How the Charter Members of ASHA Responded to the Social and Political Circumstances of Their Time.

PURPOSE: This article examines the responses of the founders of the American Speech-Language-Hearing Association (ASHA; original name, the American Academy of Speech Correction) to the social trends of their day in the United States. Those trends included migrations from Europe and the rural South, the emergence of new scientific methodologies, and the birth of a professional class. Our aims are to reveal how the founders reacted to these select social changes, to show how their reactions served to shape the newly formed profession in and around 1925, and to describe how that profession is still grappling with their choices even today. METHOD: The writings of the founding members of ASHA were examined for evidence of their views in relation to 20th century historical trends, specifically examining their attitudes toward clients and clinical practice. RESULTS: We identified elitist, ethnocentric, racist, regionalist, classist, and ableist statements in the writings of the founders. They promoted practices that denigrated those speaking dialects that were deemed nonstandard, including linguistic patterns originating from ethnic, racial, regional, and class differences. They also used ableist language in writing about people with communication disabilities, adopting a medical model that elevated the professional practitioner over the client. CONCLUSIONS: Our founders' response to social and political trends led to their creation of oppressive professional practices rather than to work within a more positive social model of professional practice, which was readily available to them at the time, one that would have embraced differences rather than seeking to erase them. Once again, we are experiencing sea changes in our society, ones that offer us the opportunity to reverse the practices shaped by our predecessors. We can learn from the missteps of our founders to create practices that empower and respect those with communication differences or disabilities. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22213738.

A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners.

Conversation partners of individuals with aphasia, including health care professionals, families, and others, play a role that is as important for communication as the language disorder suffered by individuals with aphasia. Two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners have been developed. The first measure provides an index of the conversation partner's skill in providing conversational support. The second provides an index of the level of participation in conversation by the person with aphasia. This article describes the development of the measures, including preliminary psychometric data, and discusses applications.

Values in practice and practising values.

UNLABELLED: This paper first explores evidence that speech-language pathologists are experiencing dissatisfaction with their roles and then argues that one source of dissatisfaction may be in a mismatch between personal and organisational values. In order to clarify their notion of values, the authors next present a model that outlines various levels at which values operate in therapy and show how values pervade all aspects of practice. The paper then offers some practical examples of how a new organisation has tried to address overtly the implementation of values in practice, with suggestions for how other practitioners might go about making their own personal and organisational values more explicit. The paper ends with a few caveats about the difficulties and dangers of attending to values and conclude with why it is a beneficial endeavour. LEARNING OUTCOMES: Participants will be able to (1) understand issues and practices that contribute to professional burnout; (2) describe a values-based framework for clinical practice; (3) understand the importance of concerning oneself with values, despite the difficulties in so doing; (4) explore some difficulties in adopting a medical model.

Historical and cultural influences on establishing professional legitimacy: a case example from Lionel Logue.

PURPOSE: In the film The King's Speech, the credibility of the king's speech clinician, Lionel Logue, is challenged. This article examines Logue's credentials in light of the credentialing standards and attitudes of Logue's time as well as those affecting today's practices. The aim is to show how standards of legitimacy change with the times. METHOD: Documents related to clinical qualifications and clinical practices are analyzed for the period in the early 20th century, when Logue practiced. They are then compared with how clinicians of today attain professional legitimacy. CONCLUSION: Early 20th century clinicians drew their credibility from their home disciplines such as medicine, phonetics, elocution, and education. Some of their therapies originated in the home discipline. Other therapies were commonly used, regardless of one's disciplinary background. Lionel Logue's background and methods would not have been suspect in his time. He may have been faulted by some for his lack of scientific perspective, but another likely source for the challenges to his credibility were early 20th century British social biases against Australians and against those using Australian dialects. The comparative analysis revealed that early 20th century clinicians and clinicians of today have certain clinical practices in common, but they differ considerably in how they establish their legitimacy. This indicates that judgments about a clinician's legitimacy are both historically and culturally determined.

The early years of language, speech, and hearing services in u.s. Schools.

