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What does it actually mean to “work within the system”? Megan traces the history of member voice and decision-making within ASHA, from Richard Adler’s 1990 address to the Legislative Council to the governance changes that eventually eliminated it. Along the way, she asks what happens when a profession gets better at questioning authority without necessarily building better ways to disagree, deliberate, and act together. What would it take to build a profession that can hear disagreement without needing to eliminate it? Sources: Moore, M. (2007). Step by Step, ASHA Begins Governance Change.Moore, M. (2007). New Governance Structure Adopted: Legislative Council Also Approves Preferred Practice Patterns in Audiology.ASHA Archives: Early ConventionsMalone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Connect: Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com

In this episode of Inside SLP, Megan looks beyond speech-language pathology to ask how professions decide where authority should live. From AOTA’s decision to separate certification from its professional association to decades of antitrust challenges involving ASHA and other professions, this episode explores what happens when certification, advocacy, accreditation, and professional representation overlap. Who gets to speak for a profession? What makes that authority legitimate? And what mechanisms exist to challenge it when practitioners want something different? Sources: Bogus v. American Speech & Hearing Association, 582 F.2d 277 (3d Cir. 1978).National Board for Certification in Occupational Therapy, Inc. v. American Occupational Therapy Association, 24 F. Supp. 2d 494 (D. Md. 1998).Palazzi et al. v. National Court Reporters Association, No. 2:25-cv-00077 (D.N.J. filed Jan. 3, 2025).Connect: Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com

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, we're turning our attention to a recent controversy in Oregon that sparked questions far beyond a single state licensing board. At first glance, it looked like a debate about the CFY. But as I dug deeper, it became clear that the conversation was really about something much larger: Where clinical training happens, who is responsible for it, and what assumptions we've inherited about how new clinicians become competent practitioners. This isn't a call to action, and it isn't an attempt to tell you what to think. It's an invitation to better understand the systems we're all participating in, and to consider what role each of us plays in what comes next. We explore: The CFY, the CCC, and licensure: Why so many clinicians struggle to untangle where one system ends and another begins.The hidden training model: How the profession came to rely on employers and workplace mentorship to help complete the transition from student to clinician.The CFY lottery: Why two clinicians can have dramatically different fellowship experiences while meeting the same requirements.Beyond Oregon: How a proposed workaround to a Medicare billing problem uncovered deeper questions about training, competency, and professional responsibility.Guests: Kerry Mandulak, PhD, CCC-SLP, immediate Past President of the Oregon Speech-Language & Hearing Association (OSHA) and Professor and Chair of the Graduate Admissions Committee at Pacific University in the school of Communication Sciences and DisordersJordan Tinsley, PhD, CCC-SLP, current President of OSHA and Clinical Assistant Professor at Pacific University in the school of Communication Sciences and DisordersTeigan Beck, MS, CCC-SLP, VP of Legislative Affairs for OSHAConnect: Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com

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 why it doesn’t have enforcement power over employers.The tying intervention: How the U.S. Department of Education forced a separation between accreditation and certification.The jurisdiction map: Where different kinds of power actually live, from state legislatures to licensing boards to universities.Fiduciary duty: How the law directs boards to protect institutional continuity, even under intense professional pressure.Sources: Special thank you to Dr. Angela Louvenbrouk (former President of the American Academy of Audiology, ASHA Fellow, former ASHA board member, and recipient of Honors of the Academy—AAA’s highest award—2019) for being a primary source for this podcast series.Board of Directors Fiduciary Responsibilities, Council of State Speech‐Language‐Hearing Association Presidents—Spring Program, May 16, 2016THE AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION: LEGAL RESPONSIBILITIES OF MEMBERS OF THE BOARDS OF NONPROFIT ASSOCIATIONS, October 2013ASHA Committee Toolkit, 2025Audiology Today, Volume 15, No. 3, May/June, 2023 (regarding the Department of Education)Connect: Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com

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 insider and what was gained, lost, and locked into place along the way. We explore: How federal rehabilitation funding after WWII and Vietnam reshaped who counted as a “qualified provider.”The quiet fight to keep language from being absorbed into the definition of Specific Learning Disability and why that boundary still causes friction today.How the CCC shifted from a professional marker to a billable requirement in Medicare and Medicaid.What it actually takes, organizationally, to put accessibility tools into 8,700 restaurants nationwide.Sources: Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Connect: Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com

