Inside SLP

For the first 20 episodes of Inside SLP, we explored the history of speech-language pathology and the systems that shape our profession today. We looked at how licensure, certification, clinical training, and professional identity evolved over time, and how decisions made decades ago continue to influence clinicians, students, employers, and patients. As we begin this next chapter of the podcast,...

For twenty episodes, we’ve been examining the architecture of a profession under strain, including its history, its blind spots, and the pressures it was never designed to hold. In this final episode, we step back from diagnosis and turn toward orientation. Not a to-do list, and not a call to fix what’s broken, but an invitation to understand where we’re standing, and what it means to be a stakeho...

Anger can feel clarifying, but without context, it rarely leads anywhere new. In this episode, we step back from the outrage cycle to examine what’s sitting underneath it: systemic grief, misaligned training models, and the shame many clinicians carry inside a profession that was never fully built to hold them. We explore: The arsonist parable: Why chasing villains distracts from the work of rebui...

The intensity in SLP spaces right now isn’t a sign of collapse. It’s the friction of a profession that has grown faster than the structures built to support it. In this episode, we slow the noise down to examine what’s actually underneath the debates, through data, psychology, and the real set of options the field keeps circling. We explore: The preparation gap: What the 2020 Ad Hoc report acknowl...

In 1968, the ASHA Convention became a moment of rupture. Not because of disorder, but because long-standing tensions were finally named. This episode examines what happened when Black clinicians challenged the limits of a profession that defined itself as “neutral,” and what that moment revealed about power, voice, and professional growth. We explore: The Denver moment: Why ASHA leadership respond...

Many SLPs experience ASHA membership as essential to survival even when, structurally, it is designed to be optional. This episode examines why that tension exists, and what it reveals about how professions stay healthy as they grow. Rather than framing optional membership as a threat, we look at how it functions as a stabilizing feature in mature professional systems and why the fear of “splinter...

How did ASHA come to link membership and certification? And what happened when that structure was challenged? In the 1970s, one SLP brought that question into federal court. While Bogus v. ASHA didn’t end with a dramatic verdict, it quietly reshaped the professional architecture we still live inside today. We explore: The tying logic: Why the court viewed the CCC as a unique form of economic influ...

In the 1940s, the idea that a private organization could define professional eligibility was so controversial it sparked accusations of communism. This episode traces the early decades of the CCC, when certification was fragile, contested, and anything but inevitable. We follow how it gradually became the central organizing force of the profession. We explore: The ivory tower era: Why ASHA’s early...

When we ask why change inside SLP feels so difficult, we often look to policy debates or leadership decisions. This episode looks instead at the financial architecture underneath it all and why long-term obligations shape what an institution can realistically risk. To understand ASHA’s caution, we examine the scale of the organization and the financial commitments that anchor it in place. We explo...

In moments of professional frustration, it’s easy to confuse visibility with authority and to assume that the loudest voice is also the one holding the gavel. This episode looks beneath that assumption, tracing the legal boundaries that shape what a national association can (and cannot) actually do. We explore: The HOA analogy: Why ASHA operates as a private association, not a regulatory body and...

In the early 1960s, SLP leaders described trips to Capitol Hill as terrifying, migraine-inducing encounters with a world they didn’t yet understand. A few decades later, the profession had built enough political infrastructure to partner with McDonald’s and influence federal definitions of disability. This episode traces how speech-language pathology moved from academic outsider to institutional i...

Welcome to Systems Literacy 101. In this episode, we step out of the social media noise and into the architecture of speech-language pathology, tracing how authority moves from accreditation to certification to licensure, and where responsibility begins and ends. We explore: Why accreditation (CAA) and certification (CFCC) were legally required to separate (and what that changed). How ASHA’s leade...

Audiology and SLP share a common history, but they did not share the same future. This episode traces the critical divorce of the 1980s, starting with a 1987 convention session in New Orleans that changed everything. We look at how audiologists identified the "Competency vs. Certification" trap and decided to rebuild their professional infrastructure from the ground up. The New Orleans spark: How...

Are you failing, or is the system failing you? This episode explores the psychological and political costs of an under-built profession. Using the 2020 ASHA Ad Hoc Report, we look at how a lack of a unified competency framework leads to arbitrary power dynamics and gratitude compliance. We also discuss the looming generational shift in state associations and the danger of leaving a vacuum of power...

Why has the speech-language pathology entry-level degree remained unchanged for over 70 years while the medical world evolved around it? This episode excavates the critical turning points of 1963 and 1983, where the profession repeatedly chose academic purity and economic convenience over clinical readiness.  We dive into the 2020 Ad Hoc Committee Report , a document that effectively pulled the fi...

SLP is the only allied health or education-adjacent profession that completes most of its clinical training after the degree. This episode unpacks how unusual that structure is and how it shapes hiring, supervision, billing, and professional identity. We explore why it affects nearly every tension we feel in the field today. Contact Megan: therapyinsights.com/insideslp PACT Survey: pactsurvey.com

Across the United States, speech-language pathology licensure looks wildly different from state to state. It's a patchwork of rules shaped not by a single national authority but by thousands of individual decisions over decades. This episode traces how school systems, state agencies, and clinician-run boards created a maze of inconsistent standards. And it reveals the surprising truth at the cente...

A short note from Megan.

Inside SLP is a short, weekly podcast about the systems that shape speech-language pathology. In ten minutes at a time, we explore how training, credentialing, licensure, and professional power came to look the way they do—and why so much of this structure remains unseen in day-to-day practice. This isn’t a podcast about outrage or quick fixes. It’s a slower, more reflective look at a complex prof...

In 1969, Florida became the first state to license speech-language pathologists and audiologists, which reshaped the entire profession. But the fight for licensure started years earlier, fueled by fraud, unqualified practitioners, and the dawning realization that ASHA had no legal authority to protect the public or the profession. This episode dives into the drama, resistance, and grassroots organ...

Every system has an origin story. In Episode 3, we step back in time to examine how the CCC was created, what problems it was meant to solve, and why it once made sense. This episode traces the early structure of certification in speech-language pathology and follows how its meaning and function evolved as the profession expanded, state licensure emerged, and training pathways shifted. Rather than...

In this episode, I talk about the pull of certainty and how reassuring it can feel to believe there are clear answers, fixed structures, and someone who has it all figured out. We explore how professional cultures reward confidence over curiosity, how uncertainty often gets smoothed over rather than examined, and why so many clinicians sense something doesn’t quite line up but struggle to name it....

In 2015, a paperwork mistake and a failed jurisprudence exam left me living in a tent in Montana and questioning everything I thought I knew about becoming a speech-language pathologist. This episode tells the story of my first encounter with the profession’s hidden architecture and how that experience opened a decade-long journey of trying to understand the system we all work inside of. Contact M...