Section Four
Module 13: Assumptions About Culture, Language, and Identity in Speech-Language Pathology
-
What underlying assumptions about culture, language, and identity have shaped the culture of speech-language pathology?
-
After working with the material in this module, readers will be able to
Discuss the implications of a cultural assumption that professionals exist and that clients exist
Discuss the implications of a cultural assumption that normal exists and is preferred to abnormal
Discuss the implications of a cultural assumption that the speech, language, and social communication patterns of White monolingual speakers of the northern dialects of American English are normal, typical, and/or preferred
Every culture, including speech-language pathology, is shaped by its underlying assumptions. This module addresses three fundamental assumptions about ourselves and about other people that have shaped our profession’s culture; that have shaped our profession’s culture about culture, language, and identity; and that continue to shape our work.
Most definitions of culture refer to the beliefs and behaviors that are shared by a group of people, using such words as “values,” “principles,” and “actions” (see Module 1). Some cultural beliefs and values are known, explicit, open, and verbalized, often in the form of written statements or shared recitations. Examples include religious creeds or statements of beliefs that are recited during religious ceremonies, a country’s founding and fundamental civil documents, or, in our case, our Scope of Practice and Code of Ethics documents, among others.
Other cultural beliefs or values, in any group, are implicit, unconscious, or implied and assumed, rather than explicitly verbalized. The notion of “implicit bias” has taken on distinctly negative connotations in current usage, and the term currently tends to refer to unconscious prejudices or other negative beliefs (see Greenwald & Banaji, 1995). From a broader perspective, however, the concept of underlying assumptions does not necessarily refer to negative views or ideas and is common across essentially all groups of people in a wide range of areas. As members of our many overlapping groups and cultures, we are all routinely expected to “pick up on” a group’s unspoken or assumed structures, beliefs, and rules. Aggravated parents tell children all the time that they “should not have to tell them” something or “can’t even begin to explain,” precisely because the parents remain almost unaware of fundamental assumptions that are nevertheless very important to them; we are, once again, fish in water.
It can be somewhat difficult to identify these underlying assumptions about the world; again, their defining feature is that they are implicit, unconscious, or implied and assumed, rather than explicitly verbalized. But it is not impossible, and it is definitely worth the effort, because of the importance of these assumptions to our understanding of any group and its actions. So let’s try, for the culture of speech-language pathology!
Seeking the Underlying Assumptions of Speech-Language Pathology
Try standing outside speech-language pathology and stating one thing it assumes to be true about the world. Then keep asking yourself what assumptions underlie that one and what implicit values our profession seems to assign to the assumptions you are considering.
Here are two examples. Take the time to imagine many more on your own.
Speech-language pathology assumes that speech and language exist. Underneath an assumption that speech and language exist would be an assumption that they can either exist or not exist. As a related value statement, I guess we have a broad, underlying assumption that the existence of speech and language is better than the non-existence of speech and language.
The culture of speech-language pathology assumes that it makes sense for speech-language pathologists to work both in hospitals and in schools. Underneath an assumption that the same profession could fit in both hospitals and schools would be an assumption that people who are sick and also children who are learning have something in common. Maybe we have an underlying implicit value about helping people who cannot help themselves? Underneath that thought, in this context, would be the assumption that speech-language pathologists can provide necessary help when people cannot help themselves? So we assume that some people cannot help themselves and need our intervention? Or are we assuming that people who are sick are childlike or even childish?
Did you have some fun with that little thought experiment? You might have played with ideas ranging from “speech-language pathology assumes that written records matter” to “speech-language pathology is based on research,” or you might have played with assumptions about people’s culture, language, or identity. Almost regardless of where you started, though, I’m going to guess that you relatively quickly ended up in a place that included parts of the three assumptions the rest of this module will discuss, because it is not actually that difficult to dig down a few layers and find our profession’s few shared underlying assumptions, the bedrock support for most of our beliefs and behaviors.
The rest of this module focuses on three overlapping assumptions that shape our approaches to culture, language, and identity, in particular, because these ideas are the primary topics for this website. Don’t lose track of any other assumptions that occurred to you about research, neurology, or anything else; we will come back to those later! But for now, let’s start with an assumption that combines several ideas to shape the very existence of our profession as a whole: We are professionals, we have expertise, and we apply our expertise to help people who are not professionals and do not have our expertise.
Underlying Assumption One: Speech-Language Pathology Includes Professionals Applying Their Expertise to Help Clients
Some of the most fundamental assumptions about our profession include that we, as a group, are attempting to develop and apply our knowledge about speech, voice, language, communication, and swallowing in ways that we intend ultimately to help someone other than ourselves.
You might have used parts of this idea to explain your chosen profession to your friends: I work with people who need help with their speech and language. You might have used it to distinguish us from lingustics or basic neurology: Linguists study language to understand language; we apply our linguistics knowledge to help people. This notion underlies our description of ourselves as an allied health profession, as a helping profession, or as education-related service professionals in the schools. ASHA describes itself as “making effective communication, a human right, accessible and achievable for all,” with “all” clearly intended to encompass people other than ourselves. Your unit’s mission statement, similarly, probably commits you to providing high-quality clinical services to help other people. This assumption explains how therapy approaches that might otherwise be perceived as contradictory can co-exist within our profession; when one clinician recommends Treatment A, and another clinician recommends the essentially opposite Treatment B, they are both attempting to apply their expertise in a way that they intend to be helpful for their clients. Even when we are engaged in the domains of professional practice, rather than engaged in clinical service delivery, we are usually working from an underlying assumption that our underlying goal is ultimately to help someone else, in the shorter or longer term, through our teaching, managing, research, or other activities.
