Therapy for Black Girls – Session 453:

What Speech-Language Pathologists Actually Do

Host: Dr. Joy Harden Bradford
Guest: Dr. Dawn Ellis, speech-language pathologist, advocate, and educator
Date: March 4, 2026

Episode Overview

In this insightful conversation, Dr. Joy Harden Bradford and Dr. Dawn Ellis dive deep into the field of speech-language pathology, shining a light on what speech-language pathologists (SLPs) really do, how their work stretches far beyond elementary schools, and how speech and communication intersect with mental health—especially among Black women, children, and families. Dr. Ellis shares her professional journey, the nuances of assessing and treating speech/language disorders, the importance of cultural competence, and practical guidance for families and adults seeking speech-language support.

Key Discussion Points & Insights

Dr. Ellis’s Journey Into Speech-Language Pathology

• Serendipitous Start (04:59): Dr. Ellis recounts wanting to be “a child physiologist” as a child (not knowing what it meant), being rejected from her dream college due to enrollment quotas, and discovering speech-language pathology through a work-study job at Bakersfield College’s Handicapped Service Center.
  • “God makes no mistakes.” – Dr. Ellis (06:03)
• Academic Background:
  • Bachelor’s in Communicative Sciences and Disorders at Cal State Northridge
  • Master’s and Doctorate at Howard University, including special training in pediatric speech-language interventions (ages 0–5).

The Scope of an SLP’s Work

• Daily Practice (07:54):
  • Dr. Ellis balances private practice, home health, virtual care, advocacy, and service with professional organizations (e.g., ASHA representative for D.C., associate director at the DREAM technical assistance center supporting HBCUs/Tribal Colleges).
  • Diverse settings: schools, hospitals, rehabilitation, academia, corporate consulting, and private practice.
• Careers Beyond Schools (10:15):
  • SLPs can specialize in early intervention, augmentative & alternative communication (AAC), accent/dialect coaching for actors, corporate communication, or even grant/federal policy management.

Types of Speech, Language, and Communication Disorders

• Domains of Communication (12:47):

  • Speech: Articulation, fluency (“fluency disorders” preferred over “stuttering”), voice, motor planning.
  • Language: Receptive (what is understood), expressive (what is said), grammar, vocabulary, and pragmatics (social use).
  • Cognitive-communication: Memory, attention, executive functioning.
  • Alternative communication: AAC devices, sign language, gestures, and body language.

  “When we talk about speech, we think of production, articulation, motor planning, voice, fluency... and then cognitive-communication, memory and attention, executive function... those are some of the areas that communication could be effective.” – Dr. Ellis (12:47)

Understanding Fluency (Stuttering) and Causation

• Origins of Disfluency (14:39):
  • Normal part of children’s development, often resolves over time
  • Can be affected by stress, trauma, or adverse childhood experiences
  • Important: Avoid labeling or shaming, and model slow, supportive speech

Misdiagnosis, Stigma, and Disparities in Black Communities

• Over and Underidentification (20:06):
  • Black children are sometimes overrepresented in special education but also underdiagnosed with specific communication disorders.
  • Stigma and lack of awareness (especially around language/cognitive issues as opposed to visible speech production challenges) contribute to disparities.
  • Importance of family and broader societal acceptance: “The more that there’s awareness… the more acceptance there is to get help and not feel that shame because my child is not perfect.” – Dr. Ellis (22:46)
• Intersection with Incarceration:
  • Many incarcerated people have undiagnosed speech/language or cognitive-communication challenges.

Recognizing and Addressing Concerns in Children

• Developmental Milestones (24:13):
  • Awareness of sound acquisition (e.g., “S” and “th” may develop as late as ages 6–8)
  • Importance of not comparing children; each develops differently
  • COVID-19 pandemic effects: Less socialization may delay language development for some
  • Early intervention is key—don’t “wait it out” if concerned; use resources like Child Find

Access and Insurance

• Coverage and Eligibility (27:27):
  • Public school/early intervention programs typically provide services free if eligible
  • Private insurance generally only covers services if there is a diagnosed disorder

Dialects vs. Disorders

• Cultural Competence (29:23):

