This presentation covers the current lack of diversity in the field of speech-language pathology, the potential impacts of this lack of diversity, as well as suggested remedies.

1. Diversity in the Field of
Speech-Language
Pathology in the United
States
Erin Roberts, M.S., CCC-SLP – August 2023

2. Current Demographics
● The American Speech-Language and Hearing Association (ASHA)
reports that, as of 2022, 8.9% of its speech-language pathologists
self-identify as a member of a racial minority group.
● According to the US census (2020), 24.5% of US residents identified
as a race other than white.
Speech-Language Pathologists US Residents
8.9%
24.5%
That is a massive
difference!

3. What does that mean?
This disparity makes it less likely that clients who are
not white will be treated by a clinician of the same
racial or ethnic group or another minority group.
This is also true across several other
healthcare fields (Salsberg et al.,

4. Racial Disparities in Speech-Language
Pathology
● There are several examples of racial and ethnic disparity in treatment when it
comes to speech services, including:
Black children and children whose
caregivers speak a language other than
English are less likely to receive
speech therapy by kindergarten than
their white, monolingual peers (Morgan
et al., 2016)
Black children are less likely to be
taught to utilize augmentative and
alternative communication than white
peers (Pope et al., 2022)
Black patients who sustained strokes
are more likely to have severe
aphasia symptoms than white peers
even after treatment (Gadson et al.,
2022)
Multilingual children are at risk for
being both under- and overidentified
for speech services (McLeod et al.,
2017)

5. Why are these disparities present?
● Differences in beliefs or
values such as:
● Conditions are
temporary (Zuckerman et
al., 2015)
● Speech disorders can
be resolved by trying
harder (Bebout & Arthur,
1992)
● Causes of disorders are
based in morality
(Ndung’u & Kinyua, 2009)
Family or Cultural
Preferences
● Many studies have found
evidence of implicit bias in
healthcare providers (Maina
et al., 2018; Zescott et al.,
2015)
● This bias can result in:
● Poorer patient-provider
communication (Maina et
al., 2018)
● Different diagnoses and
treatment decisions
(FitzGerald & Hurst, 2017)
● Worse patient outcomes
(Hall et al., 2015)
Provider Bias*
● “…structures that designate
and maintain differential and
unequal value of
individuals and groups…”
(Boynton-Jarrett et al., 2021, p. 2)
such as:
● Decreased access to
health information and
services (Richardson & Norris,
2010)
● High costs of intervention
(Singh & Bunyak, 2019)
Systemic Barriers
They likely come from a variety of factors, such
as:
● Examples include cultural
differences in
communication style (Kim
et al., 2000) and use of
different dialects (Geist-
Martin et al., 2002).
● Patients and clinicians have
two different sets of
information, and
communicating across
cultural boundaries and
listening to each other
results in better outcomes
(Ashton et al., 2003)
Communication
Differences
Note: The cultural beliefs given here as examples
are not representative of any one community.
*Most of these studies on bias are in the wider
field of healthcare, as they’ve yet to be thoroughly
investigated in SLP.

6. What does that have to do with increasing
diversity in SLP?
Increasing the diversity of providers in the field of
speech-language pathology could improve provider-
patient communication and decrease provider bias
for patients from minority racial and ethnic groups.
(Shen et al., 2019; Maina et al., 2018; Chapman et
al., 2013)
…on top of being more representative
of the people we treat!

7. How can we increase diversity in the field of SLP?
Reduce microaggressions
to increase belonging.
Currently, many Black SLP students report
the presence of microaggressions
(Ginsberg, 2018), which can decrease self-
esteem (Nadal et al., 2014).
Actively recruit CLD
students.
Doing community outreach with high
schoolers and preliminary education could
increase the number of divers applicants to
SLP programs (Medina et al., 2022)
Provide mentorship.
Mentorship has the potential to improve
student retention and increase student
success in SLP students from minority
racial or ethnic groups (Mahendra &
Kashinath, 2022).
Adopt more holistic
admissions processes.
Consider utilizing variations on GPA and
GRE scores, diversity assets, and prior
life experience in graduate admissions in
SLP (Guiberson & Vigil, 2020). Also,
provide appropriate financial aid!

8. The Bottom Line:
Diversity is valuable in any field, and SLP is no
exception.
Investing in increasing diversity will help our
patients and our field!
Spread the word!

9. References
American Speech-Language and Hearing Association (2022). 2022 Member & Affiliate Profile.
https://www.asha.org/siteassets/surveys/2022-member-affiliate-profile.pdf
Ashton, C.M., Haidet, P., Paterniti, D.A., Collins, T.C., Gordon, H.S., O’Malley, K., Petersen, L.A., Sharf, B.F., Suarez-Almazor, M.E., Wray,
N.P., & Street, R.L. (2003). Journal of General Internal Medicine, 18, 146-152.
Bebout, L., & Arthur, B. (1992). Cross-cultural attitudes toward speech disorders. Journal of Speech & Hearing Research, 35(1), 45-52.
https://doi.org/10.1044/jshr.3501.45
Boynton-Jarrett, R., Raj, A., & Inwards-Breland, D.J. (2021). Structural integrity: Recognizing, measuring, and addressing systemic racism
and its health impacts. eClinicalMedicine, 36, 100921. https://doi.org/10.1016/j.eclinm.2021.100921
Chapman, E.N., Kaatz, A., & Carnes, M. (2013). Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities.
Journal of General Internal Medicine, 28(11), 1504-1510. https://doi.org/10.1007/s11606-013-2441-1
FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18, 19.
https://doi.org/10.1186/s12910-017-0179-8
Gadson, D.S., Wesley, D.B., van der Stelt, C.M., Lacey, E., DeMarco, A.T., Snider, S.F., & Turkeltaub, P.E. (2022). Aphasia severity is
modulated by race and lesion size in chronic survivors: A retrospective study. Journal of Communication Disorders, 100, 106270.
https://doi.org/10.1016/j.jcomdis.2022.106270
Geist-Martin, P., Ray, E.B., & Sharf, B.F. (2002). Communicating health: Personal, cultural, and political complexities. Wadsworth/Thompson
Learning.
Ginsberg, S.M. (2018). Increasing African American student success in speech-language pathology programs. Teaching and Learning in
Communication Sciences and Disorders, 2(3), 5. https://doi.org/10.30707/TLCSD2.3Ginsberg2