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 leadership structure evolved, including why academic representation dominates and why executive stability is often cited as exceptional.Why state licensing boards (not national associations) hold the only enforceable regulatory power.How the interstate compact is stress-testing existing structures and quietly embedding national standards into state law.Sources: ASLP-ICMalone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Council for Clinical Certification in Audiology and Speech-Language PathologyCouncil on Academic AccreditationConnect: Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com

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 a minority group within ASHA realized they would never achieve autonomy inside the existing majority.Competence vs. revenue: Why audiology had to separate from a "certification-first" model to create the AuD.The 2020 mirror: How the same "bursting seams" found in audiology 30 years ago are now documented facts in the SLP master's degree.This is a story about system literacy in action. Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSources:Special thank you to Dr. Ian Windmill (former President and Fellow of the American Academy of Audiology, former Professor and Director of the Division of Communication Science at the University of Mississippi Medical Center, and former partner in University Surgical Associates) for being a primary source for this podcast series. The Crabby Audiologist Column (published in Hearing Health and Technology Matters) The Crabby Audiologist - Who's Teaching Who, and When?  — October 14, 2014Back to the Beginning - Some History and a Mystery — October 29, 2014Back to the Future of Audiology - Part 2 - The Tumultuous 70's — December 3, 2014Back to the Future - The Contentious 80's — December 31, 2014The 90's Onward:  Fighting the Inevitable, the Mountain Moved and Promises Not Yet Kept — Jan. 21, 2015The Millenium - Crabby Audiologists Learning the Alphabet — February 10 2015With Friends Like These:  A Strange Saga of "Teamwork" — February 24, 2015With Friends Like These:  Continued — March 10, 2015Making a List - Checking It Twice:  Someone's Been Very Naughty — March 31, 2015Commoditization: New/Old Kid on the Block — April 21, 2015Got Soul?  Who Are We — May 5, 2015Our Place In the Sun: Value Added Audiology — May 19, 2015How's the Water or What Sea Are We Swimming In — June 2, 2015One Plus One Equals the Wrong Two - New Math Needed — June 23,2015

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 that insurance lobbyists and competing disciplines are eager to fill. Subjective gatekeeping: Why competence feels like a personal judgment without objective rubrics.The certainty market: How structural gaps in grad school created an influencer economy that sells confidence as a product.The power vacuum: Why the decline in professional volunteering is a threat to our scope of practice.This is an invitation to stop personalizing the friction and start seeing the architecture. Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSources: Final Report, Ad Hoc Committee on Graduate Education for Speech-Language Pathologists, March 2020

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 fire alarm on our current training model. We also cover: The Highland Park standoff: Why 1960s leaders feared a vocational degree and institutionalized the workaround we now call the Clinical Fellowship. The 1983 economic pivot: How the profession crunched the numbers and chose a model that favored immediate paychecks over university-owned clinical residencies. The modern crisis: Why 47% of modern graduate programs admit they may not have the capacity to teach the full scope of practice across the lifespan. The subtext of survival: A look at the faculty deserts and the hidden revenue needs that keep our accrediting systems anchored to a 1960s architecture. This episode is about policy and also about removing the shame of the training gap by seeing it as a documented structural failure rather than a personal one. Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSources: Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Final Report, Ad Hoc Committee on Graduate Education for Speech-Language Pathologists, March 2020Graduate Education in Speech Pathology and Audiology: Report of a National Conference Highland Park, Illinois, April 29 Through May 3, 1963.National Conference on Undergraduate, Graduate, and Continuing Education (1983 : Saint Paul, Minn.); Rees, Norma S.; Snope, Trudy L.

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/insideslpPACT 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 center of it all: The people regulating SLPs… are SLPs. Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSources: New Jersey statutesUtah — Speech Language TechniciansIdaho public school requirementsNorth Dakota licensing rules and satutesMalone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.

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 organizing that led clinicians in Florida to say: “If we don’t regulate ourselves, someone else will.” Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSources: Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.

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 asking whether the CCC is “good” or “bad,” this episode asks a quieter question: What happens when a solution outlives the moment it was built for? Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSources:Duchan, J. F., & Hewitt, L. E. (2023). How the charter members of ASHA responded to the social and political circumstances of their time. American Journal of Speech-Language Pathology, 32(3), 1037-1049. Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.

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. Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.comSpecial thank you to Dr. Angela Louvenbrouk (former President of the American Academy of Audiology, ASHA Fellow, former ASHA board member, and recipient of Honors of the Academy—AAA’s highest award—2019) for being a primary source for this podcast series.

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 Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com