It's not just linguistically, there's much more going on’: The experiences and practices of bilingual paediatric speech and language therapists in the UK

• Published in: International journal of language & communication disorders 2024-09, Vol.59 (5), p.1715-1733
• Main Authors: Gréaux, Mélanie, Gibson, Jenny L., Katsos, Napoleon
• Format: Article
• Language: English
• Subjects: Accountability; activity theory; Adult; Attitude of Health Personnel; Bilingualism; Chat; Child; Children; Cultural differences; Demography; disability; diversity; Empathy; Female; Humans; Inclusion; Intersectionality; Language; Language therapy; Language Therapy - methods; Male; Multilingualism; Pediatrics; People with disabilities; Qualitative Research; Racism; Speech; speech and language therapists; Speech therapy; Speech Therapy - methods; Speech-language pathologists; Speech-Language Pathology; thematic analysis; Therapists; United Kingdom
• ISSN: 1368-2822; 1460-6984; 1460-6984
• DOI: 10.1111/1460-6984.13027

Background Despite the high prevalence of bilingualism in the United Kingdom, few speech and language therapists (SLTs) are bilingual themselves. Most SLT research on bilingualism has generated knowledge to inform service delivery for bilingual clients, but few studies have investigated how being a bilingual SLT influences one's professional experiences and practices. Better understanding the unique positionality of bilingual SLTs can yield critical insights to meaningfully address issues of diversity, inclusion and equity in the profession. Aims To investigate the experiences and practices of bilingual paediatric SLTs in the United Kingdom through the lens of Cultural‐Historical Activity Theory‐International Classification of Functioning, Disability and Health (CHAT‐ICF), a new theoretical framework developed to conceptualise the activities of professionals working in the field of disability. Methods In this qualitative study, 19 bilingual paediatric SLTs practising in the United Kingdom were interviewed individually. Participants were recruited through a snowball sampling strategy, and semi‐structured interviews conducted online. The data were analysed using reflexive thematic analysis and following a hybrid inductive‐deductive approach to map the results onto the CHAT‐ICF framework. Results Six overarching components of the CHAT‐ICF framework hosted the 12 sub‐themes identified to capture the experiences and practices of bilingual SLTs: (1) Subject (intersectionality); (2) Tools (language skills, education, clinical resources); (3) Rules (systemic barriers, sense of responsibility); (4) Community (sense of inclusion); (5) Division of labour (parents, colleagues); and (6) Practice (empathy with children, holistic mindset, flexible approaches). The use of the CHAT‐ICF theoretical lens revealed two fundamental structural phenomena: (1) the distribution of sub‐themes across many components of CHAT‐ICF demonstrated that being a bilingual SLT is a multifactorial experience; and (2) the chain reactions between sub‐themes illustrated the dynamic nature of bilingual SLTs’ experiences which can be harnessed to challenge marginalisation and promote equity in the profession. Conclusion & Implications This is the first qualitative study to date to provide in‐depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. These insights can be mobilised to inform the meaningful inclusion of bilingual SLTs in workforce planning efforts and s