Serving Culturally and Linguistically Diverse Clients: A Review of Changing Trends in Speech-Language Pathologists’ Self-efficacy and Implications for Stakeholders

Abstract

The cultural and linguistic landscape of the United States has been changing rapidly in the last three decades. According to the U.S. Census Bureau, 21.1% (60.3 million) of the population in the United States speak a language other than English at home [1]. It is expected that these numbers would increase to about 43% by the year 2020 [2]. Correspondingly, speech-language pathologists (SLPs) in the United States are seeing a rise in their caseload of culturally and linguistically diverse (CLD) clients [3]. SLPs are often faced with clients who speak a language or belong to a culture different from their own. Kritikos [4] reported that 95% of SLPs serve at least one client from a CLD background. Yet, a vast majority of SLPs in the United States are monolingual English speakers. There continues to be a stark minority of bilingual SLPs [5] and a mismatch between the proportion of CLD clients and the available proportion of bilingual service providers. Only 6.5% of American Speech-Language-Hearing Association (ASHA) members identify themselves as bilingual service providers. Spanish-English bilingual SLPs conWith the rapid rise in our culturally and linguistically diverse (CLD) clientele, it is essential to understand the clinical self-efficacy of speech-language pathologists (SLPs) serving these clients and to examine the efforts we have taken as a field to better prepare our future clinicians. Studies from the past 25 years that examine SLPs’ clinical self-efficacy in CLD service delivery were located using electronic databases and manual searchers. A total of 13 articles were identified. A review of the existing studies indicated that reports on clinical self-efficacy among SLPs working with CLD clients has not markedly improved during the last two decades. Nevertheless, there is a positive trend in two areas: (1) the availability and access to training and resources for SLPs, and (2) the willingness to work with more CLD clients. Factors that are barriers to bilingual service delivery still need to be addressed. Future implications for stakeholders are discussed.