Take a moment to think about the underlying assumptions that allow these descriptions, beliefs, and missions.
One of the implicit pieces, here, as we commit ourselves to helping other people, is the very interesting idea that “we” can be or even should be divided from “other people.” Our professional culture assumes, in other words, that the world can be divided into speech-language pathologists, on the one hand, and separate people who are relevant to speech-language pathology but who are not speech-language pathologists, on the other.
The other implicit piece is that we, the speech-language pathologists, exist in part to help them, the non-speech-language-pathologists.
Do these ideas strike you in any way? Are they positive or negative assumptions? Do they matter to our work, to our culture, or to our identities as speech-language pathologists?
One important thing to notice about these ideas is that none of them are objectively necessary. A profession about individuals’ speech and language abilities, or about helping people with their speech and language, or even about “correcting” individuals’ “speech defects,” does not require experts and non-experts. Our professional ancestors could have created an observational self-study group, if all members were assumed or required to have the condition being studied. They could have created a research society, if they were interested in individuals’ speech and language but not interested in changing or helping those other people. They could have created a self-help group or mutual-aid society, within which everyone was seen as an equal contributor, or with no distinctions between professionals and clients.
Because of the abilities and the interests of our professional ancestors (Module 12), however, we are not primarily a research group, a self-help group, or a mutual-aid society. We are a group of applied professionals, by which we mean that we have knowledge, skills, and abilities that we seek to use to help people who are not ourselves. We assume, as a profession, in other words, that professionals exist, that clients exist, and that the professional’s role is to help the client.
Your Turn
Try to think of at least four or five very different categories of things you do not know or cannot do and might seek a professional’s help with (my list might include plumbing, abdominal surgery, and understanding the role of the poet in pre-Islamic Arabic society). What would you be seeking and hoping for, when you sought someone’s help with any of those things?
Use our models of continua and dimensions to think about “helping” other people. Have you ever heard that it is “help” if the person asked for it, but it is “intruding” if they did not? Is that a good rule? What other dimensions can help us to differentiate between helping someone else and interfering with their right to live their life their way?
Some of the issues this module is raising might be read as suggesting that there is no need to distinguish between professionals and non-professionals, or that we could or should re-arrange our profession so as to deemphasize our specialized expertise about characteristics, abilities, or experiences that we ourselves do not have. I do not actually believe that at all; I think expertise matters, a lot, for a lot of reasons, and I think different people know different things in different ways from different angles for many good reasons. (We will come back to this idea throughout Section Five, as we address the kinds of expertise we can have and how we can use it most effectively in what we think of as clinical service delivery.) How do you view experts or expertise generally? How do you view the importance of experts or expertise for speech, language, communication, and swallowing? Why? Could completing a 16 Questions matrix help you think about your views on specialized professional expertise? How do your basic underlying assumptions about “expertise” shape your clinical and professional practice?
It does happen within our field that some professionals do have or acquire the characteristics, abilities, or conditions that they are trying to study or had previously tried to help other people with. Stuttering research throughout the decades has been populated by several professionals who stuttered, for example, and speech-language pathologists can have strokes and acquire aphasia or dysphagia just as anyone else can. Do these examples contradict or support the claim of a basic underlying assumption that, on the whole, speech-language pathology includes professionals who are seeking to help other people?
Underlying Assumption Two: Normal Exists, Normal Serves as an Important Starting Point, and Normal is Preferred
Now think about the overall organizing structure of your undergraduate program and your graduate and clinical education. How did you earn your right to become part of the group of professionals known as speech-language pathologists?
You probably learned first about normal anatomy, physiology, and neurology; the normal phonetic structure of English; and typical child language development. Then you learned about the departures from normal that our profession views as disorders (or conditions, or at least potential problems; see Module 12). Finally, you learned about general strategies and specific methods for applying that information in clinical assessment, treatment, or management (in ways that were intended to help other people, as we discussed immediately above). You were required to pass tests, and then you were allowed and required to demonstrate your knowledge in your clinical practicum assignments, and then you were required to pass a final, high-stakes licensing examination.
Why was your education organized that way?
The usual answers include that we cannot understand what is abnormal or atypical until we understand what is normal or typical and that we cannot make appropriate decisions about management unless we understand the nature of the disorder.
But dig a little deeper underneath those answers.
Why do we say that students cannot understand atypical until they understand typical?
Why do we say that clinicians cannot understand treatment or management unless they understand the normal referent and the “departures from normal” that the client’s current abilities represent?
Notice, if we keep playing this game, that your explanations will probably devolve into restatements of the conclusion: “Students cannot understand what is atypical until they have learned what is typical because the typical serves as the base for learning about the atypical.”
These beliefs make sense to us, once again, because we are fish in water.
But if can manage to find the underlying assumptions underneath our assumptions, we might realize that starting with “normal” is not strictly necessary in any objective sense; it is merely an underlying cultural assumption of our profession. If we had not started with a distinction between professionals and clients, and/or if we had started with a shared interest in something that “we” as a group were all living with, our professional culture could have been one of centering the experiences and the abilities and the related desires or goals of people with essentially any set of characteristics or abilities. Our educational systems might then have been built in completely different ways, emphasizing completely different knowledge, skills, abilities, and professional-development activities.
But we did not start somewhere else; we started where we started, and we have the cultural belief system that we inherited. As Duchan and Hewitt (2023) catalogued in some detail, our profession’s assumption of normalcy or tendency toward ableism (or perhaps “normalism,” an assumption of and preference for that which is perceived as “normal”), was clear in the earliest writings of the 25 founders of the 1925 association that became ASHA — and the same view has continued to shape our profession, not only as a belief but as the underlying structure of our entire educational system and our entire approach to what we describe as basic clinical practice.
