Shift from Ableism to Cultural Humility
I have been going through an unraveling of sorts for the last several years in my speech-language pathologist brain which hinges on the concept of ableism.
There are many definitions of “ableism” on the internet and the one I like best belongs to Rachel Dorsey. Ableism is “the belief that people with typical abilities are superior to those with disabilities.” She has since taken down her content prior to 2023, but she wrote a piece about ableism within the field of speech pathology that resonated with me deeply. Once I was aware of ableism, I saw it everywhere. It was something I was unable to unsee.
My unraveling process started when I sought out the perspectives of actual AAC (alternative, augmentative communication) users in the community. I was attempting to find people in the community I could connect my AAC-using students transitioning from high school into adult life. One resource I went to immediately was the Facebook group “Ask Me, I’m an AAC User.” I came across a post stating that they did not allow any “pro-ABA” comments on their page. If you’re new here, “ABA” stands for “applied behavior analysis” which is prescribed by pediatricians to children, almost by default, when they receive an autism diagnosis. It turns out the AAC users, in that group at least, had some opinions about ABA, a service that many of them had been subjected to. That led me to discover that there was a gigantic community of autistic people speaking out against ABA under a broader umbrella that was the “Neurodiversity Movement.” The concept that a group of people that the medical community blanket prescribes a service to has a big problem with that service blew my mind wide open. The service professions were not listening to the people they served.
The Neurodiversity Movement is of course not just about ABA nor is it just about autism, although I’ve learned many things about both since joining that Facebook group in 2018. The Neurodiversity Movement is ultimately a push back against ableism directed towards those with neurological diagnoses other than what is considered “typical.” It caused a paradigm shift in me not just about the neurodiverse people I support but all people I support. The shift is from ableism- that the non-disabled professional will automatically “know better” than the disabled client, to a place of cultural humility- that the non-disabled professional cannot know more about the disabled client’s experience than the client themself.
I now actively seek out the perspectives of people who have similar communication challenges to the ones my clients are experiencing. I make the client a part of their own treatment decisions (this can look like having an open discussion with a middle school student about his communication goals or it can look like child-led therapy with a 3-year-old- listening to them and changing an activity if they’re not enjoying it). I talk to the client about their own experiences and how their communication challenges impact their lives as a whole. This drives treatment approaches and priorities. This can mean sometimes that a generally-intelligible student stops working on their /s/ sound if they’re okay with it the way it is. It can mean open discussions about what does and doesn’t help an individual who stutters. I also bring up the concept of ableism to all discussions with caregivers and school support teams to ensure that decisions are made which will ultimately empower the individual- not mold them into being indistinguishable from their peers.
The shift started for me with my discovery of the Neurodiversity Movement- and it has changed everything I do. I hold out hope that we can see this shift in our cultural understanding of disability as well.
