1.1 History of the speech pathology profession
Globally, the speech pathology profession provides services and support to people who experience communication and swallowing challenges. There has been a strengthening of the view that communication is a human right, globally and within the speech therapy / speech pathology community – see, for example, “Communication Rights and the United Nations’ 70th Anniversary of the Universal Declaration of Human Rights” (McLeod, 2018).
However, this wasn’t always the case. The initial focus was primarily on speech, in particular, speech correction. It appears that the origins of the speech pathology profession emerged during the nineteenth and early twentieth centuries in response to the “demand for docile efficient, and thus productive speech” (St. Pierre & St. Pierre, 2018, p. 151) as the ability to speak effectively became a necessity in the increasingly industrial and democratic modern societies, and is seen as a feature of White British and Euro-American colonisation. The ability to ‘speak well’ was viewed as a key commodity for capital production (St. Pierre & St. Pierre, 2018). An example of the importance for individuals in positions of power to be able to ‘speak well’, was King George VI, who experienced a stutter or ‘stammer’ as he described it. As portrayed in the movie, The King’s Speech, Australian speech therapist Lionel Logue worked with King George VI to improve his speaking fluency. Around the time of World War One, the profession expanded beyond ‘speech correction’ focus to include broader communication remediation for soldiers who had experienced head injuries.
A further example to highlight this ‘speaking well’ focus was the establishment of the The American Academy of Speech Correction in 1925 by a group of individuals working in the areas of theatre, debate and persuasive speaking. This Academy later became the American Speech-Language-Hearing Association (ASHA) in 1978. Speech and language therapy in the United Kingdom became organised under a single professional body in 1945 as the College of Speech Therapists, now called the Royal College of Speech and Language Therapists (RCSLT). In Australia, the first speech therapy clinic opened in Sydney in 1931. In 1949, the Australian College of Speech Therapists was founded. In 1975, the title of the national body was changed to the “Australian Association of Speech and Hearing (AASH)” and the undergraduate professional education program was expanded from three to four years. In 1996 the Speech Pathology Association of Australia was established with a public name of Speech Pathology Australia (SPA).
The notion of ‘socially acceptable’ speech and communication as contributing to economic production “gave critical legitimacy to speech and language therapy as a discipline because it focused on the remediation of “pathology” inherent in disabled individuals” (Nair et al., 2023, p. 781). The term pathology in speech pathology originates from the Greek roots pathos, meaning “suffering” or “disease,” and logos, meaning “study” or “science.” In the speech pathology context, pathology refers to the diagnostic process used in the discipline to study the cause, development and effects of communication and swallowing difficulties.
Around the 1930s, speech pathologists started to work in the area of oral feeding and swallowing, initially with children who experienced oral motor disorders due to cerebral palsy (Miller & Groher, 1993). Prior to the 1970s, speech pathologists primarily worked in public school and ambulatory care settings. During the 1970s and 1980s, speech pathologists started working in acute and chronic care clinical environments where many of the patients had experienced neurological injury. Many of these patients often had coexisting communication and swallowing difficulties (dysphagia). As the assessment, diagnostic processes, and potential rehabilitation approaches overlapped, speech pathologists started to practice in the area of dysphagia (Miller & Groher, 1993).
To find out more about the history of the speech pathology profession in Australia, please refer to this resource: Speech Pathology Australia celebrates 60 years
Speech pathologists now have a broad scope of practice and work in diverse practice settings. There are more than 230 000 people working as speech pathologists across the world (International Association of Communication Sciences and Disorders [IALP], 2023), but the name of the profession differs between countries.
