Section Four
Module 12: A Cultural History of Speech-Language Pathology
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What influences shaped our profession’s culture?
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After working with the material in this module, readers will be able to
Explain why speech-language pathology can be viewed as a culture
Describe the sequence of professional associations that led to the current American Speech-Language-Hearing Association
Describe how the identities and interests of our association’s founders have shaped our professional culture
Compare the terminology used at different times in our profession’s history to describe our profession’s primary goal
As speech-language pathologists, we have shared professional ancestors, a shared professional language, and shared professional tendencies, just as any other group of people might have. What happens when we think about our profession as a culture?
Every speech-language pathologist in the U.S. is an individual. We each bring our individual identities, languages, cultures, and experiences to our work. I have my knowledge, skills, families, dreams, and journeys, and I have my own answers when I use a 16 Questions matrix to think about any situation (see Modules 1 and 2). You have yours, and each of our classmates and colleagues have their own. We each approach our work in different ways, because we are different people.
At the same time, as fellow speech-language pathologists, we are also all part of the same group. We are recognizably speech-language pathologists, not astronauts or zoologists. Our group can be described as a group, using any of the definitions of groups or cultures we considered in Modules 1 and 2. We have explicitly stated group values (in the form of the ASHA Code of Ethics, among the other documents we discussed in Modules 3 and 4). We have a shared group knowledge base, and our group functions using behaviors that we assume to be necessary and that we explicitly teach to younger members of our community. And as this module and the rest of Section Four will explore, we have shared professional ancestors, a shared professional language, shared beliefs, and shared professional tendencies, just as any other group of people might have (from Module 2).
Let’s start by thinking about what we have named our group over time, and why, and why these few words matter.
Our Professional Association’s Names
The founding of our professional association is usually dated to 1925 (ASHA, n.d.), but an expanded version of our shared origin story begins much earlier, with the 1857 creation of the National Teachers Association.
The National Teachers Association was a professional organization, intended to “advance the dignity, respectability and usefulness” of the “calling” of public-school teaching (Holcomb, 2021), at a time when public-school teaching was relatively new and quickly expanding in the U.S. (see Module 11). It was also short-lived: Only 13 years later, in 1870, the National Teachers Association merged with the National Association of School Superintendents, the Central College Association, and the American Normal School Association. The large new organization took the name it still holds, the National Education Association (NEA).
The NEA, as you might already be aware, now has an extensive and continuing history. For close to 150 years, the NEA has worked not only to “promote professional excellence among educators” but also, much more broadly, to “advance the cause of public education... promote the health and welfare of children...... protect the rights of educational and other public employees and advance their interests and welfare... promote, support and defend public employees’ right to collective bargaining... [and] promote and protect human and civil rights” (NEA Constitution, 2023-2024, p. 1).
The NEA’s comprehensive breadth served an important role in the development of our own profession, because we are the result of a series of organizations with sequentially narrower interests.
First, in 1911, a small group split from the NEA to form the National Council of Teachers of English (NCTE), an organization intended to focus on the quality of high-school and college-level English education in particular. A few years later, in 1914, because of the emphasis within NCTE on reading and writing, another small group of professionals withdrew from NCTE, this time to create the National Association of Academic Teachers of Public Speaking.
Between 1914 and 1922, it became clear that the National Association of Academic Teachers of Public Speaking also addressed not only public speaking but also the closely related issues of rhetoric, persuasion, and criticism. A name change, in 1923, therefore converted the National Association of Academic Teachers of Public Speaking into the National Association of Teachers of Speech.
Notice that “speech,” for this group, was narrower than “high-school and college English education” (as addressed by NCTE) and certainly much narrower than “education” (as addressed by the NEA), but it still referred relatively broadly to everything involved in what you might call “giving a speech”; that is, the National Association of Teachers of Speech was interested in all aspects of conceptualizing, organizing, crafting, and then presenting persuasive, critical, entertaining, and other forms of spoken language. At that time, public speaking also still included a significant emphasis on the oratorical styles and gestures that had been critical before the widespread use of microphones.
