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Beyond Bilingualism: The essential role of culture in speech-language pathology


Course Transcript

This is a transcript from our podcast episode published November 14th, 2022. The podcast episode is offered for .1 ASHA CEU (introductory level, related area). This transcript is made available as a course accommodation for and is supplementary to this episode / course. This transcript is not intended to be used in place of the podcast episode with the exception of course accommodation. Please note: This transcript was created by robots. We do our best to proof read but there is always a chance we miss something. Find a typo? Email us anytime.


A special thanks to our Contributing Editor, Caitlin Akier, for reviewing and editing drafts of our transcripts. Her work helps keep our material accessible.





S4 The Bold SLP Collective

[00:00:00] 

[00:00:00] Kate Grandbois: Welcome to SLP nerd cast, the number one professional resource for evidence based practice in speech, language pathology. I'm Kate Grandbois 

[00:00:09] Amy Wonkka: and I'm Amy Wonka. We are both speech, language pathologists working in the field and co-founders of SLP nerd cast. 

[00:00:16] Kate Grandbois: Each episode of this podcast is of course offered for ASHA CEUs.

Our podcast audio courses are here to help you level up your knowledge and earn those professional development hours that you need. This course. Plus the corresponding short post test is equal to one certificate of attendance. To earn CEUs today and take the post test. After this session, follow the link provided in the show notes or head to SLP nerdcast.com.

[00:00:41] Amy Wonkka: Before we get started, one quick disclaimer, our courses are not meant to replace clinical. We do not endorse products, procedures, or other services mentioned by our guests, unless otherwise specified.

[00:00:53] Kate Grandbois: We hope you enjoy the course.

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Join as a member today and save 10% using code nerd caster 10. A link for membership is in the show notes. 

[00:01:43] Kate Grandbois: Welcome everyone to today's episode. We are so excited to welcome the founding members of the bold SLP podcast and collective welcome Ingrid Owens -Gonzalez, Liza Selvarajah, and Desi Pena. [00:02:00] 

[00:02:00] Liza Selvarajah: Hello, 

[00:02:03] Desi Peña: Hey you guys. 

[00:02:05] Amy Wonkka: We're so happy to have you here with us today. Um, and you are here to discuss issues related to culture bilingualism and speech language pathology.

But before we get started, uh, could you please tell us all a little bit about yourselves? 

[00:02:21] Ingrid Owens-Gonzalez: I can go first. My name is Ingrid Owens-Gonzalez. I've been in SLP for almost 11 years now. Uh, I am a graduate of the University of Texas at Dallas. Um, and then also New Mexico state university for my undergrad. I have two girls. And I've been married to my husband and we moved here to New Mexico, his hometown, uh, for over 10 years now. Um, and yeah, I'm on Instagram, my speech blend and the bold SLP collective, just trying to make connections, starting my private practice, just new [00:03:00] adventures all the time as I go along in this SLP journey.

[00:03:04] Desi Peña: All right, well, I'll step in next. Um, I'm Desi Pena. So I have been practicing as a speech pathologist for five years. Um, I'm a bilingual English, Spanish, um, speech pathologist, and I've lived all over the east coast. Um, I most recently landed in Maine a few years ago. Uh, thanks to my husband's work. Um, I work mostly with early childhood, so.

Between the ages of like two and 10, approximately? Um, I, it was really great. A few hmm. I was gonna say maybe about almost two years ago, I met Ingrid on Instagram and that's how we started, um, getting together. And eventually Liza got wrapped up in it too, and we created the bold SLP podcast. Um, and so I think that's it for me.

What about you, Liza? 

[00:03:59] Liza Selvarajah: Yeah, my name is [00:04:00] Liza Selvarajah. I'm a speech and language pathologist in Canada. Um, I own a company called Montreal speech therapy, and I've also been doing a lot of school based work. I'm a clinical educator with our local university here, and I'm super passionate about mentorship and collaborating with other SLPs.

That's why I got wrapped up in the bold SLP collective. Um, I'm also very big with social media. I think that that's such a powerful tool and that's kind of what brought all of us together today too. I'm a mom. Um, I dance, I sing outside of speech therapy and uh, yeah, that's it for me. 

[00:04:38] Kate Grandbois: We're so excited to have this conversation with you all today.

Before we jump into it, I have to read our learning objectives and our financial and non-financial disclosures. Learning objective number one, describe the role of culture and cultural erasure in the field of communication, sciences, and disorders. Learning objective number two, describe the difference between a traditional intake [00:05:00] interview and an ethnographic interview in the evaluation process, and learning objective number three, describe the difference between collaborative and authoritative approaches to applying an evidence based practice model when completing multicultural and or multilingual evaluations. 

Disclosures Ingrid's financial disclosures.

Ingrid is the owner of My Speech Place, LLC. And is the employee of a public school. Ingrid also received an honorarium for participating in this course. Ingrid's non-financial disclosures. Ingrid is the co-founder of the bold SLP collective and the co-host of the bold SLP podcast. Ingrid is also the co-founder Ingrid is also the co-founder and lead mentor of the bilingual empowerment through allied mentorship program and an Asha step mentor.

Ingrid is also the mother of two bilingual and bicultural children. Liza's financial disclosures. Liza owns a private practice called Montreal speech therapy. Liza also received an honorarium for participating in this course Liza's non-financial disclosures. Liza is [00:06:00] the co-founder of the bold SLP collective and the co-host of the bold SLP podcast and is a mentor of the bilingual empowerment through allied mentorship.

She is also the mother of the bilingual and bicultural. Desi's financial disclosures. Desi is the owner of Panorama speech therapy, LLC. And is faculty of the main New Hampshire leadership education in neurodevelopmental disabilities program. Desi also received an honorarium for participating in this course. Desi's non-financial disclosures: Desi is the co-founder of the bold SLP collective and the co-host of the Bold SLP podcast. Desi is a mentor of the bilingual empowerment through allied mentorship, and she is a child of Cuban American exiles, and is also raising a bilingual bicultural. Kate that's me. I am the owner, my financial disclosures.

I am the owner and founder of Grandbois therapy and consulting LLC. And co-founder of SLP nerd cast. My non-financial disclosures. I'm a member of ASHA SIG 12 and serve on the AAC advisory group for Massachusetts advocates for children. [00:07:00] I'm also a member of the Berkshire association for behavior analysis and therapy and the association for behavior analysis international and the corresponding speech pathology and applied behavior analysis, special interest group.

I'm a person of monolingual experience and a person of cultural and a person of cultural privilege as a CIS white woman in the United States of America. 

[00:07:19] Amy Wonkka: Amy that's me. Uh, my financial disclosures are that I am an employee of a public school system and co-founder of SLP nerd cast. And my non-financial disclosures are that I'm a member of Asha and a member of Asha sig 12.

I serve on the AAC advisory group for Massachusetts advocates for children, and I am also a monolingual person of cultural privilege as cisgender white woman in the United States of America. 

[00:07:42] Kate Grandbois: So before we get into all of the really wonderful conversation today, and before we start learning from the three of you, I wanted to just reflect on a conversation we had right before we hit the record button.

So here at the nerd cast, whenever our guests join us, we go through a couple of housekeeping [00:08:00] things. We review our learning objective. We confirm the title of the episode and we review and confirm our financial and non-financial disclosures. And as we were going through those financial disclosures and non-financial disclosures and discussing what a non-financial disclosure was, what our lived experiences were that may cause us to present information in a certain way.

Liza brought up a really good point and it generated a really great conversation. And I wanted to know if you could walk us quickly through the point that you. 

[00:08:33] Liza Selvarajah: Definitely. So this is new to, to us, I think just all the disclosure business. And so we had a lot of questions about what, what is meant to be disclosed and what, what exactly do you need to know?

And what you so graciously explained was, are you bringing any bias into the conversation? If you are, then you need to disclose it. You didn't label any of the biases you just said, do you feel you're bringing any biases? And we somehow felt the need to talk about our biracial [00:09:00] bicultural kids and our backgrounds and, and something about that got me thinking, like, why are we othering ourselves?