This cultural centering of normalcy has also shaped how we describe our profession to ourselves and to other people, throughout our profession’s history. In 1952, for example, multiple representatives of our profession worked together to develop a description of speech-language pathology to be used by the organizers of the MidCentury White House Conference on Children and Youth (ASHA Committee, 1952). In the ASHA Committee’s report to the Conference, children with speech disorders were described as one of the country’s “largest groups of seriously handicapped youngsters,” “urgently” in “need” of help. Persons with disabilities who “can speak normally” or at least “nearly so” were described as “tremendously different, as a rule... from [those] whose speech is gravely impaired,” and “the degree to which the family life may be carried on, in a normal fashion” was described as depending “very heavily upon whether the speech function of the handicapped individual is intact.” Even “relatively minor speech and voice defects” were described as disqualifying children from potential careers “such as teaching, [that] requir[e] good speech.”
Do you hear the underlying assumptions that are made explicit by these words? “Handicapped,” “impaired,” “normal,” “intact”; one of the more striking features of the ASHA MidCentury Report, to my reading as we approach the middle of the 21st century, is how casually and confidently the committee used such terminology. They seem to have been either utterly unaware of, or utterly convinced of, their underlying assumption that people who spoke or communicated in ways other than the ways that they assumed to be “normal” were “handicapped,” unable to participate “normally” in family life or in their chosen vocations, interfering with their entire families’ “normal” lives, and “urgently” in “need” of therapy designed to return them to an “intact” state.
Other examples of more or less explicit ableism or normalism are also obvious in our profession’s clinically-oriented journal articles or textbooks from different eras, including well after the 1950s. Our literature includes a continued emphasis throughout the decades on seeking “normal” speech and resonance for children who were born with cleft lip or cleft palate, as one of many examples (e.g., Blakely & Brockman, 1995). And it’s not just history; well into the 21st century, our publications and textbooks continue to emphasize how exactly to elicit “correct” production of phonemes; the “need” to “suppress” and “eliminate” the use of “deviant” phonological patterns; and recommendations for the use of interventions that not only teach conversational skills but actually provide word-for-word scripts and specific goals for how an “appropriate” conversation must be structured, for clients we have diagnosed with social (pragmatic) communication disorder (see ASHA, n.d. and current as of this writing, about social communication disorder).
Why?
Why have we assumed that some residual hypernasality is a problem that must be fixed, rather than assuming and accepting that people are born with a range of facial anatomies that can reasonably be expected to lead to a range of nasality?
Why would it even occur to us to literally script something as dynamic and unpredictable as a future conversation between two other human beings?
In these and many other examples, there is definitely some very clear evidence that our profession assumes that normal exists, that normal serves as a reasonable starting point, and that normal is preferred.
Has anyone ever questioned these assumptions? Yes, of course, and such questions are also becoming more common within our professional culture, as you might have already been aware while reading this section.
As long ago as 1976, Clase drew on the constructs of stereotypes, social judgments, and continua that have shaped this website’s discussions as she asked “how different” speech must be to be considered “too different” and asked “To whom must it sound different?” (Clase, 1976, p. 51). She also questioned whether we “have the right” to make judgments about other people’s speech or to decide who needs treatment, given that such judgments can often be “subjective, arbitrary, and personal” (p. 51). She concluded by “questioning the ethics of... imposing our values on others and fostering a prescriptive position regarding acceptable speech behavior” (p. 55).
Later, similarly, in the first issue of the new American Journal of Speech-Language Pathology, Crais (1991) reviewed what had by that time become close to 10 years’ worth of work in the field of early intervention. Her article emphasized collaborating with parents and families, by which she meant supporting them as they seek to find the resources they want and develop the routines they find useful, given their reality as a starting point rather than given our values or our views about “normal” as a starting point. (We will discuss ethnographic interviewing, a specific clinical technique for helping ourselves understand clients and families in their own worlds, in Module 18.)
Most recently, as the constructs of ableism and neurodiversity have become common in society and in our profession (see Diedrich, 2023; Duffy, 1981), many other authors in ASHA’s journals and elsewhere have begun to argue explicitly in favor of rejecting the notion that any “normal” exists or can be preferred. They write about resisting ableism, accepting neurodiversity, and embracing our “ethical duty” as professionals to “acknowledge, respect, and value disability as a culture” and as an identity (Saia, 2023, p. 795; see also the collection of papers edited by DeThorne & Gerlach-Houck, 2023, among other examples).
The intersecting dimensions reflected here are complex, and we will return in the next module to thinking about the professional behaviors that seem to have flowed or that could flow from our assumptions about “normalcy.” Before we get there, however, we need to address one more assumption that combines the constructs of professionals, clients, and normalcy or normality with several other critical issues.
Your Turn
As you think about normal, typical, normalism, or ableism in our professional culture, does it matter if we are discussing congenital, developmental, progressive, or suddenly-acquired characteristics, abilities, or conditions? Why or why not?
You might be familiar with the abbreviations WNL and WFL (within normal limits and within functional limits, respectively). If your work setting uses these abbreviations, how are they interpreted and applied? Do they represent an ableist assumption that “normal” exists, or do they represent an anti-ableist understanding that functional is a range that can be achieved in many ways? If your answer was “recognition that functional is a range,” is that really how your work group uses the abbreviation? Or does the “functional range” still basically center a presumed “normal” (by allowing that some people might be “away from normal but still okay”)? Where do our different interpretations of words such as “functional limits” come from?