The further narrowing that is often described as the beginning of our own professional organization occurred two years later, based in part on the work referred to as “speech correction” that had been occurring in some large school districts since approximately 1900 (see Moore & Kester, 1953). Specifically, in 1925, a small group of professionals withdrew from the National Association of Teachers of Speech to pursue their interests not in rhetoric, persuasion, criticism, and public speaking (and not in any of the other larger political, sociological, educational, and/or language-related topics that the NEA and NCTE addressed), but in speaking or speech as an individual motoric skill or behavior.
The new group named itself the American Academy of Speech Correction, introducing to this lineage the two defining features that distinguish our profession from our predecessors:
(a) the conceptualization of speech as a person’s physiological, motoric, or motoric-linguistic action, rather than as a piece of rhetoric or public persuasion;
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(b) a focus on the characteristics of an individual speaker’s anatomy, physiology, motor-speech, and motor-linguistic behaviors that might be considered correct, incorrect, or in need of correction.
The word “correction” disappeared from our name temporarily 2 years later, in 1927, when our new organization renamed itself the American Society for the Study of Disorders of Speech. But the emphasis on correcting the speech or voice behaviors of individual speakers endured, and the group renamed itself again in 1934, this time becoming the American Speech Correction Association. Thirteen years later, in 1947, the word “correction” was permanently removed, and the important interactions between hearing and speech were explicitly recognized, creating the American Speech and Hearing Association and leading to the ASHA acronym that we still use (ASHA, n.d., History; Duchan, 2002; Moore & Kester, 1953).
Our professional organization kept the American Speech and Hearing Association name for 31 years, before one more name change and one related event occurred in relatively quick succession.
First, the importance of an individual’s skills in the content, form, and use of language, and our improved scientific understanding of distinctions between speech (as a neurophysiological and motoric act performed by an individual) and language (as a neurocognitively-mediated symbol system used by an individual to create and exchange meaning, often but not necessarily realized through speech), were explicitly recognized in our association’s name in 1978; this was the change that created our current name, the American Speech-Language-Hearing Association.
Second, and not unrelated, a group of 32 audiologists created the separate American Academy of Audiology (AAA) in 1988, withdrawing from ASHA and/or creating their own organization because they sought a disciplinary and professional organization focused on their interests in hearing, balance, and the science and practice of audiology, not on hearing as an adjunct to speech and language.
ASHA and AAA have now existed in parallel for close to 40 years, and both continue to serve their members and other stakeholders in many ways. The NEA, NCTE, and the National Communication Association, the current name of the previous National Association of Teachers of Speech, all remain active professional organizations, as well.
Your Turn
What meaning should we attach to the disappearance and reappearance from our professional organization’s name over time of the word “correction” or to the short-lived use of the word “disorders” in our association’s name? What meaning should we attach to the lack of either word in our current name?
Try using this website’s basic emphases on group-based cultures, individual identities, and dimensions and continua to think about this history of progressively more focused professional organizations. Which group-based tendencies did which associations demonstrate? Which defining dimensions or continua mattered to whom when, and which parts of those continua were judged to be preferred or inadequate by whom?
Our Professional Ancestors’ Cultures and Identities
Let’s think about some implications of our professional origin story.
Imagine for a moment that you are one of 25 people who have chosen to withdraw from a larger organization, of which you were all already members, to form a new organization of your own. Your new organization would almost certainly have what we can refer to as a culture, or group-based assumptions, group-level values, and group-level actions (as Module 1 addressed for any group). Each member as an individual would also bring their own identities, values, preferences, and strengths. Might these individual characteristics, combined with the shared interests that had driven the formation of your new organization, probably influence the work that your new group would do and also continue to influence the later membership and actions of your organization through time? Yes, of course they would – and that is exactly what has happened for ASHA.
Consider, for example, the fact that our 25 original professional ancestors were already members of an existing national professional organization for teacher-leaders. This aspect of the group meant that they were all highly educated professionals, at a time when fewer than 10% of Americans had earned a bachelor’s degree (National Center for Education Statistics Table 104.20). Indeed, 13 of the 25 original members of the American Academy of Speech Correction were associated with a college or university, and seven were agency-level or state-level administrators of speech correction programs (Duchan, 2002; Duchan & Hewitt, 2023). The organization they created, not inevitably but certainly predictably, required its members to hold extensive clinical and scholarly credentials, a general approach to association membership that has not changed (see Bernthal, 2007). ASHA remains an organization for professionals that emphasizes stringent educational and practice-related requirements for membership, certification of individuals, and accreditation of educational programs (ASHA, 2023; Council on Academic Accreditation, 2023).
