Evidence and research

Evidence-based practice

Evidence pages

• RCSLT bilingualism clinical guidance – evidence pages

Ask the experts

• Ask the experts, Bulletin March 2018: How does multilingualism affect the communication of children with neurodevelopmental disorders? (PDF)

Evidence from the IALP Multilingual and Multicultural Affairs Committee

• Overview of the membership and research undertaken by the Multilingual and Multicultural Affairs Committee (PDF).
• FAQ: Common questions by SLTs about progressive aphasia and Alzheimer’s disease in bilingual/multilingual populations (PDF).
• FAQ: Common questions about teaching in a diverse classroom (PDF).
• FAQ: Common questions by SLTs about bilingual/multilingual children (PDF).
• FAQ: Common questions by parents and caregivers of bilingual/multilingual children (PDF).

National Black Association for Speech-Language and Hearing

In the United States, there is a National Black Association for Speech-Language and Hearing, who publish their own peer-reviewed journal: the Journal of the National Black Association for Speech-Language and Hearing (JNBASLH).

The journal publishes papers “concerning communication and communication disorders and differences within and across socially, culturally, and linguistically diverse populations, with an emphasis on those populations who are underserved.” 

You can access their journal archive online for free.

Other resources

See the #ReSNetSLT blog on “Working with ‘under-served’ populations” and online journal club transcript on the same topic (open access).

Journal articles

Health services, workforce and curriculum

Berger, J. T. and Miller, D. R. (2021) Health Disparities, Systemic Racism, and Failures of Cultural Competence. The American Journal of Bioethics, 21(9), 4-10.

Brewer, K. M. and McCann, C. M. (2020) Perceptions of cultural competence in the New Zealand speech-language therapy profession. Speech, Language and Hearing, doi: 10.1080/2050571X.2020.1808345.

Brottman, M. R., Char, D. M., Hattori, R. A., Heeb, R. and Taff, S, D. (2020) Toward Cultural Competency in Health Care: A Scoping Review of the Diversity and Inclusion Education Literature. Academic Medicine, 95 (5), 803-813. doi: 10.1097/ACM.0000000000002995.

Clark, EL, Easton, C. and Verdon, S. (2020) The impact of linguistic bias upon speech-language pathologists’ attitudes towards non-standard dialects of English. Clinical Linguistics & Phonetics, doi: 10.1080/02699206.2020.1803405.

Curtis-Lopez, C., Robinson, D., Shirke, M., Dominic, C., Sharma, S., Roy, A., Bhala, N,. Daga, S. and Patel., R. (2020) Narrowing the gap in careers in clinical research and academia for healthcare professionals. Sushruta Journal of Health Policy & Opinion, 14 (1), doi: 10.38192/14.1.3

Essex, R. Markowski, M. and Miller, D. (2021) Structural injustice and dismantling racism in health and healthcare. Nursing Inquiry. e12441. https://doi.org/10.1111/nin.12441

Finn, G. and Morgan, J. (2020). From the sticky floor to the glass ceiling and everything in between: a systematic review and qualitative study focusing on gender inequalities in clinical academic careers.  Available online: https://www.hyms.ac.uk/research/research-centres-and-groups/hpeu/gender-inequalities-in-clinical-academic-careers. Accessed 23 October 2021.

Hassen, N., Lofters, A., Michael, S., Mall, A., Pinot, A. D. and Rackal, J. (2021) Implementing Anti-Racism Interventions in Healthcare Settings: A Scoping Review. Environmental Research and Public Health, 18 (6), 2993.

Hewat, S., Walters, J. and Lee, M. (2020) The Impact of an Online Cultural Simulation Activity on the Development of Speech Pathology Students’ Cultural Empathy: A Pilot Study. International Journal of Practice-based Learning in Health and Social Care, 8 (2), 16-28.

Khamis-Dakwar, R. & DiLolla, A. (2018). Critical Thinking in Facilitating the Development of Cultural Competence in Speech Pathology: A Training Module Based on a Review of Resources on Arab Americans. ASHA Perspectives, 3 (14), 5-18.

Mahendra, N. (2019) Integrating Lesbian, Gay, Bisexual, Transgender, and Queer Issues Into the Multicultural Curriculum in Speech-Language Pathology: Instructional Strategies and Learner Perceptions. Perspectives of the ASHA Special Interest Groups, 4(2), pp.384-394.

