School “Speech-Language Pathology” vs. “Speech Therapy”

As we have pointed out in a prior post, more often web authors use “speech therapy” to refer to speech-language pathology.   The following search hit rates were presented:

Speech therapy—–8,320,000

Speech pathology—–1,222,000

Speech-language pathology—–943,000

Speech therapy reflects medical- diagnostic and programmatic thinking rather than scientific.  The speech therapy era effectively ended in 1960 when the field of communication disorders experienced a burst of scientific activity and moved toward language foundations.

A Parallels Universe exists.   For example, across clinical service domains phonology, articulation and oral motor training are regarded as separate treatment foci.  Hence, theory integration is being held back by the misuse of terminology.

A lack of integration is also blocking the proper growth of “educational speech-language pathology,” wherein hybrid school criteria are developing for special education placement and intervention models tied to IDEA 2004.

“Speech therapy” notions are not suitable for school settings.  The most obvious failing is that modern language theory is excluded and there is no concern for the overidentification of  non-disabled minority children and the stigma of going to “speech therapy” as a factor in high school success.

More subtle are the effects of social expectations for types of treatment.  Those who speak of “speech therapy” come to expect oral-motor practice and sound-by-sound content, i.e. “bottom up” methods.  Administrators and teachers believe they know what good “speech therapists” do.  They anticipate seeing “therapists” in a small room guiding clients to produce sounds accurately.  Administrators advertise for “speech therapist”   employment.  State and federal government documents mention “speech therapy.”

Mr. Chang, swan-goose and friend, Lakeside, Arizona

Needless fragmentation of the discipline occurs when “Speech Therapy” holds sway over “Speech-Language Pathology.”

Post Script

A reader writes in to provide this experience:

“Our school district’s IEP computer based program defaults to Speech Therapist. After many requests the tech dept added Speech Pathologist. Getting close aren’t we? Now I am trying to get the original request of Speech/Language Pathologist. I have to routinely go into this computer based program and change Speech Therapist to Speech/Language Pathologist.”

Update

We have since noticed that 11,900,000 pages are  found for “MEDICAL SPEECH PATHOLOGY.”  A further sign of fragmentation of the field of speech-language pathology?

Another interpretation is the field is naturally evolving with sub-specialties whose missions are tied to unique contexts, thereby stretching “one-size-fits-all” certification pushed forward from the 1930s.  Is the medical model obsolete?  Or is it perfect for “medical speech pathology” and imperfect for school speech-language pathology?

What kinds of organizational structure is needed to accommodate expanded  knowledge, policy formation, standards and communication?  Does the non-profit model under a single umbrella function to support mature  growth in the school setting?  Does  the pattern of conflicting terminology reflect a breakdown in the model?

July 2012 update

One of our most popular posts.  It  is more than just a terminology issue.

Dr. John Muma adds a scientific perspective to the problem (ASHA Leader, June 5 2012).  Whereas academic programs have settled on “communication disorders” to refer to the specialty, ASHA continues to cling to an “arcane” modalities approach.  Language theory makes this approach obsolete.  “Just as professionals are charged by the ASHA Code of Ethics to be up to date with developments in the field, the professional association (ASHA) should also reflect an up-to-date perspective.”

 http://journals.asha.org/misc/ifora.dtl#mission

Dr. Muma’s comment is confirmed looking at ASHA’s research mission statement:

“ASHA’s mission is to promote the interests of and provide the highest quality services for professionals in audiology, speech-language pathology, and speech and hearing science, and to advocate for people with communication disabilities. To help fulfill our mission and support science and research in the discipline of communication disorders, we publish four peer-reviewed scholarly journals” (my emphasis).

School speech pathology is buried another level down in “speech-language pathology.”

The more one passes this topic, the more one wants to ask, “Who’s in charge of ASHA to fix these things?  Doesn’t this confuse our publics?”

http://journals.asha.org/misc/ifora.dtl#mission

Mission Statement

ASHA’s mission statement   places emphasis on communication:

“Empowering and supporting speech-language pathologists, audiologists, speech, language and hearing scientists by:

Advocating on behalf of persons with communication and related disorders;

Advocating communication science;

Promoting effective human communication.”

Sloppy Administration

Another explanation of a confusing and obsolete  professional nomenclature as promulgated by the American Speech-Language-Hearing Association is sloppy management of ASHA information systems, especially on the ASHA website.  There should be a clear  and valid conceptual model for professional programs and terminology, and consistent usage across all platforms of public communication.

In May of 2012 at the ASHA Board meeting a proposal which would strengthen the medical outlook was made and approved:

“A group of members, who are board-recognized swallowing specialists, asked the Board to consider changing ASHA’s mission statement to include swallowing. President Chabon led the Board in a discussion concerning altering the mission statement. Following discussion, it was decided that ASHA should consider adding the words swallowing and balance to ASHA’s mission statement, while maintaining the original sense of the mission. A team, including Vice President for Planning Barbara Moore and ASHA staff, will draft language for the Board to discuss at a future meeting.”

This provides more evidence of how terminology is fractionated as Dr. Muma’s model predicts.  When medical thinking is elevated as a mission focus we are keenly aware of how school practice languishes in the backwaters of the field.

June, 2014 Update

In 2011 ASHA held a summit meeting on “Clarifying and Promoting the Regulation of Clearly Differentiated Provider Roles.” The panel came up with this proposal:

“To address the misunderstanding and misalignments that can result from the lack of a shared nomenclature,
ASHA should develop (or revise) and publish a lexicon for the field of speech-language pathology. Where
necessary, the lexicon may acknowledge the range of terms now in use, but the intent should be to promote
a shared vocabulary…”

Will this amount to talk and no action? That is a typical ASHA response to membership concerns.

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