Note, also, that the original 25 people were members of a national association for teachers of public speaking, in particular. You might have read other histories that emphasized other precursors or contributors to our discipline’s development: the development of amplification and other hearing- and speech-science technologies during the late 19th and early 20th centuries, the hearing- and communication-related needs of soldiers and veterans after World War I (see McIlwain et al., 2008), or the existence from 1918 to 1939 of a separate association for early “speech correctionists” who were working exclusively with children and exclusively in public schools (Duchan, 2002). All of those elements unquestionably contributed to our discipline and to our professions.
Despite those other elements, however, the original association that became ASHA was created by college faculty and program-level administrators who had been connected to education and who were interested in speaking as an individual behavior, with a focus on “correct” ways of speaking. They left the National Association of Teachers of Speech because they were less interested in education, politics, advocacy, rhetoric, persuasion, language, or communication in its broadest sense. They were interested in the speech itself, as a skill or behavior worth studying in its own right, not necessarily interested in the complete lived experiences of the people who were doing the speaking. These shared interests and emphases were reflected in our association’s name until 1978 (“speech,” but not “language”); are still reflected in our association’s current name (“speech” and “language,” but not “speakers” or “communication”); were part of why the founding members of AAA in 1988 felt that ASHA was not meeting the needs of audiology or audiologists; and still shape much of our association’s culture and focus.
It is also noteworthy, in several ways, that only 15 of the 25 people who formed the association that would become ASHA were women. Teaching had become a distinctly “feminized” (Strober & Lanford, 1986) profession in the U.S. by the beginning of the 20th century, and, in contrast to our 15:10 ratio, the parallel organization to ASHA in the United Kingdom was founded in 1945 by 18 women. In many ways, therefore, our original organization, a splinter group of nationally-active teacher-leaders interested in speech, included from its inception the disproportionate representation of men in leadership roles that has continued to characterize our association.
As Rogus-Pulia et al. (2018) highlighted, the approximately 5-8% of men in our currently almost completely “feminized” profession hold at least 20% of the research doctoral degrees, hold close to 30% of the academic department-chair positions, and received 62% of the Honors of the Association awards from 1940 through 2015. Some of these numbers are changing (see the lists of 2023 and 2024 ASHA awardees), but overall we as speech-language pathologists in the U.S. seem to have inherited from our 25 original members a continuing professional culture within which women, in general, serve as clinicians or possibly as clinical faculty members while men often serve as professors, department chairs, researchers, and recipients of such recognitions as Fellowship or the Honors of the Association.
Finally, let’s address one more cultural and identity-based feature of our professional ancestors: They were all White, and most of them lived and worked in the northeast or the upper Midwest (in states that are still important to our field, including Wisconsin, Michigan, Minnesota, and Illinois, among others; see the biographies published as supplemental material with Duchan & Hewitt, 2023). The remaining five were from California, Hawaii, Iowa, and Missouri. None of them were from the Spanish-speaking areas of the southwest. None were from the southeastern states where speech, language, and social-communication patterns are influenced by Southern regional dialects, African American cultural dialects, and the social and economic issues of the American South. And none of them were scholars of the relationships among the speech, language, social, health, and economic issues shared by (or imposed on) people from Native American or Alaska Native backgrounds.
I am also going to emphasize here, with a more positive emphasis than many previous articles and chapters about our profession’s history have adopted (e.g., see Duchan & Hewitt, 2023; Holt, 2022; St. Pierre & St. Pierre, 2018), that there is nothing inherently or necessarily wrong with an association of highly educated, English speaking, White people in the northeast who are interested in the speech behaviors of individual people. Many of you reading this module are probably highly educated, English speaking, White persons in the northeast who are interested in the speech behaviors of individual people. You are neither better nor worse as human beings, on the basis of these characteristics, than you would be if you had completed less formal education, spoke any language other than English, were not White, lived anywhere other than the northeast, and/or were more interested in public education, sociology, political communication, or mass media. As we started Modules 1 and 2 by recognizing, and as essentially all materials about cultures and identities emphasize, one of the most important points in considering culturally and individually appropriate work, in speech-language pathology or anywhere else, must be that no group, culture, or individual can reasonably be ranked as better or worse than any other on the basis of their identities. We begin, in other words, by explicitly recognizing and then also respecting every group’s tendencies and every individual’s identities, including those of our original 25 founders.