PURPOSE: This article focuses on various aspects of the beginnings of speech therapy offerings in America's public schools. It traces the pioneering professionals and significant milestones associated with diagnostic and therapy practices during the late 19th and early 20th century. The aim is to uncover the neglected history of public school speech therapy practices and to show how the practices of yesterday compare with those of today. METHOD: Historical documents were analyzed to discover the key contributors and locations of the first public school speech-pathology programs. The analysis also traces the populations that were served and the professional training of the early practitioners, as well as their therapy and service delivery practices. CONCLUSIONS: Between 1895 and 1921, most of the major cities in the United States had hired their first speech clinicians. Between 1921 and 1930, many cities expanded their programs and were hiring supervisors to coordinate these services. These early clinicians carved out some now-familiar practices. Comparing what they did and when and how they did it with today's practices can offer school clinicians of today a sense of their own history and identity. Such an understanding can also provide insights about some of today's taken-for-granted practices.

Engagement: a concept and some possible uses.

This article examines how the term ENGAGEMENT has been used in various literatures. The construct of engagement is found to have advantages over other similar constructs in that it portrays degrees of involvement, it readily assumes the point of view of the person with disability, and it conveys involvement in interpersonal relationships as well in ongoing imagined or directly experienced activities. The article concludes with a set of points that can help create a framework for incorporating the construct of engagement into clinical practice, including the creation of climates for fostering engagement and indicators for measuring it.

How conceptual frameworks influence clinical practice: Evidence from the writings of John Thelwall, a 19th-century speech therapist.

BACKGROUND: The impact of speech therapists' conceptual frameworks on their clinical methods tends to be ignored or taken for granted by today's practitioners. One way to show the importance of such frameworks is to study how they were used previously. John Thelwall, a 19th-century elocutionist, offers a rich source for studying the influence of conceptual frameworks in the past and provides needed distance for clinicians to discover how they frame their own practices. AIMS: To discover how conceptual frameworks have influenced past and current speech-therapy practices. METHODS & PROCEDURES: Content analyses of the writings of Thelwall were performed to discover his conceptual frameworks and how and when they were used. The results were then compared with frameworks in use today. OUTCOMES & RESULTS: Four frameworks were found in Thelwall's writings: medical, linguistic, educational and political. All are still used, but each differs from Thelwall's in scope and detail. These comparisons have the potential for revealing the significance of conceptual frameworks in today's clinical practices. CONCLUSIONS: The ways Thelwall wrote about his work early in the 19th century bear striking resemblances to today's construals of speech therapy practices. It is the scope and application of the frameworks that have changed with time. Both the similarities and differences between current practices and those of Thelwall offer instructive insights into about how frameworks can influence clinical choices and practices.

History and principles of exercise-based therapy: how they inform our current treatment.

Exercises designed to strengthen muscles involved in respiration, phonation, and articulation play a key role in the remediation of voice and swallowing disorders. This article presents exercise physiology principles that are beginning to be used by a small group of speech and swallowing researchers to undergird their efficacy-based studies of exercise-based therapy. Three principles--contraction type, task specificity, and overload--are used to compare past exercise-based therapies with present therapies. Comparisons are made between today's methods and Oskar Guttmann's (1893) principles for strengthening muscles of respiration, Emil Froeschels' (1944) therapy to improve laryngeal function, and the myofunctional therapy of the 1960s to improve swallowing and articulation.

Views of Facilitated Communication: What's the Point?

Facilitated communication (FC) has generated considerable debate, with the main concern being whether the facilitators (often speech-language pathologists) are physically influencing what is being expressed by the communicator. FC has placed speech-language pathologists in an ethical bind, having to weigh the risks of denying their client the right to effective and efficient communication against the risk of using an approach that has not held up under the rigors of controlled scientific studies. The dilemma is further complicated by the different ways FC has been described. Those who describe it in social participation terms are more positive concerning its potential than those who see it in terms of information processing. In this article, views of FC are outlined. A way out of the dilemma is suggested through the development of clinical practice guidelines. Such guidelines should include protections of both clients and clinicians and should be built on both social participation and information processing views of FC.

A Framework for Managing Controversial Practices.

Every day, speech-language pathologists working in schools make difficult, life-impacting decisions regarding which assessment and intervention approaches to use with their clients. These decisions can become even more difficult when the approaches being considered for use are controversial. The risks involved in making choices about controversial practices are likely to have increased significance simply because the approach being considered is not widely accepted. The increased professional risk may cause decisions to be made based on risk avoidance rather than on a careful consideration of the pros and cons of the approach itself. This article offers a clinical practice framework for gathering information about controversial approaches and for implementing and monitoring their use. The framework will be illustrated using facilitated communication as an example of a controversial practice.