This question seems to perplex many, and the numbers do seem pretty staggering. Recent figures are something like 96% of SLPs being women in the U.S., with similar numbers abroad. As a male speech-language pathologist I thought I would chip in a few reasons why I believe these numbers are the way they are.
Some of these reasons have been offered before. They include
- There’s a perception of low opportunity and pay, especially considering the cost of the at least six years of college education required to become an SLP. This has been extensively discussed, such as here and here. Generally, there seems to be some justification for the perception, though it’s probably true that opportunity and pay is decreasing in many professions as the middle class continues its long decline.
- Gender roles and expectations definitely play a part. Fortunately, I had someone who knew about the field that suggested speech and language pathology as a possibility for me – a college professor trying to finally give me some direction as I was just about to graduate with a degree in communication. I had never even considered this profession, nor did I even know about it, before I was 22 years old. I’m guessing that more women than men have speech pathology suggested to them by others thanks at least in some part to gender expectations.
- Speech pathology is a helping, nurturing profession, which tends to attract women. Many men just tend to think that they can’t derive as much satisfaction from helping others. I obviously disagree, but I do understand how it took me so long of my own life to realize this.
I have a few additional reasons contributing to the huge disparity which I haven’t seen before.
- A big one is recognition. I think men crave recognition more than women, and teaching, nursing, SLPs, and similar professions are just not appreciated nearly enough. Individual greatness in these professions tends to go unacknowledged, as does the importance of the professions’ overall contributions to society. Men want to be heroes. This is genetic and evolutionarily driven. Meanwhile, our society tends to idolize men in some professions – sports, military, etc. – while ignoring the hard work, sacrifice, and importance of people in helping professions.
- Many men are timid about working with kids. Many SLPs work with kids. Every now and then the media decides to start focusing on (what I believe to be) the extremely small amount of male teachers who do something inappropriate with children, which causes suspicion of all male teachers that I believe is inaccurate relative to the actual risk.
- There is also some genetic, inherent component to women enjoying being around kids more, and especially younger kids. This really shouldn’t be ignored as a contributing factor, but it usually is. My experience has been that many male SLPs end up working with older children, I think in some part because of inexperience dealing with the behaviors of younger kids.
So one question then always arises in these discussions. What can be done to attract more males to speech pathology? Some contributing causes are more easily addressed, while others may take a long time. We can try to get the word out to more males. We can try to better prepare males, especially in dealing with behavior issues in the population SLPs often work with. I think though, unfortunately, that the most biggest hurdle to overcoming this issue may with the factor that contributes the most. Societal expectations need some shifting. We can start by taking cues from how many people react to those in certain other professions. When we start seeing things like special parking spaces for teachers and words like “That’s great!” when hearing that someone is a nurse or SLP, then maybe we’ll start seeing more males in these professions.
Goals for following directions are commonly seen in Individualized Education Plans (IEPs) of language disordered kids. Anecdotally speaking, they’re probably the most common language goal. Most of them tend to have some serious problems though, which perhaps we can illuminate from a quick analysis of one or two examples. And there’s one thing that’s really conspicuous by its absence. We’ll see if we can use these examples to figure it out.
Example 1: “Paul will follow two step directions in the classroom for three consecutive days.” What’s wrong with this? Plenty, actually, but one thing especially. Let’s say that for three straight days Paul is handed some trash, and after receiving the directions, “Paul, take this to the trash can and throw it away,” he does it. Goal achieved, right? There’s two steps and three days in the classroom, after all.
But what if Paul is twelve years old? What if Paul has been throwing away trash like this for years? Maybe he has done it so often, he knows what to do merely by giving him trash. He may not have even been listening to the directions. In this case, Paul has not been taught, nor has he accomplished anything that he wasn’t already able to do, despite having “achieved his goal.” The goal did not include something measurable that he wasn’t already able to do. And there still is that one thing that’s seriously missing.
Example 2: Mary will follow multi-step directions in the classroom or wherever at some percentage. Okay, this admittedly is a softball example, but it’s one I’ve seen plenty. What’s wrong? It’s not specific enough. I’m assuming it means more than two, but it doesn’t really say. Again too we run across the difficulty of the fact that no two directions tend to be equal in difficulty. “Get the ball and give it to me!” and “Please walk to the board and write the answer below the date,” are both notably two step directions. But they’re vastly different in difficulty. Which leads us to the one biggie that’s missing in these goals, and almost all following directions goals that I’ve ever seen. It’s the language itself.
Oral Motor Therapy and Facilitated Communication
…it is far easier to come up with an idea than it is to do the grunt work of scientifically verifying if that idea is a good one.
The stories of both non speech oral motor exercises and facilitated communication are both fascinating, and have sometimes had, at least in the case of facilitated communication, tragic results. So, then, what are the similarities? And what can we learn from them?
