Critical Race Theory for Speech-Language Pathology: How Race-Conscious Practice Mitigates Disparities

Critical Race Theory for Speech-Language Pathology: How Race-Conscious Practice Mitigates Disparities

Chelsea Privette
DOI: 10.4018/978-1-7998-7134-7.ch005
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Race has yet to be discussed as a significant factor in the field of speech-language pathology. Race is often conflated with nonmainstream dialects and discussed in purely linguistic terms. However, the terms we use to describe dialects are highly racialized, centering white mainstream norms and treating nonmainstream varieties of English as “different” and, therefore, inferior. Hierarchical thinking about language contributes to the misdiagnosis in Black and other communities of color because racialized language ideologies have been left unstated. This chapter demonstrates through a critical race theory approach how structural racism shapes the field's conceptualization of language and competence. Using an intersectional lens in particular, this chapter discusses race, disability, and language ideology as systems of domination that compound the effects of racism for communities of color. CRT is then used to reveal, critique, and intervene on the historically embedded racist structures that continue to manifest in speech-language pathology research, teaching, and practice today.
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I think knowing one’s history leads one to act in a more enlightened fashion. I can not imagine how knowing one’s history would not urge one to be an activist.

-John Hope Franklin



The field of speech-language pathology has yet to adopt a systematic framework for addressing racism. Because race is traditionally omitted from the ideological discussions that inform research, pedagogical, and clinical practices, any efforts to integrate race result in assimilation (Gotanda, 1991). As a result, the demographics of the profession continue to be predominantly white (92%; American Speech-Language-Hearing Association [ASHA], 2019); research on nonmainstream populations remains underpublished (Kohnert & Medina, 2009); multicultural/multilingual issues (MMI) are glossed over in the curriculum (Stockman, Boult, & Robinson, 2008); and clinicians are unprepared for the diversity of their caseloads by their own admission (Privette et al., 2017). Until traditional policies and administrative practices are critically evaluated through the lens of race, the profession will continue to lag behind the cultural and linguistic diversity that has always existed in this country. Meaningful and lasting change requires systemic intervention. This chapter assumes a substantial knowledge of and agreement with the concept of systemic, or institutionalized, racism on the part of the reader. The purpose of this chapter is to provide researchers, instructors, and clinicians with an understanding of Critical Race Theory (CRT) as a tool for interrogating the systems that inform the research, teaching, and practice of speech-language pathology and for implementing effective strategies that are antiracist and inclusive.

Defining Critical Race Theory (CRT)

CRT was birthed out of legal studies in the 1970s by Black legal scholars who observed the constraints that the law imposes on the civil rights of Black people, even when practiced by progressive lawyers working to expand those rights. In response to the courts’ ability to stagnate - even reverse - the advancement of Black people in the United States using “race-neutral” language, race critics sought to expose how racism influences - and, at times, explicitly motivates - judicial decisions. While CRT has “no canonical set of doctrines or methodologies,” a CRT approach starts with an understanding of the institutional production of white supremacy and ends with an intervention that is liberatory in nature (Crenshaw et al., 1995, p. xv). Known as a movement, a framework, and a lens, CRT empowers one to reveal, critique, and intervene on racialized power structures (see Crenshaw et al., 1995 for a full discussion). A foundational knowledge of the history of racism in the US is fundamental to utilizing CRT as a tool for correcting the institutional bias that rewards whiteness and punishes Blackness. The establishment of racism in the US depends on two basic elements: white supremacy and anti-Blackness (Charmantier, n.d.). Therefore, CRT centers the Black experience in its analysis of racist structures as an anchor for understanding how racism is imposed upon other communities of color. The next section provides an overview of the evolution of racism that is particularly relevant to the field of speech-language pathology. This overview is by no means comprehensive. Rather, it is a starting point for understanding the mechanisms that underlie racist practices in the US and a bridge to developing antiracist practices within the profession.


Background: The Need For Crt

Speech-language pathologists (SLPs) practice at the intersection of education and healthcare. Regardless of setting or clinical population, the systemic roots of the educational and healthcare systems shape our understanding of language and the subjective values that we place on various forms of communication. The title pathologist, one who studies diseases (American Psychological Association [APA] Dictionary of Psychology, n.d.), makes the profession’s emphasis on disorder evident. The profession’s power to pathologize cannot be considered outside of the healthcare system; and the application of normative standards of development cannot be considered outside of the education system. Thus, it is important to understand how the history of racism in each of those systems impacts their operation today.

Key Terms in this Chapter

Hegemonic: Related to dominating authority exerted by the socially, economically, and culturally powerful (i.e., mainstream) over subjugated (i.e., nonmainstream) groups.

Dialect: Any variation of a language, including the “standard” or “mainstream” variety. Linguistically speaking, dialects of the same language are mutually intelligible; however, the boundaries between languages and dialects can be politically determined. All dialects of English are mutually intelligible. In this chapter, dialect and language variety are used interchangeably.

Nonmainstream: Describes people, cultures, languages, and dialects that are systematically excluded from accruing social power. It is a sociopolitical position defined by social hierarchies that shape society’s notions of difference and inferiority.

Language: A system of communication—oral, written, or manual—used to transmit ideas from one person to another. The rules that govern a language are socially agreed upon and change over time. Languages are constantly in evolution.

Minoritized: Describes groups or identities that are viewed as “other.” This term emphasizes the reality that “othered” groups are not necessarily the numerical minority, but minoritized by the dominant group to maintain their social power.

Mainstream: Refers to the dominant group in a society whose cultural norms and practices are assumed to be universal and expected to be adopted by other groups in order to fully participate in that society (i.e., assimilation). In the case of the US, the mainstream group is white monolingual Mainstream American English speakers in the upper and middle classes.

Code-Switching: A linguistic skill by which speakers of multiple languages or dialects switch between languages or dialects depending on the audience, setting, topic, and communicative intent. Speakers of NMDs are expected to acquire MAE often at the expense of their native dialect. Use of MAE by NMD speakers is posited as a prerequisite to success in various institutions, which are founded upon mainstream (i.e., white) norms.

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