Amplifying the voices of underrepresented speech-language pathologists: A scoping review using the transformative research paradigm

Figures & data

Table I. The 10 criteria of the transformative checklist (Sweetman et al., 2010).

Did the authors openly reference a problem in a community of concern? Did the authors openly declare a theoretical lens? Were the research questions written with an advocacy stance? Did the literature review include discussions of diversity and oppression? Did the authors discuss appropriate labelling of the participants? Did data collection and outcomes benefit the community? Did the participants initiate the research, and/or were they actively engaged in the project? Did the results elucidate power relationships? Did the results facilitate social change? Did the authors explicitly state use of a transformative framework?

Table II. List of keywords used in the search strategy.

Concepts	Keywords^a
Speech-language pathology workforce	“speech and language therap*" OR speech-language therap* OR speech therap* OR "speech and language patholog*" OR "speech-language patholog*" OR "speech patholog*" OR SLT* OR SLP*
Minority groups	minorit* OR under-represented OR represent* OR unrepresent* OR "lived experience*" OR racial or race* OR "racial* divers*" OR "racial minorit*" OR white OR black OR ethnic* OR "ethnic* divers*" OR "ethnic minorit*" OR "people of colo?r" OR "person of colo?r" OR "cultural* divers*" OR "cultural minorit*" OR Latino OR "Latin American*" OR Hispanic OR "African American*" OR Africanamerican* OR African* OR "Native American" OR Asian* OR Roma* OR gypsy* OR gypsies OR travel?er* OR travel?ing OR bargee* OR indigenous OR BAME OR BME OR migrant* OR refugee* OR emigrant* OR immigrant* OR expat* OR transient* OR alien* OR "asylum seeker*" OR forgein* OR religio* OR faith OR spiritual* OR Jew* OR Muslim* OR "linguistic* divers*" OR bilingual* OR bicultural* OR multilingual* OR multicultural* OR "non-native speaker*" OR "english as a second language" OR gender* OR "gender minorit*" OR male OR men OR female OR women OR transgender OR "sexual orientation" OR "sexual minorit*" OR lesbian OR gay OR bisexual OR LGBTQ+ OR LGBTQI OR or LGBT OR queer OR homosexual OR single OR "marital status" OR married OR maternity OR pregnant OR disabilit* OR disabled OR handicap* OR autis* OR neurodiver* OR "social class" OR socioeconomic OR "social factors" OR "economic status"

^aThis is a non-exhaustive list of keywords due to certain adjustments made to account for the specificities of the individual databases.

Figure 1. CHAT-ICF framework: Conceptualising the activities of professionals working in the field of disability and rehabilitation.

Figure 2. PRISMA flowchart adapted from Tricco et al. (2018).

Table III. Characteristics of the studies included in this review.

