes and instead taking pride in their unique ways of speaking, seeing them as a marker of identity and inclusion in a social group or cultural community.

Its also important to recognise that communicating doesn’t need to involve speech at all. Many people communicate via alternative and augmentative communication (AAC) methods such as sign language, voice output devices, tablets, visuals and gestures. Communication is a two way process and can only be effective when both communication partners are working to make the exchange successful. The greatest thing we can do as communication partners is to learn how to effectively communicate their way. Learn how to engage with their device, or how to use sign language to enable their voice to truly be heard.

Another example where a major shift is taking place is in the area of stuttering. In traditional speech pathology practice the concept or stuttering/stammering has long been pathologised and speakers put through arduous intervention programs to “eliminate” their stutter. In contrast, many people who stutter are now embracing this diversity in their communication and choosing not to change the way that they speak. This is particularly true for those on the neurodiversity community where stuttering can be a typical aspect of communication. Advocates argue that it is the role of society to be more respectful and understanding of diverse forms of communication, rather than forcing people to change who they are and how they speak in order to appease their communication partner.

In fact, the neurodiversity affirming movement may be the greatest advocate for change in this space by calling for the abolition of outdated techniques that seek to “cure” or “minimise” features of neurodiversity (such as Autism and ADHD). Frequently, speech therapy for autistic children has focused on removing stimming behaviours (such as flapping hands when excited), discouraging autistics from talking about their special interests, and teaching autistics to mask their neurodiversity by learning and adopting neurotypical social skills (such as making eye contact and engaging in small talk). These techniques are the antithesis of “communicating your way” and have extremely detrimental impacts upon the mental health and wellbeing of neurodiverse individuals.

While people should have the option to engage in speech therapy interventions for things they would like to change about their communication, the theme of “communicate your way” should encourage us to think about the beauty that comes from the diversity that exists in communication. By embracing this diversity and critically re-evaluating homogenising practices that teach “correct” approaches to communication, we can support people to make unique contributions to their lives and lives of others by communicating their way.

Happy Speech Pathology Week!

Dimensions of diversity

A person’s culture is made up of their unique intersection between a range of communities and identities. The diversity wheel (Verdon, 2023) was created to help professionals to engage in critical self reflection upon the dimensions of their own diversity and how these may inform their cultural lens, biases and practice decisions.

The Principles of Culturally Responsive Practice

In 2015 I developed the 6 Principles of Culturally Competent Practice as part of my PhD. In the time since then these principles have continued to evolve based on my own learning, research and clinical experiences. The principles are now called the Principles of Culturally Responsive Practice, as we will never be competent in the culture of others, but rather as speech-language pathologists, educators and health professionals we work to respond appropriately to the culture of others and to reflect on our own culture and its impact to make others feel culturally safe. The principles are designed to holistically guide health and education professionals when engaging with children and families.

These 6 principles are:

(1) Cultural self-awareness

Health professionals need to engage in reflexive practice by recognising how their own culture influences the way they perceive and interact with the world around them. Critical self-reflection on one’s own values, worldview and sociocultural positioning in relation to dimensions of diversity facilitates insight into how a culture impacts upon their services delivery and interactions with clients.

(2) Identification of culturally appropriate and mutually motivating goals

Goals need to be developed in conjunction with the individual and their family in accordance with E3BP. Culture impacts every aspect of a person’s life and therefore will be inextricably linked with goal setting – functional goals cannot exist without context.

(3) Culturally and linguistically appropriate tools and resources

Tools for assessment and intervention must be culturally and linguistically relevant to the individual and their context. As such, standardized assessments may not be appropriate and alternate forms of assessment such as dynamic assessment may need to be used. 

(4) Co-production of services with families and communities

Families and communities possess cultural knowledge and support to enable positive therapy outcomes. Engaging with trusted members of a client’s family and or community can help to create a safe and culturally inclusive environment in which therapy can be enacted.

(5) Consideration of cultural, social, political and historical context

It is important to recognise where individuals and families are coming from and cultural and contextual factors that may impact upon their ability to engage in therapy. This includes socioeconomic status, past experiences of discrimination when engaging with health services, and stigma around help seeking.

(6) Collaboration between professionals

Working collaboratively can facilitate holistic client care that builds on existing trusting relationships with professionals to act as a bridge towards expanding care teams in a culturally safe way.

Professional development workshops using the PCRP

I have discussed the application of these principles in a number or publications and have also taught them to professionals through a number of professionals development workshops. If you are interested in learning more about the Principles of Culturally Responsive Practice or in how to support early communication development please contact me to discuss professional development opportunities.

Why support diversity in childhood?