And like, what are we othered from? We're othering ourselves from a standard. And what is the standard? Cisgender white. And so neither of you, I think before this had ever disclosed that you were white or privileged or cisgendered and all of a sudden you're like, yeah, I, I didn't disclose it because it's the standard I'm putting giant quotes.

You can't see me on the podcast. 

[00:09:30] Kate Grandbois: That's what I was doing. lots of air quotes happening over here, but it was such a 

[00:09:34] Amy Wonkka: good point. And it was, and it was such a good point that as members of a majority group, we actually one could argue have potentially the most bias coming into this conversation. I mean, particularly like reflecting on our learning objectives, um, you know, and, and it was, it was, you know, you'll notice our learning objectives or our disclosures look differently or sound differently on [00:10:00] this podcast than they ever have before.

And it is an interesting, it was interesting for me to reflect on my personal bias and. All of the conversations we've had with so many different people on this podcast. And that, that question has never been something that I've raised myself. Um, so anybody who is listening, I think that that would be an interesting exercise to sort of ask yourself that question.

What groups do you identify with? Um, and, and what potential bias does that give you? And have you ever asked yourself that question? 

[00:10:36] Kate Grandbois: It was such a good question. It was such a good question. And I think it's a nice, I know we're sort of starting off this episode with a very, uh, serious tone in terms of self-reflection and intersectionality, but it's a really, it's a, it's a, one of the most important threads of this topic that we are now going to hand over the mic to you all, um, to teach us.

And I wonder if you could talk to us a [00:11:00] little bit about identity and bias and how that relates to culture in our first learning objective. 

[00:11:07] Desi Peña: Yeah, so I'll start us off. Um, I wanted to, I'm just such a nerd, so I'm on the right podcast. Um, I brought, um, this book, uh, with me, uh, it's called culturally responsive practices and speech language and hearing sciences.

And it's by Dr. Hyter, uh, Dr. Hyter and Dr. Salas-Provance. Um, so this book is really wonderful and I was, um, introduced to Dr. Hyter through a continuing it that she offered back, uh, at the beginning of this year, 2022. Um, and she just rocked my world. I think that it was a conversation that I didn't really get to witness very often in speech therapy circles.

So she really talked about the role of culture, the role of identity and the way that we, um, even discuss our own identities. Um, [00:12:00] So she, um, very much is a proponent of disclosing like positionality, like what sort of privileges you hold, what powers you hold and also, um, you know, what your racial or ethnic markers are, right?

So she presents those up front. So it's something that we, as a, as, um, members of the bold SLP collective we've always discussed, um, and having this opportunity come on the podcast is really a great way for us to kinda structure that conversation. Um, as it's something that really runs its course when we record together.

But, um, we've never presented it from this angle. So I'm happy to start with some definitions from Hyter’s book. And that way we can kind of just jump into the topic itself. Hyter for example, in her book defines culture at its core culture, as a set of factors from multiple dimensions that can describe how one person or a group of people experience life and engage in daily practices.

[00:13:00] Culture is learned and transmitted socially through patterns of behavior driven by such factors as problem solving strategies, value systems, beliefs, symbols, attitudes, religions, artifacts, and communication. So all to say. Um, one of the reasons that I really thoroughly enjoy this book is because, um, as you're reading it, she actually gives you little vignettes stories of, um, where you can kind of place yourself in these new cultural context.

So, um, kind of funnily enough, in the first chapter, she talks about going to a Matanza, which is, um, Something that I'm very familiar with. Um, as I mentioned in my disclosure, my family's Cuban American. We slaughter pigs and eat them. Um, so, you know, it's not uncommon for my family to go and watch the pig, get slaughtered, and then they bring it back.

They put it on a spit and they just cook it up right in front of us over several hours. Right. We, we play music, we all get around the pig and we eat it's meat. Um, again, you know, so that was one of the [00:14:00] scenarios that she gave as an example, how comfortable would you feel? What are your biases going into that kind of situation?

Um, So that's kind of the foundation for what we're hoping to talk about, right? Like what does culture mean? What are its core components and then how does that interplay with identity and then how does that relate to speech pathology? So in our view, um, and I hope I'm not talking over you guys very much, but I just wanted to say that, um, you know, for us it's essential and that's why the, this conversation is so important for us.

We can't really disentangle language or communication from culture. Um, and sometimes, uh, we've observed that in our profession. There is this tendency to disaggregate those or to not consider culture as a backdrop, to everything that a person does. So it's really valuable for us to have this conversation, to highlight which ways we should be actually doing a deep dive into that [00:15:00] person's culture.

And then what influence that culture might have on their communication behaviors, so that we are not imposing our own culture onto that child or that adult.

[00:15:11] Kate Grandbois: I think that makes a lot of sense, particularly when you think about what our profession is, I know it seems sort of obvious, but we study language. If language and culture are connected, and we have a hard time separating them as SLP. You would then assume that it's just as important for us to.

At least consider culture. And yet I don't know about anyone else on this panel. I did not get any formal training in graduate school on how to consider and adjust my own perspectives or biases based on those considerations. 

[00:15:48] Ingrid Owens-Gonzalez: I didn't, I went to school a long time ago. Um, I hear from the new students that things are changing, which is very, very exciting.

But [00:16:00] yeah, as you said, Kate, you know, when we go to school, um, a lot of us, me, myself, personally, I moved to the us when I was 16 from Mexico, I'm Mexican American, and I find myself learning a lot in grad school about standards and about how things work, you know, in X, Y, and Z setting with X, Y, and Z clients, uh, and never really going and learning about how to help my community.

So I had to come out of grad school, learn that on my own and unlearn a lot of the things I had learned in grad school in order to serve my community in the way that was, you know, ethical and not harmful. So yeah, I, our program, my program didn't prepare me for that portion of my job as a bilingual speech therapist.

[00:16:54] Liza Selvarajah: I wanna jump on your, your pig story Desi. I love it so much. And it's so, so [00:17:00] beautifully visual because to one, something could seem scary or different. And then to another it's totally normal. And in our field, when something is different, it's a disorder. Or it's meant to be placed in a severity range.

Um, I'd shared this story like already on, on the Instagram and TikTok, but there was a little four year old girl that I was screening a little Indian girl.

And, you know, you have these common screening measures of like asking about food items or, uh, things in their pencil case, things like that. And she was like perfectly going through everything. But then when it came to food, she didn't wanna answer like, what is in your lunch box? She didn't wanna answer.

And something about her told me that there is no language disorder here. She just she's trying to hide something. But I don't know why. And I, I couldn't tell if it was that she didn't have any food or if it's that the food that she had, she thought I wouldn't accept as a professional checking. [00:18:00] Cuz we know that like typically we're looking for things like sandwich, banana, apple, very like culturally white things that kids eat.

So. She was silent for a while. And then I said, um, you know, in my lunchbox today, I have bryani and she was like, I have Chapi and I was like, and full points. Cause I'm not looking for what this test is. Like those specific words, right. They're not culturally appropriate for this child. I'm looking, can she communicate?

Can she tell me what she eats? Yes, she can. So yeah, things like that to keep in mind. 

[00:18:33] Kate Grandbois: I think that is an awesome example of the intersections of the cultural quote, norm air quotes here, for those of you who can't see me and the, and the potential for a professional to jump right to disorder, to not pause, consider the role of culture in an individual's linguistic response or lack of response in your example, um, and [00:19:00] just jump right to, oh, fail, failed portion of the screening, this individual needs services.

And we know that, and I, I don't have the literature right in front of me, but I think it's safe to say, maybe you all can share some of that literature. We know that over referral is a big problem. Um, and I think that was just a really great story to highlight how quickly, if you don't take that moment to pause and reflect on the importance of culture, how quickly that can turn into a referral for services that is totally not appropriate.

[00:19:29] Liza Selvarajah: I know we're going to jump in next time, um, to a like dynamic assessment, but just, just in terms of scoring, you know, that it, it just takes one point to move a child from like moderate, severe to severe, like it's, it's so arbitrary, it's so scientific. It takes the humanness and the connection out of it.

