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Speech-language pathologist advocates for cultural competence
by Liz Baudler
2017-09-27

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Veteran speech-language pathologist Dr. Arnell Brady preaches two things: the value of oral language—which he has dedicated his career to focusing on—and the need for cultural competence.

"Oral language is the thread that binds us into a culture," said Brady. "It is also the most powerful medicine we have on this planet. It's the very tool that we use to negotiate with each other. Talking, speaking, language, is just so second nature to us that we don't think about it until something goes wrong. In the process we develop it just by being around it. Nobody should have to teach us how to talk. We should be able to just pick it up from our environment. But for some, it doesn't go so well, and when it goes wrong, it really goes wrong."

Key aspects of Brady's life have taught him the importance of cultural competence. He is the father of a transgender son, local activist Myles Brady. When the elder Brady attended Morgan Park High school decades ago, it was 95-percent white—and Brady is a Black man in a profession dominated by white women. According to Brady, white women account for 94 percent of the 191,000 speech-language pathologists in the country, and speech-language pathology is the profession with the fourth-highest percentage of whites in the United States.

Despite this, when a leading journal of his profession had the opportunity to spotlight Brady, recipient of countless awards and who owns of his own Hyde Park speech clinic, in a magazine feature called "Inspirational Friday," the publication, Brady said, "forgot" to interview him. He was less than pleased, particularly when the feature that was slated to be his spotlighted yet another white woman.

"There's less than 100 Black men out of that 191,000," Brady said he told the editors. "You had an opportunity to show our community, to show some Black male out there, to show any male out there, there are some men in this field."

Brady called this another example of the need for cultural competency, which he said could benefit not only his profession and its lopsided racial dynamics, but the LGBT community. To Brady, language is the obvious vehicle to gain this knowledge.

"An expansion of meaning, an expansion of understanding, would give you an appreciation of people's differences, and would give you an ability to not only accept but to also enjoy their differences," said Brady.

Brady's path to his profession was unlikely. He calls Morgan Park High School "a meat grinder" for poor Black students; he was one of only 7 Black graduates of his class, though it began with 99. He tried college at Western Michigan University, dropped out, and in his second attempt, at University of Wisconsin-Superior, took a class called Speech Correction for the Classroom Teacher. Not only did the Franciscan priest who taught the class introduce him to the idea of speech-language pathology, he took the class on a field trip to Duluth where the university had a speech clinic complete with oscilloscope.

"When I saw all that machinery, I said, "oh, this is what I want to do!" Brady remembered. But his university didn't have the right program, so he returned to Chicago, married and started a family. The only local school that offered speech-language pathology was St Xavier University, the former all-girls school. Brady remains the first, last, and only Black male graduate of that program. He had a family to support, so he applied to CPS for an assistant position. Upon viewing his stellar undergrad transcripts, his interviewer had other ideas.

"She said, 'Oh no, you're not stopping now,'" Brady said with a laugh. "She got on the telephone and called Northwestern University in Evanston and said, 'I got a young Black guy here who has a 3.8, he doesn't have a dime, he has a family, but he needs to keep going.' This was in the middle of June and I'm sure all of their application stuff is closed. They said, 'well, send him up here.'"

In a now familiar theme, Brady is the second of only two Black male graduates in the history of Northwestern's program. His clinic is the only Black male-owned speech pathology clinic in Chicago, and one of only a handful in the country. Brady attributes the lack of Black male peers in the field partly to unprepared and uninformed students. Should that trend change, young Black men will find plenty of opportunity, as Brady cites Department of Labor statistic that put speech-language pathology as one of the fastest-growing fields in the country. "When I came into the field in 1984, there was only something like 50,000. Today there's 191,000."

It's a growth created partly by a paradigm shift. "What we're finding out is that we have been wasting an awful lot of human resources by not assisting those who are different," Brady said of renewed interesting in speech-language pathology. "It's so typical of people who are culturally incompetent to throw people away because they're different."

Brady also credited the 2002 discovery of neuroplasticity—how the human brain can change its structure and function based on experience—and the revelation that the brain produces new cells throughout a person's lifetime, as fueling desire for his services. "In 1994 people thought that the human brain had all of the cells it would ever have at birth," Brady remembered.

Neuroplasticity has given home to enhanced communication for stroke patients and autistic people, among others. "We can activate cells that aren't doing anything and activate the power of the brain," Brady explained. "We have been able to overcome many of the communication disorders that for many, many years, we were able only to get a person to a level to where they just maintained the skills that they had left. We now can restore, and cure, a lot of communication disorders."

And neuroplasticity doesn't just have benefits for obvious issues. "One of the greatest gifts a skilled speech-language pathologist has is the ability to not just work with people who might have impairments, but we can also take that so-called normal person, and enhance and improve their functioning," Brady explained.

