Regional Dialects, Bias, and Speech Therapy Treatment

Gazing over the Appalachian mountain range.

Should Dialect be Treated?

The field of speech-language pathology has undergone a critical shift in recent years, explicitly moving away from viewing dialectal differences as disorders that need fixing and moving toward a more inclusive understanding of linguistic diversity.  I like to think we are well beyond the idea that dialect is a disorder however, despite this progress, we would be doing a disservice to children and adults if we failed to acknowledge the persistent biases that continue to exist toward certain dialects. The American Speech and Hearing Association’s official statement is:

It is the position of the American Speech-Language-Hearing Association (ASHA) that no dialectal variety of English is a disorder or a pathological form of speech or language. Each social dialect is adequate as a functional and effective variety of English.

Being Different=Natural Judgement

The nature of communication, both verbal and non-verbal, is an inherent part of identity and is judged subconsciously with primal fervor. The same instinctual tool, developed to keep us safe, can also just as quickly be misused to judge competence, intelligence, and professionalism. So, even for those who try to be well-meaning in our intentions of being free from bias,  we are no less immune to making judgments based on misinterpretation.  Living in the northern part of the United States and within the very seat of the Standard American English dialect, I often forget about the impact of how I sound or don’t sound when speaking. That is, until I’m in the middle of a passionate conversation and a listener stops listening to my message and proceeds to say,

“I didn’t know you were from Texas.”

Now, I in fact have never lived in Texas, and after almost twenty years of living away from my Kentucky home, I still get this comment more than occasionally in grocery stores, schools, and even right in the middle of serious and important conversations. 

Though no fault of their own, and primarily coming from a place of curiosity,  I am still often slightly irritated that the deeper message I am speaking is seemingly lost in contrast to the verbal entertainment I was unknowingly providing.  Early in my career as a traveling speech-language pathologist, I learned that for anyone to listen to what I was actually saying and to not be distracted by how I was saying it I needed to methodically erase a part of myself, and in part, my heritage. And so, over the years, I used the same methods on myself that I use for speech modification with any of my clients and unless I am emotional, tired, or around other Southern speakers my specific dialect often stays hidden outside my home.

Appalachian English Dialect

As a native Kentuckian, now having settled more permanently in Wisconsin, I have found myself modifying my dialect to sound more “professional” and frankly to avoid being perceived as uneducated or unsophisticated.  Since I teach others how to communicate, I don’t take the reality of this specific bias lightly.   It’s not that Appalachian English or any other dialect is inherently inferior, far from it. Rather, societal biases have long worked against those who speak in ways that deviate from the standardized English ideal. This isn’t just a personal struggle; it’s a systemic issue. And for those of us with an Appalachian English dialect which might even be colloquially named Hillbilly or Mountain Talk the way it is perceived has been influenced by decades of less-than-lovely media portrayal.

Check out the video below of me speaking about some of the positives of having this dialect on my TikTok channel:

@speakharmony_coach Southern talk’s not just charm—it’s survival. We’ve been saying everything without saying a thing for generations. Snakes in the grass? Wolves in sheep’s clothing? Watch and learn. #southernwomen #womenempowerment #empowerment #womensupportingwomen ♬ Appalachian Way - The Chilliout Folk

History of Appalachian English

Historically, Appalachian English has been misunderstood, mocked, and even used as a tool of oppression to exploit workers and the rich natural resources often found in the mountains of eastern Kentucky and the surrounding states. However, early linguistic theories suggested that the dialect was maybe a relic of Shakespearean or Elizabethan English, and that is one of the notions that persists in popular culture. Since I was steeped in the King James Bible as a child I concur from my experiences that some of this may make sense. However, while some elements of the dialect do trace back to older forms of English, research actually shows that Appalachian English is not frozen from that period but rather is a separate dynamic and evolving linguistic system.