And it treats our, our kiddos, like, I don't know, little standard robots with like same language, same culture. And that's, that's really what we're, we're trying to undo here. 

[00:19:58] Amy Wonkka: Well, and we've talked a lot on this show [00:20:00] too. Sorry, D I see that you're unmuted, but we've talked a lot on this show too. We've had some guests on, and I know today we're not talking in depth about dynamic assessment, but just talking about the inherent bias that is present in so many of our norm referenced standardized assessments, um, and which populations are even included in that normative sample.

So there are a lot of, there are a lot of problems there inherent to, um, to assessment that we'll talk a lot more about in our next podcast with you guys. 

[00:20:30] Desi Peña: Yeah. And to feed off of that, I mean, we were, um, the, what Liza's talking about, like that practice, that ability to pivot, um, and say, okay, well let me figure out if I, um, maybe if I funnel it through the parent, maybe if I add a cultural element, maybe we can tweak a different response.

Right. So that's that culturally responsive practice piece. Um, and so really we wanna take into consideration. Perspectives beliefs values. [00:21:00] And that can be tricky. Um, you know, especially if you've not really had exposure to other cultures or other ways of, um, experiencing what it is to live in a majority culture.

Right. Cause that's kind of part of what we're talking about today in terms of bias, right. We all carry bias. Um, one of the points that we were hoping to talk about today is the role of implicit bias. Um, and what's been fascinating for the three of us Ingrid Liza and I to discuss is that we all carry bias that, um, from our own cultural perspectives, but also just like from white majority culture perspectives, because this is the way that we have been like professionally trained.

You know, we all have administered standardized instruments that do not apply to children, um, of those backgrounds. And so how do we undo these practices? And one way is by recognizing that there are culturally responsive ways, um, there are ways to stop an [00:22:00] assessment and to say, wait a minute, before I deduct this point, what else can I do?

So, um, again, yeah, not to jump the gun, but just to insert that this is what I, this is what stopping your bias looks like. It looks like pumping the brakes and maybe flagging that question coming back to it, referencing, um, someone else, someone who is part of that cultural group. Um, so anyway, that's just one idea and we'll, we'll keep adding more ideas, um, to your toolkit, um, in this conversation as to how to, how to just be a more responsive clinician.

[00:22:36] Kate Grandbois: And I, I wanna take a second and sort of loop this back to one of the first things we said in this episode of the, the power of pausing and reflecting on your own bias. So if you are listening to this episode and you are part of the, of the white majority, and you know, maybe you started this episode listening to Amy and I read our non financial disclosures and considering your own perspectives as [00:23:00] a, as an implicit.

That is a great first step is just acknowledgement and reflection. Even if it is, feels uncomfortable or feels weird, or you just wanna have the conversation privately in your own head, and you're not ready to talk to somebody else about it. Just taking that minute to pause and consider that your own existence in the majority or your lived experience in the majority is an implicit bias that you can correct.

Not necessarily correct, but you can account for, or mitigate through pausing. Um, and, and considering your, your, your own implicit bias. 

[00:23:39] Desi Peña: And I think this really brings us around to this idea of culturally erasure, um, which I wanted to hand off to Ingrid, cuz I, I feel like she really, um, embraced that concept.

Uh, when we first started talking about this episode and I know it's something that has weighed on her as, um, an SLP and as a parent. So. [00:24:00] I hope I'm not putting you too much in the spotlight Ingrid, but I feel like you're definitely the, the bearer of that message. 

[00:24:07] Ingrid Owens-Gonzalez: I, well, for me personally, I think it started very early on in grad school.

Um, assessment class is the worst grade I've ever gotten in my whole life, which is really ironic because I love assessment. I feel like I'm really good at it now. Uh, but back then, I was already asking questions that were not in the syllabus and that were not getting me the points I needed on the test.

Um, but my first experience with erasure in this field, uh, was an assignment to go find a child to assess use the PLS or whatever was available. I think it was the tell actually, well, I went and found my neighbor and she's bilingual. Mexican American just like me [00:25:00] and I'm reading through the manual as I'm assigned, you know, and I'm like this little person that is volunteering to help me is not represented here.

So I wrote that out on my report and that was my first inkling like this field is not designed for people like me, like, and I was, you know, 23 years old. So I'm already having that seed of like, oh, like this teacher is an expert in this. And her livelihood is, you know, here and her passion is publishing these things, but they're all based on white, upper middle class sometimes and neurotypical, monolingual kids and families.

And they don't mean anything to me. And they won't mean anything to me in the reality of practice outside of this. And I was just starting my career. And like I said, it was the worst grade I've ever gotten. I thought I was gonna have to retake the [00:26:00] class if I didn't like bump up my C you know, cuz you need your B in your master's program because I just kept pushing.

I was like not okay with the answers she was giving me about why, what did you with my assignment with the child that I found? Um, so that was my initial kind of like thread of how many other people are being erased and to start asking questions, 

[00:26:24] Kate Grandbois: I think that story highlights so many components of your you intersecting and brushing up against institutions.

Mm-hmm . Um, but for our listeners who aren't familiar with the term cultural erasure, what is, what is that as a, as a construct, as a concept? 

[00:26:44] Ingrid Owens-Gonzalez: honestly, to me and you guys can look it up, like I'm not gonna read the definitions out there. To me, it just means, speaking for others, speaking for others who are of a different experience than you [00:27:00] and speaking for others under the assumption that you know better.

And then in turn erasing the validity of their lived experiences of their culture, of their traditions. Um, so cultural erasure to me is just, we need to stop speaking to others if we wanna do some speaking for others, if we wanna do something about it. So, um, speaking for others is what it means to me. I don't know if Desi and Liza wanna jump in and help me out.

I'm not the academic in the group. Um, when we were starting that conversation earlier, uh, I just wanted to highlight, because this is why I love these ladies so much. Like we were talking about disclosures. I had no idea what I should disclose, and I knew that something felt off about having to disclose that I'm in an interracial marriage that I have bicultural children.

Like, why do I have to disclose that? So I started it off as a [00:28:00] joke. I think I said, um, do I have to disclose that I'm bad at volleyball? It's kind of like how I dealt with that feeling like I don't, it feels weird that my identity is being seen as something that can bring bias. And then Desi started asking questions and then Liza comes in with the, you know, the knockout punch and says, Hey, how come Kate and Amy don't have to disclose that they're white

And so that to me is the absolute opposite of erasure. If that makes sense. Like, I felt validated just Liza saying that I'm like, oh, that's what I was feeling like. She gave me the words, like how come I have to disclose that I'm bilingual, you know? Um, so that to me is what erasure means. 

[00:28:50] Liza Selvarajah: I'm taking erasure as like very literally like erasing my culture all together.

So right now, um, I [00:29:00] don't speak Tamil though my parents are from Sri Lanka and they spoke Tamil right through their lives until they came to Canada. And the way your tongue rolls and the way the language is spoken is very different from the way English is spoken, or maybe it's closer to Spanish with the Rs.

And, um, so something like like, how are you? You know, is like I said that one day in, because I was talking about my uncle and the way he said something and my husband, who's black, like didn't was like, I haven't even heard those sounds come out of your mouth. Like it's so foreign to me. And that's when I realized how much of my culture had been erased.

He hadn't even heard it. My daughter hadn't even heard these sounds, my daughter speaks French in English. Even though her grandparents fully speak, uh, Tamil and Sinhalese. So it kind of hit me in that moment. And I mean, we, and my husband was asking me like, what do you wanna do about that? Like how, how do we bring [00:30:00] it back?

How do we not completely erase it? So thankfully our food, we still eat S Lanka and food. That's just a start just to like, keep that in there. Um, I just wanted to highlight that example, but something happened today that I messaged the group. I sent like a WhatsApp message to you. So I met, um, a Persian family this morning because their doctor had written all over the place that like, they think their child has a language disorder.