Parveen, S. and Santhanam, S. P. (2020). Speech-Language Pathologists’ Perceived Competence in Working With Culturally and Linguistically Diverse Clients in the United States. Communication Disorders Quarterly, 42 (3), 166-176.

Peterson-Besse, J.J., Walsh, E. S., Horner-Johnson, W., Goode, T. D. and Wheeler, B. (2014) Barriers to health care among people with disabilities who are members of underserved racial/ethnic groups: a scoping review of the literature. Med Care, 52 (10 Suppl 3), 51-63. doi: 10.1097/MLR.0000000000000195.

Piacentini, T., O’Donnell, C., Phipps, A., Jackson, I. and Stack, N. (2018). Moving beyond the ‘language problem’: developing an understanding of the intersections of health, language and immigration status in interpreter-mediated health encounters. Language and Intercultural Communication, 19 (3), 256-271.

Ricks, T. N., Abbyad, C. and Polinard, E. (2021) Undoing Racism and Mitigating Bias Among Healthcare Professionals: Lessons Learned During a Systematic Review. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-021-01137-x

Sim, W., Lim, W. H., Ng, C. H,., Chin, Y. H., Yaow, C. Y. L., Cheong, C. W. Z. et al (2021). The perspectives of health professionals and patients on racism in healthcare: A qualitative systematic review. PloS ONE. 16(8), e0255936. https://doi.org/10.1371/
journal.pone.0255936

Slobodin, O., Kula, Y., Clempert, N. and Cohen, O. (2021) Building capacity in times of crisis: Increasing cultural competence of healthcare professionals in the context of the COVID-19. Nursing Inquiry. https://doi.org/10.1111/jocn.15897

Staley, B., Hickey, E.,  Rule, D., Barrett, H., Salter, C., Gibson, R. and Rochus, D. (2020). Speech-language pathology and ethical practice in global contexts. International Journal of Speech-Language Pathology, doi: 10.1080/17549507.2020.1743358.

Subramanian, A. (2020). Importance of Cultural Competence in Supervisory Relationships. ASHA Perspectives, 5 (2), 489-491

Taliancich-Klinger, C. Hernandez, N. A. and Maurer, A. (2021) Engaging Graduate Students in Cultural Experiences Early: The Development, Implementation, and Preliminary Student Perceptions of a Community Engagement Clinical Experience. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2021_AJSLP-20-00335

Trusson, D. and Rowley, E. (2021). A qualitative study exploring experiences and challenges of combining clinical academic training with family life. BMC Medical Education, 21 (432). https://doi.org/10.1186/s12909-021-02849-8

Wade, C., Malhotra, A. M., McGuire, P., Vincent, C., and Fowler, A. (2022) Action on patient safety can reduce health inequalities. BMJ, 376 :e067090. https://doi.org/10.1136/bmj-2021-067090 

Wilbur, K., Snyder, C., Essary, A. C., Reddy, S., Will, K. K. and Saxon, M. (2020) Developing Workforce Diversity in the Health Professions: A Social Justice Perspective. Health Professions Education, 6 (2), 222-229.

Willey, S., Desmyth, K. and Truong, M. (2021) Racism, healthcare access and health equity for people seeking asylum. Nursing Inquiry. https://doi.org/10.1111/nin.12440

Working with diverse populations

Burns, A. and Radford, J. (2008) Parent—child interaction in Nigerian families: conversation analysis, context and culture. Child Language Teaching and Therapy, 24, 193 – 209.

Crowe, K., Cuervo, S., Guiberson, M. and Washington, K. N. (2021) A Systematic Review of Interventions for Multilingual Preschoolers With Speech and Language Difficulties. Journal of speech, language and hearing research, 64 (11), 4413-4438.

Dam, Q., Pham, G. T., Pruit-Lord, S., Limon-Hernandez, J. & Goodwiler, C. (2020) Capitalizing on cross-language similarities in intervention with bilingual children. Journal of Communication Disorders, 87, 106004.

Digard, B., Sorace, A., Stanfield, A. and Fletcher-Watson, S. (2020) Bilingualism in autism: Language learning profiles and social experiences. Autism, p.136236132093784.

Ebert, K. D. (2017) Convergence between parent report and direct assessment of language and attention in culturally and linguistically diverse children. PLoS One, 12 (7), e0180598.

Gréaux, M., Katsos, N. & Gibson, J. (2020) Recognising and protecting the communication rights of autistic children. Languages,Society & Policy.