Dr Sarah Verdon Pedemont

There is currently a focus on teaching early years professionals how to support the diversity of the children they work with by engaging in culturally responsive practice. However, only recently has it become apparent that many professionals are unsure why it is useful, necessary or important to support diversity.

The existing evidence for supporting cultural and linguistic diversity in children is comprehensive, exciting and compelling. Benefits are present at the individual, community and broader social level. Over two thirds of the world’s population are multilingual, meaning that monolingual speakers are in the minority. But in English-dominant countries the many advantages of supporting diversity for children’s being, belonging and becoming are often unknown or are overlooked.

Cognitive advantages

When children from culturally and linguistically diverse backgrounds are having difficulty with their learning it is frequently recommended that they stop speaking language(s) other than English to focus only on English. While this recommendation has often been made with the best intentions, the evidence tells us that supporting children’s first or home languages, does not hinder, but in fact supports children’s acquisition of English.  Multilingual speakers often mentally translate learning material into their home language to process and consolidate new information. This is likely because they find it easier to understand complex material, store information, and integrate new knowledge into existing schemas of understanding in their first language. Furthermore, there is no evidence that competence in a language other than English is detrimental to English language and literacy proficiency.

Investigations into the relationship between multilingualism and cognitive outcomes has found that multilingualism is associated with increased:

  • mathematical aptitude;
  • abstract and symbolic representation;
  • attention;
  • problem solving;
  • phonological awareness;
  • vocabulary;
  • executive functioning; and
  • metacognitive capabilities.

Emotional advantages

All children have a culture and benefit from seeing their culture reflected in their early learning space. Having their culture present in their surroundings through images, language, music and experiences helps children to feel included, accepted and supported in their environment. It provides children with a sense of belonging, which creates space for developing a strong sense of identity, self esteem, self confidence and resilience. When multiple cultures are present in the same space it provides children with the opportunity to learn about diversity and the different approaches each child brings to learning, creating, communicating and expressing their personalities. Exploring these different approaches can enhance learning for all children in the space as they learn that there is more than one way to view and solve a problem.  

Multilingual speakers can also describe the experience of the world through the prism of multiple languages by using words and phrases to express emotions for which there is no translation in English. For example, kummerspeck”, which is the German word for weight gained from sorrow or emotional overeating, and translates to mean “bacon grief”, or “gigil” which is the Filipino word for the irresistible urge to squeeze something cute.  

Social advantages

Children who are exposed to multiple languages in early childhood have better social skills, including empathy and theory of mind, than children who are only exposed to one language. This is thought to be because multilingual speakers constantly need to evaluate what their speaking partner does or does not know in order to choose the correct language and cultural norms for their interaction. Interestingly, this increased aptitude in communication and social skills has been found in otherwise monolingual children who are exposed to other languages in their environment. This emphasises the benefits of exposing children to multiple languages in early childhood spaces.  

Economic advantages

Australians who are competent speakers of another language as well as English and are more likely to be employed, have postgraduate qualifications (such as a masters or PhD) and earn a higher salary than monolingual Australians. From a national perspective, Australia will be more strongly placed to participate in a globalised economy by having competent multilingual speakers who can work effectively across languages and cultures. Therefore, supporting the diversity of our children is essential for their ‘becoming’ as lifelong workforce participants and the indispensable contributors to our society.  

Early childhood educators play a vital role in supporting diversity so that this multitude of benefits can be realised. They have the opportunity to positively influence the minds of our children from their earliest moments. Through generational change comes societal change. By embracing diversity in our children, they will grow up to enjoy the benefits of such diversity in the world around them. Now, think again before questioning whether early childhood educators have the most important job in the world.

Let, first service: The breakdown of the serve and return in children’s communication

A great tennis analogy, the serve and return, exists to describe the best way to support and shape children’s brain development. A child “serves” by initiating communication, and then an adult “returns” serve in a way that models and builds upon their language attempt.

A serve can be non-verbal (a smile or gesture) or verbal. Babies start serving and building these neural pathways that will form the foundation of their brain architectures from birth. This interactive game of serve and return, played with a spirit of genuine engagement and curiosity is how children best learn to communicate and strengthen their language skills. It also builds the bonds of trust, attachment and security between a child and their caregiver.

It’s Australian Open time and we are currently in the grips of tennis fever, which has got me thinking about an extension to this analogy. That is, when a child serves a “let” in their game of interaction.

A “let” is an authentic attempt to serve, and it lands inside the court, but it’s obstructed in its delivery by the net and therefore there’s no attempt at a return. I’ve seen this time and time again, at cafés, shopping centres and, in my own living room.