Their child is not talking this and that. But I read on the parent intake form that they didn't see a problem. But since the doctor said to come, here they are. And it is expensive to have a language assessment. So I met with this family and the child is like fully chatting in Persian. They read a story together and I thought.

Does your doctor know that you speak a different language at home? She was like, yeah, but like, I think she was just worried that like, not enough English is coming out and just utter nonsense. I was like, okay, well, these are the things I'm checking. And so say it in your language. I took a whole phonetic repertoire based on the words the child says in [00:31:00] Spanish, uh, Spanish.

Sorry. Persian. I'm looking at you two. But yeah, I don't know. I thought the whole thing felt so icky. The fact that nobody asked like, well, is there another language spoken as opposed to just taking the silence as probably a language disorder, please go check. And this family. I didn't even charge them. I was like, this is ridiculous.

Like we're not wasting each other's time. This was fun. Call me back when, when you need more help. 

[00:31:27] Kate Grandbois: well, and I, I, I, I so appreciate the stories that you're telling, because I think as, as human beings and for those of, for those of our listeners who are listening as human beings experiencing and listening to the experiences of others is a great way to highlight some things that are available for change.

And in the story that you just told, where there's the physician making the referral without pausing and considering the role of culture and the risk of cultural erasure. I think about the [00:32:00] role of the speech pathologist and had that family landed in another. Speech pathologist clinic, who hadn't maybe done some work in cultural competency training, or hadn't considered the role of their own implicit bias.

And again, that risk of referral for, and I'm using air quotes. For those of you who can't see me disordered language or language disorder, when there really is a larger component of, of being not in the being, not of the majority. Um, and in that lens, how much more important it is for us as the ones who are, and again, air quotes, diagnosing language disorders, people end up in our offices to investigate and provide the diagnosis, right?

We are, that is so much more important for us as a profession. It's important for everyone, but we are often for a lot of families. One of the last points of contact before either for screening or for [00:33:00] evaluation before we get into this pipeline of services for not having a quote disorder. 

[00:33:08] Amy Wonkka: Well,and I, it makes me think of our second learning objective talking about the way that we are conducting our interviews is as, I mean, that's really where you start with a client that's where you start with a family.

Um, so I didn't know if you, because I think that what I'm most accustomed to, my training was also a long time ago. I think that probably when you described traditional intake interviews and ethnographic interviews, I'm probably going to be doing a lot of things that fall under traditional intake interviews.

So I was wondering if you could just talk us through what are those two different approaches to interviews, um, and, and what are some things that we can do to do better? 

[00:33:52] Kate Grandbois: I had never heard the term. Um, I will admit it. I mean, I think that this is something that's really important. And for anyone listening, who hasn't heard of this, that's okay.

We're here [00:34:00] to learn. So please tell us about that and how they're different. 

[00:34:05] Desi Peña: So, uh, Carol Westby is, um, I think the most recognized name in terms of, uh, ethnographic interviewing, um, at least in the field of speech pathology. Um, so really the goal of it is just to have a more like conversation with families, um, using like open ended questions, um, I would say is the primary driver of what an ethnographic interview's goal is.

Right. So, um, you would want to have them give examples, right? Walk, walk me through your day. What does this look like? What does that look like without inserting yourself and your own experiences. Right. So I think. We were talking about this a, a few weeks ago. And I said, right, like, I wouldn't ask you about breakfast per se, because maybe you don't eat breakfast.

Um, and that may be tied to something [00:35:00] cultural and maybe just tied to your personal preference. But again, why would I wanna make that assumption that that's something that you partake in. When it's not something that makes a difference for you, if that makes sense. So, um, so I would say that that's mostly the basis of what, um, we are here to discuss.

So I know it sounds very, very simple and very, very basic, but I think we can give a lot of examples through our own clinical practice of ways that we've incorporated this strategy. So, um, just to kind of tack on to what Liza said, um, in terms of her experience recently, um, I interviewed a family, um, who was.

descent recently. Uh, the family at home speaks Mala, which is, um, a language, um, that is not very highly represented anywhere in the US, like very few speakers. [00:36:00] Um, And so one of the things that came up as a concern for this child was similar to what Liza had said about this Persian child. She had evaluated, um, there wasn't, he wasn't talking very much, but there was also a concern about feeding.

So rather than just making assumptions that he's not eating or that the parents aren't trying certain things, I just said, tell me what his day looks like, what are his, you know, what, what does a meal look like for him? Um, and so I had them just list out times in the day when they try to feed him what they try to feed him.

What's the vehicle? Is it a spoon? Is it a bottle? Whatever, um, means they try to feed him. And then I also wanted to make space for the fact that I, I recognize that in certain cultures, food is such a sensitive topic. So I asked them, you know, what is your biggest concern? You know, especially considering your culture that you come from.

Uh, what are some things, what are, what are some [00:37:00] expectations in your culture around feeding your child? So again, not from my standpoint as well, he needs to eat and how are you getting him to eat food? Um, but more so, um, yeah, or even guiding the, the, you know, well, what does lunch look like? What does dinner look like?

Right. We, I just literally wanted to take myself out of the equation by asking questions that were more open ended. Um, and that were more of like a grand tour is another way that they discuss this interview style. 

[00:37:33] Kate Grandbois: So I, I have so many things that I wanna say, because everything you said made me think of five other things.

I'm gonna organize my thoughts here for a second. I, I think from what I've the way I've heard you explain it, the difference between a traditional interview and an ethnographic interview is very subtle, but critically important because of the word implicit in the term [00:38:00] implicit bias, and I'm gonna quote someone else.

Um, I heard this quote from Jeanette Washington. I asked Jeanette where she heard it. She said she got it from somewhere else. And couldn't remember, so this is not me, but it made me think of this quote, which is ‘systems of oppression work within us and upon us’. And our language is so, is so our, our cultures are so deeply ingrained in us that they happen with a certain level of automaticity often.

And you can insert yourself implicitly, quietly, accidentally in the words that you use and in interview is linguistically based. This is how you're collecting information and gathering data by asking questions. And it is so easy to insert yourself or your own implicit bias in questions. So I, I just, I had to say that because it was rattling around in my brain and all these connections were happening as you were talking about this very subtle, but critically [00:39:00] important, different.

And it's because of that, I, I, I am assuming please feel free to correct me or reflect back something else. Uh, you know, in terms of this dialogue. Um, but it, it just, it struck me how critically important, but so subtle. So, so subtle

[00:39:15] Desi Peña: and I wanted to add in really quickly that, um, this is, this is how we try to undo that cultural erasure, right?

By giving opportunities for those families to center their experiences. So it's not that the standardized assessment is crucial to my evaluation. No, it's that the family's experience has to be central to it because they experience their culture within this larger majority culture differently. Um, and I don't want to misidentify their child.

[00:39:48] Kate Grandbois: and it's also making me think of, and I know we're, this is sort of touching our third learning objective and we're not there yet, but centering someone's culture is evidence based practice. Our evidence based [00:40:00] practice model is three-pronged. We tend to, as our professional culture over rely on external evidence, this something, we talk about a lot on our podcast, but one third of our evidence based practice model is person-centered care and client perspectives and values and culture.

It actually, as a matter of fact, as I'm saying this ASHA, if you're listening, please change it to be person centered perspectives, values, and culture, because that is a really important, important piece. And Liza, I can see that you have something to say, I'm sorry, I cut you off 

[00:40:33] Liza Selvarajah: just itching. So I think a huge difference here is that the goal of this interview is not to pathologize the child or family, but to support. and many of our pre-written intake forms or interview questions are really looking for that problem. Where is the problem? I check the reading, I check the food. I check the you're not looking for that.

You're looking to know what this family goes through on a daily basis and what it is they need from us. And we're here to help.

You had [00:41:00] mentioned Ingrid, like on our first podcast, um, in the bold SLP, something about like, we're not here for your average SLP. Like we're here for the ones who wanna think the ones who wanna change the one who, the ones who wanna create like a, a real impact. And this type of interviewing takes a lot of critical thinking skills.