Some of the most important potential problems for our profession, however, relate to the next step: We are required, as a group of communication-focused professionals, not only to recognize and respect cultural and individual characteristics but also to respond appropriately. Let’s continue to explore not just our culture and our identities, as an association and as a profession, but the words and the actions that have defined our profession.
Your Turn
The National Education Association, our original ancestor organization, currently describes itself as “more than 3 million people—educators, students, activists, workers, parents, neighbors, friends” (https://www.nea.org/about-nea). Current ASHA members include approximately 14,000 audiologists and approximately 206,000 speech-language pathologists (https://www.asha.org/siteassets/surveys/2023-member-affiliate-profile.pdf). What are the advantages and the disadvantages of smaller, focused organizations or organizations intended for credentialed professionals versus larger, inclusive organizations intended for all persons with any interest in a topic or in a profession’s work?
The previous National Association of Teachers of Speech, our immediate parent organization, is now known as the National Communication Association. It addresses the “modes, media, and consequences of communication through humanistic, social scientific, and aesthetic inquiry.... foster[s] and promot[es] free and ethical communication, [and] promotes the widespread appreciation of the importance of communication in public and private life” (https://www.natcom.org/about-nca/what-nca). How might the history and the continuing journey of speech-language pathology have differed, if we had remained within an organization that embraces and studies these broader realms of media, ethics, and public communications?
ASHA appears to have developed a group-level belief that something “needs to be done” about the “scarcity” of men in our field (Maier, 2013; see also Lindsay & Kolne, 2023, and the comments of the 2025 President of ASHA, Bernadette Mayfield-Clarke, as presented in Murray Law, 2025). The Royal College of Speech Language Therapists, while similarly seeking to attract more men into the profession, has also occasionally framed similar numbers from the other direction, including by choosing to “celebrate our place as a strong, female-led profession” (https://www.rcslt.org/about-us/history/#section-6). Do you agree or disagree with either of these interpretations of our profession’s demographic facts? Why? How might people’s interpretations of this kind of data shape the actions and therefore the future culture of an organization?
Our Professional Terminology: Our History of “Correcting Speech Defects”
Our professional association and our professional ancestors focused originally on the “elimination and correction of speech defects” (ASHA, n.d., from 1925), a phrase that may sound distinctly negative to today’s ears (see, e.g., Duchan & Hewitt, 2023). Let’s grant ourselves an etymological detour about both “defect” and “correction,” just as we took the time to explore the word “stereotype” in Module 9.
Defects, Deficits, Disorders, Conditions, and Differences
In the early 1900s, as our ancestors were attempting to differentiate our field from public speaking, rhetoric, and mass communication, the word “defect” was common, becoming increasingly common [as shown in the Oxford English Dictionary (OED, 2023) Frequency Estimates], and used in many situations. The OED’s citations of the noun “defect,” and other examples of its use from the 1600s and well into the 1900s, show that it could refer to a wide range of concerns with humans, animals, plants, materials, perceptions, or experiences. Eleven of the 16 articles in the first volume of our first journal (the Journal of Speech Disorders, 1936) used the word “defect” to refer to specific speech conditions (such as stuttering or cleft palate), or to refer generally to “speech defects” as a large set of possible problems with what we today might refer to as an individual’s skills or abilities in speech production or in expressive or receptive language.
As our professional organization was forming, in other words, “speech defect” summarized a wide range of possible issues, differentiating the interests of our new organization and its members from those of their parent organizations by using words that were common at the time (see St. Pierre & St. Pierre, 2018) and that were interpreted as referring to a much larger range of possibilities than “defect” implies today.
By the middle of the 20th century, however, the connotations of “defect” had shifted to those we recognize as readers of the 21st century: a problematic flaw, usually a physical flaw, or perhaps an anatomical anomaly such as a “congenital heart defect.” ASHA’s journals reflect this change in the implications of “defect” through both a strikingly sudden decrease in the word’s use after 1974 and a corresponding increase in the word “deficit” during the 1980s (both patterns also appear in the OED’s more general usage estimates). “Deficit” is a relatively new word in English (its first OED citation is from 1782), and it originally referred in a relatively neutral way to anything that was not present; thus, authors and speakers in the middle or late 20th century who were trying to avoid the increasingly negative and increasingly physical connotations of “defect” would have been drawn to “deficit” as a more neutral and more figurative word.