If you use the abbreviation WFL to describe any client’s abilities as functional for them, do you think of yourself as being actively anti-ableist when you do so? Why or why not? Where do our different interpretations of words such as “anti-ableist” come from?
Underlying Assumption Three: The Speech, Language, and Social Communication Patterns of White Monolingual Speakers of the Northern Dialects of American English Are Normal, Typical, More Important, and Preferred
Did that heading bother you?
It might have, and it should, in a lot of ways and for a lot of reasons.
And yet, have you ever heard the old aphorism that anyone with access to your checkbook or your calendar can figure out what you value? It’s an imperfect joke, of course, but it’s not entirely untrue; where we spend our money and how we spend our time reflect, on the whole, what we believe in. Archeologists, anthropologists, sociologists, psychologists, and others use a similar method when they study the products of a culture. We can learn a lot about any group of people, including about the implicit assumptions that drove their actions, by observing the things they make and the records they leave behind.
Consider, for example, our professional journals.
First, think about the fact that we publish professional journals. Many assumptions underlie a group’s decision to publish professional journals! Our journals physically exemplify our assumption that our specialized professional expertise exists, and they are certainly related to our assumption that our specialized professional body of knowledge needs to be communicated to new professionals in graduate-school courses.
The content of our journals also provides a fascinating record of our professional culture’s beliefs and behaviors over time.
Do you happen to know, for example, what the very first article was, in the first issue of the first volume of our profession’s first journal?
The first article in Volume 1, Issue 1, of our new profession’s first journal, the Journal of Speech Disorders, was titled “Correcting the mechanism causing most foreign brogue” (Barker, 1936). The first thing that our professional ancestors felt the need to publish, when our new profession started its own journal in 1936, was that the spoken English of people who had immigrated to the U.S. was “unsatisfactory” (Barker, 1936, p. 4). Our new profession was encouraged to help clients “overcome all trace of faulty accent” (Barker, 1936, p. 4). A year later, in a different article focused primarily on some details of French pronunciation and linguistic theory, Barker (1937) again referred to the need for “correction” of accents.
And it was not only Barker and not only our research journals. Our profession’s textbooks also explicitly furthered the professional assumption that certain accents or dialects needed to be “corrected.” The first edition of Van Riper’s (1939) classic and still influential textbook, for example, ended with six treatment chapters, one each for what he called language delay, articulation, voice, stuttering, cleft palate, and “bilingualism and foreign dialect.” The “bilingualism and foreign dialect” chapter explicitly used the word “error” to refer to the speech patterns and the word “treatment” to describe the necessary actions by the speech therapist.
This assumption that “foreign” speech could be considered a disorder, on an equivalent footing with language disorders or cleft palate, marked our profession for decades. Wise’s (1946, p. 330) “classification of disorders of speech” referred to “the defects that result from environmental background such as foreign language dialect.” Konigsberg and Windecker (1955) began their tutorial about speech correction in high schools by listing five types of disorders typically seen in that setting: “articulatory faults...voice problems...disturbance in fluency...speech problems related to hearing loss, and...foreign accent” (p. 247). The second (1947) and third (1954) editions of Van Riper’s book retained the foreign dialect treatment chapter. As late as 1978, MacKay (1978) explained that teaching English to speakers of other languages is “remediation,” requiring the same pedagogical or clinical techniques that are required in treating disorders for monolingual English speakers.
Many of these phrases might sound bad enough to your current ears, depending on your starting point, your journey, and your personal views — but we are not finished asking about the next layers of underlying assumptions. We also need to be blunt and clear, as we were in addressing raciolinguistics in Section Two, that our profession’s foundational emphasis on treating accents as disorders did not extend to all accents.
Which Dialects Are We (Not) Talking About?
Let’s think for a moment about some of the dialects and accents of English.
Did your phonetics or language development classes include the opportunity to complete narrow transcriptions of any version of Scottish English or British English? They are distinctly different from American English, including in several characteristics of vowel use, realizing the grapheme “th” as the phoneme /f/, and the use of the velar fricative /x/. The differences extend well beyond accent, also, into language forms that characterize dialects. Many individual semantic items differ, from lifts and lorries to chips and biscuits. British English uses several prepositions differently from the way American English uses them (including to live “in” a street and to do things “at” the weekend). Speakers of British English use present perfect verb constructions (“I’ve lost my wallet,” “She’s brought some pencils”) where an American English speaker would probably describe the simple past as correct or necessary, and speakers of British English frequently add what American English considers an unnecessary (or even incorrect) verb in such phrases as “I might do” (for the American “I might” – although some Southern dialects of American English use the related “I might could”).
But would a White, monolingual English-speaking child from London be judged in need of speech or language therapy in the U.S. on the basis of these patterns?
Of course not.
And is the reason astoundingly obvious, as you think about which accents and dialects have been judged to be problematic by our profession and which have not? Remember, as we discussed in earlier modules, that the reasoning behind many judgments about accents and dialects often has much less to do with the phonology or the language forms and much more to do with the (incorrect, stereotyped, and discriminatory) assumptions and judgments that a listener has already made about the speaker, or about the speaker’s identities or background.
You are correct, therefore, if you are aware that the “foreign” or language-history-based accents deemed to be problematic within our profession have often been those accents produced by people who, as we have addressed, had already been judged by our White, English-speaking professional ancestors to be not White, not speaking the “appropriate” dialects of English with an “appropriate” accent, or both.