Hall, K. and Johnson, L. (2020) The Three CCC’s of Dysphagia Management: Culturally Competent Care. Perspectives of the ASHA Special Interest Groups, 1-6.

Huang, A.J.R., Siyambalapitiya, S. & Cornwell, P. (2019) Speech pathologists and professional interpreters managing culturally and linguistically diverse adults with communication disorders: a systematic review. International Journal of Language & Communication Disorders, 54, 689-704. doi: 10.1111/1460-6984.12475.

Krampe, F., Fabry, G. & Langer, T. (2022) Overcoming language barriers, enhancing collaboration with interpreters – an interprofessional learning intervention (Interpret2Improve). BMC Medical Education, 22, 170. https://doi.org/10.1186/s12909-022-03213-0

Leslie, P. & Broll, J. (2022). Eating, Drinking, and Swallowing Difficulties: The Impacts on, and of, Religious Beliefs. Geriatrics, 7 (2), 41.  https://doi.org/10.3390/geriatrics7020041.

McLeod, S. (2020) Intelligibility in Context Scale: cross-linguistic use, validity, and reliability. Speech, Language and Hearing, 23 (1), 9-16.

Ng, Z. Y., Waite, M., Hickson, L. & Ekberg, K. (2021) Language accessibility in allied healthcare for culturally and linguistically diverse (CALD) families of young children with chronic health conditions: a qualitative systematic review. Speech, Language and Hearing, 24 (2), 50-66. doi: 10.1080/2050571X.2021.1879611.

Poole, C., Harrison, J. and Hill, J. (2021). Understanding dementia in South Asian populations: an exploration of knowledge and awareness. British Journal of Neuroscience Nursing. https://doi.org/10.12968/bjnn.2021.17.4.156

Proctoer, T. & Joshi, A. (2020) Cultural Competency in Voice Evaluation: Considerations of Normative Standards for Sociolinguistically Diverse Voices. Journal of Voice. doi: 10.1016/j.jvoice.2020.09.025.

Schwob, S., Eddé, L., Jacquin, L., Leboulanger, M., Picard, M, et all. (2021). Using Nonword Repetition to Identify Developmental Language Disorder in Monolingual and Bilingual Children: A Systematic Review and Meta-Analysis. Journal of speech, language and hearing research, 64 (9), 3578-3593.

Stankova, M. et al (2020) Cultural and Linguistic Practice with Children with Developmental Language Disorder: Findings from an International Practitioner Survey. Folia Phoniatrica et Logopaedica. doi: 10.1159/000511903.

Tan-McGrory, A., Madu, A. O., Kenst, K. S. & Betancourt, J. R. (2020) Engaging Patients from Diverse Backgrounds in Healthcare Treatment. The Wiley Handbook of Healthcare Treatment Engagement: theory, research and clinical practice. (eds Handler, Al. Sutton, S. Osterberg, L.). doi: 10.1002/9781119129530.ch18.

Üstün‐Yavuz, M.S., Warmington, M., Gerlach, H. and St. Louis, K.O. (2021) Cultural difference in attitudes towards stuttering among British, Arab and Chinese students: Considering home and host cultures. International Journal of Language & Communication Disorders. doi: 10.1111/1460-6984.12617.

Whiteside, K.E., Norbury, C. F. (2017) The Persistence and Functional Impact of English Language Difficulties Experienced by Children Learning English as an Additional Language and Monolingual Peers. Journal of Speech, Language and Hearing Research, 60 (7), 2014-2030.

Inclusive research methodology

Jones, K. C. (2020) Bridging the Research Gap: A Toolkit on Inclusive Research and Development Practices. Chicago Council on Global Affairs.

Levinson, M. P (2020) The Quest for Genuinely Participatory and Inclusive Research Approaches: Exploring and Expressing Experience Through Cultural Animation and Transcription Poetry. International review of Qualitative Research, 13 (2). doi: 10.1177/1940844720934372.

Link, B. G. and Garcia, S. J. (2021). Diversions: How the Underrepresentation of Research on Advantaged Groups Leaves Explanations for Health Inequalities Incomplete. Journal of Health and Social Behaviour, 62 (3). https://doi.org/10.1177/00221465211028152

Portz, K. J. & Burns, A. (2020) Utilizing Mixed Methodology to Increase Cultural Competency in Research with Transgender and Gender Nonconforming Individuals. Transgender Health, 5 (1), 69-73. doi: 10.1089/trgh.2019.0057.