That lead the doctor to discuss ways in which he's seen his profession be undermined. "The insurance industry has for years denied services to people that could have overcome their impairment, but could not afford to," he said. "And none of the social services agencies had the type of budget that could help middle-class and poor people overcome their problems. We got to put a focus back on the real value of human life."

Sometimes, social services are the problem. "I've had cases where the speech-language pathologists in the schools have actually doctored the reports in order to defend the schools against denial of services, to say they've gotten services when they didn't," Brady remembered. "It is so much easier to get the services than to get around not getting it."

In the case of Illinois Medicaid, Brady said the agency argued that its clients weren't actually people, and when that tactic failed, gave judges an outdated list of service providers. "One of my colleagues sat on the Illinois State Medicaid Board and they were bragging about the fact that in one fiscal year, they had only provided $2700 for speech and language services for the whole state," Brady exclaimed. "If that's not a case of cultural incompetency, I don't know what is. That's a lack of appreciation. That goes to the very core."

Brady feels his job inherently requires him to have the skills to deal with a diverse population. The speech-language pathologist must listen well to their client, as their job literally requires recording speech with the international phonetic alphabet.

"Some of us in this field have been able to realize that if you're going to be good at this, we have to be able to accept people," he said. "We should be able to give back a pure clinical description of you without our own value system contaminating what we have observed. It's almost like we're forced into a role of cultural competence."

Brady often works with LGBT clients, particularly those who are transitioning and want to shift their voice to match their gender presentation, a job he said he likes.

"We don't recommend surgery for this type of thing because there's just so many negative consequences to that," he said. "With practice, you can easily do it through resonance shifts, pitch shifts, things of that nature." It's a process that's gotten easier with computer technology, and Brady thinks it's fairly easy to do in a self-directed way with initial guidance from someone like himself.

His trans son, Myles, is Brady's direct link to the LGBT community, and a notable figure just like his father. Myles Brady-Davis is now a giving officer at Howard Brown Health, and married to fellow trans activist Precious Davis. The couple gained worldwide attention for being the first trans couple featured on TLC's Say Yes to the Dress, have starred in Miley Cyrus's #InstaPride campaign, and are a fixture in Chicago's LGBT community

Brady wanted his children to have a diverse upbringing that encouraged them to be who they truly were, but Myles' identity came as a surprise.

"Things are going along as you expect them to, and then all of a sudden you realize that there's been this big change in your home. It's like waking up one day and there's a hole in the roof," Brady recalled. He remembers feeling alarm and the very real concern that he could no longer keep his child safe. But he also knew he needed more information. "I think what is good in situations like that is to step back for a while and then observe to see where it's going and what's going to happen," he said.

He wanted to support and enjoy his child's newfound identity, buying Myles "a real masculine motorcycle jacket". And overtime, he saw Myles buoyed up and affirmed by his college community. "When I saw the groups and friends [he] had in that community and how they took care of each other, and supported each other, I said, this is all right."

On some level, Brady feels, nothing much changed. "The true Myles, my son, is so enjoyable. The person is a wonderful person. That guy is so much fun, so real. It's hard for me to put it into words. The person has not changed."

Overall, Brady views his son's identity as an educational opportunity. "In a way it was kind of exciting," he said. "Because we learned so much. And I thank him for it. I think it made me a better person. All of my kids are still doing things that carry us to new heights as parents, to new heights as individuals, to new levels of being human. We enjoy that. We thank him for carrying us down that road. We're anxious to see if Myles and Precious get some grandchildren in here. That's going to be even more fun."

But he knows historically not everyone has shared his attitude, and attributes both racism and homophobia to the destructive power an idea can have in a culture.

"We're seeing an idea overpower [the] ability to appreciate human life," Brady said. "We are the only animal on this planet that has a brain capable of destroying itself over an idea. We're the only animal that will kill itself over an idea, something that it has created, something that is not even permanent, something that is transitory, and constantly changing. We can get stuck at a level of an idea and destroy ourselves because of that idea."

Other concepts, however, can give life. Brady's excited about the World Health Organization's new focus on oral language and its disorders, historically left out of their work with disabilities.

"They did not consider oral language important because they said it wasn't part of the human body," Brady said, with incredulity. "The only handicap that they recognized was blindness and hearing impairment. How do you separate oral language from the human body? How do you separate the grunts and the groans that we make, and sometimes make consistently...how do you separate that from the human body? How do you draw a line between the behavior of the human body and the body? But now they are refocusing, and now they're doing studies all over the world trying to find out what is the need in terms of oral language in different countries."

Finally, the World Health Organization is acting on what Brady has believed for years: "Every human being should have access to functional oral language."


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