Researchers have documented that racial and ethnic minority clients face barriers to accessing health care services in general and frequently receive lower levels of care (Smedley, Stith, & Nelson, 2002). Although limited published data exist about barriers experienced by minority clients' access to general health care services (Flores & Vega, 1998), there is no empirical evidence and only scant anecdotal data about barriers faced by these clients in accessing specialty services like speech and language therapy. Further, existing research on general health care access has largely focused on financial barriers (e.g., not having health insurance) to accessing services and not on cultural or linguistic (CL) factors impacting access.
The goal of this research project was to gather empirical evidence about CL barriers faced by minority clients when accessing speech pathology and audiology services. These data will allow the investigation of the perceptions of different racial and ethnic minority clients about their encounters with SLPs, the health care providers that refer them for speech therapy (physicians, nurses, other rehabilitation personnel, teachers, etc), and their interactions with third party payers or health care intermediaries (case managers, insurance company representatives, etc) that authorize reimbursement for speech and language therapy. Such data are critical in order to make SLPs and audiologists aware of CL barriers for minority clients and to enhance the quality of education, outreach, and diagnostic/therapeutic services provided to culturally and linguistically diverse clients.
Linguistic diversity across the nation has increased dramatically over the past decade and extends to every state, community, and school district. Even Minnesota, previously known for its relative homogeneity, now has large populations of individuals who speak Spanish, Hmong, Somali, Laotian, Vietnamese, Korean, Urdu, and Russian. Similarly, nationwide non-metropolitan communities report increases in the number of immigrant families and school-aged second language learners. These new challenges for speech-language pathologists (SLPs) are especially acute for professionals in remote or rural districts, where exposure to linguistically diverse populations may be limited or sporadic. In addition, SLPs consistently identify a growing gap between graduate preparation and complex practice knowledge needed to serve linguistically diverse children effectively.
The objective of the proposal was to provide SLPs "access to free, on-demand curriculum and professional resources of the highest caliber that support improved services for children who speak languages other than, or in addition to, English." This objective was achieved through the development of a resource posted on the homepages of the University of Minnesota, Department of Speech-Language-Hearing Sciences and consisting of four learning components:
It is well known that across the nation culturally and linguistically diverse (CLD) professionals are needed at every level of employment: schools, hospitals, clinics, research institutions, etc. There are not enough graduate students, much less CLD students, in the pipeline to change the continuing attrition of doctoral-level faculty in Speech-Language Pathology and Audiology (ASHA, 2002) or to staff MS level positions in schools and other settings. CLD students comprise only 9% of the undergraduate, 11% of the MS, and 12% of the doctoral populations nationwide. While high school completion rates for many minority groups have increased over the past 20 years, sizeable gaps still remain between the college enrollment rates of minority and white student populations (Opp, 2001).
The objective of this Pilot Program was to recruit "eight heritage language and/or minority students at the 9th Grade level who demonstrate the skills, interest and knowledge to successfully enter and complete a Master's or AUD degree in COMDDE, and mentor and retain them through degree completion using an integrated program of faculty/college student mentoring, after school cooperative internship experiences, high school and undergraduate mentored research experiences, career counseling, and financial support." This Pilot Program is consistent with the best practices for recruitment and retention of CLD students as outlined in Exemplary Practices in Recruitment, Retention and Career Transition of Racial/Ethnic Minorities to CSD (ASHA, 2006). These practices include: 1) Early and extended awareness and outreach; 2) Admission process flexibility and recruitment from special programs; 3) Expanded faculty roles, curricular modification and retention efforts; 4) Peer tutoring and University academic support; and 5) Mentors, role models, and career preparation and transition help.
Hispanic Americans are among the fastest growing demographic groups in the United States. The United States Census Bureau has documented that over half of the U.S. foreign-born population originated from Latin America (2002). Projections by the year 2025 include 51 million Spanish-speaking people in the United States.
Low socioeconomic English Language Learners (ELL) often face obstacles in acquiring language and literacy learning and present with a higher prevalence of language disorders. Children of migrant Spanish-speaking families are at high risk for inadequate early literacy exposures and experiences, putting them at high risk for underachievement and academic failure (Diener, Wright, Julian, Byinton, 2003; Reese & Gallimore, 2000; Snow et al, 1998). In a recent survey, first or second generation Hispanic immigrants were significantly more at risk for low child literacy orientation than those who had lived in the U.S. longer (Diener et al., 2003).
Considering the growing population of children with language and literacy disorders from Spanish-speaking families, additional training and technical assistance is warranted to support speech-language pathologists, families, and professionals in addressing the unique language and literacy needs of second language learners with disabilities.
This pilot program proposed training and technical support designed to enhance early literacy and language skills of ELL with disabilities. The project utilized bilingual graduate students in a speech-language pathology university program in collaboration with PAEC (Panhandle Area Educational Consortium) to develop and provide training and technical assistance for low socioeconomic Hispanic-American migrant families and their children in Gadsden County, Florida.
The aim of the project was to address (1) the disparity between the diversity of clinicians and researchers with respect to race and ethnicity and the people they serve across the United States, and (2) the critical shortage of doctoral students pursuing academic careers in speech, language and hearing science. Approximately 6.3% of ASHA members belong to an identified racial/ethnic minority. This is in sharp contrast to the data provided by the 2000 United States Census, in which racial/ethnic minorities represented 24.9% of the population. In a 2002 ASHA survey of PhD programs, it was reported that 333 slots available for PhD students went unfilled in 2001-2002. This shortage hinders both the advancement of research in communication sciences and disorders and the training of future audiologists and speech-language pathologists.
To address these critical needs, the Department of Speech and Hearing Science at Indiana University developed an eight-week summer training program for undergraduate students from racial and/or ethnic minority groups. Because of the historically low numbers of racially and ethnically diverse students in our undergraduate programs, recruitment was extended beyond CSD programs to related fields (e.g., psychology, cognitive sciences, education, physics, biology). Emphasis was placed on recruiting students from historically black institutions, tribal four-year colleges, and from universities with high enrollments of Latino/as and/or Asian Americans and Pacific Islanders.
2006–2007 Review Panel: Lisa M. Aniversario, Kimi K. Chung, Christina G. Foreman, Charlette M. Green, Byron L. Ross and Megha Sundara