Facilitated communication (FC) is the technique of using a helper’s hand to guide a severely disabled person’s fingers or hands to type or point at a letter board. It is a practical requirement that the disabled person must not be able to communicate in any other way. The facilitator is trained in ways to help hold and support, but theoretically not guide, the patient’s hand to enable communication. FC was first enthusiastically embraced by many media outlets, and by the general special education community in the 1980’s and 1990’s, before being thoroughly refuted by research, and denounced by every major association that matters, including the American Psychological Association and the Association for Science in Autism Treatment. It seemed also that in many cases, these facilitators’ extreme desire to help their students led them to trump up stories of parental sexual abuse – stories that they didn’t seem to realize that they were concocting. FC seemed to generally fade from the public consciousness, but lately it has been revived. Unbelievably, Syracuse University helped its reemergence under the re-branding of “supported typing” by promoting its founder, Douglas Biklen to Dean of its School of Education, and by renaming its Facilitated Communication Institute as the School of Communication and Inclusion. (Maybe these people have been trying to jump on the autism explosion gravy train that earlier FC had just missed?)
While oral motor therapy has been less – let’s just say – notorious than FC, it has certainly garnered its fair share of criticism and controversy.
parallel talk - a great method for motivating children to talk without the frustration of high demand – the child is given opportunities to engage in activities that he finds interesting, while the caregiver talks about what the child is doing -the caregiver uses language that is at or just above the child’s level – often used in collaboration with self-talk
examples: for a child playing with a plane, say things such as, “You’re flying the plane. The plane is high. The plane is low. You gave the plane to me.”
play therapy – very useful for initiation, social language, turn-taking, sharing – can involve moving child from lower levels of play (such as banging or shaking toys) to higher (such as self directed play, play directed toward others, relational play, and symbolic play) – strategies are taught to caregivers, often involving allowing child to lead play, with adult redirection as necessary
priming – introducing topics beforehand – can involve stories, index cards, explanations, or anything that can quickly familiarize student with upcoming material – can occur immediately preceding the lesson, the prior morning, or the prior evening – especially effective when part of a routine
example: an autistic child’s anxiety increases in response to certain things, such as handwriting, so the morning activities are briefly explained to the child ahead of time each morning, including handwriting
Looks like this conference will be focusing on Social Stories…
— ASHA (@ASHAWeb) July 23, 2014“
I just hope they mention a few other autism therapies while they’re at it – Such as the thirty or so on this list.
The author of this post from the Language Log blog, Ben Zimmer, makes three main points, two of which I really like. (There’s nothing wrong with the other point, I just don’t think it’s as great.) The points are in reference to the evident uproar in the linguistic community caused by Weird Al Yankovic’s Word Crime’s video. The uproar has been caused by Weird Al’s suggestion to everybody who can’t use proper grammar – which is just about everybody – to obtain the services of a linguist for help. Many linguists, to the contrary, have been fighting for years to get everybody to loosen up their prescriptive shackles, and focus on everyday, more casual language – as pointed out in this article.
The first great point is this: “…the notion of “Proper English” typically serves to prop up the already-privileged speakers whose native language variety it is (sort of) based on. This puts speakers whose native language variety does not approximate “Proper English” at an immediate disadvantage in society, the same way that privileging Whiteness puts those who are not White at an immediate disadvantage in society.”
The second great point is… “that the view of “grammar” as “you must learn the rules or else be ostracized” just makes grammar no fun at all! Studying language—really digging into it, uncovering its remarkably complex yet orderly structure, investigating what makes it different across speakers and communities—is SUPER FUN! Giving people a list of rules of things to do in order to not be criticized is NOT FUN!”
(note: this is another installment in an ongoing series on various language therapies)
Mand-Model approach -This is an extension of the incidental teaching model. The mand-model approach involves the teacher or caregiver modeling and/or manding (requesting) a response from the child. In modeling, sometimes known as child-cued modeling, the teacher or caregiver observes the focus of the child’s interest (e.g., a ball) and models the correct verbalization (e.g., “that’s a ball”). If the child makes the correct verbal response the teacher or caregiver then praises the child and provides the object of interest.
example: child reaches for a candy – caregiver keeps candy out of reach, while saying “candy. Say, ‘Candy please!” – caregiver gives candy immediately if child requests, or after a time delay, while modeling correct request if child doesn’t request
Milieu Teaching -As a naturalistic, conversation-based teaching procedure, in milieu teaching the child’s interest in the environment is used as a basis for eliciting elaborated child communicative responses. Milieu teaching includes other strategies, such as incidental teaching, mand-model, and time delay. It is based on behaviorism, but rewards are from natural environment. With incidental teaching the teacher waits for response, while mand-model requires asking (mands) for response. While often the subject of research, few SLPs seem to actually claim to use milieu teaching. Maybe it’s the odd pronunciation.