Winner of the 2023 Gospel and Academia Project essay prize for post-doctoral researchers

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How Christianity has enriched the profession of Speech and Language Therapy, and how Speech and Language Therapy can enrich faith in the Lord Jesus Christ

The following is aimed at any clinical academic or speech and language therapist interested in the foundations of speech and language therapy (SLT) and how they affect its ongoing development. It is also aimed at Christians and church leaders interested in promoting the accessibility of the gospel to those with communication needs. It will first discuss the relationship between the field of SLT and the Christian gospel, by examining how the Christian worldview irrefutably underpins SLT with its foundation of objective reality, morality, and communication, and how the particulars of the gospel message can, and have done nothing but, enrich SLT research and practice. It will also examine how the Christian worldview can liberate SLT from recent attempts to deconstruct its foundations through modern critical theory and the influence of behaviourist beliefs. Finally, the impact the field of SLT can have on building up of the body of Christ, the direct proclamation of the gospel, and the worship of God are discussed.

From Christ to Speech and Language Therapy

Christianity is the foundation of SLT

Although the roots of SLT go back to antiquity, the modern profession stems largely from elocution in the eighteenth century. With the publishing of Samuel Potter’s book in America¹, and the case of stammering of King George VI in the UK, this focus began to shift towards speech disorders such as stammering and lisps. As the twentieth century progressed and further technological advances were made, and as the incidence of brain injuries from soldiers returning from the First and Second World Wars increased, brain function and the links between cognition and language² became the focus of research. This is when ‘speech therapy’ became known as ‘speech and language therapy’. Since this time, the profession has developed understanding of and therefore ability to treat a huge variety of communication disorders.³

The Christian gospel is the belief that there is one God who made all of creation; the universe and everything in it. He made mankind in his image, male and female, and set them to rule over the earth with him. Mankind rejected God and this mandate. Therefore God, being both fully just and merciful, sent himself in the form of his Son Jesus Christ to live an innocent life and die in the place of all of mankind in order to atone for the injustice of the original rejection of the truth. Jesus then rose again conquering death which mankind brought on itself and invites all who acknowledge the truth to live eternally with him as intended. God, through Jesus is now “[reconciling] to himself all things… by making peace through the blood, shed on the cross.”⁴

Three connections unite SLT to Christianity: there is objective reality, and it can be partly known through our senses; there is objective morality which is beyond human will and creation; and God communicates, particularly through the person of Jesus Christ. Each are expounded below.

Christianity underpins objective reality

There are two basic ontologies about reality: that there is Something outside of space and time, and that space and time is all there is.⁵ The only way to believe in objectivity is to believe that there is Something outside of space and time. Equally, if you believe there is Something outside of space and time, you must believe there is such a thing as objectivity. If space and time is all there is, then the only viewpoints we have are our own as human beings; and these are necessarily subjective.⁶ Objectivity by human beings is, by definition, an impossibility, since it is only ever one human being’s view and ideas against another’s, with no truly objective outside source.

A speech and language therapist’s remit is communication and this itself illustrates why objectivity is incontrovertible. Communicating is the ability to recognise and symbolise concrete and abstract concepts within reality via a shared modality in order to converse about those concepts with others. The concrete and abstract concepts directly link to referents.⁷ When learning language, a child does not learn a word by someone describing it using other words, they learn the association between asymbol, for example, phonemes making up the word, and the concept through a real-world referent; for example, ‘cat’ by sensorily experiencing a real cat. The shared modality is termed ‘language’, and can take various symbolic forms, most commonly the spoken word, but the written word, signs, body language, gestures, facial expression, and others should all be considered legitimate. Combining these symbols allows increasingly complex messages to be communicated. Therefore, there must be a shared understanding of reality as a prerequisite to communication. It is beyond the realm of probability to assume that humans all just happen to be able to communicate based on chance with every word spoken, every movement made, or every facial expression presented.⁸ This shared objective realm is the starting point for speech and language therapists in ameliorating communication disorders.