And on the spot analysis, it's not a check, like a check box of like, I check this, I check that it's really like a blank page almost. And you're really just listening and taking it in and accepting them wherever they are in whatever place they're. Linguistically culturally wherever. And so that's the thing, and I know a lot of new SLP just graduating.

That's a very scary thing to go in with almost no information. You know, you want some kind of framework. But it's the framework that causes all the biases. So we're really trying to undo that. And I don't hope that I didn't make it more confusing for you, Kate. 

[00:41:57] Kate Grandbois: No, not at all. Um, it's actually making me [00:42:00] think of, um, a framework that we use in AAC, the SETT framework, where you're considering environmental variables, you're considering, uh, person-centered variables.

You're considering communication partner variables, as opposed to, I think you think of an interview it's um, you go down your list of questions. It's exactly what you said. How about this? How about this? And you check them off as you go down, but using that, um, you know, using some sort of, not necessarily a framework, but I love that you said critical thinking skills, where the answer to a question may lead you to another question.

It's sort of like a, choose your own adventure novel. Maybe I'm dating myself from the eighties, but you know, it's, it is the, it's an, it's an unwritten road that you travel down next to the family instead of in front of them, I guess, would be another sort of, I like visuals. It really helps me understand complex, uh, concepts.

I wonder if you could tell us for anyone listening, who has never done an [00:43:00] ethnographic interview or is a new grad, or is intimidated by this concept or even intimidated by this topic? Uh, where, how can someone get experience with this? Do you, are there components of competency that you recommend, like mentorship or, um, a, a, a resource or a book that's that someone could read, uh, related to acquiring skills to be more competent in this area?

[00:43:28] Ingrid Owens-Gonzalez: I can jump in. Um, I actually was trained in this area, um, and this is something that has been around. Um, I think the article we, you will see in our show notes is from 2003. Um, and I was introduced to this concept in a neurology class. Um, because my program didn't have a bilingual track for me. So I took a neurology, a bilingual brain class.

So it was a researcher who was, uh, working on what does a bilingual [00:44:00] brain do when, uh, dementia comes, that was kind of her area. And so I took this neurology class with her and she's the one who introduced me to this concept of, if you, to me, it was introduced, um, similar to what Desi said, kind of like a roadmap.

Um, but she said, you're asking for the use of the tool. Like she viewed the brain as a tool and not just, uh, for the function, you know, you're not just like yes or no. Um, so that's how I was trained on it and how I'd heard the term and then knew to look it up and, and just experiencing a lot of the times the questionnaires that were given to me.

From standardized assessments, just really not fitting, uh, the families that I was working with, you know, they didn't ask like, who does the child spend the most time with and what language do they speak? You know, that was critical for me. Uh, and it was nowhere to be found in these rubrics that had been designed before, without them in mind.

So that's where, [00:45:00] where it comes from for me. But, um, I'm referencing an article that we put on, on our show notes and it's asking the right questions in the right ways. I mean, summary of what ethnographic interview is, it's that the title of this article and it was on the ASHA leader and it's anybody can go see it.

And it's by Carol Westby. Um, does he link that to us, but like I said, I've heard this term before, and it's just honestly, a lot of going back to era or a lot of the things that we know. And, um, a lot of other monolingual SLPs don't know, we know by necessity. Because we are out there practicing with tools that are not designed for the people we serve.

And so we have to figure it out. I read journal articles from Puerto Rico. I read journal articles from Mexico and fields of study in linguistics and, and social work. Like I, things that I can't find in ASHA, I go and find on my own [00:46:00] time because we're not there yet. 

[00:46:03] Kate Grandbois: That was very well said. Um, go ahead. 

[00:46:07] Desi Peña: I, I just wanted to jump back in before we move on.

Um, I really love what Liza said about that blank page. I know that that's super uncomfortable, especially for anyone who is new to that concept. But I would really encourage people to do that. Even if it's somebody who's, you know, you think may belong to your own, like let's say you're a white SLP. Who's like, you know, grown up in the Northeast, like try that with somebody that is also white is also, you know, generations deep from the Northeast.

See what that feels like. Um, but the, the other thing I was gonna say is, um, we always talk about, uh, standardized assessment, standardized assessment, but even non-standardized assessment, let's say you download a screener from teachers pay teachers, right? And it's for preschoolers. Let's say that in that screener, it [00:47:00] says, tell me about your last birthday party.

Now, what would happen if you asked that to a child who is a Jehovah's witness, they don't celebrate birthdays. What if you said, tell me about the process for making a peanut butter and jelly sandwich. Well, if you had asked me as a child, I had never made a peanut butter and jelly sandwich until maybe I was like 10.

And I had like brought that from school to home. Right. Like it wasn't something that I had exposure to and it would've over-identified me in those areas. Um, so I just wanted to say, put that plug in there, put that critical thinking piece. It is that we have to question standardized assessment, but we also have to question things that are not standardized things that are viewed from this lens of cultural erasure, right?

Like making assumptions that all these children have exposure to birthday parties and dinosaurs and PB and J like they can, while they look, seem so harmless, it's really not in this assessment [00:48:00] context. 

[00:48:02] Kate Grandbois: I, I think those are great examples. Um, those are very American, very upper middle class, white American things, the apple and the peanut butter and jelly sandwich.

I think that those were such great examples. And I'm, I, I wanna ask a question that might seem obvious. Um, but I, I, I think it's important to really take a minute to connect all the dots here of why this is important. Why is acquiring this skill as a speech pathologist important thinking about our field and the scope of practice that we have that is so wide or the SLPs working in schools who are expected to be generalists and have never, maybe had a bilingual child on their caseload. And all of a sudden there is one. So what are, what are the components of ethnographic interviews that are critically important?

Why is this such an important thing for an SLP to acquire, even if they don't have a ton of [00:49:00] experience in this area? 

[00:49:03] Ingrid Owens-Gonzalez: I can jump in. Um, I know we're coming at it from our pediatric experience, but this is really helpful in med SLP world. Uh, especially when people are going through a stroke recovery or post TBI, uh, having that open mind that open framework really leads to better diagnosis.

And I'm not a med SLP anymore. I started off as one and I tried to keep up with my med SLP things. But, uh, whenever you are say, even just recommending a diet, you can cause a lot of harm to a patient and a lot of stress to their family. If you don't do this kind of procedure, just take the little extra step to be open and listen to what their priorities are in [00:50:00] terms of food.

Um, and I can think of one little story super quick that I'd never even connected to SLP until two summers ago. My grandmother had a stroke when I was six and I was living in Mexico, but we came to the us to be with her. And I remember her getting her list of. That would be good for her because she had diabetes.

That's why she had her stroke. And there was pita bread on the list. You wanna talk about erasure? We didn't know what pita bread was. There was no Google, this is the nineties. And so we go to the store looking for pita bread. And now that I think about it, I'm like, what are the nutritional textural benefits to pet bread over gorditas or tortillas?

Yes, or flour and corn things that we know that we make from scratch. But we had to get her pita bread. All of us were sitting around having tacos. And my [00:51:00] poor grandmother was eating pita bread because the doctor put pita bread on her list. And we had no idea what it was. And so now that I'm older and think about those things and I don't even think it was a doctor, it was a nutritionist, you know, cuz they were trying to keep her blood sugar under control.

And now I look like the, if you look at the carbs in the pita and a corn tortilla, corn has more fiber, like it's even better than a wheat pita, but it was erased. Like our preferences were not taken into account. Our culture was not taken into account. So it's not just pediatrics. It's not just families.

It's our entire scope where we need to like, be more critical and more open. I think 

[00:51:50] Liza Selvarajah: I had to, I have to jump in on that story in grid because, you know, I only teach through storytelling. I know it's the same there. Um, I was at like an ASHA [00:52:00] conference. I think it was like a south Asian caucus. Didn't even know that existed.

That was very excited and that so many, um, south Asian SLPs, but they were talking about an Indian man at the hospital and he kept spitting out the applesauce. Cause it was like, what is this? Like, we don't mash apples. We don't eat that. And he just wouldn't and he kept not being able to move past that diet because he wouldn't swallow the apple sauce.