#	Authors	Year	Country	Journal	Attribute	Aims	Characteristics of underrepresented SLP participants			Methodology (methods)
							Status	Defined as^a	n (%)
Studies on interventions supporting underrepresented SLPs and speech-language pathology students (n = 4)
1	Epstein	2012	USA	ASHA-SIG11 on Administration and Supervision	Linguistic	To describe a clinical placement pairing speech-language pathology students with varied levels of Spanish language proficiency in a Spanish-bilingual preschool	Students	Bilingual	9 (26%)	Qualitative (observations)
2	Mahendra & Kashinath	2022	USA	American Journal of Speech-Language Pathology	Mixed	To evaluate a mentoring program aimed at enhancing the retention and success of underrepresented graduate and undergraduate students in speech-language pathology	Students	Male	7 (16%)	Mixed methods (record performance, interviews, questionnaire, workshops)
								Bilingual	33 (72%)
								Non-White	37 (80%)
3	Núñez et al.	2021	USA	Journal of Language, Speech, and Hearing Services in Schools	Linguistic	To identify the support needs of bilingual SLPs working in a US school district and to investigate their experiences engaging in a professional learning community	Qualified	Bilingual	23 (100%)	Qualitative (questionnaire, focus groups)
4	Wofford & Morrow-Odom	2016	USA	Contemporary Issues in Communication Science and Disorders	Linguistic	To determine the effectiveness of an online training module on speech-language pathology terminology in Spanish for students in a speech-language pathology graduate program	Students	Bilingual	6 (100%)	Quantitative (evaluation pre-/post-training, questionnaire)
Studies on the experiences and perspectives of underrepresented SLPs and speech-language pathology students (n = 6)
5	Azios & Bellon-Harn	2021	USA	International Journal of Speech-Language Pathology	Gender	To explore the role of gender on the academic and professional experiences of male SLPs working in the USA	Qualified	Male	16 (100%)	Qualitative (interviews)
6	du Plessis	2018	South Africa	South African Journal of Communication Disorders	Gender	To describe the perceptions of male students in a SLP and audiology training program regarding gender imbalances	Students	Male	31 (100%)	Quantitative (survey)
7	Hudnall	2022	USA	American Journal of Speech-Language Pathology	Mixed	To document the knowledge and lived experiences of SLPs from cross-cultural perspectives to meaningfully critique and evolve practice standards	Qualified	Race/ethnicity (Latina/o, Bangladeshi)	3 (75%)	Qualitative (interviews)
								Bilingual; multilingual	3 (75%)
8	Hudock et al.	2018	USA	ASHA-SIG4 on Fluency and Fluency Disorders	Disability	To examine the perceptions of speech-language pathology students who stutter on how their experiences of stuttering impact their personal and professional lived experiences	Students	Students who stutter	2 (100%)	Mixed methods (self-report clinical tools, interviews)
9	Lowell et al.	2018	USA	ASHA-SIG14 on Cultural and Linguistic Diversity	Mixed	To collect and analyse experiential narratives of clinicians from culturally and linguistically diverse backgrounds	Qualified	Ethnicity (Latina/o)	3 (100%)	Qualitative (interviews, narrative analysis)
								Bilingual (English-Spanish)	3 (100%)
								Cultural (roots in Puerto Rico)	3 (100%)
10	Westby	2021	USA	Communication Disorders Quarterly	Disability	To provide insight into the experiences of a SLP with a hearing loss and how they influenced her clinical work with children with hearing loss	Qualified	SLP with a hearing loss	1 (50%)	Qualitative (interviews)
Studies on a social construct related to an underrepresented attribute (n = 2)
11	Ebert	2013	USA	ASHA-SIG14 on Cultural and Linguistic Diversity	Ethnicity	To explore perceptions of White privilege among students training to become speech-language-hearing professionals	Students	Participants of colour	10 (12%)	Mixed methods (survey)
12	Litosseliti & Leadbeater	2013	UK	International Journal of Language & Communication Disorders	Gender	To explore the role of gender in people’s decision to pursue a career in speech-language pathology and provide recommendations for speech-language pathology recruitment and practice	Qualified	Male	12 (14%)	Qualitative (interviews, questionnaire, focus groups)
Studies on speech-language pathology service delivery or clinical training (n = 8)
13	D'Souza, et al.	2012	Canada	Canadian Journal of Speech-Language Pathology and Audiology	Linguistic	To determine the state of speech-language pathology service delivery to linguistically diverse clients	Qualified	Bilingual; multilingual	300 (78%)	Quantitative (survey)
14	Fuse	2018	USA	Journal of Communication Disorders	Mixed	To identify the needs for and barriers to success of underrepresented students in speech-language pathology and to determine factors linked to student persistence and academic achievement	Students	Ethnic groups (not Caucasian)	68 (54%)	Mixed methods (survey)
								Bilingual (speaking English and non-English language[s])	38 (30%)
								Financial status (lower classes)	78 (62%)
15	Harris & Owen van Horne	2021	USA	ASHA-SIG16 on School-Based Issues	Ethnicity	To provide a preliminary report on SLPs’ practices with regard to the selection of representative materials of clinical service delivery	Qualified	Black or African American	22 (22%)	Quantitative (survey)
16	Keshishian & McGarr	2012	USA	International Journal of Speech-Language Pathology	Mixed	To determine whether background factors influence the choice of speech-language pathology as an academic major, identify motivating factors and their influence on the perceived value of a career in speech-language pathology	Students	Racial/ethnic background (African American, Native American, Asian, Hispanic/Latino, other)	48 (34%)	Quantitative (survey)
								Annual family income (under $50 000)	33 (23.1%)
17	Narayanan & Ramsdell	2022	USA	ASHA-SIG14 on Cultural and Linguistic Diversity	Linguistic	To explore factors associated with multilingual and monolingual SLPs’ knowledge base and confidence levels when working with clients who are culturally and linguistically diverse	Qualified	Multilingual	561 (45%)	Quantitative (survey)
18	Nieva et al.	2020	Spain	Revista de Logopedia, Foniatría y Audiología	Linguistic	To document the beliefs, needs, and practices of SLPs in Spain and investigate SLPs’ linguistic, cultural, and professional competencies	Qualified	Bilingual	118 (57%)	Quantitative (survey)
19	Parveen & Santhanam	2021	USA	Communication Disorders Quarterly	Linguistic	To examine the perceived competence of SLPs, including monolingual and bilingual, working with culturally and linguistically diverse clients in the USA	Qualified	Bilingual	213 (63%)	Quantitative (survey)
20	Santhanam et al.	2019	USA	Communication Disorders Quarterly	Linguistic	To investigate monolingual and bilingual SLPs’ use of language interpreters and related factors (such as years of experience and relevant training)	Qualified	Bilingual	213 (63%)	Quantitative (survey)