Another remit of SLT in practice and in academia is the promulgation and use of evidence-based practice; the treatments we deliver to our clients should be grounded in theories that work based on evidence. Gaining evidence fundamentally relies on there being objective reality. We suggest theory and hypothesise about truth, and test if it lines up with reality.⁹ Humans do not create the physical and mathematical laws that govern our universe, we theorise about and identify them, and in doing so reveal religious belief, which will always act as a “regulative presupposition” to any theory.¹⁰ However very few academics acknowledge this. Philosophy is left to the humanities and arts, and some social sciences, but “science can never be neutral with respect to the religious ground-motive out of which it operates”.¹¹ Medicine, psychology, SLT and other allied health professions, as well as natural sciences and engineering, are as inextricably bound to worldview as other disciplines. It is no wonder that modern science emerged in western Europe in deep Christian tradition in which this was acknowledged.¹² The reason academics in such disciplines tend to avoid these truths is because the only way to fully justify an objective stance on reality is to admit the need to believe in Something outside of reality, and they are therefore compelled to face the question: what or who is this Something on which we predicate our worldview?

Christianity underpins objective morality

The existence of an objective physical law points to a lawgiver, a Someone who is consistent and ordered as physical laws are. Likewise, the existence of an objective moral law also points to a lawgiver. The issue with identifying an objective moral law is that we as subjective human beings are highly unreliable sources from which to understand this. There never has been a full consensus on what constitutes morality by all human beings, but this does not mean there is no objective morality. The Christian explanation is based on the truth of human subjectivity in comparison to God’s objectivity. God is the objective moral lawgiver, and all people know this law but have turned from it, choosing to live according to their own morality, ‘worshipping’ themselves or other aspects of created reality, rather than God. Saint Paul’s letter to the Roman church states “…for all… fall short of the glory of God” and “…[people] exchanged the truth about God for a lie and worshipped and served created things rather than the Creator”¹³. This explanation balances the truth that humans cannot agree on a moral law, with the truth that there is an objective moral law; it comes from outside of ourselves and has been communicated to us. However, only some accept this; others reject it in favour of their own morality.

Furthermore, although a full and complete consensus has never occurred, there is very powerful evidence that there always has been at least some agreement on morality among groups of people¹⁴, again disproving total subjectivity, and affirming the Christian worldview. For example, today it is often taken as a given that helping others is the self-evident ‘right’ thing to do, and that healthcare, including being able to communicate, eat, and drink, are ‘human rights’. SLT, whether acknowledged or not, is founded on the belief in the ‘rightness’ of caring for others and improving human life. This is a moral position and is based on the belief that human beings have inherent rather than acquired value. Christianity stands alone in the assertion that humans are made equal in value, rooted in the fact that they are made in the image of God. Other theistic religions consider, for example, women of lower value than men; pantheistic religions often consider those of lower social status of lesser value and deserving of circumstance; atheism has no basis on which to claim anything has value since it not only forfeits objective reality in its materialism, but also morality in its nihilism.¹⁵ It is only because in the West we are living on the vestiges of a society which was steeped in the Christian worldview that these values generally remain as consensus. With the gospel foundation stripped away nobody knows, or questions, why what they believe is right.¹⁶ Questioning the origin of our morality is not considered ‘scientific’ (and therefore of relevance) to healthcare professionals such as speech and language therapists, which is a fatal omission. It is imperative that we interrogate the underlying assumptions of the idea of human rights, and the rightness of caring for others for three reasons. Firstly, because we cannot identify an outcome which appeals to us and not also adopt its foundation, otherwise that outcome and its supposed foundational principles are subject to change at any time. Secondly, it is impossible that what we as therapists and clinical academics believe about these fundamentals does not make any difference to our integrity in practice and research; it is the underpinning of our motivation for our work. Finally, it secularises and therefore ignores the spiritual dimension of the care of our clients. Suppressing this foundation ultimately only does us and those we care for a disservice.¹⁷