And then this Indian SLP came in and was like, dahl, same viscosity, same texture just crushed up lentils. And he was able to go through it. But just that simple little critical thinking piece. Is it really the apple sauce that we want or is it the nutrients and the texture that we're referring to? Just like your, your tortilla story.

People are, or SLPs in general. They, we kind of wanna make it easy on ourselves and just go with, whatever's always been done. And now we see that what's always been done only serviced a very small minority. They are the minority right now. So [00:53:00] it's just, who are we really supporting? So, yeah, it's scary to start with a blank page, but we talk about evidence based practice and following the child's lead that goes with following the family's lead, following the cultural needs, the bilingual needs, all of that is still part of following, following the lead.

[00:53:18] Kate Grandbois: And I think to go back to, to sort of reflect on my, my most recent question, why is this so important? Ingrid? I think you nailed it because you can do harm because there is potential harm. On the other side of the therapy table. On the other side of the hospital room, you can be doing harm in your treatment spaces and.

When we, to me, when we are one of the things we've learned on this podcast, by interviewing so many people, is that regardless of your clinical specialty, regardless of your areas of competency, to be an effective clinician, you need to create safe spaces where your clients, patients, and families can feel vulnerable, can feel safe and [00:54:00] grieve work with you through counsel, whatever components of counseling are appropriate to their care.

Um, and, and do the, do the therapeutic work in a safe environment. And you absolutely cannot do that without considering some of these cultural aspects. Because if someone is concerned about a risk for harm, they are not going to feel safe. They are not going to trust you as a clinician. And this is how, why it's so important to look at things through this lens because of those risks to me, as a, as a person reflecting all of this back to, to what you've been saying, 

[00:54:39] Ingrid Owens-Gonzalez: Now I really love that you picked up on that because I was actually thinking of something Desi shared with us.

And it's, if you don't open up that safe space, then the families may not be willing to give you all the information that you need. And then you risk misdiagnosis, even if you're trying your best. And I remember Desi [00:55:00] that research that you participated in when they made you feel a certain way, when they just upright asked you, how much do you talk to your son in the car?

Like, it seems so harmless, right? But Desi's like, I have a toddler. I just want quiet time in the car. Like the question already had a judgment. Yes. 

[00:55:22] Kate Grandbois: Already have I feel you, the judgment totally. A reasonable thing to say

[00:55:25] Ingrid Owens-Gonzalez: lean in there. And you know, Desi maybe is more likely to say, oh, I talked to him a whole bunch, you know, because it's already the, answer's already in the question for you.

Yeah. What I want you 

[00:55:37] Desi Peña: to traditional interview style.

[00:55:39] Ingrid Owens-Gonzalez: Yes. And so how can we change that? How much do you talk in the car into a ethnographic interview? Kind of question is just, Hey, what does a typical car ride look like for your family? Maybe they play DVDs the whole time. Yeah. Maybe mom just needs quiet time and plays a podcast.

Yeah. Maybe 

[00:55:59] Kate Grandbois: [00:56:00] here, here, you deserve it. You take that quiet time,

[00:56:02] Desi Peña: right. Or maybe your toddler gets car sick. Like I know families that the kid can't even get in the car seat without vomiting. Like maybe you just say, Hey, we're gonna go for a walk I'm gonna go run all the errands by myself. Um, 

[00:56:16] Ingrid Owens-Gonzalez: or you don’t have a car or they don't have a car run into other problems there and you have to just be willing, you know?

So maybe before you ask that you ask, like, what is your household typical day for your household look like? And if they don't mention driving anywhere. Right. And they showed up on the bus to your, your clinic. 

[00:56:35] Desi Peña: strip back all the layers of privilege, right? We're assuming cars, we're assuming activities.

We're assuming things that the child may or may not have access to. Let's just strip all of that and say, tell me about your day. Yes. Start from scratch. I have my blank sheet. Um, and I think the, tying it back to the, the question that you had originally asked Kate, I was thinking about, um, I was [00:57:00] thinking about the fact that, um, In this discussion that we've had, which has been so awesome about, uh, selecting treatment, right.

We sometimes don't even think about the power dynamic. So where it seems that like, you're not thinking about, oh, this isn't harmful because you know, this is just like a list. Like everyone receives the same list. The power dynamics embedded in that culturally are so strong. Um, you know, so much to the point that yeah, families go out of their way to like try new foods when this is really not, it, it doesn't, it's not needed per se. Um, you know, we, we can adapt. Right. Um, and I wanted to bring it up because I know it ties into like our last objective, um, in terms of being a collaborator with families. Right. And I think that that's another place where we really ha have to access that vulnerability and recognize [00:58:00] power differentials.

So if you're not capable of, of doing that cultural, um, responsive practice, you may not be aware that there's a power dynamic. There's a majority culture, there's a minority culture. There's a majority language, there's a minority language in each of these situations. How are you gonna level the playing fields culturally?

Um, or how will, how will you, um, help reduce your bias as well as make that fit parent feel as if. They're a collaborator. Like that's a really big stretch for a lot of these families. They enter spaces where they are not considered collaborators. I mean, I, I think of this on my own as being a parent, like I have been in conversations with people where, um, or professionals and they just kind of tell me what it is and I'm like, well, but that's your perspective.

Right. So, you know, not to say that I could push back at all my doctor's appointments. Um, although I have some really fascinating ones from it.

[00:58:59] Ingrid Owens-Gonzalez: That's [00:59:00] too real. We all know you do Desi 

[00:59:02] Desi Peña: no, I have some really, um, you know, I, I tend to be like a hesitant person, like I process later and then I'm like, oh shoot, I should have said this.

Um, but I, I think that, um, you know, without really assessing ourselves without that self-reflection piece, um, think, you know, again, Be the, be the blank paper, right? Like try to be as blank as you can, because that is really how we can meet these families where they are. Like, I'm not, I, I try not to be super intimidating and bring in all this stuff with me.

Like I, you know, I, I, I know that parents have to be kind of vulnerable with me. Um, I recently evaluated a child who only is exposed to Brazilian Portuguese. I had to just let the parents do the whole thing. I don't speak Portuguese . Um, and so, you know, little did they, you know, they, they, I had warned them like, this is what I'm gonna do.

I'm gonna try to use other tools to help him communicate with you. However, um, [01:00:00] It's you like you're on mom and dad, you know, like I'm I, and, but I have to build trust before I can even get to that point where I'm asking them to perform certain tasks with him. Right. So, anyway, I feel like I went off on a big tangent, but maybe this is a good point to just bring in that last learning objective.

[01:00:18] Kate Grandbois: It is. And I have a, I have a comment that's gonna help us segue there. If you don't mind. I just think that another layer of power hierarchy for us to consider is being in the position of the quote expert to begin with. So there are components and this is an issue of infrastructure in medicine. Um, it's an issue of infrastructure in terms of our field there's issues of disciplinary centrism, where we think we're right, and the other professional is wrong.

There are layer upon layer upon layer of power differentials that are inherent in, in the spaces that we inhabit, unless we can change them actively and try and control for [01:01:00] those things. So it's a really important piece. Um, Regardless of someone's lived experience. There may be feelings of vulner, extra feelings of vulnerability because of the, the power differential that's already at play.

And I think moving, considering that it, it was just making, reading our third learning objectives about the authoritative approach to evidence based practice and needing to dismantle some of that authority. Um, I, I is a really important component regardless because it's of the infrastructures that we have, 

[01:01:33] Ingrid Owens-Gonzalez: 

[01:01:34] Amy Wonkka:  thisis a little tangential, but I think for, I know that a lot of our listeners are school based SLPs.

And even just thinking about the team meeting, what is the team meeting? It is maybe one, maybe two caregivers and then a whole bunch of like fancy people that, that must be such an intimidating, uh, experience to walk into. So there, there are so many layers to this like infrastructure. [01:02:00] 

[01:02:00] Ingrid Owens-Gonzalez: Set up and now imagine you walk into that room and you're the only brown person who doesn't speak English 

[01:02:10] Liza Selvarajah: so much, Ingrid so much the power dynamics are so real and we don't know how much we're bringing.