“Deficit” in general English peaked at about 1990 (in the OED’s Frequency Estimates, and probably because of widespread economic circumstances at the time), but it continues to be used in our field and others. The connotations implied by “deficit” have also become more specific and more negative over time, as had previously occurred with “defect.” Thus, “deficit” currently carries a distinct implication of “less than” or “not enough”; a deficit occurs when something is less than desired, less than expected, or less than there used to be. Recent ASHA journal articles (2023 and 2024) provide many examples: We currently refer to deficits in working memory, language comprehension deficits in children, cognitive-communication deficits after traumatic brain injury, the writing deficits that characterize dysgraphia, and, of course, “attention-deficit disorder.”
Interesting examples!
What is happening in the phrase “attention-deficit disorder”?
As this usage exemplifies, we still use “deficit” in specific applications. The word currently refers to a specific skill that has been judged to be low or missing, and it definitely expresses the “less than” or “not enough” implication. The word “deficit” did not entirely replace all earlier uses of “defect,” however; remember that “defect” had been both a specific label and also an overall or umbrella term.
As “attention-deficit disorder” demonstrates, “deficit” has maintained its specific implication of “less than,” in our current terminology, while “disorder” has come to be used to refer to a problematic or undesired difference in skills, abilities, or function, both in specific applications and in general references to a class or category.
But “disorder” is actually an old word, both in English generally and in our profession specifically.
Its original senses were close to the related term “disarray” or to the formal phrase “disorderly conduct.” The Oxford English Dictionary provides citations from the mid 1500s showing the use of “disorder” to refer generally to any problem with human physical, psychological, or other function, and it appeared in 2 of the 16 articles in the first volume of the Journal of Speech Disorders in 1936. Over time, “disorder” has maintained the most general connotations, as compared with “defect” or “deficit”; thus, “disorder” currently refers to any negatively-interpreted health-related problem or trouble with physiological functioning that the person using the word does not attribute to simple personal variability or benign intra-group difference.
From another direction and for other reasons, “disorder” has also come to be used in a way that means roughly that something is in the same territory as some diseases but is not itself a disease. Thus, our use of the word “disorder” often assumes and implies that some problems with function (the disorders) either stem from but are not themselves, or cannot easily be attributed to, internal systemic issues or external infections (as some, but not all, diseases can; see Pies, 2023).
In this rather complex linguistic, historical, social, and medically-tinged context, ASHA has currently settled on the word “disorder” to describe our profession. Thus, speech-language pathologists are described as focusing on “speech, language, and swallowing disorders” (https://www.asha.org/about/), which are in turn further divided into categories including speech sound disorders (and then articulation disorders and phonological disorders), fluency disorders, and voice and resonance disorders, among others.
As you think about our profession’s past and present terminology, however, are you also uncomfortable, as a reader of the mid 2020s, with both “deficit” and “disorder”? Just as no current author or clinician would refer to a group of people as “the speech defectives” (as Fruewald, 1936, did, in the first issue of the Journal of Speech Disorders), many current professionals avoid both the word “deficit” and the word “disorder,” for many reasons. The word “condition” has become one common alternative, often intended to serve as a neutrally framed alternative to “disorder” that seeks to describe the presence of certain features or abilities but without imposing the negative judgment that might be implied by the label “disorder.”
But be careful! In this sense, even the word “condition” carries negative connotations and labels a person as somehow different from an assumed norm or an assumed goal state. We would never describe children who produce all phonemes the same way we do as having an “accurate articulation condition,” and, as many wry commenters have noted, calling it a heart condition, rather than a heart defect or heart disease, does not change its underlying reality. And many questions remain, as we think about the words that we inherited from our ancestors or have decided to use instead!
Your Turn
Think about the terminology from this section: defects, deficits, disorders, and conditions. Do you use any of these words to refer to speech and language abilities as categories, to refer to any particular subset or type of speech or language abilities, or as any other part of your work? Why do you use the term or terms that you use, or why do you avoid all of these terms? Are you aware of having been taught about this cultural terminology explicitly, or did you absorb your beliefs from our professional culture implicitly?
