Lay Publication Details

Defining communication disability in underserved communities in response to the World Report on Disability.

Easy Access Summary

The World Report on Disability takes a broad view on disability, and includes a wide range of disabilities. Many believe this should include communication disability, and seek to promote a broader view of communication disability. It is important we include communication disability within the broad range of disabilities in the World Report on Disability.
This article comments on a review of the World Report on Disability and focuses on people in ‘under-served’ communities, people who may not have any, or very limited, speech therapy options available to them.  This may be due to factors such as; living in rural areas, having limited ability to travel or not being able to communicate. A definition of ’under-served’ communities is required because different specialists see communication disability differently. Therefore, it is hard to say how many people in ‘under-served’ communities aren’t getting the therapy they need, because people see communication disabilities differently, meaning that we can not count how many people with a speech disability there are let alone how many are not getting the therapy they need.
Some people suggest that a reason some people might not seek speech therapy could be cultural (how they grew up and what is normal). While people from one culture might see a child having a communication disability, people from another culture would dismiss it and say it wasn’t a problem. Another idea is that whilst recognising that their child is slow to talk, some people may seek out the community for support as opposed to looking going outside the community (e.g. a hospital) because it could lead to the being judged by other member of the community.
The paper mentions the programme called ‘Child Talk – What Works’ which is specifically interested in speech-language services and looks at ‘under-served’ communities regarding speech-language therapy services in the United Kingdom. The programme identifies that community groups are perceived to not currently (at the time of publication) access speech-language therapy services and investigates why this may be.

Practical Implications

The values of service users must be sought and considered while planning services.


S. Roulstone; S. Harding


The World Report on Disability takes a broad emphasis on disability, with a dominant focus on
physical disability. It is important that speech-language pathologists SLPs promote communication
disability within that context. In this commentary, we explore the challenges of investigating the
epidemiology of communication disability, in particular, the difficulties defining the disability and
then measuring it in a valid and reliable manner. We discuss the two interpretations of the concept
‘medically underserved’ as it relates to speech-language pathology: service availability and service
accessibility. We then explored Bourdieu’s ‘Forms of Capital’ as a way of understanding an
individual’s perception of capital and how service provision can enhance perceived capital and
minimise loss of capital. We make the point that it is important that communities come to access
and value SLP services. The focus throughout is on children with communication disability in the
context of a programme of research in England, called ‘Child Talk – What Works’. We did this with
specific reference to preschool children and a current research programme.