Something very similar can be said, of course, about our profession’s history as regards the cultural dialects of American English, including especially the African American Englishes. One intriguing difference between language-based accents and cultural dialects emerges, however, as we try to explore our profession’s early approaches to the African American Englishes.
We noted above that our profession’s journals and textbooks began by asserting that the spoken English of some people who had happened to grow up somewhere other than the U.S. was “unsatisfactory” and “faulty” (Barker, 1936). What were our early professional journals publishing, at the same time, about the many native dialects of American English that have been combined and referred to as African American English, African American Vernacular English, or Black English?
The answer, amazingly enough, is almost nothing.
Boxes 13.1 and 13.2 summarize some patterns from our profession’s early journals.
Start with Box 13.1. (It won’t take you long!)
Box 13.1. Selected Publication Patterns in ASHA’s Early Journals, Based on Title-Word Searches for Articles About Culture, Cultural Dialects, or the African American Englishes (https://pubs.asha.org/)
1930s
No publications with title words cultur*, dialect*, Afric*, Black, or the older word Negro.
1940s
No publications with title words cultur*, dialect*, Afric*, Black, or the older word Negro.
1950s
The earliest article in ASHA journals with any form of the title word “dialect*” appeared in 1955. It focused on the listener’s “difficulty” when what it called the “dialect” of adults learning English “distorts the phonetic nature, intonation, and stress patterns of the English language.”
No publications with title words cultur*, Afric*, Black, or the older word Negro.
Is that what you were expecting?
It was not what I was expecting, when I started exploring our profession’s journals as part of my attempts to dig underneath our profession’s assumptions. I fully expected that our 1930s and 1940s and 1950s journals would be full of cringeworthy old articles about the “errors” made by Black speakers, and about the “deficiencies” of the African American Englishes, and about the “need” for speech-language pathologists to “correct” the speech and language of people who were simply going about their lives using any of the many variations of African American English or any of the other (natively spoken) dialects that have somehow been viewed as not close enough to “General,” “Mainstream,” or “Standard” American English (see Module 7 and Module 8). I assumed that our profession’s cultural products would include decades of frankly awful old articles followed by a growing recognition, starting in perhaps the 1960s, that dialects are dialects.
I was wrong, and what I found — or, rather, what was not there to be found — was even more indicative of our underlying assumptions, in a very interesting way.
There was nothing there.
From 1936, when we started our first journal, until 1966 (see Boxes 13.1 and 13.2), more than 30 years later and encompassing almost one-third of the timeline of our profession’s entire existence, our professional journals published no articles with the title words culture or cultural, Black, African, or even the older word Negro (remember, we are discussing the timeframe between 1936 and 1967) and no articles with the title word “dialect” except one 1955 reference to “foreign dialect.”
What does it mean when nothing is there? When something is deemed completely unworthy of any mention? When something is simply not part of the conversation, not on the table at all?
It means, obviously, that the topic has been deemed uninteresting, unimportant, not under consideration, or not worthy of consideration.
It means, in our case, that the guiding cultural belief and implicit assumption of our profession, as reflected in the content of our professional publications for more than 30 years, was clearly that the speech, language, and social communication patterns of White monolingual speakers of the Northern dialects of American English were of interest. These speakers and these dialects were assumed, presumed, normal, typical, more important, and preferred — and this assumption was so firmly entrenched that there was no reason for our journals to even bother mentioning any other people or any other possibilities. Our ancestors addressed the “errors” made by “foreign” speakers, but as our journals created and shared our developing professional expertise about people born in the U.S., Box 13.1 shows clearly that the frame was obviously assumed to be White monolingual speakers of the Northern dialects of American English.
What Assumptions Drove Our Profession’s Changing Conversations?
We also know, of course, that our current journals and our current profession do at least attempt to address some of the African American Englishes, other natively-spoken dialects of American English, the American Englishes that are not grouped as the Northern regional dialects (or not viewed as part of as General, Mainstream, or Standard American English), and the people who use them. When and how did this change occur, and what underlying assumptions or beliefs are reflected in the change?
Box 13.2 summarizes a few of the earliest relevant publications.
Box 13.2. Selected Publication Patterns in ASHA Journals, 1960 - 1979, Based on Title-Word Searches for Articles About Culture, Cultural Dialects, or the African American Englishes (https://pubs.asha.org/)
1960s
The second article in ASHA journals with any form of the title word “dialect*,” and the first such (title-word) article to refer to African American English as a dialect, appeared in 1966. The article was the report of an experiment conducted by Hurst et al. (1966) about “changing pronunciation dialect” for speakers of African American English and speakers from India who had learned English as a second or later language.
The earliest ASHA journal publication with any form of the word “culture” in its title (i.e., from searching cultur* as a title word at https://pubs.asha.org/ ) was published in 1967. Its title was Language and Speech Deficits in Culturally Disadvantaged Children (Raph, 1967).
A search for the older word “Negro” in titles of ASHA journal articles returns of total of two publications, from any time. The earliest appeared in 1967. (The second appeared in 1972.)
1970s
The third article in ASHA journals with the title word “dialect*”, and the first publication in our journals with the title word “dialect” that provided information about African American English as a dialect, was published in 1971 (Adler, 1971, Dialectal Differences: Professional and Clinical Implications).
The earliest ASHA journal publication with the word “Black” in the title and used to refer to Black culture, people who would identify themselves as Black, or Black English was published in 1972. (The earliest ASHA journal publication with “black” in the title is from 1963 and refers to the visual wavelengths known as black light.)
The earliest ASHA journal publication returned by a search for the title word “Afric*” (at https://pubs.asha.org/ ) was published in 1973.