The word “difference” might have belonged in this section also, as a potential descriptor for a set of features or abilities. When do you use the word “different”? Were you taught that differences are not disorders? Is it true that (all) differences are not disorders? If not, which differences are disorders — or, if you do not use the word “disorders,” which differences are problematic to whom and/or need to be changed, and why?
Elimination, Correction, Treatment, Management, and Support
Let’s also think about the terminology our profession has used, and currently uses, for the professional actions that we take after we have identified a state or a trait that we consider to be a deficit, a disorder, or otherwise a potentially problematic condition, situation, or ability.
Our professional ancestors used the words “elimination and correction” to describe their professional goals. Do these words sound as rough and old-fashioned to your ears as “defects” and “deficits” sounded? They might, but “correction” remained common in our field for decades. Journal articles and published commentaries referred to “speech correction programs,” “speech correction in the public schools,” and “progress in speech correction” well into the 1970s, and as late as approximately 1980, before this word faded from our profession’s publications.
Currently, well into the 2020s, we use different words than our ancestors used. We tend to draw on terms such as prevent, screen, assess, identify, diagnose, treat, and manage (see ASHA, 2016), rather than describing ourselves as focused on “correction” or “elimination” of any disorder or condition. We also describe ourselves as providing “education, guidance, and support”; counseling clients and families about “acceptance, adaptation, and decision making”; and working to “empower the individual and family to make informed decisions related to communication or feeding and swallowing issues” (also from our Scope of Practice; ASHA, 2016).
Our current professional emphases also include developing straightforward descriptions of clients’ existing behaviors, skills, and abilities, not of their deficits; that is, we focus on what people do and on what they can do, using neutral descriptors, and using positive or at least neutral interpretations, wherever possible (Braun et al., 2017). We describe ourselves as scaffolding clients’ learning, not as eliminating their defects. We select supportive or errorless-learning approaches, and we emphasize strengths-based approaches when we do feel the need to intervene. Dolquist and Munson (2024) even called on us recently to be working toward developing “a palette of transmasculine voices,” terminology and actions that our ancestors almost certainly would not have understood, much less written.
Are you convinced?
Do these words and actions feel gentler to you than the original “correct” and “eliminate,” possibly in a way that satisfies you that our profession has made some necessary and positive changes during its 100-year history?
Or are you reading this segment from a place of frustration, opposition, or even anger about some of the fundamentally judgmental, ableist, elitist, sexist, racist, and otherwise discriminatory aspects that continue to define our entire profession and our actions, regardless of the words we use (see Duchan & Hewitt, 2023; Yu, Nair, et al. 2022)?
One of the many complexities that mark our professional culture, as many scholars in our profession have emphasized (see Duchan & Hewitt, 2023; Holt, 2022; St. Pierre & St. Pierre, 2018; Yu, Nair, et al. 2022), is that the entire underlying shared, presumed, or cultural basis of our profession, and most of our shared assumptions as a group, continue to focus on some form of our professional ancestors’ original desire to “correct” and to “eliminate” certain types of speech and language.
Whether we call it management, treatment, correction, or support, our profession’s shared, group-level, and overall goal often remains to change something about another human being.
So here is the next question:
Is your interpretation of this fact about our profession’s goals and associated actions positive or negative?
Some change is wonderful, fun, exciting, energizing, or necessary. Vacations, new clothes, new haircuts, new friends, re-organizing the garage — all good! Repairing something that needed to be repaired, or even “eliminating” something that needed to be eliminated, tends to make us feel good, as well, from a quick super-glue fix for a fingernail to a years-long labor of love eliminating rust as we repair and restore a classic car. With respect to human speech and language, examples along the lines of surgically repairing orofacial injuries after a car accident, introducing an AAC system for a child who needs it, or helping an adult to re-learn or to develop different communication skills after a head injury might strike most of us as necessary and important changes or corrections. Changes and corrections are not inherently bad.
A positive view of our profession’s history, similarly, might start by recognizing that the possibility of correcting anything about the structure or function of the human body, or about educational, vocational, or health-related opportunities for individuals or for groups, would have felt exciting, optimistic, and modern in the famously “roaring” 1920s.
