Karen-ism in Speech-Language Pathology

Image Courtesy of Pixabay.com

Let’s be honest: We have a Karen issue in speech-language pathology.

I’ve run into it myself several times as a woman who identifies as mostly white (I’m Native American enough to claim tribal affiliation, but never have). Let me just say that my experiences have given me a glimpse of what it must be like to be a person who identifies as a person of color in our field.

The first time was in grad school. I’ve always been somewhat of a free spirit. And, I ‘came of age’ in the early 1990s in the very liberal, very insulated island that is Bloomington, Indiana. Grunge music, Broomstick skirts, extra long t-shirts, no make-up, long, loose hair that was then pulled up into a ponytail, sandals as many days as possible for shoes, sweatshirts with shorts the first day the temperature was above freezing in the spring, partaking in the Culture Shock festival and environment – that was me. It still is.

In Bloomington, diversity was expected and encouraged – in thought, in personal expression, in music, in everything. I loved the four years I spent in B-town.

Then, I moved to Knoxville, Tennessee for grad school. Talk about a whole other kind of culture shock. My entire closet in Bloomington was comprised of clothes that were comfortable and generally too big. I was all in on grunge fashion. I’ve never been one for make up. I don’t like the way it feels on my skin. About a month after our first clinical rotation started, I found myself called into the clinic directors office to talk about my appearance. Being all of 22 years old at the time, I acquiesced on the outfits I wore on clinic days and made sure my hair was dry before therapy sessions. Fine, there’s something about professional appearances in student handbooks, clinic guidelines, and even in the ASHA bylaws. I’ll even go as far as to say boob cracks and butt cracks need to be covered and that politically charged wording should stay out of the therapy room/client’s homes (I’m looking at you, “Let’s Go, Brandon” crowd!) But, I pushed back when told I needed to wear make-up. I told the clinic director when she could show me where ASHA said I needed to wear make-up for clinic, we’d talk. That didn’t win me any friends, but there wasn’t much she could do or say about it.

Fast forward several years, post professional experience and a Ph.D. from Florida State and I found myself in Nevada and California – in some ways, truly still the Wild West. Once again, I found myself in a situation where as long as boob cracks and butt cracks were covered and nothing politically charged was written on clothing, people were pretty free to be themselves. It was okay to have visible facial piercings as long as studs were worn. Tattoos were acceptable. So, I began adding to my own tattoo and piercing collections. Two more tattoos (inside of my wrist and just above the ankle) and three more visible piercings (nostril, rook, & conch). The West Coast is mostly definitely not free of Karen-thinking. In fact, Bar-B-Que Becky (the OG Karen) was from the Bay Area in California. But, there is definitely much less of it out here.

A few years ago, I decided to try to return to higher ed full time. I applied primarily to schools that were more focused on teaching rather than research. I was offered and accepted a position at a small, public liberal arts university in New England. I’ve spent my life moving around the country. I learned as a young child that “When in Rome, do as the Romans do” is very true. I used that adage to survive as an adult in places as vastly different from each other as Greeneville, Tennessee, Lawrence, Kansas, metro Atlanta, Tallahassee, Florida, Reno, Nevada, and Merced, California.


I had never lived in New England. In fact, I’d never been farther east than Niagara Falls before moving to New England. I was excited to make the move because I’d heard how liberal the area was. I knew the political positions of people like Elizabeth Warren and Ed Markey and Ayanna Pressley. John Adams and John Kennedy were from New England. Yeah, I might have to actually wear shoes again, but I could adapt. I’ve always been able to before.

I very quickly felt like I was trapped in the movie Legally Blonde. And, people were that open about making comments about me and my appearance within earshot. One of my co-workers whose hair clearly had not been washed in a couple of days told me I was unprofessional to my face in front of another colleague because of my facial piercings and went on to say, “I can take that jewelry out of your ears. Just give me a pair of pliers.” When I asked what was so offensive about my piercings, she commented that they would make the clients uncomfortable. And then stated, “At least you don’t have any tattoos.” I found that ironic because she clearly hadn’t noticed the aum tattoo on the inside of my wrist which I didn’t have covered that day. I’ll let you decide about the level of professionalism in her behavior.

Message received, Karen – you don’t like my appearance and you feel entitled to tell me that in the name of professionalism. You think I should remove the studs from my body that offend you. You think I should cover tattoos that are meaningful for me because they offend you. Too bad the clinic handbook only required students to comply with the rules. You should have seen your face when I pointed that out to you, while you stated, “Well, it’s implied for faculty!”

Unfortunately, it didn’t stop there. The pearl clutching when they found out I was teaching graduate student clinicians to try to think like I do in clinic! That students should learn to take the family’s needs into consideration when treatment planning. That students should learn to match a child’s energy in the therapy room and make the therapy process fun and that kids might laugh out loud when that happens. The horror! That not every client needs to have a receptive language goal unless you can demonstrate the need for it and how you plan to measure it accurately. That, when you work with a client from a CLD background, you must take that background into consideration. Difference is not disorder. There’s no such thing as “proper” language. That there are the numbers on the tests and those are needed. But, what are the client’s functional strengths and weaknesses? How can you address what you see as the biggest issue while also addressing the family’s concerns? How can you get the greatest amount of change in the shortest amount of time for your client? Or, let’s not forget about teaching students to do things the way they’re actually done in the real world as far as documentation goes. Oh, and lest I forget, I must reprimand students for failing to remove any jewelry from visible piercings or letting a glimpse of a tattoo show.

All of this lead to questioning what I was teaching in the classroom – because it wasn’t what the clinic staff wanted the students to think. Because it was different. Because I was different. I was asked to submit copies of syllabi so that ‘they’ could make sure I covering the content ‘they’ wanted covered. But, those issues were fairly easy to swat away in the context of the classroom itself. Academic freedom still exists. For now, anyway. Thank goodness.

I made it two years. Then, I escaped back to the sunshine of the West Coast. It’s refreshing that the comments about my piercings and tattoos are once again generally, “That’s cool. Where’d you get that done?’

Again, message received, Karen. It’s time for those of us who are different and who think differently to have a turn. So what if we have piercings and tattoos? So do our clients and/or our clients’ families. So what if you think we’re ‘doing it wrong.’ Your way hasn’t worked. Your way makes people think all SLPs do are show flashcards and play board games and then kids work on the same goals year after year. It’s been time to do things differently. Who’s with me?

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