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Inside SLP is a limited series podcast that reveals how our profession came to be and why it functions the way it does. Most clinicians work inside a system they were never taught to see, shaped by decades of history, policy, economics, and unspoken assumptions. This show offers lightbulb moments that bring clarity to the structures beneath our everyday work and opens space for thoughtful, grounded understanding of the field we share.
Welcome to Inside SLP. This is a weekly ten minute podcast about how our profession came to be and where it's heading. Most of us work inside a system we were never really taught to see. Inside offers a way to understand that system with more clarity, calm, and context. Each week we explore one idea that helps illuminate the structures, histories, and tensions shaping our field.
Megan Berg:This podcast is not about outrage or quick solutions. It's about understanding a complex profession so we can navigate it with more confidence and curiosity. I'm Megan Berg. Let's look inside. Today, we're stepping into Florida in the mid 1960s, a place where speech therapy looked a lot less like a regulated healthcare profession and a lot more like the Wild West.
Megan Berg:And you're going to see exactly why Florida became the first state to license SLPs and audiologists in 1969 and why that moment changed everything. But first, imagine this: You're a speech language pathologist working in Florida in 1965. You've just learned that someone in your community, someone with no professional training, is selling a correspondence course that claims to cure stuttering. They're raising money statewide. They're enrolling people and families who are desperate for help are sending in checks.
Megan Berg:You're alarmed. You call ASHA. You report it. And the answer you get is, There's nothing we can do. Not because ASHA didn't care, but because they had zero legal authority.
Megan Berg:None. Not partial authority, not limited authority. Zero. The only thing that ASHA could do in 1965 and today is revoke someone's CCC. And in 1965, the CCC wasn't required to practice.
Megan Berg:It was and is an optional certification that people could purchase or not. Losing it meant losing a membership card, not the ability to treat patients. This is the moment when Florida clinicians realized, We need more than standards. We need the law. Before state licensure, anyone could call themselves a speech therapist or a speech correctionist, or an expert in stuttering cure by mail.
Megan Berg:And in Florida, three stories lit the fuse for legislative action, stories documented in ASHA's first seventy five years and oral history. The junior chamber of commerce, trying to do something helpful, adopted a correspondence course claiming to cure stuttering. They raised funds to send people through it. SLPs across the state wrote letters begging the organization to stop. They succeeded in ending the fundraiser, but the scam kept operating.
Megan Berg:To challenge it legally, clinicians had to pay out of pocket. ASHA couldn't intervene. It wasn't a regulated profession. As one Florida leader later reflected, ASHA had no capability at all of solving this problem. Next came a hearing aid dealer who advertised that he offered speech therapy to customers.
Megan Berg:Florida's Attorney General stepped in, ruling that speech therapy could be considered a medical subspecialty, meaning anyone offering it would be violating the Medical Practices Act unless supervised by a physician. This was a huge red flag. If speech therapy was seen as a medical procedure requiring physician oversight, SLPs would lose their independence entirely. And again, ASHA couldn't do anything. There was no law defining speech language pathology as a profession.
Megan Berg:The third incident happened when a Florida hospital hired someone to offer speech and hearing therapy, but the person wasn't actually A newspaper covered the story in a way that made it sound like a medically credentialed practitioner was providing services. A physician in the community responded publicly, These people are practicing medicine, and they're not even licensed. We think we ought to license them. That line, quoted in the oral history book, captures the urgency better than any modern summary could: Outside forces were about to regulate the profession for SLPs if they didn't do it themselves. By 1965, the Florida Speech and Hearing Association had had enough.
Megan Berg:They realized ASHA could not protect the public, ASHA could not regulate practice, ASHA could only revoke a certification product it sold. And if someone else stepped in firstphysicians, the state medical board, or legislatorsthey might define SLP practice practice in ways that didn't reflect the profession. So FLASHA made a bold decision. They raised their dues by 100% to fund lobbying and legal work. They hired attorneys, they drafted the legislation themselves, and they organized statewide to get it passed.
Megan Berg:This part is easy to miss, but crucial. State licensure was a grassroots movement. It wasn't ASHA's idea. It wasn't top down. It came from working clinicians.
Megan Berg:And ASHA? ASHA opposed it strongly. Kenneth O. Johnson, ASHA's executive director from 1957 to 1979, later admitted this openly. He said, If you set up a state licensure, you end up having 50 different sets of standards.
Megan Berg:That would make it more difficult to change the standards. ASHA feared there would be inconsistent requirements across states and barriers to mobility. There would be a loss of control over credentialing. It would challenge the authority of the CCC and possibly weaken the accreditation program. They didn't oppose licensure because they thought practitioners didn't deserve it.
Megan Berg:They opposed it because they feared fragmentation. But clinicians in Florida looked at the harms around them and said, We cannot wait. And ultimately, Johnson reflected, It was dumb of me to oppose state licensure at the beginning. On 06/06/1969, Florida's governor signed the first licensure law for speech language pathologists and audiologists in The United States. It followed ASHA's standards on paper because Florida wanted alignment, but it had one critical difference: licensure had legal force.
Megan Berg:The CCC did not. For the first time, SLPs had protection from unqualified competitors, professional recognition under state law, enforcement mechanisms, fines for misrepresentation, and credibility in court with insurers. Robert Harrison, one of the leaders who shepherded the bill, described the impact decades later: Hearing aid dealers stopped advertising speech therapy, fraudulent practices disappeared, standards could be enforced, and when giving legal depositions, the first question became, Do you have a license to practice your specialty? He called licensure a matter of professional pride. State licensure is now so normal that it's hard to imagine the profession without it.
Megan Berg:But licensure exists only because clinicians in Florida in the 1960s were willing to recognize the limits of ASHA's authority, raise their dues 100%, write legislation, hire lobbyists, and push back against their own national association. As one leader said, If we didn't do it, somebody else was just going to pass a law. And that is where we're headed next. Today we talked about Florida, the first state. Next week we're going to explore what happened after 1969, when state after state began creating their own licensing laws, each with its own structure, standards, CE requirements, and oversight agency.
Megan Berg:This is where things get messy. And this is how we ended up with 50 different interpretations of what it means to be an SLP. If you have any questions, thoughts, or stories you want to share, you can reach me anytime at therapyinsights dot com slash Inside SLP and I'll see you next week.