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Editorial: Reforming American Speech-Language Pathology Programs

Panagos, John M. PhD

doi: 10.1097/01.HJ.0000418993.10436.c2

Dr. Panagos is professor emeritus at Wayne State University in Detroit, MI.

American school speech-language pathology should be a separate division of the American Speech-Language-Hearing-Association, or even a separate organization like the National Association of School Nurses. A historic bias favoring medical speech pathology must be addressed to align ASHA's mission with contemporary school practice. The aim should be to improve budget accountability, organizational focus, content relevance, academic preparation and public relations. More than half of ASHA's membership is school based.

School speech correction flourished from 1905 to 1930 with academic programs, professional meetings, and research. The National Society for the Study and Correction of Speech Disorders held meetings until things changed in 1925. A small group of speech professors took control of speech correction to enhance their academic programs, forming the American Academy of Speech Correction. The academy struggled, its members realizing in 1930 that they needed speech correction teachers to build programs and generate income. Bylaws were written to exclude teachers in AASC leadership roles, and the medical model became the basis for clinical training.

New revenue funded costly programs in research, hospital speech pathology, speech science, and audiology. Exotic courses were offered in cerebral palsy, tongue thrusting, cleft palates, and swallowing. Audiology developed because school trainees enrolled in campus programs. ASHA directors sought to control certification and accreditation, effectively establishing a national training cartel, and investment in school practice was meager by comparison. Forty years elapsed, and by 1970 ASHA established a small school office and a modest school publication.

An epistemological smash-up occurred in 1975. The medical bias was exposed when Public Law 94-142 (Individuals with Disabilities Education Act [IDEA]) was enacted. (See FastLinks.) No unique vision for the future of school speech pathology existed, and a failure to grasp the broad implications for the changing legal role of school speech pathologists was evident. ASHA regarded IDEA for 20 years as involving only technical issues (e.g., workload, paperwork). Collaboration continued to be communicated as a good notion, but IDEA had made it obligatory. Least restrictive environment had no effect whatsoever on the overuse of pull-out intervention. Cultural and linguistic variation was taken as enrichment material rather than being considered necessary for decision-making. Literacy took its place as a language subtopic in the scope of practice document.

Looking at the NASN and the National Association of School Psychologists enables us to think outside the box. NASN broke away from education to form a nimble and well focused national organization with a mission specifically adapted to school issues. NASN is a full-service organization operating on a relatively small budget. Membership dues are reasonable. A division of school speech and language pathology would push ASHA reform forward. The aim would be to improve budget accountability, organizational focus, content relevance, academic preparation, and public relations. Otherwise, it is not a bad idea to form a separate organization like NASN to get the job done.

© 2012 Lippincott Williams & Wilkins, Inc.