23. The History of School Speech Pathology

Are School SLPs Stakeholders?

New Executive Director Dr. Kenneth Johnson had worked as an audiologist at the VA hospital in San Francisco.   He was known to be disciplined in his work and put effort into developing the organizational structures for ASHA. He set high standards for his professional staff.   During his tenure audiology gained definition and recognition. His leadership brought results:

Johnson, who directed ASHA’s national office from 1958 until his retirement in 1980, oversaw the organization during a period of enormous growth. During his 22 years at the helm, ASHA’s membership reached 37,000, a nearly tenfold increase. And, when he retired, the association and its staff of 75 were preparing to move into a spacious new headquarters in Rockville, MD, a far cry from the two rented rooms in Washington, DC, where he began his tenure”(http:// journals.lww.com/thehearingjournal). 

Man with cat

Capacity

Dr. Johnson had a big job ahead of him to change a fledgling organization into a fine-tuned system of national prominence and service to stakeholders. There was first the problem of

building capacity. Revenue prospects were enhanced by the thousands of potential public school dues-paying speech pathologists, something the founders understood and anticipated. There were potential products and services to be sold, and a promising foundation already in the works. Having an office building and staff would give support for coordination. Purchased public relations, legal consultation, advertising and technical services would ready the team. ASHA Magazine would yield membership communication and public brand-building.

Capacity could be expanded through the legal papers of non-profit organization and incorporation. This would create a board for oversight, the protection of professionals on the job, and liaison opportunities with government and private agencies. Non-profit status would allow ASHA to “partner” with similar organizations in the Washington sphere. The position of Executive Director established leadership and continuity.

Non-Profit Risks

Risks came with the new organization supplanting the old American Speech Correction Association.   Would the “national office” be able to bring along stakeholders to accept central planning and authority? The quality of the relationship between professors and clinicians would change, now mediated by an independent organization having legal foundations according to the government.  When the asha foundation was proposed in Iowa City to support stuttering interests, ASHA recommended broadening the charter to include all disorders. In 1930, there would be no disagreement. When audiology wanted more independence, negotiations dissuaded proactive members. When founders objected to requiring the master’s degree, their opinions were set aside.  When the movement toward the clinical doctorate arose, no special support was provided. When members on principle objected to swallowing practice, swallowing went through.  Dr. Johnson was a task master:

“Johnson was a man of firm convictions who did not shy away from controversy. Personally very disciplined, he also imposed strict standards on his staff, forbidding men to have facial hair and women to wear slacks. Employees could not take sick leave until they had been with ASHA for 5 years.”

Incapacity

Did the revamped ASHA organization use its significant capacity wisely? Money had not been a problem but setting the right priorities for diverse stakeholders was a challenge — swallowing, reading, clinical doctorates, building funds, sale of products, staff salaries, multiculturalism, faculty shortages, workloads, separated memberships, certification standards, student organization autonomy, gender bias. When groups wanted independence, it was not received well.   While capacity was large and growing, decision-making was still being tested as to the correct priorities for ASHA to follow.

“Capacity building is an ongoing problem faced by NPOs for a number of reasons. Most rely on external funding (government funds, grants from charitable foundations, direct donations) to maintain their operations and changes in these sources of revenue may influence the reliability or predictability with which the organization can hire and retain staff, sustain facilities, create programs, or maintain tax-exempt status…Resource mismanagement is a particular problem with NPOs because the employees are not accountable to anybody with a direct stake in the organization” (wiki).

Comment

If more than half the ASHA members were school speech-language pathology stakeholders, was this group a higher priority group? The historical answer is no. Not as much energy was put into it, many school SLPs would say. In fact, many school people felt ignored and viewed school practice as a lower Association priority.  SLPs faced crushing loads while being asked to take on reading intervention, a paradox which was impossible to understand as a practical matter.  It raised doubts about the capacity of central planners to sort out school issues and respond directly according to proper analysis of true circumstances. School opinions about scope of practice never sunk in among ASHA leaders, certainly not as an action imperative.

SLPs have been carrying ASHA for 100 years, even when it was too weak to survive. In the 1960s education ties brought in the funds and helped grow departments and associations. It provided the academic enrolments to justify departments which would otherwise would be dropped or merged. School SLPs were there to create linkage with the U. S. Department of Education.  School SLP jobs were mandated federally making ASHA revenue projections possible. Yet when IDEA came along, the organization showed little capacity to support school SLPs knowledgeably at a time when workloads and scope of practice were exploding. Leadership vision was needed but lacking. Adherence, come hell or high water, to the medical model and organizational activities, to once and for all, achieve the dreams of ASHA founders, blinded us from what was equally important.

The founders’ vision has never been the vision for school speech and language pathologists.

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