What do the patterns summarized in Box 13.2 show us?
During the era when the older word “Negro” would have been in use, articles about the needs of people who would have been described as Negro essentially did not appear in ASHA journals. (A title-word search identifies a grand total of two articles in ASHA’s publications, one from 1967 and one from 1972.)
The first time the word “dialect” was used in the title of an ASHA journal article to refer to African American English was in 1966, in an article that focused on listeners’ “difficulties” and reported a method intended to change speakers’ productions of individual words (Hurst et al., 1966).
The first time our journals included any version of the word “culture” or “cultural” in the title of an article was in 1967, in the context of “deficits” and “disadvantages” (Raph, 1967).
The third article in ASHA journals ever to use the title word “dialect*”, and the first publication in our journals with the title word “dialect” that provided information about African American English as a dialect (rather than using the word dialect in the context of the “difficulty” or “difficulties” that listeners were presumed to face when speaking with people who had immigrated to the U.S. and/or learned English as adults) did not appear until the 1970s (Adler, 1971).
In these and many other ways, again, our profession’s products, the publications we produced as the permanent records of our guiding science, opinion, and recommendations, show very clearly that the speech, language, and social communication patterns of White speakers of the Northern dialects of American English have been assumed to be not only the topic of interest but explicitly normal, typical, more important, and preferred. For decades, these speakers were the only ones worthy of mention or consideration. In the late 1960s, when other speakers began to be discussed in our journals, the message was that all other dialects cause difficulties for listeners and that culture refers to “deficits” and “disadvantages.”
And of course, the cringeworthy old material that I had been expecting to find about sociocultural dialects is there, too, even if it did not appear until much later than I was expecting. Raph (1967), in the first article in our journals to use any form of the word “culture” in its title, wrote about the “underlying problem of language structure” for children from “deprived backgrounds” such as “urban slums” or “a remote reservation” (Raph, 1967, p. 204) — obvious allusions to African American children, children of families who had immigrated to the U.S. and settled in cities, and Native American children. She asserted that the children from the homes and neighborhoods she called “deprived” were “disadvantaged”; she described them as “show[ing] marked limitations…in both reasoning and speaking” (p. 205). She managed to claim that what she called “lower-class” African American children did not understand such constructs as first and last, or long and short, until they were almost 9 years old. Overall, she dismissed the children she called “culturally deprived” as unable to communicate, to learn, or even to think, and therefore destined to achieve essentially nothing in life unless they received substantial intervention. She reached these conclusions based, in part, on her claims that the children could not “use language as a means of carrying on a dialogue with themselves” and that “they lack the use of language as a means of getting and dealing with incoming verbal cues” (Raph, 1967, p. 207) — genuinely unbelievable claims, to my reading; laughably absurd, were they not also so monumentally serious.
How could anyone have looked at entire large groups of children in this manner and declared them to be incapable of using language? And how in the world did such patently bigoted views end up in our profession’s journals?
The answer lies in the power of underlying cultural belief systems and assumptions, precisely as this module is exploring.
We are amateur archeologists, anthropologists, or sociologists at the moment, studying the products that a culture left behind. We are uncovering the evidence of, and the power of, our professional culture’s underlying assumptions. The evidence is right there in our profession’s records.
And what have we found?
First, our profession’s research and practice journals spent more than 30 years essentially ignoring people who were native speakers of American English but not monolingual White speakers of the Northern dialects of American English. Then, when our profession decided to write about people who were native speakers of American English but not monolingual White speakers of the Northern dialects of American English, the message was that “their” speech patterns caused “difficulties” for “listeners” and that “their” children somehow did not possess or display the basic human ability to use symbolic communication.
Your Turn
Stop here for a moment and breathe. Shake out your shoulders. Cry or scream or whatever you need to do. Take a walk. Take care of yourself. Take care of each other.
When you are ready, try going back to our original notion of your unique life journey, from Module 1. Where are you now, in your life’s journey? How do the publication patterns summarized in Boxes 13.1 and 13.2 intersect with your journey? How do Raph’s (1967) words intersect with your journey? How do my interpretations, as reflected in the words I wrote to create this module and to create this website, intersect with your journey? Where are you going next, and why?
Raph’s (1967) article was criticized in published letters to the editor by Weber (February, 1968) and Baratz (August, 1968). Weber described several of Raph’s statements as clearly “erroneous” (Weber, 1968, p. 96). Baratz described Raph’s article as “lopsided at best, incorrect at worst” (Baratz, 1968, p. 299). Baratz also noted that several of Raph’s citations of previous authors had misrepresented those authors’ positions, that many of Raph’s claims made no sense as criticisms of the children she was discussing or simply made no sense at all as sentences, and that several of Raph’s points rather transparently reflected old stereotypes. Try discussing how or why Raph’s (1967) article could have made it through the peer-review process to be published, if it had these obvious flaws as a piece of scholarship.
Weber’s (1968) and Baratz’s (1968) published critiques of Raph’s (1967) article both emphasized that “[t]he language of the culturally different child is neither destitute nor underdeveloped but simply different. It is as well-developed, highly structured, and grammatical as any other language” (as phrased by Baratz, 1968, p. 300). These conclusions center some backgrounds as the typical or normal ones and position some as the “culturally different” ones, but at least they affirm the fundamental equality of dialects and the overall cognitive, linguistic, and social abilities of the speakers who use them. Raph’s (1967) original article appears in Google Scholar searches and has been cited 64 times (in Google Scholar, as of mid 2025). Neither Weber’s (1968) nor Baratz’s (1968) critique appears to be retrievable by Google Scholar searches. Try discussing the continuing influence of extreme or erroneous claims, as compared with the influence of any attempts to correct those claims that might come later. (There are multiple current examples of this issue that you might think of, ranging from the devastating effects on young people when certain photos of them have been distributed to society’s continued discussion of unsupported claims about the cause of autism that have been literally withdrawn from journals, not merely criticized in later papers.) What can any individual clinician do, when incorrect, stereotyped, or discriminatory information is repeated or when corrections are not repeated?
