that “pathology” word

A footnote caught my eye recently.

In a footnote at the beginning of her Introduction to a recent collection of papers in Perspectives, Scott (2025) wrote that she would be referring to our profession as “Speech, Language & Hearing Sciences” instead of “speech-language pathology” and referring to the relevant professionals as “speech-language practitioners” instead of “speech-language pathologists.” Her goal was “an intentional move away from a harmful medical model that pathologizes individuals” (p. 61).

I noticed the collection of papers because their topics are directly related to many issues this website addresses. I noticed the footnote, in particular, because I have wondered about these words myself, as I have worked on this website.

As a bit of background, I am of the professional generation that proudly claimed the name “speech-language pathology.” When we started our careers in the 1980s or 1990s, the addition of “language” to our profession’s title (ASHA, 1976; see Module 12) was still relatively recent. We were taught that the “new” name honored the important distinctions and also the connections among speech, voice, language, and communication. We viewed ourselves as so much more than “merely speech therapists”; in our minds, speech-language pathology was modern, comprehensive, research-based, client-centered, supportive, helpful, and necessary in many more important ways than “speech therapy” could ever have been.

But times change, and language changes, and somewhere along the way, as Scott (2025) and others have written, the word “pathology” began to feel medical and judgmental, rather than comprehensive and supportive. At this point, I think it is safe to say that its medical connotations have won whatever etymological battle might have been occurring. A pathologist, in current usage, is a person in a lab with a microscope figuring out exactly which version of which disease is causing which symptoms — or caused a patient’s death.

And if we played a word association game with the adjective “pathological,” would your immediate response be “liar”?

These are not the appropriate connotations for a human-centered, client-centered, communication-centered helping profession. I hope and assume that there must be committees at ASHA discussing the name of our profession. It’s well past time for an update to the 1976 statement declaring “speech-language pathologist” to be our “official title.”

That having been said… I will not be embracing Scott’s use of “Speech, Language, and Hearing Sciences” to refer to our client-centered application profession, in part because I use that phrase to refer to our supporting background discipline or to the separate non-clinical professions of speech, language, and/or hearing scientist. I am also not sure about “practitioners”; does that imply a “doing to” rather than my desired “doing with” (or in the good ways with only the best implications, the good version of “doing for”)? And is a practitioner an independent and creative professional, or would “practitioner” be better reserved for speech-language aides or assistants?

I do not know.

But Scott (2025) is absolutely right that we cannot use “speech-language pathology” too much longer.

And strangely enough, as I think about it, I find myself drawn back to “therapy” and “therapist,” the very words we were taught explicitly to avoid. Good therapy, and good therapists, when good therapy is done well by good therapists, are often exactly what is needed! The best therapy helps us see ourselves, and understand ourselves, and accept ourselves, and change things we need to change about ourselves, and move forward with confidence in our lives. What was so wrong with that?

I hope and believe that our profession is aiming for research-based, client-centered, culturally and individually appropriate caring, assistance, education, therapy, and public service about speech, language, voice, communication, and swallowing, not aiming to identify pathogens under a microscope. Does that make us carers, assisters, educators, therapists, and public servants?

Yes, and I absolutely agree with Scott (2025) that we need to find a better word for all that than “pathology.”

Anne Marcotte | April 2, 2025