Christianity underpins communication

SLT is founded on the understanding of what human communication is and how to support it when it goes wrong. This is inextricably tied to the origin of language, speech, and communication. The nature of the God of the Christian bible is essential in understanding these.¹⁸ God communicates, and since he is unchanging, he has always been in communication within the three persons of the Trinity; Father, Son, and Holy Spirit. John 1:1-2 says, “In the beginning was the Word, and the Word was with God and the Word was God.” This title of Jesus is the Logos, the “Word”, rendered in the original language as ‘the expression of a thought’, and can be described as God’s total message to mankind.¹⁹ Through Jesus, God spoke creation into being; “And God said, “Let there be light,” and there was light” and “Through [Jesus] all things were made; without him nothing was made that has been made.”²⁰ As image bearers of God, human beings communicate through language and speech, and this is totally unique in creation. This is agreed by current consensus in SLT and its theoretical under-pinner, linguistics. Noam Chomsky, “the father of modern linguistics” and an agnostic evolutionist, refuted Burrhus Skinner’s purely behaviourist view of language, that language only comes about by learning (based on the evolutionary view that humans are animals), saying that this did not account for all the facts. Chomsky described human language as “miraculous” and agreed with Descartes, long before him, that language is “species specific”.²¹ The gospel tells us that mankind has turned from God, and with that rejection came the marring of human communication, including language and cultural barriers, miscommunications and misunderstandings, and disorders of speech and language. This is not to say that an individual accepting or rejecting the gospel will heal or cause communication ability, but that the brokenness of the world is the root of all communication breakdown and disorder. For speech and language therapists then, the starting point of addressing these needs is an acknowledgement (conscious or unconscious) of God – as arbiter of objective reality and morality, and communication, and redeemer of the fallen nature of the world and human beings.

Christianity has transformed SLT

As outlined above, it is clear that the Christian gospel is the foundation of SLT, which is ascribed to by all therapists automatically, whether acknowledged or not. It is this which unites SLT and allows the advancement of  the profession. To bring the full bearing of the meaning of the gospel into SLT and so allow its further development, the impact of the life, death, and resurrection of the Lord Jesus Christ on this young profession must be examined.

Christianity in the development of SLT

Viewing human beings through the lens of the Christian gospel, as image bearers of God, has changed SLT. The idea of conforming speech and language to increase social status as does elocution, the modern origin of the discipline, is not Christian. In fact, it is rooted in a worldview which divides people based on supposed ‘social class’,²² though popular understanding of SLT sadly remains as a form of elocution. The move away from this categorisation and toward a construct of disability in communication and its associated duty on the part of a therapist to help and support those who are needy, is irrefutably Christian. Jesus Christ died for every person, not only for some. We are all equal in value because we are made in the image of God, and “There is no one righteous, not even one”.²³ This extends to the way we communicate, though even today this is not popularly agreed upon. It is a significant role of the speech and language therapist to challenge perspectives which hold onto this idea, partly because of our expertise and partly because we are so often mistaken for elocutionists. Without a gospel-centred idea refuting social class, SLT could not have diverged from its elocution roots.

Christianity in the vocation of SLT

Altruism is repeatedly cited as a reason for joining and remaining in the profession of SLT.²⁴ Therapists see their role as one of service, a self-sacrificial vocation, entered not because it is ultimately good for themselves, but for others. Obligatory professional competencies of a speech and language therapist outlined by the Health and Care Professions Council in the UK are filled with attributes which can only come through a firm moral foundation and altruistic desire found in the Christian worldview;²⁵ doing good because it is right. When we care for the pinnacle of God’s creation, human beings, we fulfil his enduring mandate to take dominion as royal stewards over the fallen world, and work with him in his redemption of the earth. Just as God brings order out of chaos, redeems, heals, makes right what is wrong, a speech and language therapist’s amelioration of communication difficulties both emulate and glorify him. Without God, such attempts would be meaningless.

Christianity in the parameters of SLT

As in any other profession, SLT follows process and procedure, both in academia and in practice. These are in place only because of the (generally unconscious) acknowledgement of both the sinfulness and the imperfection of mankind. For example, the peer review process for academic writing acknowledges bias and requires the disclosure of conflicting interests. The teaching of SLT students requires them to understand professional boundaries, procedures for diagnosis and treatment, and to learn the processes involved in day-to-day SLT work settings. Professional integrity is highly valued, and bias, personal profiteering, and selfishness are condemned. There is also an (again, generally unconscious) acknowledgement of the fallenness of humanity when we put policy and procedures in place which protect against mistakes and human error. Without such moral principle and foundation of truth as the gospel, such principles would not exist.

Christianity can liberate SLT

There are subtle but foundational changes occurring in SLT today as a result of abandoning the Christian gospel. These primarily come from critical theory, behaviourism, and the pervasive idea that there is a neutral ground upon which SLT operates. Without serious academic opposition to these, the foundation of SLT will collapse, and with it, all worthwhile care for our clients.