Powell, R. A., Njoku, C., Elangovan, R., Sathyamoorthy, G., Ocloo, J., Thayil, S. et al. (2022) Tackling racism in UK health research. BMJ, 376, e065574. https://doi.org/10.1136/bmj-2021-065574

Roche, P., Shimmin, C., Hickes, S., Khan, M., Sherzoi, O., Wicklund, E., Lavoie, J., Hardie, S., Wittmeier, K. and Sibley, K. (2020) Valuing All Voices: refining a trauma-informed, intersectional and critical reflexive framework for patient engagement in health research using a qualitative descriptive approach. Research Involvement and Engagement, 6(1).

Witham, M. D., Anderson, e., Carroll, C, Dark, P. M., Down, K. et al (2020) Developing a roadmap to improve trial delivery for under-served groups: results from a UK multi-stakeholder process. Trials, 21 (694). doi: 10.1186/s13063-020-04613-7

Other journals

Articles from the journal Languages, Society & Policy, stemming from the ‘Multilingualism: Empowering individuals, transforming societies’ (MEITS) project may be of interest to SLTs.

Articles from the Journal of the National Black Association for Speech-Language and Hearing (JNBASLH), from the National Black Association for Speech-Language and Hearing, may be of interest.

Inclusive Research Methods

Researchers, as well as clinicians, need to be inclusive in their practice. When selecting your approach to research, you should consider aspects of diversity, inclusion and anti-racism.

To support you with this, we have picked out a few key resources that are available through the RCSLT subscription to Sage Research Methods.

To access the Sage Research Methods package, please visit the RCSLT Research methods page. Once you have logged in through the portal, come back to this page and click on the titles below (or, you can search for them on the Sage Research Methods).

Gordon Crawford, Lena J. Kruckenberg, Nicholas Loubere, and Rosemary Morgan. (2017) Understanding Global Development Research: Fieldwork Issues, Experiences and Reflections. 55 City Road, London: SAGE Publications Ltd.

Joseph Trimble, and Celia Fisher. (2006) The Handbook of Ethical Research with Ethnocultural Populations & Communities. SAGE Publications, Inc.

McLaughlin, H. (2012) Research and Anti-Oppressive Practice. Understanding Social Work Research. 2nd ed. London: SAGE Publications Ltd pp. 73-94.

Norman Denzin, Yvonna Lincoln, and Linda Smith. (2008) Handbook of Critical and Indigenous Methodologies. Thousand Oaks, CA: SAGE Publications, Inc.

Thomas, V. (2009) Critical Race Theory: Ethics and Dimensions of Diversity in Research. The Handbook of Social Research Ethics. Thousand Oaks, CA: SAGE Publications, Inc. pp. 54-68.

Yasmin Gunaratnam .(2003) Researching Race and Ethnicity. London: SAGE Publications Ltd.

The National Institute for Health Research (NIHR) applied research collaboration (East Midlands) have released a toolkit for increasing participation of Black, Asian and Minority Ethnic groups, in health and social care research.

Supporting researchers from diverse backgrounds

There is a lack of diversity in the research and academic landscape as well as the clinical landscape. Here are some resources to support the success of aspiring and current researchers from diverse backgrounds.

• Our Clinical Academic Mentoring programme now includes an option for you to request mentorship (if available) from someone with similar experiences to you (including ethnic background or heritage, matched characteristics on LGBTQ+ status or disability, for example).
• Check the ‘Inclusive research opportunities and resources’ section in our bi-monthly research newsletter.
• Read our Bulletin Research & Outcomes Forum article on ‘Diversity through the ‘research’ lens’ (PDF) discussing the elements of work we’re supporting.
• Wiley (publisher of our journal, the IJLCD) have partnered with ‘Leading Routes’, an initiative that aims to prepare the next generation of Black academics.

Reports on diversity within research and academia

• Find the NIHR’s first diversity data report (covering applicants and awardees over 2020-2021)
• Find the annual UKRI reports on diversity results for UKRI funding.
• Read the detailed ethnicity analysis of funding applicants and awardees from UKRI (PDF).
• Read a Wiley report on research publishing and its ‘own diversity problem’.
• Find the ‘Analysis of full REF 2021 panel membership’ which summarises the representation in nominees and appointees with different equality characteristics and compares this to previous REF rounds, and the academic population.