Nope. That’s not what that meant.

“The CAA encourages academic programs to focus on how their program is preparing students to provide necessary evaluation and treatment services using the principles of person and family centered care in ways that do not violate state or federal law.”

The above statement is from an open “Message to Programs” posted on March 25, 2025, to the homepage of the Council on Academic Accreditation for audiology and speech-language pathology, the group that accredits educational (primarily master’s-degree) programs. It’s the group that is actually involved when we tend to say, informally, that a program is “ASHA accredited.”

And on its face, it sounds wonderful, doesn’t it? Person-centered care means providing the client what they need. That’s a good thing. Family-centered care means starting with the family and their community as we design care programs with them. That’s a good thing, too. And not violating state or federal law is certainly a good thing!

But sometimes there is more going on under the surface — including, to start with, why did the CAA feel the need to reassert, on March 25, 2025, that speech-language pathology master’s programs should teach students to help clients, help families, and obey the law?

I think the key is this part, from the same March 25 Message to Programs: “[E]nsure students learn to provide person and family centered care, which is the intent of Standard 3.4A/B.”

No, it’s not.

Vagaries about “person and family centered care” are not the “intent” of Standards 3.4A (for audiology) and 3.4B (for speech-language pathology) at all.

Here is the actual text of Standard 3.4B:

“An effective speech-language pathology program is organized and delivered in such a manner that diversity, equity, and inclusion are reflected in the program and throughout academic and clinical education.”

And here are some of the associated requirements for programs (all from CAA, 2017/2023, pp. 21-22):

• “The program must provide evidence that diversity, equity, and inclusion are incorporated throughout the academic and clinical program, in theory and practice.”

• “The program must provide evidence that students are given opportunities to identify and acknowledge approaches to addressing culture and language that include cultural humility, cultural responsiveness, and cultural competence in service delivery.”

• “The program must provide evidence that students are given opportunities to identify and acknowledge the impact of both implicit and explicit bias on clinical service delivery and actively explore individual biases and how they relate to clinical services.”

• “The program must provide evidence that students are given opportunities to identify and acknowledge:”

  • “The impact of how their own set of cultural and linguistic variables affects patients/clients/students care. These variables include, but are not limited to, age, disability, ethnicity, gender expression, gender identify, national origin, race, religion, sex, sexual orientation, or veteran status.“

  • “The impact [that] cultural and linguistic variables of the individual served may have on delivery of effective care. These variables include, but are not limited to, age, disability, ethnicity, gender expression, gender identity, national origin, race, religion, sex, sexual orientation, or veteran status.”

  • “The interaction of cultural and linguistic variables between the caregivers and the individual served. These variables include, but are not limited to, age, disability, ethnicity, gender expression, gender identity, national origin, race, religion, sex, sexual orientation, or veteran status.”

  • “The social determinants of health and environmental factors for individuals served. These variables include, but are not limited to, health and healthcare, education, economic stability, social and community context, and neighborhood and built environment, and how these determinants relate to clinical services.”

  • “The impact of multiple languages and ability to explore approaches to addressing bilingual/ multilingual individuals requiring services, including understanding the difference in cultural perspectives of being d/Deaf and acknowledge Deaf cultural identities.”

• “The program must provide evidence that students are given opportunities to recognize that cultural and linguistic diversity exists among various groups, including among d/Deaf and hard of hearing individuals, and foster the acquisition and use of all languages (verbal and nonverbal), in accordance with individual priorities and needs.”

How would you summarize all that? What is the “intent” of Standard 3.4B?

Sure, we can fall back on generalities like “person centered" or “family centered.” As this website addresses, recognizing a person’s cultural background and preferences, languages and dialects, and identities and associated needs are all part of what we call client-centered, culturally and individually appropriate practice.

But Standard 3.4B does not exist to quietly mumble something vague about person centered care. Standard 3.4B exists to name culture, language, identity, diversity, equity, inclusion, and the social determinants of health. That’s why it exists.

The intent of Standard 3.4B is to bring culture, language, identity, diversity, equity, inclusion, the social determinants of health, and all the related issues specifically and explicitly into the conversation and into the education of future speech-language pathologists.

These issues, by name, must be part of our conversations, our programs, and our practice. How can we possibly even begin to talk about providing person-centered care, or begin to educate future speech-language pathologists, if we are not explicitly at least trying to understand the many layers of complexities — which start with asking people who they are, what languages they use, what matters to them, and what they have experienced in their lives?

I am eagerly awaiting the promised “additional guidance” that the CAA says “will be available by May 1, 2025.” And I am hoping against all hope that the CAA might find the courage to defend its own Standard 3.4B against current political pressures that are trying to demonize or legislate away necessary conversations about the details that make us who we are.

Anne Marcotte | April 25, 2025