^aOnly reported characteristics when they were explored in analysis and for which authors had something to say about in the findings or discussion, not simply reported as characteristics in descriptive statistics (such as age, place of birth). Where more than one characteristic is listed, these may not be mutually exclusive.

Figure 3. Map and table illustrating geographical and group distribution. Grey boxes indicate evidence towards the transformative criteria (deleting the mention of the white boxes because it should be self-explanatory). The map was produced on Microsoft Excel version 16.70 powered by Bing, Australian Bureau of Statistics, GeoNames, Microsoft, Navinfo, OpenStreetMap, TomTom, Zenrin (21.03.2023).

Figure 4. Distribution of studies based on publication year.

Table IV. Transformative criteria of the included studies.

#	Authors	1	2	3	4	5	6	7	8	9	10
1	Epstein
2	Mahendra & Kashinath
3	Núñez et al.
4	Wofford & Morrow-Odom
5	Azios & Bellon-Harn
6	du Plessis
7	Hudnall
8	Hudock et al.
9	Lowell et al.
10	Westby
11	Ebert
12	Litosseliti & Leadbeater
13	D'Souza et al.
14	Fuse
15	Harris & Owen van Horne
16	Keshishian & McGarr
17	Narayanan & Ramsdell
18	Nieva et al.
19	Parveen & Santhanam
20	Santhanam et al.

Criteria defined in Sweetman et al. (2010), themselves adapted from Mertens (2003):

1. Did the authors openly reference a problem in a community of concern?

2. Did the authors openly declare a theoretical lens?

3. Were the research questions written with an advocacy stance?

4. Did the literature review include discussions of diversity and oppression?

5. Did the authors discuss appropriate labelling of the participants?

6. Did data collection and outcomes benefit the community?

7. Did the participants initiate the research, and/or were they actively engaged in the project?

8. Did the results elucidate power relationships?

9. Did the results facilitate social change?

10. Did the authors explicitly state use of a transformative framework?

Shaded boxes indicate evidence towards the transformative criteria. White boxes indicate no evidence towards the transformative criteria.

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