Integrating the local and the global: Using critical reflection to understand our own responsibilities in change and transformation

The theme Local Contexts, Global Practice was selected for the 2020 Speech Pathology Australia (SPA) national conference in Darwin, and no one anticipated just how relevant the relationships between local and global were to become. The emergence of COVID-19 meant global events shaped our local contexts and local decision making directly influenced how individuals were able to engage in national and international spaces. Subsequently, the 2020 SPA national conference was cancelled, and in 2021 a virtual conference with the same theme was held in its place. In this editorial, we reflect on how the papers within this edition connect with the 2021 conference theme and prompt us to consider the links between global and local.

Keynote speaker Yvette Hyter explicates some of the critical issues in the profession, calling on us to understand the global context and the impacts of history (e.g. colonialism) on our contemporary communities. Hyter (2022) provides a powerful narrative describing the importance of critical reflection for examining inequities in the ways speech language pathologists (SLPs) practice and offer services. Such reflections can be a tool for reframing and adjusting our perspectives as we work towards improving our own (and the profession’s) cultural responsivity. This is in line with our professional standards which require us to “reflect on and integrate insights into our practice” to improve the ways in which we deliver services to people who experience communication and swallowing difficulties (Speech Pathology Australia, 2020, p. 13).

We note here that each time we reflect, we make choices about how deeply we reflect, what we reflect on, and who we are prioritising in our reflections. Critical reflection can be deeply uncomfortable, particularly when challenging any positions of privilege that we hold. Moving away from more superficial observations to the critical spaces, including interrogating our perceptions of truth, may lead us to a place of ethical unease or uncertainty about our actions. For example, reflecting on the epistemologies and ontologies that we value, challenging the power imbalances between ourselves and the clients we aim to support, or thinking about whether our services are truly accessible to all.

Sally Hewat, in her Elizabeth Usher Memorial address reminds us that disruption can result in transformation (Hewat, 2022). Uncomfortable experiences can act as a catalyst for change. We challenge you to feel discomfort and uncertainty on your own journeys, to re-imagine and reconceptualise practices that combat the institutionalised and systemic racism and inequity that remains unexamined (Hyter, 2022). Use the questions posed by Hewat to reflect on how we, as a profession, may transform our practices and our profession to meet both global and local needs.

As COVID-19 has demonstrated, the world is an interconnected global society. We are an increasingly globalised profession, made up of individuals who have lived, worked and/or are connected to global practice. Even for those clinicians who never intend to leave Australia’s shores, the clients that come to you with their communication and swallowing needs often come from, or have, loved ones overseas. Whether we live and work in the same community all our lives or work in other countries, at the heart of the theme Local Contexts, Global Practice, is a call for clinicians and researchers to think carefully about the nature of our knowledge base and the contextual application of our practices.

Diversity, representation, equity, and responsivity are some of the critical issues we have been reflecting on as we collated this special issue and, opportunely, several papers in this conference edition address these issues directly. In Australia, Catherine Easton and colleagues’ paper queries the reproduction of homogeneity found in the composition of the profession. The authors propose that online education may be an opportunity to diversify the profession, providing accessibility to people who may not otherwise be able to attend a more traditional, campus-based approach to speech-language pathology education (Easton et al., 2022).

Dimitra Ohtaras and colleagues explore issues in equity and access by analysing and discussing data from the 2013 Australian government senate inquiry (Parliament of Australia, 2014) which elucidates the shortcomings of SLP service delivery in the education sector. Critical reflection on this issue should drive systemic advocacy efforts to pursue models of service funding and delivery that are more equitable and are not dependent on ‘luck’ (Ohtaras et al., 2022).

Shifting from a largely Eurocentric view of speech-language pathology to a more global knowledge base is an important part of improving equity and access to services, as well as the way we practice. In this issue, two papers diversify knowledge about speech acquisition in global contexts. Holly McAlister and colleagues document the English speech sound acquisition of Fijian students and, importantly, remind us that it is necessary to understand the context of the child’s speech sound development (e.g. language environment and dialect) to assess whether their development is different or disordered (McAlister et al., 2022). Jennifer Boer and colleagues describe outcomes of a phonological study of consonant development in Tok-Pidgin in children from New Guinea (Boer et al., 2022).

Reflecting on the appropriacy of the services and supports we offer is an important area for critical reflection. In the paper by Jordan Nash and colleagues, the authors describe how SLPs currently support the psychosocial wellbeing of people with aphasia in South Africa. Understanding the existing situation described in the paper offers directions for improving services and appropriate supports in the region, including enhancements in interprofessional practice such as increased training opportunities and collaboration (Nash et al., 2021). Ensuring that we have assessment processes that appropriately support a diverse range of people in the communities where we work is vital. Chantelle Khamchuang and colleagues consider the use and suitability of early vocabulary assessment tools with Aboriginal children living in urban Australia. They describe a familial preference for the Early Language Inventory - their work is an important reminder about the need for culturally responsive assessment practices (Khamchuang et al., 2022).

Evidence about speech, language, communication, and swallowing sits at the heart of our clinical practice and our professional endeavours to improve theoretical and clinical understandings which inform practice at a global and local level. In this issue, Nor and colleagues investigate error patterns in polysyllabic words for English speakers with stroke-related apraxia of speech, which offers the potential to underpin a more “sensitive diagnostic protocol” (Nor et al., 2022) for apraxia of speech, while Varkanitsa and Kiran (2022) interrogate both patient-specific and treatment-specific factors on intervention outcomes for people with aphasia. They consider how understanding more about the interplay of factors may ultimately support predictive modelling for treatment decision making.

The papers presented in this conference issue engender reflection about how we may improve practice at the local level. As the speech-language pathology evidence base grows, so does the opportunity to consider the applicability of our research and practice in varied service contexts and with people who come from different cultural and linguistic backgrounds. We must always interpret the evidence carefully and reflect on whether this knowledge is applicable to other contexts in which we work, or for the clients with whom we work. We must critically reflect on the parts of our knowledge which are potentially transferable, and the assumptions and understandings about our practices which only apply to local contexts.

We envision the 2021 conference theme, and the papers in this collection, as a starting point for how we can expand the representation of speech-language pathology knowledge in the global space. Hewat (2022) calls for us to embrace change and we concur. For fertile and innovative professional evolution, we would like to see Speech Pathology Australia branches take up the discussion of local and global broached by the papers in this issue. We would like to see Australian SLPs lead changes in practice and knowledge production which better includes local and global, multicultural, and multilingual, experiences and perspectives.

Declaration of interest

No potential conflict of interest was reported by the author(s).