Kathard (2002) wrote about the culture of speech-language pathology in South Africa during that country’s apartheid era, the similarities of professional culture that she had seen among speech-language pathologists around the world, and the challenges facing any attempts to develop multiculturalism as part of the culture of speech-language pathology in the U.S. I found her 2002 article after I had written this module, but many of the points her article raised are so eerily similar to the three assumptions this module addresses that I spent quite a moment wondering if somehow I had seen her article before and been influenced by it. I remain convinced that I had not, which leads to an interesting possibility: Maybe her experiences in South Africa and elsewhere during the time before 2002, and my experiences primarily in the U.S. during the time before 2025, were similar precisely because we share a professional culture! It is a confirming-evidence example, to be sure, but I think it’s a fun one. (Kathard has continued to write since 2002; we will address a couple of her main themes in Module 14.)
My own personal and professional journeys, and my own biases and blinders, are on full display, here, in that I am using journal articles as my source material for these analyses of our profession’s beliefs and assumptions. I am familiar with the people and processes that create our profession’s research and clinical journals, and I value and use research journals as a source of information. It makes sense to me, therefore, to use our journals as a source of information about our professional culture. I am well aware, of course, that many speech-language pathologists spend relatively little time reading research journals, much less publishing in them (although use of research articles appears to be increasing, at least among speech-language pathologists who chose to complete an online survey about their use of evidence-based practice). Have you been thinking, as you read this module, about the Columns and Rows problem? This entire module is effectively committing the error of trying to describe an entire culture (speech-language pathology) based on one author’s interpretation of one source of information (me, and journal articles). But you started somewhere different from where I started, so how are our journeys affecting our interactions with this material? (Would a 16 Questions matrix help you think about your thinking here?)
What example assumptions did you start with and play with, at the beginning of this module? Did any of them ultimately reduce to parts of the assumption we are currently addressing (that, when our field focuses on people born on the U.S., the assumed group is monolingual White speakers of the Northern dialects of American English)? Why or why not?
What Implicit Assumptions Are Driving Our Profession’s Current Conversations?
Is there any good news to be found, as we finalize this archeological investigation of our profession’s publications and wrap up our consideration of underlying assumptions?
I might again be more positive than many other critics of our field have been, but I do believe, yes, that there is a bit of good news to be found.
Box 13.3 summarizes a few trends over time in the use of certain terms anywhere in our journals’ publications (i.e., our method here has shifted from title-word searches to “anywhere” searches). What beliefs and assumptions are driving our profession’s current publications, and when did those belief systems become accepted or popular?
Box 13.3. Selected Publication Patterns in ASHA Journals, 1936 - 2025, Based on Word (i.e., “anywhere”) Searches for Articles About Culture, Cultural Dialects, the African American Englishes, and Related Terms (https://pubs.asha.org/)
Fewer than 10% of the articles about speech or language ever published in ASHA journals have also named or addressed speakers’ specific or relevant dialects.
A search for the word “speech” “anywhere” in an article and a separate search for the word “language” “anywhere” in an article both return what appears to be the same list, totalling well over 30,000 articles published in ASHA journals since 1936.
Over 2400 articles that use the word “dialect” have been published in ASHA journals since 1936.
Over half of all ASHA journal articles that use the word “dialect” are from 2010 or later (search “dialect” “anywhere”; https://pubs.asha.org/).
1936 - 1979: 316 articles
1980 - 1989: 187
1990 - 1999: 249
2000 - 2010: 481
2010 - 2020: 765
January 2020 - May 2025: 599
Over half of all ASHA journal articles that use any form of the word “culture” or “cultural” are from 2010 or later (search “cultur*” “anywhere”; https://pubs.asha.org/).
1936 - 1979: 562 articles
1980 - 1989: 279
1990 - 1999: 583
2000 - 2010: 1752
2010 - 2020: 2734
January 2020 - May 2025: 1854
Over 90% of all ASHA journal articles returned by a search for “African American English” are from 2000 or later. Over one third of all ASHA journal articles returned by a search for “African American English” have been published since 2020. (The search for “African American English” returns and includes articles that used near synonyms from other eras, including “Black English” and “Negro dialect.”)
1936 - 1979: 21 articles
1980 - 1989: 4
1990 - 1999: 116
2000 - 2010: 404
2010 - 2020: 540
January 2020 - May 2025: 556
What do you see, in Box 13.3?
It’s a bit of a Rorschach test, because we each bring our own lenses to bare numbers like these. And obviously, this analysis addressed only the mere inclusion of a word, not the content of the articles. As we noted above, an article that uses the word “culture” could do so while making problematic or even obviously bigoted claims about any group of people.
Nevertheless, and perhaps because I tend to be an optimist, I see positive changes in Box 13.3.
I see a sudden increase, after approximately 1990, in our profession’s willingness to name and address the African American Englishes and the people who use them. I see a steady increase, starting in approximately 2000, in our profession’s willingness to name and address culture, cultures, dialect, and dialects generally. I see growth, improvement, expansion, and increased inclusion, all of which I interpret as good changes. I see reason for hope that our profession might eventually move beyond its previous guiding assumptions about whose speech, language, and social communication patterns, abilities, and needs are normal, typical, more important, preferred, and worthy of our professional attention and efforts.
