Trials and Tribulations of the Urban SLP

By Kerri Liljegren July 29, 2013

Photo credit Kim Rodriguez

Photo credit Kim Rodriguez

Working as a first-year speech-language therapist in an urban school district came with its fair share of rewards and challenges. I knew going into this job that my students’ families would be bilingual and of mixed socioeconomic statuses. In my mind, this would be a great opportunity to work with diverse populations and immerse myself in new cultures—and it absolutely was. What I was not expecting was the vast discrepancies in worldview that my students brought with them into the therapy room.

The rich culture in this urban school district was something that had attracted me from the start. Hundreds of countries, and languages were represented. Come to find out, the same was the case for my small group sessions. I treated groups of three in which all three students spoke different languages at home, came from three different countries, and were of three completely different socioeconomic statuses. With that came vastly different worldviews and life experiences which greatly impacted the students’ ability to learn. How can we expect students to remember the life cycle of a caterpillar when that student has never heard of a caterpillar and has only seen butterflies in books at school?

I struggled with these types of questions on a daily basis this past year—especially when choosing targets and planning treatment in the area of semantic knowledge. Many students’ families could only take them as far as they could walk, eliminating many of the experiences that middle class families take for granted such as going to a farm, playing on a sports team, or going on vacation. The majority of my students’ parents had recently immigrated into the United States and had limited English proficiency. These children had never owned or read a book before starting school because their parents were illiterate.

This begs the question: as school-based SLPs, do we teach the “life” vocabulary that these students have missed or do we teach the academic vocabulary necessary to succeed in school? Do we teach a lesson on caterpillars (a fuzzy little insect that is always very hungry) or do we teach strategies kids can use to memorize its life cycle for the unit test? And is it even our job to step in when cultural or socioeconomic factors may be such a large underlying issue? According to the American Speech-Language-Hearing Association (ASHA), it is the school-based speech-language pathologist’s role and responsibility to provide “culturally competent services,” including identifying “a language disorder versus ‘something else,’” which may include “cultural and linguistic differences, socioeconomic factors, lack of adequate prior instruction, and the process of acquiring the dialect of English used in the schools” (ASHA, 2010). What would the “culturally competent” course of action be in this situation?

After mulling over these questions (for months and months…and months) and with such a fine line to walk in terms of choosing semantic knowledge targets and treatment, I finally came to some semblance of a conclusion. Yes, if we are treating students with true language disorders (we’ll save the disorder vs. difference debate for another day), we should be addressing that “life” vocabulary. It is our job to help these students access the school curriculum, and in order to do that, we have to help them to build a solid language foundation that will serve as a springboard for academic learning. Suzie will be much more likely to remember those four life cycle stages if she gets some extra multi-sensory experience, repetition, and practice with our fuzzy little friend, and that is absolutely where we come in as SLPs.

That being said, we’d love to hear what you all have to say on the subject! Feel free to chime in below. Looking forward to hearing from you!

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American Speech-Language-Hearing Association. (2010). Roles and responsibilities of speech-language pathologists in schools [Professional Issues Statement]. Available from


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