27. The History of School Speech Pathology

1980

One can say in 1980 there was the Perfect Storm of converging factors.  There was compulsory education laws dating back to 1918.  There was civil rights movement, parent advocacy, and Public Law 94-142. Disadvantaged, bilingual, handicapped and minority children by way of Child Find arrived at SLP doorsteps. Public Law 94-142 changed the substance of practice from medical to educational, from autonomous to legal, from organizational simplicity to mind-busting complexity, under strict supervision of appointed administrators with the responsibility of ensuring accountability to the new law. 

In 1995, the California Speech and Hearing Association published a paper on controlling caseloads.  For the times it summed up issues nicely:

“In California there is a growing concern among speech-language pathologists (SLPs) employed in the public schools about the number of students assigned to them for services. This concern is magnified by the increasingly complex communication disorders presented by many of the students assigned. Caseload data are beginning to reflect a trend toward fewer children being identified as having a speech-language disability (ASHA, 1992). This is not surprising when we consider advanced medical technology which impacts survival rates among pre-mature infants who are at risk for normal communication development, as well as the detrimental effects of substance abuse. There are the additional challenges of cultural and linguistically diverse student populations; single parents, working with little time for family responsibilities; changes in service delivery models; revisions of eligibility criteria for services; expansion of age groups, including pre-school and even infants and toddlers; multi-disciplinary conferences; paperwork which may now include tracking Medicaid and health insurance reimbursement; and meeting the many responsibilities involved in comprehensive service delivery. Add to this economic constraints, budget cuts, personnel shortages, and overall downsizing of government programs. There is no doubt that professionals in California, particularly those working in the public schools where caseloads are the highest (1992 Omnibus Survey, ASHA, August 1992, p. 61), are dealing with increasingly complex service delivery issues.”

http://www.csha.org/documents/positionpapers/caseloads_language_speech.htm

Preparation

In 1977, just two years after the law, Jeffery Zettel delivered a paper on the impact on education. He isolated 10 critical issues and indicated a …“massive need for preservice and inservice training of professional staff.”  Grants were being authorized to train personnel at all levels, from higher education to local. Washington was buzzing with news, and ASHA had offices in Washington. Consistent with Johnson’s Great Society programs, additional funding had started in the 1960 to help disadvantaged children in schools. There were lots of signs! 

http://www.eric.ed.gov:80/PDFS/ED140554.pdf

Response

From the little we know ASHA was caught flat-footed.  It was lacking neither money nor structure. Then Director Dr. Frederich Spahr looking back had this perspective:

“There have been big changes also in speech-language pathology in the schools. When I first began at ASHA almost 90% of the caseloads of school-based clinicians were made up of children with articulation disorders. Today 90% of their caseloads are children with language-based disorders. This change is owing to the foresight of leaders in the late 1970s and early 1980s who recognized that the education and training of speech pathologists (as they were known then) would allow us to deal with issues related to language and language training in children…” http:www.asha.org/Publications/leader2003/031007 /03100 e.htm

The Founders’ medical model, one-size-fits-all thinking, could no longer be sustained without denial.  It was more than language.  A whole different approach was needed quickly.  

In the same period the national office was suffering from internal conflict and inflexibility, according to Dr. Spahr.  A consultant was hired to help senior managers work together.  They had personal agendas.  “One of the problems was that we had these silos – fiefdoms – that had developed and had to be eliminated,” Spahr recalls. “We needed a different way of operating.”

http://www.winningworkplaces.org/library/success/outspoken.php

 

At the same time senior managers were not open to women in key roles, and to multicultural perspectives.  When ASHA needed to be nimble and demonstrative on behalf of school speech-language pathology hit by special education changes, the phantom visions of the original founders were still being played out in ways limiting program development.

Comment 

Haunting the history of our profession are the speech correction teachers of 1920 who were forsaken for the installation of a vision which diminished the importance of education and educational speech pathology.  To this day we do not wish to acknowledge their existence, caring to say the profession did not start until 1925. Had that stream of influence continued, it is not hard to imagine school clinicians with the kinds of knowledge to prepare them for changes in education beginning in 1975.

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