So what plays the role of the net in this analogy?

What is the barrier between a child’s serve and their communication partner’s lack of attempt to return serve?
No prizes for guessing, it’s our phones.

I’ve seen babies and children patiently attempt to serve, with no response, then again, no response. Again and this time more agitated, no response. One more time, pulling on the adult’s shirt, no response. Then the child yells, adult puts their phone down and says “what?!”.
The thing is that the adult genuinely did not hear the child’s first four attempts. Research has found we literally can’t hear what is going on around us when engrossed in our phones.

Of course we can’t return every single serve that is sent our way, and research shows that the occasional misfire can actually build children’s resilience. But number of things can happen when a child’s communication serve is consistently unreturned. Children who don’t receive rich language input and interactive experiences to support their development in the early years are significantly more likely to have delayed communication development, difficulties learning to read and difficulties achieving at school. This makes sense as each of these areas require strong knowledge of language and strong communication skills. Additionally, research has shown that when children’s communication attempts are regularly ignored over time their brain structure changes, impacting emotional attachment, trust and vulnerability. 

The purpose of this article isn’t to chastise parents and caregivers. I’ll be the first to admit I do this too. In this modern world so much of our life administration occurs on our phones, we steal moments between running from A to B to pay bills, organise appointments and answer emails. Unfortunately this isn’t just a turn of phrase, it’s an accurate representation of what our phones do. They steal moments.

But like it or not, for the foreseeable future, phones are here to stay. Learning to navigate raising children in such a technologically connected world is challenging because we are the first generation of parents to have grappled with the ever-present nature of devices. So it’s important for us to find a way to balance the many conveniences brought about by phones with the potential harm than can come from being disengaged or temporarily deaf when they are in our hands.

No parent or caregiver is perfect, as Dr Jack Shonkoff from the Brain Architectures podcast so eloquently puts it: “the best parents in the world do a dozen things wrong every day…raising healthy competent children is much more a bumbling art than a precise science”.

So, no, the purpose of this article is not to chastise, but simply to heighten our consciousness to the communication opportunities around us and the amazing impact we can have upon children’s lives by taking up these opportunities. If we return just one more serve a day that would give a two year old 1,095 more chances to strengthen their communication by the time they turn five. Imagine if we returned two or three more serves? We cant always be perfect, but every extra interaction counts. Every new connection is worth it.

Much has been said about the negative impact of children having devices upon their communication development, and these concerns are certainly valid. But I fear that in the game of serve and return, the most dangerous devices obstructing children’s attempts to serve are the ones in our hands. So now that I’ve stolen a few moments of your time to read this on your device, pop it down go play some tennis.

NAIDOC Week 2017 – 10 facts about Aboriginal and Torres Strait Islander languages

This week, 2nd-9th of July is NAIDOC week. The theme for this year is “Our languages matter”. To celebrate I thought I would share 10 interesting facts about Aboriginal and Torres Strait Islander languages.

  1. Prior to European colonisation there over 250 languages and 600 unique dialects of these languages spoken by Aboriginal and Torres Strait Islander people.
  2. Each of these languages has there own unique phonology (sounds), vocabulary (names for different things), grammar (markers of tense, plurals etc.) and pragmatics (rules for how languages are used in social interactions). Languages of neighbouring groups were as different as say French and German.
  3. In order to communicate between groups, people have often been able to speak a number of languages.
  4. Today there are over 120 unique Aboriginal and Torres Strait Islander languages still spoken.
  5. In addition to traditional languages, new languages have also formed since European colonisation. These include Kriol and Torres Strait Islander Creole. These languages have formed as a result of contact between English and Indigenous languages and contain features of both.
  6. Many Aboriginal and Torres Strait Islander people also speak a unique dialect of English known as Aboriginal Australian English (AAE). AAE has unique phonology, vocabulary, grammar and pragmatics from Standard Australian English (SAE). Given that children are taught in SAE in Australian schools, many Aboriginal and Torres Strait Islander children are bidialectal.
  7. Research from the Longitudinal Study of Indigenous Children found that some Aboriginal and Torres Strait Islander children are able to speak up to 8 different languages!
  8. NAIDOC chair Anne Martin states: “Aboriginal and Torres Strait languages are not just a means of communication, they express knowledge about everything:  law, geography, history, family and human relationships, philosophy, religion, anatomy, childcare, health, caring for country, astronomy, biology and food”.
  9. Around Australia many groups are working to revitalise their languages so that they can continue to be transmitted to future generations.
  10. Practices such as language revitalisation facilitate the ongoing transmission of cultural knowledge and practices which has made Indigenous Australians the oldest continuous culture in the world.

 

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