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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 is heading. Most of us work inside a system we were never really taught to see. Inside SLP 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. Before we talk about the CCC, what it is, how it formed, and why it shapes your career today, I want you to imagine something.
Megan Berg:It's the early 1900s. You live in a Midwestern town. Your child stutters. Your mother speaks with a thick Polish accent, your neighbor was born deaf, another child in the classroom is selectively mute, and anyone, truly anyone, can call themselves a speech therapist. There is no credential, no standard, no training requirement, no universal definition of competence.
Megan Berg:A high school teacher can hang out a shingle, a charismatic preacher can promise cures, a doctor can prescribe a treatment with no understanding of language, a self taught elocutionist can advertise speech correction. It is, in every sense, the Wild West. The idea that a profession of speech correction even exists is brand new, and it is emerging at the same moment that America itself is undergoing seismic, demographic, scientific, and political transformation. This is where our story begins. Between the late 1800s and early 1900s, over 20,000,000 immigrants entered The United States at a time when the entire US population was only around 76,000,000.
Megan Berg:At the same time, more than 6,000,000 African Americans migrated north during the Great Migration, fleeing racial terrorism and the oppressive violence of Jim Crow laws. Cities were swelling, accents were shifting, dialects were colliding, racism and xenophobia were openly embedded in science, politics, and education. Psychology and psychiatry were exploding as new fields. Childhood development norms were being inventedliterally invented. Doctors were performing lobotomies.
Megan Berg:The Eugenics movement was gaining political power. And people were sterilized without consent in the name of improving society through white supremacist ideology. This was the world into which ASHA was born. This matters because every profession reflects the era that created it, its norms, its fears, its biases, its obsessions. Ours is no exception.
Megan Berg:In 1925, members of the National Association of Teachers of Speech or NAATS gathered in New York City. Within that group, a small subset of academically elite speech correctionists believed that NAATS was too focused on communication as an art form. They wanted the emerging field focus on scientific principles and communication disorders. So they broke away and they formed what is now ASHA. That founding group consisted of nine charter members, all white, all highly educated, and predominantly male, with a few women whose race was the same.
Megan Berg:Their exclusivity was so extreme that for the first five years, no one even applied to join. Was not considered a field for the working class or the everyday teacher. This founding group was obsessed with evidence based practice, long before an evidence base actually existed. So their early publications became the evidence base. And this is where the history becomes uncomfortable.
Megan Berg:From the American Journal of Speech Language Pathology article, How the Charter Members of ASHA Responded to the Social and Political Circumstances of Their Time, which I'll link in the show notes, we get a window into the values shaping early speech correction. Here's a quote: Poor tone, inflection, and certain usages of the voice that inevitably disclose a lack of breathing (Blanton and Blanton, nineteen twenty). And another: Nasality, harsh, unpleasant production of tone, slovenly, indistinct articulation of sound units, provincial and foreign dialect, lisping, mouthing, stammering all contribute to the lowering of our national speech standards (Borden and Bussy, nineteen twenty five). In other words, our field defined disorder through the lens of whiteness, elitism, and assimilationist ideology. Now contrast that with Hallie Quinn Brown, a Black educator, elocutionist, and activist writing at the same time, who said, Talk not of the Negro woman's incapacity, of her inferiority, until the centuries of her hideous servitude have been succeeded by centuries of education, culture, and refinement by which she may rise to the fullness of the stature of her highest ideal.
Megan Berg:Her words reflect dignity, possibility, and cultural groundedness. The founding ASHA literature reflects fear, hierarchy, and cultural punishment. This is the soil from which our profession grew. This lineage still threads through our norms about clear speech, standard English, appropriate tone, and professional identity. Let's fast forward to 1952.
Megan Berg:For the first time, ASHA opens its doors to the working clinician, what was seen as the lower class of the profession. But membership came with a condition: you had to purchase the Certificate of Clinical Competence. At that time, to earn the CCC, you needed a bachelor's degree and nine months of supervised clinical training. Why nine months? Because that was the length of a school year.
Megan Berg:The general structure of the CFY has barely changed since 1952. Even today, only eighteen hours of direct supervision and eighteen hours of indirect supervision are required across the entire nine months. As thousands of clinicians entered the association in the 1950s and 1960s, ASHA's finances grew dramatically. Membership revenue became the organization's life blood. With this stability, ASHA purchased its first properties, expanded staff, built a publishing infrastructure, and established itself as a national leader.
Megan Berg:The CCC wasn't just a credential, it was the mechanism that allowed ASHA to become the ASHA that we know today. By the mid twentieth century, ASHA had become a financial powerhouse. The CCC had become a gatekeeping tool, and clinical training lacked national consistency. And there was still no law anywhere defining what an SLP must be. Which brings us to the moment I want to leave you with Imagine you're an SLP in Florida in the late 1960s.
Megan Berg:You're deeply concerned about unethical behavior in your workplace, so you do what you believe is right. You call ASHA to report it. And the person on the other end of the line says, There's nothing we can do. Because ASHA has no legal authority, no governmental regulatory power, no licensure structure, no jurisdiction over who can or cannot practice. Anyone can call themselves a speech therapist.
Megan Berg:ASHA is an association, not a licensing body. So your concerns go unanswered. Your patients remain unprotected. And your profession, which you believed was regulated, turns out to be completely unregulated. This moment becomes a spark.
Megan Berg:'69, Florida becomes the first state to establish state licensure for speech language pathologists, reshaping the field forever. But that's a story for next week. Invite you to reflect on the origins of our field this week and ask yourself, where do I still see the influence of early speech correction ideals today? And notice how history shapes your assumptions about speech norms, professionalism, and competence. And consider the power of regulation versus optional membership association.
Megan Berg:Who should hold authority in a profession and why? If you want to understand the system more deeply, I invite you to learn about the PACT survey, a national effort to capture how SLPs, audiologists, employers, consumers, and educators experience our profession. You can sign up for updates at pactsurvey.com. That's pactsurvey.com. And if today's episode sparked a question you'd like me to sit with, you can submit it at therapyinsights.com/insideslp.
Megan Berg:I don't respond one on one, but your questions help guide where we go next. I'm Megan Berg, and this is Inside SLP. See you next week.