Nineteenth Century Origins of Speech Therapy Services in America

Many who have considered the history of speech language pathology in the US have placed its origins in the founding of the professional organization around 1925 (e.g., Paden, 1970; Malone, 1999). This abrupt rendering of our beginning as the day that Edward Lee Travis called a meeting at his house in Iowa City, Iowa about forming a new organization, leaves unanswered the question of what happened prior to that day that led to the meeting. What prompted those at the meeting to want to separate themselves from their mother organization, the American Speech Society? Where did they get their ideas, their expertise, their sense of professional identity? What other options besides separating from their parent organization did they have available to them?

Answers to these questions requires several trips back in time, to much earlier periods when the intellectual seeds that influenced the thinking of the men and women at Travis’s meeting were planted. We will follow the historical paths to the beginning of the 19th century. We will identify who were considered to be the experts and intellectual leaders along each of these journeys and, in some cases, will talk about those who were left out. We will explore who the individuals were who were working and writing about communication disorders, what their backgrounds were and what sorts of services they were providing. We will consider reasons for why these particular individuals were the ones to take on a professional therapeutic role. We will also provide a glimpse of what else was happening in the US that influenced the thinking and activities of these early ancestors.

There were at least three trends in the 19th century that led to the need for the first speech-language pathology professionals. Each exerted a separate identifiable influence on the evolution of the field. As with other trends, these worked together to form a common pathway that was to eventually lead to the formation of the profession in 1925.

The first pathway, the elocution movement, was a broad movement in America where elocutionists set up practices to work with orators, politicians, singers, preachers, actors, and non specialists who wanted to improve their speaking, orating, or singing. Some elocutionists, such as Andrew Comstock and Alexander Graham Bell, also offered lessons for individuals with speech, language or hearing problems.

Also operating early in the 19th century was a dramatic shifting from a religious and philosophical view of causality to a scientific one. Charles Darwin published his influential book on the origin of different species, Paul Broca and Carl Wernicke’s studies of the brain were having their impact, and the first academic psychology programs were becoming established in the Europe and the United States. All these influences created a scientific revolution, one that strongly influenced the participants at that historic meeting that led to the founding of ASHA in 1925.

In 19th century America there was no such thing as “allied health professionals”. Indeed, the professions making up this group such as occupational therapists, physical therapists, and speech-language pathologists were not yet founded. Services when they were provided in these areas were administered by self-styled practitioners—those who had an interest, talent, or personal experience with a type of therapy.

Among these pre-professionals, was a group of practicing specialists who drew their expertise from having cured their own speech problems, or from their felt talents in teaching or orating. These pre-professionals increased in number in the mid and late 19th century, as a result of other reforms that were taking place in the United States. The group members began to work together contributing to a general rise of professionalism that was happening throughout the United States early in the twentieth century.

I will be describing the influences that the elocution movement, the scientific revolution, and the rise of professionalism had on the practices carried out by speech correctionists in the United States. While the influences overlapped and intermingled, they are arranged roughly in chronological order, with the elocutionary practices holding sway early in the 19th century, the move toward scientific experimentalism later in the 19th century, and the developments in professionalism occurring at the turn of the 20th century.


We begin by talking about these four domains in the ancient cultures of Mesopotamia, Egypt, Greece, and Rome. The treatment is roughly chronological beginning with the earliest cultures of Mesopotamia, and ending with the Romans. The time period covered in this ancient history review begins around 3500 BC and ends around 500 AD, when the medieval period began.