Picture the time: Growth had been occurring in finance, industry, music, and many other aspects of American life since the end of World War I. Approximately half of homes already had electric power, and that number was growing. Basic public health developments such as dependable public sanitation systems were relatively new and expanding. The growth of public education for White children, and the strength of many schools for African American children and others (see Module 11), were resulting in steadily increasing literacy rates. For our field more specifically, major advances in anesthesia and in surgical and nursing knowledge had allowed major advances in cleft palate surgeries, a change that introduced the distinction we now take for granted between obligatory speech and resonance characteristics and potentially changeable compensatory characteristics. New technologies were allowing major gains in our understanding of voice production, speech physiology and acoustics, and related topics; similarly, the new discipline of psychology was advancing our understanding of behavior, behavior change, and the role of emotions in human lives.
Against this backdrop, the possibility of being able to help individuals develop their speech and language abilities could have been seen as a new, exciting, and purely positive modern development.
From one point of view, then, our profession’s original goal of correction or change might be distinctly positive, laudable, forward-thinking, client-centered, caring, helpful, supportive, desired, and necessary. You can imagine, I am sure, many management or treatment actions on your part that you would intend to be kind, helpful, and client-centered and that the client and the family would, in fact, perceive as caring, supportive, and desired.
From another point of view, however, as critical scholars of our field emphasize, “fixing” something that was never “broken” in the first place is completely different. Why did our professional ancestors start by assuming that anyone’s speech or language needed to be changed? Were their guiding assumptions genuinely positive, laudable, forward-thinking, client-centered, caring, helpful, and supportive? And do we remain truly focused, in our current professional culture, on suggesting or implementing changes that we intend to be caring, helping, valuing, including, guiding, empowering, and supporting?
As I mentioned above about our professional ancestors, my views of our profession’s founding assumptions and continuing goals are not quite as negative as the views some other authors have expressed (e.g., Duchan & Hewitt, 2023; Holt, 2022; St. Pierre & St. Pierre, 2018). I do join our profession’s critics, however, in questioning not only our terminology but also the underlying assumptions that our terminology reveals and some of the professional actions that our terms and assumptions lead us to take.
And even more important than my views are your views.
How does your view of your profession’s history, culture, and goals shape your present and future work?
It’s an important question, so let’s keep going! The next two modules address our professional culture’s assumptions or underlying beliefs (Module 13) and then address the actions that seem to constitute the shared and culturally accepted behaviors of speech-language pathology (Module 14).
Your Turn
Discuss the connotations you feel from the terminology discussed in this segment: elimination, correction, prevention, assessment, treatment, management, inclusion, support, or care. Are these positive or negative words to you? Why, or under what circumstances? If you see a word as positive or negative, can you imagine a life journey that would have led someone else to perceive that word differently? If you were from, with, in, or for something else (our 16 Questions matrix, Module 2), might a word you perceive as negative strike you as positive, or vice versa? How do our personal identities and experiences influence our relationships with our profession’s terminology?
Highlight Questions for Module 12
Think about the sequence of professional associations that led to our current American Speech-Language-Hearing Association, and think about what you believe to be the strengths of our current professional culture. Did our profession’s current cultural strengths develop because of the emphases of the many professional associations that are part of our professional history, or in spite of them, or for some other reasons?
Several articles about our professional history have been much more critical of ASHA’s founders than this module was (e.g., Duchan & Hewitt, 2023; Holt, 2022; St. Pierre & St. Pierre, 2018). Read one of these articles and discuss its premises, its data, its logic, and its conclusions. What value do you see in criticizing past groups, and why?
Revisit the terminology discussed in this module and that has been used to describe our profession (including defect, disorder, elimination, correction, prevention, inclusion, support, care, and related terms). For each term, think of a use or an implication that you perceive as positive and also a use or an implication that you perceive as negative. What makes any action, or any description of that action, positive or negative?
Find and read a current article about our professional culture. Evaluate its terminology, and evaluate your reactions both to the terminology itself and to the ideas those terms represent. How do you respond to sentences like “Our critical inquiry stance that is guided by our continuous reflection and action can simultaneously disrupt the objectified, bound, and idealized standard of observable linguistic competence, as well as decenter the dominant perspective that frames who is constructed as the racialized, disabled, less competent, linguistically variable “Other” in languaging exchanges” (Brea-Spahn & Bauler, 2023, p. 684)? Would you have responded differently if Brea-Spahn and Bauler had phrased the same points using different words?