10. References
Guiberson, M., & Vigil, D. (2021). Speech-language pathology graduate admissions: Implications to diversify the workforce. Communication
Disorders Quarterly, 42(3), 145-155. https://doi.org/10.1177/1525740120961049
Hall, W.J., Chapman, M.V., Lee, K.M., Merino, Y.M., Thomas, T.W., Payne, B.K., Eng, E., Day, S.H., & Coyne-Beasley, T. (2015). Implicit
racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. American Journal of
Public Health, 105(12), e60-e76. https://doi.org/10.2105/AJPH.2015.302903
Kim, M.S., Klingle, R.S., Sharkey, W.F., Park, H.S., Smith, D.H., & Cai, D. (2000). A test of a cultural model of patients' motivation for verbal
communication in patient‐doctor interactions. Communication Monographs, 67(3), 262-283.
https://doi.org/10.1080/03637750009376510
Maina, I.W., Belton, T.D., Ginzberg, S., Singh, A., and Johnson, T.J. (2018). A decade of studying implicit racial/ethnic bias in healthcare
providers using the implicit association test. Social Science & Medicine, 199, 219-229. https://doi.org/10.1016/j.socscimed.2017.05.009
Mahendra, N., & Kashinath, S. (2022). Mentoring underrepresented students in speech-language pathology: Effects of didactic training,
leadership development, and research engagement. American Journal of Speech-Language Pathology, 31(2), 527-538.
https://doi.org/10.1044/2021_AJSLP-21-00018
McLeod, S., Verdon, S., Baker, E., Ball, M.J., Ballard, E., David, A.B., Bernhardt, B.M., & Bérubé, D. (2017). Tutorial: Speech assessment for
multilingual children who do not speak the same language(s) as the speech-language pathologist. American Journal of Speech-
Language Pathology, 26(3), 691-708. https://doi.org/10.1044/2017_AJSLP-15-0161
Medina, A.M., Alfano, A.R., & Moore, S. (2022). Considerations for addressing the needs of culturally and linguistically diverse speech-
language pathology Praxis test takers. American Journal of Speech-Language Pathology, 31(2), 601-612.
https://doi.org/10.1044/2021_AJSLP-20-00358

11. References
Morgan, P.L., & Farkas, G. (2016). Evidence and implications of racial and ethnic disparities in emotional and behavioral disorders
identification and treatment. Behavioral Disorders, 41(2), 122-131. https://doi.org/10.17988/0198-7429-41.2.122
Nadal, K. L., Wong, Y., Griffin, K. E., Davidoff, K., & Sriken, J. (2014). The adverse impact of racial microaggressions on college students'
self-esteem. Journal of College Student Development, 55(5), 461–474. https://doi.org/10.1353/csd.2014.0051
Ndung’u, R., & Kinyua, M. (2009). Cultural perspectives in language and speech disorders. Disability Studies Quarterly, 29(4).
https://doi.org/10.18061/dsq.v29i4.986
Pope, L., Light, J., & Franklin, A. (2022). Black children with developmental disabilities receive less AAC intervention than their peers:
Preliminary evidence of racial disparities from a secondary data analysis. American Journal of Speech-Language Pathology, 31(5),
2159-2174. https://doi.org/10.1044/2022_AJSLP-22-00079
Richardson, L.E., & Norris, M. (2010). Access to health and health care: How race and ethnicity matter. Mount Sinai Journal of Medicine,
77(2), 166-177. https://doi.org/10.1002/msj.20174
Salsberg, E., Richwine, C., & Westergaard, S. (2021). Estimation and comparison of current and future racial/ethnic representation in the US
health care workforce. JAMA Network Open, 4(3), e213789. https://doi.org/10.1001/jamanetworkopen.2021.3789
Shen, M.J., Peterson, M.B., Costas-Muñiz, R., Hernandez, M.H., Jewell, S.T., Matsoukas, K., & Bylund, C.L. (2018). The effects of race and
racial concordance on patient-physician communication: A systematic review of the literature. Journal of Racial and Ethnic Health
Disparities, 5(1), 117-140. https://doi.org/10.1007/s40615-017-0350-4
Singh, J.S., & Bunyak, G. (2019). Autism disparities: A systematic review and meta-ethnography of qualitative research. Qualitative Health
Research, 29(6), 796-808. https://doi.org/10.1177/1049732318808245
U.S. Census Bureau (2022). U.S. Census Bureau Quick Facts: United States. https://www.census.gov/quickfacts/fact/table/US/RHI225222

12. References
Zescott, C.A., Blair, I.V., & Stone, J. (2016). Examining the presence, consequences, and reduction of implicit bias in health care: A narrative
review. Sage Journals: Group Processes & Intergroup Relations, 19(4), 528-542. https://doi.org/10.1177/1368430216642029
Zuckerman, E.K., Lindly, C.J., Sinche, B.K., & Nicolaidis, C. (2015). Parent health beliefs, social determinants of health, and child health
services utilization among US school-age children with autism. Journal of Developmental & Behavioral Pediatrics, 36(3), 146-157.
https://doi.org/10.1097/DBP.0000000000000136.
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