Christianity provides sufficient critique and practical solutions

Critical theory is currently being used to attempt to ‘deconstruct’ SLT, with many papers published recently describing its foundations varyingly as being ‘colonial’, ‘racist’, ‘ableist’, and ‘capitalist’²⁶ and thus in need of total reform. One of the key ways this is occurring is through the deconstruction of the definitions of ‘disorder’ and ‘disability’ and of communication assessments, all widely used in SLT. This can be traced to the movement of social constructionism, the central claim of which is that knowledge is socially constructed,²⁷ including the postmodern idea that language creates reality. Based on this assertion, binary oppositions, such as ‘normal versus abnormal’ and ‘able versus disabled’ are called into question. Social constructionists deem that positive and negative connotations have been socially attached to such binaries,²⁸ therefore removing the label essentially removes the problems deemed to have been created by labelling them. Foucault especially argued against binary oppositions, due to what he perceived as the power dynamics behind them,²⁹ suggesting any care for SLT clients, which necessarily involves binary labels, is only in order to exert power over those cared for.

Social constructionism claims that it is this use of language to create labels which is the root problem, not innate human sinfulness as the gospel contends. This incorrect identification of the problem leads to an insufficient solution. For example, the natural extension of the removal of binary oppositions is to question the need for intervention, which would be decided upon based on these distinctions. If one cannot say there is an ‘impairment’, one cannot show the need to rectify it, nor acknowledge and avoid its potential consequences such as poor educational, behavioural, and psychosocial outcomes, both in the short- and long-term.³⁰ Instead, the solution offered is a change to society’s view ofdisability and disorder to be normal, even good.³¹ Christianity refutes this; disability and impairment are to be expected but acknowledged as tragic in this fallen world.³² Jesus himself saw the consequences of illness and disorder as in need of intervention through his healing of the sick, and his weeping over the death of a friend.³³

However, social constructionism is correct that the social earmarking of ‘good’ or ‘bad’ to people’s intrinsic attributes can be catastrophic, but it is only so if Christian objective reality and morality are rejected. We must be able to determine proper categories of disorder and ensure that treatment of those labelled with disorder is equitable. Christianity provides the objectivity needed to allow this. An example of this is in the proper identification of categories of communication disorder as opposed to dialectal and language difference. Speech and language therapists, influenced by objectivity found in the Christian worldview, have advocated for years that learning more than one language does not lead to disorder or delay, language and communication difference does not mean one language, dialect, accent, or method of communication is inherently ‘better’ or ‘worse’ than others.³⁴ Christianity also provides the morality required for the motivation to change ingrained prejudices about people on account of speech, language, and communication difficulties through advocacy and awareness.³⁵ 

In these ways, social constructionism and all its varied critiques currently assailing the root of SLT fall far short of the ability of the Christian worldview to critique and provide solutions for those with communication difficulties. Indeed, “Christianity truly gets to the heart of the matter and actually is the most truly “critical,” in that the Christian message offers a true understanding of reality and what is wrong with the world, and likewise offers the true solution to the myriad challenges, problems, and sufferings experienced and seen in the world.”³⁶

Christianity provides the foundation for individualised care

Individualised care is at the heart of modern healthcare professions, including SLT. Widely used models such as the International Classification of Functioning, Disability, and Health³⁷ seek to recognise the strengths and needs of an individual to treat them holistically. However there remains underlying bias and, more recently, outspoken suggestion that such things as an individual’s ‘class’ or ‘race’ should be acknowledged in order to properly deliver SLT care.³⁸ The arguments for this begin seemingly correctly; asserting that people have been classified or racialised according to incorrect ideas about speech and language development and proficiency,³⁹ that this is damaging, and therefore acknowledgement of this by grouping the individual is necessary to undo harm caused. However, this requires the use and promotion of the same terms used to group individuals, just in the opposite direction. For example, those racialised as ‘black’ are now being elevated over other racialised groups due to past discrimination.⁴⁰ Language is powerful, since with it, God created. But human beings cannot create reality using language. All that humans can do with language is to repeat the truth about reality or create the illusion of reality through lies. Instead of recognising the socially constructed illusion of reality in such terms as ‘race’ and ‘class’ and rejecting them outright, social constructionists desire to reconstruct these labels to achieve equity for clients since they believe such terms render the categories really real.⁴¹ It is right to reject any sign of classism or racism in SLT, but to properly do this the social constructionist view must be rejected, otherwise we reify the illusory categories which caused classism and racism in the first place. Talking about ‘race’ and ‘class’ does not make them real, however we can and should critically evaluate the impact the use of these terms has had in SLT. Christianity promotes both key elements here; discrimination and categorisation of people have firm opposition since human beings are made in God’s image, and we share a common ancestor in Adam; there are no ‘races’ or ‘classes’ of people,⁴² therefore the individual is valued above any grouping.