We, I know deep inside, a lot of us have like imposter syndrome and we're nervous and we don't wanna show how insecure we really are. So we double down on our power. We are the expert we are, but we really are not the expert on that child. So I'm so happy you brought the term expert in, because that is one of the first things.

And I know you're gonna ask Kate, what are we gonna tell our SLPs to do from now on when I have these interviews, I tell the parent right away, you are the expert on your child. I wanna know everything and I wanna know how I can support you. So right away, I just shift the power right back to them because it's their, it's, it's theirs.

And we're just collaborating with them. I remember starting out as an SLP, wanting to show that I know what I studied and I know what I do. And I [01:03:00] have all these check marks and, and I was so proud of myself with these big, giant words I used to use. I mean, who was I really helping? Just my ego. Apparently.

[01:03:08] Kate Grandbois: You're you're not alone. It was me too. 

[01:03:10] Ingrid Owens-Gonzalez: Yeah, I think I was gonna say, sorry, go ahead. I was just gonna say, who are you doing it for? 

[01:03:21] Amy Wonkka: Uh, It's scary though. Like I think I was it for me. Yeah. Like going into, I don't know, my first evaluation I ever did. I was so incredibly nervous and I think some of us myself anyway, that's how I deal with those nervous feelings I think is to sort of shroud it in all the expert words.

And that is not a helpful strategy. That is 

[01:03:39] Liza Selvarajah: yeah. To go back to the blank page. I know that was part of objective two. Um, we wanna limit parents going off on tangents. We're nervous that what if they take us to a place and we don't have the answer. So we really try to control that, but let it, let them take the wheel.

Let them say what they need to [01:04:00] say. More trust will be built. They talk about establishing rapport, right? In evidence based practice. They don't dive into it or how to do it, but they say that we need to, so that is a good way to do it. And then we could shift the power dynamics to show some sort of equality and collaboration.

[01:04:15] Kate Grandbois: I wanna use, I wanna elaborate on what you just said about the word rapport. I think a lot of us, particularly those of us in pediatrics and that's just my clinical experience. So that's what I'm gonna use. We think of rapport as fun. We think of rapport as I'm gonna get you to like me, I'm gonna get you to like being in my therapy room.

Right. But rapport is true. Rapport is so much more than that. And I, I wanna tie this back again to our evidence based practice model. It's about vulnerability. It's about humility, which is something, again, that's the opposite of shrouding us in our expert words, right? The ego, the protection. humility is the counterbalance to that.

And there's more strength in humility and supporting the person on the [01:05:00] other side of the table. And I love that you use the word rapport because that is so often used in our field to build these components of trust. And it is not what we think it is. And it's only when we get on the other side of maybe some experience or some uncomfortable feelings that we realize the power of humility and vulnerability.

And again, This is evidence based practice, everyone. This is not, you know, us just needing to feel good about ourselves. Evidence is so much more than a research article. Um, it's so much more than a test score evidence, one third of our evidence based practice model is using these patient centered care approaches.

Um, and I, I wonder if you could talk to us a little bit more about this, author, this, this, the words that you've used in your learning objective, the authoritative approach versus the collaborative approach. I know we've sort of described both of those a little bit. Um, but what can you tell us [01:06:00] about how you move through those two different categories?

When specifically talking about evidence based practice? 

[01:06:08] Ingrid Owens-Gonzalez: 

[01:06:09] Liza Selvarajah:Well, I wanna go to Amy's example, plus, um, Ingrid having like that mother of color, let's say, come in into this big room full of professionals where you just feel so small. No one has said you are small. We don't respect or care about you, but that's just a feeling that you get when you walk in.

So to me, the first thing we can do is believe the parent's story, whatever they say about the child. If they say my child is walking and talking and everything's fine at home, I can see all a bunch of teachers and psychologists like, Nope, that's not what happens at school. They're not listening. They're refusing to… that's the authoritative model where you're shutting down the parent and saying, that's not what we're seeing.

And I always believe the parent right away. And I just very honestly say, I believe you. It's not what I'm seeing at school, but I believe that that's how they are at home. And I would love to bring that personality into the school. What can [01:07:00] we do to make this child feel safe here? To see the child that you see.

So that's one kind of tip there. 

[01:07:09] Desi Peña: What I found super fascinating when we were, um, figuring out, you know, how to have this discussion, um, about collaborative approaches is how empty are, um, the, uh, the evidences, um, or, you know, just unstudied. I, I thought in speech pathology, this concept is like everything I kept finding were resources in early childhood, social work.

I mean, just any other field other than ours. Um, and I know that we talk a lot about like family centered practices, but I feel like this is different. Um, the collaborative approach is what Liza said, like. Okay. What's what do you see? Okay. How do we get this child to do what you're seeing? Um, again, from the perspective of do no harm, I don't wanna do harm.

I'm [01:08:00] assuming what you're telling me is what really happens. Um, so I just, um, I think that there's so much value in like, again, like a cultural, culturally responsive practice in terms of I reaching out. Um, I know that a lot of times it's hard because I know if you're practicing school SLP, like you're always limited on time, but I do think that if anything, maybe consider that you might be able to afford some more time to doing this work, to avoid.

Engaging in a standardized assessment, that's really not gonna give you the information you need. Right. Um, so seeing if you might be able to shift your time or advocate for additional time for these populations, because this is the risk, the risk is harm. The risk is over identification. And in a lot of cases, we also have under identification, which is a lot trickier.

Um, and maybe, uh, something to bring up on, on, on our next episode with you [01:09:00] guys. But, um, I do think that, uh, we just have a tendency of suppressing that third prong of evidence based practice, where we take into consideration these client perspectives. How about we just try to tilt it a little bit more and like push our administrators to also take that into consideration.

I think that that's where we can leverage some of that power. 

[01:09:26] Kate Grandbois: I think you, I love, I love that suggestion. I think. Anyone who is listening, who has had any light bulb moment or any ha that's a good point, moment. A great place to start could be having the difficult conversation with your administrator or having a bro finding a way to broach the topic with a coworker or a colleague to shift your workplace culture.

Because there are cultures within culture. This whole conversation is about different cultures, but we have professional cultures. Also, we have our professional culture as a field. You have your [01:10:00] workplace culture, your office culture, you know, what are the expectations? And. Starting to have these conversations on a small level, um, advo, or if you've already had those conversations on a smaller level with your counterparts and your colleagues, having that conversation with your administration, bringing additional resources into your administration for trainings, you know, starting to do some of this work.

Um, having conversations about the bias in research. I know in our professional culture, this is something we talk about a lot on the podcast. We tend to think of quote, evidence as a research article. That's what we're taught in graduate school. There's a huge over-emphasis on external evidence. Um, and there is a ton of bias in research, a list of reference in the show notes of a, um, book called insurgent research, which is all about how research is really, uh, driven to support funding from other, in, in institutions of oppression.

So even within the, the [01:11:00] category of external evidence, there are a lot of barriers. Um, and so even just, I know I just sort of went off on a tangent there, but point being it's layers upon layers upon layers of issues and starting to have the conversations on a small scale, um, is something that can actively be done to move the needle on a smaller level.

[01:11:20] Desi Peña: And I was gonna say the last thing that we talked about, um, as a group was cultural brokering, which I think Ingrid was gonna really talk about. But, um, you know, what does it look like if you could, beyond your administration, like who are members of your community that you've established trust with? Is there somebody who can be that cultural broker?

Um, and with that, I'm just gonna pass it off to Ingrid. Cause I know she, she was the one that was gonna talk about that in detail. 

[01:11:48] Ingrid Owens-Gonzalez: Well, I just wanted to add to kind of close it all together. Um, and Kate, you said a lot of your listeners are school based. Uh, the people that I connect with in my practice at [01:12:00] my work is the teachers and like to put it all together in like that collaboration and, you know, being, not an authoritative figure, but a collaborative figure.

