June 8, 2021

Addressing inequities in speech-language pathology services for children

According to data from the Centers for Disease Control and Prevention, nearly 8% of children between the ages of 3-17 have experienced a communication disorder. Among this population, disparities in access to and quality of speech-language pathology services exist for children from historically underserved backgrounds.

These inequities have yet to be adequately addressed in the field of speech-language pathology and stand as a critical population health challenge.

Recognizing the severity of this issue, Sara Kover, associate professor in the University of Washington Department of Speech & Hearing Sciences, and Carly Roberts, associate professor at the UW College of Education, have teamed with Natasha Arora, a UW alum and speech-language pathologist, to investigate inequity in speech-language pathology service delivery.

Together, the team of three combines their disciplinary expertise and connections to inform the design and development of this research project.

“We know that services are not accessed in equitable ways across groups of kids,” Kover said. “There are gaps in training and in the way that systems work, but it’s shockingly not well documented or studied within the field.”

The researchers intend to research and develop a better understanding of barriers to equitable access to speech-language pathology services to address this gap.

“We’re interested in gaining multiple perspectives,” Kover said. “What we’re proposing to do is collect information from two types of people in two different settings, so we’re looking at both public school settings and early intervention settings.”

The researchers will explore the perspectives of speech-language pathologists and administrators in Washington State, identifying these professionals’ understandings of what constitutes equitable service delivery and complex barriers to the implementation of equitable service delivery. The researchers are first working on developing relationships with relevant organizations, practitioners, and community stakeholders to gather this information in early intervention and public school settings.

The relevant data will be accumulated through a qualitative approach, utilizing interviews and directly engaging in conversations with administrators and practitioners in the field of speech-language pathology.

“This is a neat aspect of the project because it will be informative to see what factors or barriers to equity show up [in conversation with stakeholders], either in a similar way across settings, or whether there are differences that can help point to how to push back against inequities,” Kover said.

The researchers’ work is supported through a 2021 Population Health Initiative pilot research grant.

“The pilot research grant was an ideal opportunity for us to launch this line of research,” Kover said. “We really see it as just the beginning. It’s an enormous problem space in terms of addressing equity issues in the field of speech-language pathology.”

The ultimate goal of this work is to identify the systems responsible for creating disparities in speech-language pathology services and outcomes, paving the way for newly formed systems and delivery service that is equitable amongst children with communication disorders.

“We’re touching on human health, in terms of communication and other outcomes for these kids,” Kover said. “These are topics of social and economic equity because the factors that we understand to influence equitable service delivery fall under the categories of being influenced by race and culture, and so many others.”

The researchers are currently laying the groundwork for the beginning of their qualitative study. After conducting interviews, they hope to share their findings with community stakeholders, turning this information back to organizations within Washington State and the broader speech-language pathology community nationwide.

“The goal is to provide useful information to the people who have been kind enough to partner with us and participate in the study, so that together we can define the optimal next steps to continue this line of research,” Kover said. “I’m hoping the big takeaways will be concrete action items that increase equity in the service delivery of speech-language pathology for children with communication disorders.”