As we mentioned at the end of Module 12, however, it might be less important what I see and more important what you see, as you think about our profession; our professional culture; our profession’s culture about culture, language, and identity; and the choices you will make for your career. We also need to address not only our underlying or implicit assumptions but also the explicit beliefs that we espouse, the behaviors those beliefs lead us to, and the stories we tell ourselves about our profession and its culture; Module 14 will continue this conversation.
Your Turn
Try to explain the contents of Box 13.3 to some people in your life who know nothing about speech-language pathology. What are their reactions to these data? Do their reactions help you to think about how you can fulfill your ethical responsibility to provide high-quality services to all populations?
Box 13.3 used only the words dialect, culture, and African American. Repeat the analysis using other words related to individuals’ cultures, languages, and identities (try transgender, the older word “transsexual,” or the abbreviation LGBT and its longer variations; try Hispanic, Latino, or Spanish; try “American Indian” and “Native American” and “indigenous”; try “mental health”; or try any other words inspired by Morgan’s 1996 model of identities). Examine the results carefully, because ASHAWire’s search engine tends to provide many false positives (articles only vaguely related to your search item). When did our profession’s controlling assumptions begin to include or allow publications with the words you are thinking of or about the topics you are considering? You might be surprised by how long ago or how recent the answer is! If the answer is “a long time ago,” and if you are surprised that this topic has been addressed for so long, what was it about our professional culture that prevented you from knowing about that material until now? How many of the articles you find were published (effectively sidelined) in Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations, and how many were published in AJSLP, LSHSS, JSHD, or JSLHR?
We have noted more than once throughout this website that ASHA’s (2020) Standards and Implementation Procedures for persons seeking certification in speech-language pathology provide three definitions related to the material we are discussing.
“Cultural competence: The knowledge and skill needed to address language and culture; this knowledge and skill evolves over time and spans lifelong learning.
“Cultural humility: A lifelong commitment to engaging in self-evaluation and self-critique and to remedying the power imbalance implicit to clinical interactions.
“Culturally responsive practice: Responding to and serving individuals within the context of their cultural background—and the ability to learn from and relate respectfully with people of other cultures.”
ASHA’s definition of cultural humility appears to have been essentially quoted without attribution from Tervalon and Murray-Garcia (1998, p. 117): “Cultural humility is proposed as a more suitable goal in multicultural medical education [as compared with the older term cultural competence]. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.” One of Tervalon and Murray-Garcia’s (1998) other main emphases was that cultural humility cannot be achieved by individuals alone. Their paper focused on physician education, more so than on medical practice itself, and they emphasized that “The same processes expected to affect change in physician trainees should simultaneously exist in the institutions whose agenda is to develop cultural competence through educational programs. Self-reflection and self-critique at the institutional level is required” (Tervalon & Murray-Garcia, 1998, p. 122, emphases added). What might you say to the ASHA Publications Board (an “institution”) about the underlying belief systems, values, and assumptions that seem to have driven our profession’s publications, or about what you would like to see in the future? Search for articles published before about the year 2000 and compare them with articles published since about 2020. Do you see any changes? What “institutional level” self-reflection, self-critique (Tervalon & Murray-Garcia’s words), or change do you think might still be necessary in our profession’s publication patterns, if any? (One of the stories we will consider in Module 14 is directly related to this question, and Module 25 addresses the concept of enterprise-level or institution-level responsibilities.)
Highlight Questions for Module 13
Summarize the three underlying beliefs or assumptions discussed in this module. What evidence did the module present to support the existence of each belief or assumption? Has that belief or assumption shaped your personal or professional journey in any way, or have your experiences not led you to encounter that assumption at all? Overall, do you agree that these assumptions appear to have existed within our profession?
Discuss the implications for our profession of an underlying belief or assumption that speech-language pathology includes professionals applying their expertise to help clients. Which other professions are built on such an assumption? Is it a positive or negative assumption, to you? Why or under what conditions? (If you do not agree that this assumption has ever existed within our profession, what other assumption about expertise do you think has guided our professional culture?)
Discuss the implications for our profession of an underlying belief or assumption that normal exists, serves as an important starting point, and is generally preferred to anything that might then be labeled “not normal.” Which other professions are built on such an assumption? Is it a positive or negative assumption, to you? Why or under what conditions? (If you do not agree that this assumption has ever existed within our profession, what other assumption about “normalcy” do you think has guided our professional culture?)
Discuss the implications for our profession of an underlying belief or assumption that the speech, language, and social communication patterns of White monolingual speakers of the Northern dialects of American English are normal, typical, more important, and preferred. Which other professions are built on such an assumption? Is it a positive or negative assumption, to you? Why or under what conditions? (If you do not agree that this assumption has ever existed within our profession, what other assumptions about sociolinguistic dialects do you think have guided our professional culture?)
This module discussed a small subset of the underlying assumptions that seem to me to have guided our profession’s culture, all selected within the context of this website’s overarching focus on culture, language, and identity. I would have focused on different assumptions if this were a research-design website or a stuttering website, or if we were somehow attempting to summarize everything about our entire profession. What other guiding values, principles, assumptions, or trends did you start with, at the beginning of this module, and which others can you identify in speech-language pathology in the U.S.? How do values or topics become part of any group’s culture or become popular within that culture? Why is the fact that speech-language pathologists are, in the end, just another group of people such an important factor in what our profession can achieve for whom?
Module 13: Copyright 2025 by Compass Communications LLC. Reviewed May 2025.