Furthermore, the bible commands to love our neighbour as ourselves,⁴³ and to continually test ourselves to find out the sin in our hearts and return to the objective morality of God,⁴⁴ ensuring potential discriminatory practices are continuously rooted out. This biblical view must continue to be SLT’s core principle of care, and such incorrect and damaging groupings both historically and in their newest forms must be identified and rejected.

Christianity provides boundaries

Recent research seeks to apply behavioural psychology to SLT to understand the mechanisms of change which support improvement in client communication. This has been in intervention research⁴⁵ and in promoting the uptake of evidence-based practice.⁴⁶ The foundational concepts in behavioural psychology are addressing human capability, opportunity, and motivation in changing behaviour. Supporting behaviour change can only be implemented when there is a joint understanding of truth and reality; motivating someone to do something relies largely on them believing that the premise presented is based on truth. Therefore, speech and language therapists must be objective and moral, recommending evidence-based treatments and seeking positive outcomes, which as discussed previously can only come from the (conscious or unconscious) acceptance of the Christian worldview. In disputed assertions of truth, Christianity provides the basis for the tolerance of others’ opinions, and provides boundaries for the ‘expert’ model of care which has been rightly critiqued over the years,⁴⁷  by calling us to speak the truth in love, act humbly, putting others’ needs before our own, just as Christ did even in the face of wrongful persecution.⁴⁸ With the rise of behaviour change theory in SLT, these attributes are highly likely to again become an issue, particularly as seen with the influence of ‘the expert’ behaviour change tactics used in public health during the COVID-19 era.⁴⁹

From Speech and Language Therapy to Christ

Because there is no sacred-secular divide, or neutral standpoint, SLT is part of Jesus’ great commission and God’s cultural mandate to ‘take dominion’ over the earth.⁵⁰ It is therefore incumbent to discuss the reciprocal impact of SLT and its accomplishments on this Christian mission. Firstly, the more we understand about speech and language and how it works, the more we will be able to glorify God, who invented it. Its complexity, diversity, and mystery in acquisition and amelioration, phonology, syntax, semantics, pragmatics, semiotics, and grammar are stunning. Exploring and exploiting the knowledge base of SLT to illustrate how great God is can only serve to increase his Kingdom and glorify him. Secondly, the understanding which SLT research and practice brings to communication and its varied disorders can support Christians to illustrate and proclaim the gospel. For example, it can enhance love for neighbour, and care for those with communication difficulties, since those with such difficulties can be understood, and loved as Christ loves us – something which can be done best when communication is successful. In addition, it can then support the advocacy of such people in the manner of Proverbs 31:8 “Speak up for those who cannot speak for themselves”. It can also serve to better provide in terms of communicating the direct articulation of the gospel message alongside this active expression of it, for those who need alternative and augmentative communication strategies. Some practical examples may include large print on service sheets, the advance provision of simplified sermon outlines, installation of hearing loops, multiple linguistic translations and sign language being used in church services, communities, and workplaces – the list goes on, and it is exciting to reflect on all that could be achieved here. Engaging with speech and language therapists to understand possible means of communication for those who cannot communicate conventionally is vital. Christians must be proactive rather than reactive in promoting and providing for those who struggle to communicate in every sphere they are involved in, to support the practical illustration and proclamation of the gospel.

