Collaboration Between SLPs and CODAs

What are situations in which an SLP engages with a CODA?

Sometimes as a result, and other times independent of, CODAs will require services by SLPs. However, CODAs often become involved with the SLP services being provided to their parents and may take on an interpreter role. 

What is important for a professional, such as a Speech-Language Pathologist (SLP), to keep in mind when working with a CODA?

Previous literature has shown that CODAs may struggle with potential obstacles such as: 

• Expressive language delays (Zaborniak-Sobczak, 2021). 

• Phonologic differences compared to speakers raised in a hearing family (Schiff-Myers, 1985). 

• Differences in English versus ASL receptive skills (Brakenbury, 2005).

Yet, CODAs are often misdiagnosed with a learning disability (Frank, 2019). Careful screening and testing is very important to ensure that a CODA's language differences are not interpreted as disorders when there is no language impairment. 

When does a CODA become a translator?

Ideally, a CODA should never be a translator. A professional translator should be hired to ensure that the words of the parents and the clinician are translated in the most accurate form. This will also protect the child from interpreting situations that may affect their mental health and well-being (Frank, 2019). 

How can SLPs use culturally responsive practices when providing services to CODAs?

Because of the linguistic and cultural diversity that CODAs possess, speech-language pathologists must be aware of the unique background of each CODA. To be culturally responsive, cultural competence is a necessity. It is important to recognize the different situations that may be encountered with a CODA and their parents. Cross-cultural communication issues may occur in the presence of the speech-language pathologist. An important first step to being culturally responsive includes asking the CODA and their family the most effective communication method for them and requesting interpretation services, if necessary (Singleton, 2000). 

A common concern regarding providing care for CODAs and their deaf family members is not considering ASL to be a true language. Some providers are uneducated on this, and it was found that "the lack of acceptance of and respect for the language of Deaf parents (ASL) and, accordingly, the native language of the hearing child is one of the unfortunate biases held by many professionals working with deaf-parented families" (Singleton, 2000). To provide culturally responsive care in this aspect, speech-language pathologists must be aware of the importance of ASL as a true language and know how to properly communicate via a professional interpreter. 

It has also been shown that professionals may consider CODAs to have significant speech delay problems because of the assumption that the child is not obtaining adequate speech input in their home environment (Singleton, 2000). Speech-language pathologists cannot jump to conclusions about the home environment of a CODA because of the complex variations of culture and language that a CODA may be exposed to. To be culturally responsive, the SLP must inquire about the home environment of the CODA. They also must acknowledge ASL as a true language and the complexities of the multiple cultures and lingual environments that a CODA experiences. 

If a language delay does occur in a CODA, to be culturally responsive, the speech-language pathologist must enact a plan that is culturally considerate of their bilingual and bicultural environment. They must take into consideration the ways in which language input can increase through both spoken language input and signed language input, if necessary (Singleton, 2000).

How do the cultural identities of CODAs influence the way that SLPs provide them care? 

While it is okay to interview CODA patients about their culture to understand what is important to them, it is essential to remember that CODAs may not identify with one culture (Deaf culture vs hearing culture) more than another (Shield, 2004). The CODA may feel equally a part of both cultures and so the SLP may need to be sure to respond to aspects of both cultures. Each CODA has a unique perspective and deserves to be treated as an individual. 

An SLP should maintain ongoing education on Deaf culture and CODA research literature. This can be achieved through sites like this one, a personal literature review and/or consultation of resources such as Child of Deaf Adults Inc.