The Way It Used To Be Our professions have changed in unimaginable ways since I was an undergraduate—and will continue to change as we learn more. From the President
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From the President  |   June 01, 2018
The Way It Used To Be
Author Notes
  • Elise Davis-McFarland, PhD, CCC-SLP, is former vice president for student affairs at Trident College and developer of the interdisciplinary graduate Communication Sciences and Disorders Program at the Medical University of South Carolina. She is also past chair of ASHA’s Committee on Honors and past coordinator of ASHA Special Interest Group 14, Cultural and Linguistic Diversity, among other ASHA posts. elisedavismcfarland@gmail.com
    Elise Davis-McFarland, PhD, CCC-SLP, is former vice president for student affairs at Trident College and developer of the interdisciplinary graduate Communication Sciences and Disorders Program at the Medical University of South Carolina. She is also past chair of ASHA’s Committee on Honors and past coordinator of ASHA Special Interest Group 14, Cultural and Linguistic Diversity, among other ASHA posts. elisedavismcfarland@gmail.com×
Article Information
Speech, Voice & Prosodic Disorders / Professional Issues & Training / Language Disorders / From the President
From the President   |   June 01, 2018
The Way It Used To Be
The ASHA Leader, June 2018, Vol. 23, 4-5. doi:10.1044/leader.FTP.23062018.4
The ASHA Leader, June 2018, Vol. 23, 4-5. doi:10.1044/leader.FTP.23062018.4
I’m packing to go to my 50th college reunion at the University of North Carolina–Greensboro, where I was an undergraduate speech pathology (what it was called then) major. Our professions have changed so much since I was a student there.
In fact, I’d never even heard of what was then called “speech therapy” until I went to a health careers conference in high school. I attended a workshop conducted by Kathryn England of the (then) UNC-G Drama and Speech Department faculty. After having a laryngectomy, she had highly articulate speech. She was an inspiration and recruited me to the UNC-G program.
The speech pathology curriculum consisted of 39 credit hours. My first course was “Introduction to Phonetics” in my freshman year, followed by “Introduction to Speech Correction” my sophomore year. After that came “Principles of Speech Correction” and then “Speech Reading,” which was an entire course on lipreading. Other course topics included reading aloud, tests and measurements, anatomy and physiology, working with people with hearing impairment, and audiology. There were also six credit hours of clinical practice.
We had no idea how few diagnostic tools we truly had. The Goldman-Fristoe Articulation Test was the standard for assessing what were then referred to as articulation disorders. The term speech sound disorders came some years later, and we were not taught the distinction between articulation and phonological disorders. It was all “articulation disorders.”
Our treatment approach was mostly limited to selecting sounds that were developmentally appropriate for the child’s age. I remember how excited I was when I learned about distinctive features therapy some years later—see the ASHA Practice Portal section on speech sound disorders.
The production versus perception discussion was just beginning in the literature. The relationship between phonological development and disorders and literacy development was in its early stages, and many speech therapists were not involved in helping children learn to read. Another developing area of research and intervention was childhood language disorders. There was no distinction between what we now know as “late talkers” or “specific language impairment” and what we knew as developmental language disorders, language delay or developmental dysphasia. Those terms were interchangeable. There was little or no emphasis on semantics and the term pragmatics was not yet in use.

We had no idea how few diagnostic tools we truly had … The term speech sound disorders came some years later, and we were not taught the distinction between articulation and phonological disorders.

In addition to standardized tests (which were limited), we were taught how to do in-depth language sampling. We were also taught to take comprehensive case histories as part of the evaluation process, but our instructors cautioned us to be skeptical about some aspects of the interview. Parents “could not necessarily be trusted to be accurate informants” about their children’s speech and language milestones. After all, what did they know about language development? Of course, we now know that parents typically provide very reliable information about their children’s development. I learned much about ethnographic interviewing from the extensive practice I had taking case histories as an undergraduate. This skill has provided immeasurable value in my professional practice and research.
Parents of preschoolers with dysfluent speech referred to our college clinic were told to ignore their child’s “stuttering.” The philosophy was that overreaction would doom their child to more severe stuttering. As I learned more about childhood dysfluencies and the importance of individualized interventions, I wondered how many parents our clinical supervisors, classmates and I had sent home feeling afraid and helpless because we did not give them more guidance.
When it came to aphasia, the focus was on Broca’s aphasia and Wernicke’s aphasia. That was long before person-centered functional goals for aphasia treatment came to the fore. We were to assess, diagnose and develop as comprehensive a rehabilitation plan as possible, given the severity of the aphasia and the physician’s prognosis. The idea of continuous, intermittent rehabilitation and intervention was to come later—we now know that improvement of language function can continue well past the initial recovery period. In years to come, I learned about other types of aphasia, their symptoms and treatments.

None of us back then were taught about cultural and linguistic considerations in the assessment or treatment of communication disorders.

My first job after college (before going to graduate school) was at an elementary school in North Carolina. My “office” was the room where the custodian once kept his brooms, mops and supplies. It was just large enough for a small round table, four small chairs and a file cabinet. I kept most of my treatment materials in the trunk of my car.
Since 1965, when the master’s became the entry-level degree for speech-language pathology, our scope of practice has greatly expanded. Cultural and linguistic considerations in the assessment or treatment of communication disorders were not commonly taught until the 1980s. We were just beginning to discuss the concept of cultural competence. Similarly, swallowing was also not part of our scope of practice. Dynamic assessment, curriculum-based assessment, telepractice, autism spectrum disorder, melodic intonation therapy, interprofessional practice, high-tech augmentative and alternative communication approaches, IDEA, social communication disorder … all of these and so much more were yet to come.
All of these developments have strengthened our professions, and our ability to provide higher levels of service and intervention on behalf of our clients, patients and students. We have come a long way, but our journey is far from over.
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June 2018
Volume 23, Issue 6