Conclusion

Like every other area of life, SLT must be brought under the full dominion of Christ for its flourishing, and to prevent its decay. Much of what has been illustrated here applies to other disciplines in similar ways to SLT, because the battle for the dominion of the world is always either for or against God, it is not neutral. The many Christian speech and language therapists across the world should take courage in both proclaiming the supremacy of Christ in all areas of their work and promoting the needs of their clients within their church families and in wider society, opening conversations about accessibility and provision for those who struggle to communicate. “For from him and through him and for him are all things,”⁵¹ including speech and language therapy.

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1. Potter, S. O. (1882). Speech and its defects: considered physiologically, pathologically, historically, and remedially. Philadelphia, P. Blakiston, Son & Co. [↩]
2. There is often a conflation of ‘language’ with speech, communication, and languages. Speech refers to the sounds produced during human speech and the processes by which these are selected and formed. Communication refers to the overall message conveyed. Languages are the different cultural expressions of language proper – in the Christian worldview, different languages were brought about after Babel and have developed into the myriad languages we know today, before this there was one language. Language is fully explained in the next section: Christianity underpins objective reality. [↩]
3. It would be entirely remiss of me to point out that due to the familiarity with the head and neck anatomical structures involved in speech, SLT also includes treatment of disorders of swallowing, eating, and drinking, though these are explored to a lesser extent in this essay. [↩]
4. Colossians 1:19-20 – this and all subsequent bible verses are taken from the New International Version (NIV) [↩]
5. For a description of theism, atheism, and pantheism and their ultimate collapse into these two worldviews, see Boot, J. (2005). Why I Still Believe: (Hint: It’s the Only Way the World Makes Sense). Grand Rapids, MI, Baker Books. [↩]
6. Subjectivity exists; the argument here is against subjective ‘truth’ being the only ‘truth’. [↩]
7. Saussure was first to make this distinction in his seminal work: Saussure, F. (1986). Course in general linguistics. LaSalle, Ill., Open Court. [↩]
8. Misunderstandings and failed communication do occur, but this is not due to a lack of objective reality, but due to the Fall and its many negative effects on human communication. [↩]
9. For a full exposition of the limitations of rationality, reason, and science, see Ratzsch, D. L. (2000). Science & its limits: the natural sciences in Christian perspective. Downers Grove, Ill, InterVarsity Press. [↩]
10. Clouser, R. A. (2005). The Myth of Religious Neutrality, Revised Edition: An Essay on the Hidden Role of Religious Belief in Theories, University of Notre Dame Press. Page 3. [↩]
11. Dooyeweerd, H. (2012). Roots of Western Culture: Pagan, Secular, and Christian Options. Grand Rapids, MI, Paideia Press. Page 9. [↩]
12. For a thorough but concise history of the foundation of the sciences, see Bloom, J. A. (2015). The natural sciences: A student’s guide. Wheaton, IL, Crossway. [↩]
13. Romans 3:23 and 1:25a respectively. [↩]
14. Some put this down to the progression of the evolution of mankind; people have created societal rules and norms which allow mankind to flourish. This utilitarian idea cannot be. A considered examination of the direct link between Darwin’s evolutionary theory (Darwin, C. (1871). The Descent of Man and Selection in Relation to Sex. Cambridge, Cambridge University Press.) and the essentially eugenicist programmes of Europe, Japan and China in the last century illustrates this. For further refutation, see Turek, F. (2014). Stealing from God: Why Atheists Need God to Make Their Case. Carol Stream, IL, NavPress. [↩]