There is more components than just the patient or the families. There's more people in this, um, client's bubble in life. Uh, and so in my particular practice, it's the teachers who I have to really collaborate with, listen to. And I always go back to that question I asked before and Yes, but who am I doing this for?

If I'm not listening to what the parent says, if I'm not listening to what the teachers are saying, who am I doing all this testing for? Um, so that's kind of what, where I go back to, and then in terms of cultural brokering, I think we were just gonna discuss how taxing that is on us as bilingual bicultural, SLPs.

Uh, and going back to my, again, [01:13:00] comment of, imagine you're in that room, that team meeting, and then you're, um, a Mexican mom and you walk in and you're the only one who doesn't speak English. Well, then I walk in. And immediately, I see that mom relax when I say Hola, [speaking spanish].

And so like, I'm there and I'm not entirely the interpreter, cuz that's a whole nother story cuz interpreting is not my job, but I'm there. And I said, oh that this, where are you from? And you know, I tell her I'm Chihuahua and immediately the tone, the vibe, the mood, the heaviness lifts. Um, so, but after those days I come home and I'm like, I had a bilingual meeting today and my husband knows like my brain is fried because not only did I spend all that time thinking and two languages, I spent time feeling [01:14:00] things that maybe the other professionals didn't feel.

When I hear the demographics, the background history, I see myself in this child. I see myself in this mom. I see my mom and this mom. and it's just a lot of work that is not seen. So that was kind of what I wanted to bring up with, uh, cultural brokering. Um, I know we're running out of time, so maybe for another time, but, um, that was what was I say it a lot that's was, was in my heart when I put it in our learning of objectives and I, I put it in parentheses.

Like, do you think we'll have time to talk about cultural brokering, but 

[01:14:36] Kate Grandbois: We started this episode talking about our own implicit lived experiences, Amy and I disclosed that were of the white cisgendered, uh, privileged 

um, and I wonder if anybody who is listening, maybe hasn't considered the role of their. Bilingual colleagues. So I'm reflecting on what I said less than five minutes [01:15:00] ago. Move the needle in your office, talk to your colleagues. What would you recommend or what would you say to someone listening who is maybe realizing for the first time that if they do have a bilingual colleague that bilingual colleague may have a different professional experience and how to have that conversation and support that colleague?

[01:15:20] Ingrid Owens-Gonzalez: We actually, in a way we worked on that last summer. I don't know if Liza was a part of it, but I know Desi was, uh, we have an entire, uh, carousel post on, uh, bilingual SLP, uh, in bicultural SLPs. So bilingual bicultural, and we actually have a whole list of how can you be an ally to bilingual bicultural SLPs?

And I think the first thing on the list, if I remember correctly is just have a conversation with us because a lot of people don't even know that we exist. Um, and then I think the second one was refer to [01:16:00] us because if you don't refer out to us and you make due with what you have, you make due with what, you know, you make due with your interpreter, instead of letting your administration know, Hey, there's a Spanish, bilingual, SLP.

Like we should refer in this case, or there's a Portuguese, bilingual, SLP. We should refer in this case. How are our administrators supposed to know that these things are out there? These people are out there and that this is really the gold standard, you know, refer to a bilingual SLP. And then if you don't have that available to you, then use an interpreter ethically and there's ways to do that.

And then if you don't have that, then you can consult. So even there's another step that a lot of people forget, like reach out to us, consult with us. And, um, I know that we added on there, like pay us for our time, you know, like invite us to go teach you about what we know, because a lot of it, we learned on our own on [01:17:00] our own time, on our own money.

Um, so that would be what I would say. I don't know if that's exactly answering your question, but, um, I can also link that post cuz it was several of us who worked on it. I wanna say over 25 of us Desi who worked on that post that summer, uh, and all of us, um, I, and we wrote it out really pretty. It was like racially, ethnically linguistically and culturally diverse bilingual SLPs.

Cuz we had SLPs who were bilingual from all over in that discussion and helping us draft that post 

[01:17:37] Kate Grandbois: we'll definitely link it. Um, in the show notes for people who want more resources on, on. do you guys have any, or do you all have any, um, parting words of wisdom or recommendations for LPs listening who either wanna learn more or wanna engage in more of this [01:18:00] conversation or any advice?

[01:18:03] Liza Selvarajah: Um, I think this is gonna be a little hardcore, but believing that there is a set standard contributes to erasure. So saying like, I don't see color, or I wanna treat them all the same. They are not the same become with very different cultures, very different backgrounds, different languages behind them. So lean into that and ask the right questions.

[01:18:25] Ingrid Owens-Gonzalez: Desi. Do you wanna go we do this on our podcast processing the last word

[01:18:30] Desi Peña: yeah, I was still processing, um, We've just covered so much. I think that, um, the things that have stood out to me, um, in having this discussion, um, I feel like Ingrid Liza and I, uh, you know, we always try to bring our own experiences to these conversations.

Um, and especially with what Ingrid said, like sometimes I just don't process like how much work it is [01:19:00] for me, or like how much work it is for me personally, to always have to embed myself or always have to, um, recognize that I have an additional burden, I guess, like, I, I don't view it as a burden, but I, but I do recognize that like, , I do find myself being tired at the end of the day.

So I just wanted to say if, you know, if whoever is listening to this can consider the fact that there are so many people involved. Um, and there are so many people that, um, you can rely on and. You know that, um, we really need to consider others, I guess, in this whole process. Right. Um, kind of like what Liza was saying, but the opposite in the sense that like, not from an assessment perspective, but just from like a total human perspective, we all have something that we're carrying.

Um, and maybe folks who are not part of that central narrative carry a bit more. Um, so [01:20:00] just something to consider when speaking with these families and speaking with your colleagues who may be of a marginalized background, 

[01:20:10] Ingrid Owens-Gonzalez: I think my, uh, final message would be like, if anything that we talked about today made you uncomfortable, I would say discuss it.

Within your peer group first, before reaching out to a person of color to question, you know, what we've taught here or what we talked about here, like, just discuss it within your peer group, if you are monolingual or if you are white or even white passing. I know, um, white presenting Desi, and I have had these conversations a lot, um, because my last name is Owens and Gonzalez and my first name is Ingrid.

I get a lot of like, oh, I thought you were white. Um, and so I get a lot of insights sometimes, but that would be my thing if, cuz I know that it can be [01:21:00] hard to run away from the discomfort and just say, I can't do anything. Right. Um, but let's push past that and just sit in the discomfort and of yeah, I hold privilege and uh, others don't and what can I do to share it?

Instead of hoarding it. So I think that would be my thing.

[01:21:23] Kate Grandbois: Thank you so much for joining us today. Yeah. This was a really wonderful conversation and I'm so glad that you're gonna come back. 

Ingrid Owens-Gonzalez: Me too. 

Kate Grandbois: We didn't really talk about that much, but if you're listening and you're still with us, we are going to be publishing part two, where we go through more specific components related to assessment, uh, dynamic assessment, um, evaluation action steps, those kinds of things.

So stay tuned. We will be publishing that at some point in the near future. Um, thank you all so much again for joining us. We'll be listing all of the references and resources in the show notes. Please go [01:22:00] check out the Bold SLP collective and the Bold SLP podcast. Um, as, as has already been mentioned, there's a lot of really great information available through social media on these platforms.

Um, and we're just so grateful for your time. Thank you so much for being here. Thank you. 

[01:22:18] Desi Peña: Thank you guys. Thank you so much.

 

[01:22:21] Kate Grandbois: Thank you so much for joining us in today's episode, as always, you can use this episode for ASHA CEUs. You can also potentially use this episode for other credits, depending on the regulations of your governing body. To determine if this episode will count towards professional development in your area of study.

Please check in with your governing bodies or you can go to our website, www.slpnerdcast.com all of the references and information listed throughout the course of the episode will be listed in the show notes. And as always, if you have any questions, please email us at info@slpnerdcast.com

thank you so much for joining us and we hope to welcome you back here again soon.[01:23:00] 

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