American Speech-Language-Hearing Association (ASHA)
ASHA is the national professional, scientific, and credentialing association for 234,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students.
Health Care

Exploring Cultural Responsiveness: Guided Scenarios for Communication Sciences and Disorders (CSD) Professionals

Initiative Categories


Focus Areas

  • Age Equity
  • Cultural Responsiveness
  • Deaf/Hard of Hearing
  • Dialect
  • Gender
  • Language access/inclusion
  • Mentoring
  • Multilingualism
  • Neurodiversity
  • Race/ethnicity
  • Religion/Faith based practice/spirituality
  • Socioeconomic status
  • Trauma Informed Care


Exploring Cultural Responsiveness is a book and an e-book published in 2020 by ASHA Press.

The idea for this book originated with ASHA's Multicultural Issues Board (MIB). The MIB comprises 12 ASHA members, one National Student Speech Language Hearing Association representative, a Board of Directors liaison, and an ASHA staff ex-officio. The Board's aim was to create an accessible resource to assist audiologists, speech-language pathologists, and communication sciences and disorders (CSD) professionals to broaden their cultural competence skills and improve service delivery to clients/patients/students.

The resource contains more than 30 guided scenarios inspired by the real-life experiences of the MIB members. The scenarios explore how cultural factors such as race, gender identity, disability, religion, age, and sexual orientation can affect the provision of appropriate services. The reader is encouraged to engage with their own emotional responses and to consider the impact of any implicit or explicit cultural bias. Each scenario is accompanied by

  • a series of critical thinking questions designed to help the reader think through the case,
  • commentary which presents different perspectives and outlines evidence-based resources and best practice,
  • suggested responses to the questions, and
  • key takeaways.

The scenarios are designed to expand upon a clinician's existing knowledge of the relationships between cultural, communication, language, and clinical practice and to challenge ways of thinking about how culture impacts every aspect of their work and service provision. The reader is exposed to a wider range of experiences than they are likely to have encountered in their own practice; thus they are provided with an opportunity to think through unfamiliar situations and a level of preparedness to address situations in the future. The reflective questions and evidence-based resources allow practitioners to explore situations that may be uncomfortable, identify their biases, and be better prepared to respond in the moment. Throughout, practitioners are encouraged to recognize the importance of cultural responsiveness in providing appropriate service delivery.

Content development was led by Alicia Fleming Hamilton, MS, CCC-SLP, with co-editors Carmen Ana Ramos-Pizarro, PhD, CCC-SLP; Jean Franco Rivera Pérez, PhD, CCC-SLP; Wendyliza González, MS, CCC-SLP, TSSLD-BE; and Karen L. Beverly-Ducker, MA, CCC-A, CAE. All the MIB members at that time contributed scenarios and acted as peer reviewers. ASHA staff created the cover design and layout and provided project management and production support.

As well as individual purchase, the book has been adopted for university courses, helping to educate the next generation of professionals. Selected scenarios have been adapted into a micro-course series and another scenario forms the basis of a cultural competence assessment module for ASHA's That's Unheard Of website.

For More Information

See the ASHA's online store or contact Catharine Gray at

This initiative was submitted on May 29, 2024.

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