15. An objection to the idea that in order to believe all human beings have inherent value by nature, one must believe in the foundation of Christianity is that many people do not call themselves Christians but believe that humans have inherent value. Of course, one can claim this, but it would be bastardising both the worldview they claim to adhere to and the Christian worldview by mixing them entirely. This stems from inconsistent application of worldview, which is often based on subconsciously adopting worldviews dependent on which one will give the outcome which the individual desires, without considering them as a whole. For further exposition of this idea see Clouser, R. A. (2005). The Myth of Religious Neutrality, Revised Edition: An Essay on the Hidden Role of Religious Belief in Theories, University of Notre Dame Press. [↩]
16. Taylor, C. (2007). A Secular Age. Cambridge, MA and London, England, Harvard University Press. [↩]
17. Thankfully this is recognised though in a limited and divided way in some literature, but only very recently in SLT: Mumby, K. and S. Mackenzie (2023). Perspectives on Spirituality in Speech and Language Therapy, J&R Press Ltd. [↩]
18. A brief overview is given here, see Taylor, C. V. (1997). “The origin of language.” Journal of Creation 11(1): 76-81. for a thorough discussion. [↩]
19. See Acts 11:1, and 1 Thessalonians 2:13. [↩]
20. Genesis 1:3 (emphasis added) and John 1:3a. [↩]
21. Chomsky, N. (1966). Cartesian linguistics a chapter in the history of rationalist thought. Cambridge; New York, Cambridge University Press. as cited in Chomsky, Ref. 6, p. 8-9. [↩]
22. See section ‘The gospel provides the foundation for individualised care’ below for further discussion of this. [↩]
23. Romans 3:10 which is referencing several Old Testament scriptures. [↩]
24. McLaughlin, E., M. Lincoln and B. Adamson (2008). “Speech-language pathologists’ views on attrition from the profession.” International Journal of Speech-Language Pathology 10(3): 156-168.; Whitehouse, A. J. O., K. Hird and N. Cocks (2007). “The Recruitment and Retention of Speech and Language Therapists: What Do University Students Find Important?” Journal of Allied Health 36(3): 131-136. [↩]
25. See the current standards here: Health & Care Professions Council (2013). Standards of proficiency: Speech and language therapists. London: 20. [↩]
26. See for example, Flores, N. and J. Rosa (2022). “Undoing Competence: Coloniality, Homogeneity, and the Overrepresentation of Whiteness in Applied Linguistics.” Language Learning, Watermeyer, J. and J. Neille (2022). “The application of qualitative approaches in a post-colonial context in speech-language pathology: A call for transformation.” International Journal of Speech-Language Pathology 24(5): 494-503, Brea-Spahn, M. R. and C. V. Bauler (2023). “Where Do You Anchor Your Beliefs? An Invitation to Interrogate Dominant Ideologies of Language and Languaging in Speech-Language Pathology.” Language, Speech & Hearing Services in Schools: 1-13, Nair, V. K., W. Farah and I. Cushing (2023). “A Critical Analysis of Standardized Testing in Speech and Language Therapy.” Language, Speech, and Hearing Services in Schools: 1-13. Likely the only reason ‘sexist’ or ‘patriarchal’ is not also used is due to the fact that this does not hold water in such a female-dominated profession. [↩]
27. Andrews, T. (2012) “What is social constructionism?” Grounded Theory Review 11. [↩]
28. Derrida, J. and A. Bass (1981). Positions, translation. Chicago & London, University of Chicago Press. [↩]
29. Foucault, M. (1980). The eye of power. Power/Knowledge: Selected Interviews and Other Writings 1972-1977 by Michel Foucault. C. Gordon. [↩]
30. There is a plethora of evidence of this, see for example Conti-Ramsden, G., K. Durkin, U. Toseeb, N. Botting and A. Pickles (2018). “Education and employment outcomes of young adults with a history of developmental language disorder.” International Journal of Language and Communication Disorders 53(2): 237-255.; Nathan, L., J. Stackhouse, N. Goulandris and M. J. Snowling (2004). “Educational consequences of developmental speech disorder: Key Stage I National Curriculum assessment results in English and mathematics.” British Journal of Educational Psychology 74: 173-186. Hilari, K. (2011). “The impact of stroke: are people with aphasia different to those without?” Disability and Rehabilitation 33(3): 211-218. [↩]
31. Murphy, J. W. and F. M. Perez (2002). “A Postmodern Analysis of Disabilities.” Journal of Social Work in Disability & Rehabilitation 1(3): 61-72. And see also Anastasiou, D. and J. M. Kauffman (2011). “A Social Constructionist Approach to Disability: Implications for Special Education.” Exceptional Children 77(3): 367-384. and Hubach, S. (2020). Same Lake, Different Boat: Coming Alongside People Touched by Disability, P&R Publishing Co. for an academic and Christian critique respectively. [↩]