  • Distinguishing differences due to dialect, secondary language acquisition, or background from true disorders
  • Academic impact is key: Is communication affecting learning/participation?
  • Perceived intelligence is often unfairly linked to speech patterns; bias must be countered

  “Just because someone doesn’t sound like you… does not mean that it equates to intellectual...” – Dr. Ellis (32:10)

Impact on Mental Health & Self-Worth

• Social and Psychological Effects (33:29):
  • Communication disorders can cause anxiety, low self-esteem, social isolation, or avoidance.
  • Co-occurrence with conditions like ADHD, OCD can complicate challenges.
  • Internalized stigma and self-comparison can hinder participation.
• Strategies for Adults (35:19):
  • Adults can and do seek SLP support, often for post-trauma, brain injury, or elective self-improvement.
  • Therapy focuses on tailored, goal-oriented interventions and confidence-building activities (e.g., practicing ordering in restaurants).

Building Confidence and Advocacy

• Self-Acceptance (41:21):
  • Embrace individual differences (accents, dialects, unique speech features)
  • "Be confident in my smile and how my gap shows up in my life, in my personality. So the same with your speech... be confident in however you speak..." – Dr. Ellis (41:21–42:30)
• What Loved Ones Can Do (45:00):
  • Avoid finishing others’ sentences, shaming, or “rushing.” Give time and space for expression; include and support participation.

Inclusive Work and School Environments

• Universal Design and Accommodation (46:34):
  • Use closed captions, diverse instructional methods, and adaptive workflows.
  • Ensure accessible interviews and allow extra processing time.
  • Encourage all students with disabilities to proactively seek campus accommodations—before a crisis arises (50:01).

Resource Recommendations

• For Families and Professionals:
  • asha.org – American Speech-Language-Hearing Association offers accessible resources for parents and the community.

Notable Quotes

• “God makes no mistakes.”
  — Dr. Ellis on her unexpected career path (06:03)

• “Just because someone has a disfluency or doesn’t sound like you does not mean that it equates to intellectual [difference].”
  — Dr. Ellis (32:10)

• “We are all uniquely and wonderfully made... a lot of it is building that confidence with self-acceptance.”
  — Dr. Ellis (42:30)

• “Do not wait until you need [accommodations]… It’s better to have it so you can use it when you need it instead of trying to go through the process as you’re taking the test.”
  — Dr. Ellis to college students (50:16)

• “Just embrace who I was becoming and knowing that I belonged in those spaces where there were not people like me.”
  — Dr. Ellis’s advice to her 18-year-old self (53:59)

Timestamps for Key Segments

• Dr. Ellis's Career Path: 04:59–07:49
• Where SLPs Work: 10:15–12:38
• Common Communication Disorders: 12:47–14:39
• Understanding Fluency / Disfluency: 14:39–16:55
• Disparities in Black Communities: 20:06–23:42
• What Should Caregivers Watch For: 24:13–27:27
• Insurance/Eligibility: 27:27–29:23
• Dialect vs. Disorder: 29:39–32:39
• Speech Disorders & Self-Worth: 33:29–35:19
• Speech Therapy for Adults: 35:19–37:35
• Building Confidence: 41:21–42:48
• What Loved Ones Can Do: 45:00–46:34
• Inclusive Work/School Strategies: 46:43–49:51
• Accommodations for College Students: 49:51–51:44
• Resources/Advice to Younger Self: 53:13–53:59

Memorable Moments

• Dr. Ellis’s moving retelling of her unintended path into SLP—and how serendipity combined with resilience shaped her career.
• Reframing "stuttering" as "fluency disorders" and the shift from labeling to describing characteristics.
• The nuanced discussion of dialects as cultural assets, not deficits.

Resources & Further Information

• Dr. Ellis’s Private Practice: aurorasunservices.com
• DREAM Center (for faculty, academics, HBCUs): @dreamstacenter on Instagram/Facebook
• American Speech-Language-Hearing Association: asha.org
• Therapy for Black Girls Community: community.therapyforblackgirls.com

Closing Thought

This episode underscores the vital breadth and cultural relevance of speech-language pathology. It advocates for holistic, bias-free, and accessible approaches to communication—emphasizing everyone’s right to be heard, understood, and fully included.