32. Morrison, C. (2022). Accessibility in the church. Jesmond Parish Church. [↩]
33. See John 11. [↩]
34. Letts, C., S. Edwards, I. Sinka, B. Schaefer and W. Gibbons (2013). “Socio-economic status and language acquisition: Children’s performance on the new Reynell Developmental Language Scales.” International Journal of Language and Communication Disorders 48(2): 131-143, Letts, C. (2018). Language disorder versus language difference: The impact of socio-economic status. Handbook of communication disorders: theoretical, empirical, and applied linguistic perspectives. A. Bar-On, D. D. Ravid and E. Dattner. Boston, De Gruyter Mouton: 585-597. [↩]
35. See for example, Isaiah 1:17 which says “Learn to do right; seek justice. Defend the oppressed. Take up the cause of the fatherless; plead the case of the widow.” [↩]
36. Green, B. (2022). “Critical Theory and the Gospel.” American Reformer. Page 1. [↩]
37. International Classification of Functioning, Disability and Health (ICF) (who.int) [↩]
38. Nair, V. K., W. Farah and I. Cushing (2023). “A Critical Analysis of Standardized Testing in Speech and Language Therapy.” Language, Speech, and Hearing Services in Schools: 1-13. [↩]
39. For example a landmark study suggested those of lower ‘social class’ heard less words than their ‘middle’ or ‘upper class’ counterparts, creating a false ideology of a ‘word gap’ between different ‘classes’ (and associated ‘races’) Hart, B. and T. R. Risley (1995). Meaningful differences in the everyday experience of young American children. Baltimore, MD, Brookes. [↩]
40. Clearly no group should be raised over any other. The most public influence in this way of thinking stems from Robin DiAngelo and Ibram X Kendi’s books DiAngelo, R. (2019). White fragility: why it’s so hard for white people to talk about racism. London, Penguin Books, Kendi, I. X. (2019). How to be an antiracist. London, The Bodley Head. [↩]
41. For an excellent exposition of the philosophies of ‘race’, see Mason, S. M. (2022). Theory of racelessness: a case for antirace(ism). Cham, Switzerland, Palgrave Macmillan. For a brief deconstruction of the concept of ‘class’ from a Christian perspective, see Dooyeweerd, H. (2012). Roots of Western Culture: Pagan, Secular, and Christian Options. Grand Rapids, MI, Paideia Press. See also my own tweet thread on this in relation to SLT https://twitter.com/SE_BarnettSLT/status/1560932526813855744?s=20 [↩]
42. Revelation 7:9. [↩]
43. Matthew 22:39. [↩]
44. Lamentations 3:40. [↩]
45. For example, see Govender, R., C. H. Smith, S. A. Taylor, H. Barratt and B. Gardner (2017). “Swallowing interventions for the treatment of dysphagia after head and neck cancer: a systematic review of behavioural strategies used to promote patient adherence to swallowing exercises.” BioMed Central Cancer 17(1): 43, Barnett, S. E., H. Stringer and C. Letts (2021). Applying the Behaviour Change Technique Taxonomy (BCTT) to Parent-Led Language Interventions (ABC-PALS). PhD Speech and Language Sciences, Newcastle University, Johnson, F., S. Beeke and W. Best (2021). “Searching for active ingredients in rehabilitation: applying the taxonomy of behaviour change techniques to a conversation therapy for aphasia.” Disability and Rehabilitation 43(18): 2550-2560, Butler, J., H. Asbridge and H. Stringer (2023). “Applying behaviour change theory to speech and language therapy intervention for inducible laryngeal obstruction.” International Journal of Language & Communication Disorders 0(0): 1-12. [↩]
46. McCabe, P. J. (2018). “Elizabeth Usher Memorial Lecture: How do we change our profession? Using the lens of behavioural economics to improve evidence-based practice in speech-language pathology.” International Journal of Speech-Language Pathology 20(3): 300-309. [↩]
47. Davis, H. and L. Meltzer (2007). Working with parents in partnership. Department for Education and Skills, Crown. [↩]
48. Ephesians 4:15, Micah 6:8, Philippians 2:3-4, John 15:13, Matthew 5:11. [↩]
49. See for example Kamran, A. and M. Naeim (2021). “Behavioural change theories: a necessity for managing COVID-19.” Public Health 197: e4-e5. See also deft Christian critique of this in Boot, J. (2022). Ruler of Kings: Toward a Christian Vision of Government, Wilberforce Publications Ltd. [↩]
50. Greene, M. The Great Divide, The London Institute for Contemporary Christianity. [↩]
51. Romans 11:36. [↩]