Studies by David Hackett Fischer (1989) and Michael Ellis (1992) indicate that Appalachian speech patterns draw from a blend of Northern English, Southern Scots, Scotch-Irish, and Midland English dialects.   For example, this mixture resulted in distinctive grammatical structures such as the use of “might could” for “might be able to,” the “a-” prefix in verbs (“a-goin’”), and the addition of “-ed” to certain words (“knowed” instead of “knew”).  Something I might very likely say to my Wisconsin children who are well versed in Kentucky Appalachian dialect would be:

“I might could-a given you your ipad if I’d knowed where it was.”

And they’d have no problem understanding. :)

Isolation or Continuity?

The idea is that these specific linguistic traits, once common in England, persisted in Appalachia due to cultural continuity rather than isolation. To add to this deep dive,  pronunciation patterns such as h-retention (“hit” instead of “it”), “afeared” instead of “afraid,” and the use of double negatives have been traced back to rural England and Scotland.  Also interestingly, some features of Appalachian English even show Scandinavian influence, such as the use of “till” in time expressions (“quarter till five”) and the use of “at” in place of “that.” In my home, the following phrase would also not be amiss when joking around:

“I aint afeared of it no more, not til the sun comes up at least.”

Despite this rich linguistic history, Appalachian English and other nonstandard dialects continue to be stigmatized and often treated as evidence of a lack of education or intelligence. This bias of course extends beyond Appalachia. African American Vernacular English (AAVE), formerly called Ebonics, has long been met with similar prejudice. A college professor of mine, who is Black and the first minority in our communication disorders department faculty, spoke bluntly about the realities of dialectal bias, advising some of us—mainly me and my friend Chasity specifically—that if we wanted to move into professional settings, we would have to adapt our speech. As harsh as that was, I’m thankful that she said what others may not have because while it is understood that we should not judge dialect, until the reality changes, I don’t want to be held back for it. Consider this uncomfortable scenario:

Recently diagnosed with a cancerous brain tumor you enter the neurosurgeon’s office for your pre-op consult and are greeted with a nice syrupy southern voice: “Hey y’all, don’t you worry none about this little bitty tumor, it’s gonna be just fine. I’m gonna cut that little booger out like nothing and then just wrap it all up with some itty bitty stitches and you’ll be right as rain.”

Now really how would you feel? Confident? I wouldn’t, and…….I speak like this. I’m not even immune to the bias.

These experiences highlight an uncomfortable truth: while we should not have to change the way we speak, the reality is that people make snap judgments, and those judgments can impact opportunities.

Dialectal Homogeny?

As an SLP, I fully support linguistic diversity and advocate against the discrimination of any dialect. However, I also believe it is important to have open and honest conversations about how dialects are perceived in different settings. Some individuals may choose to modify their speech to navigate these biases, and this should be a personal choice, not an imposed requirement or a shunned area of therapy.

That being said, I cannot ignore the fear that dialects like my own may disappear over time. Language is so much more than just communication, it is culture, history, and art. Appalachian English, with its rich storytelling traditions, is deeply tied to the heritage of its speakers. The way we talk carries the weight of generations who softened life’s hardships with humor and wisdom. We say things like “I’m gonna beat the tar out of you,” in jest or as a gentle warning, not as a literal threat, mostly. There is a nuance, a warmth, and a rhythm to the dialect that cannot be easily replicated. It’s an emotional dialect and it’s hard for me to not see the stark contrast of the standard American English that I code-switch to as more stark, stoic, and bare. Lacking the humor and double entendres that I learned and acquired from a myriad of native speakers in my life since childhood.

As a lover and appreciator of all types of communication, I know and accept that language is an evolving force, and while individuals should have the freedom to code-switch as needed, we must also work toward a society where all dialects are respected. After all, language is a mirror of humanity, in all its complexity and beauty.

Accepting Variety

I recognize the important shift of honoring dialects in speech-language pathology as only part of the process. In years past, therapists were often explicitly trained to correct dialectal variations as if they were errors, sometimes even saying they were uneducated or incorrect and reinforcing the idea that nonstandard dialects were inherently deficient. Thankfully, this outdated approach is being replaced with a strengths-based perspective. No dialect is more valid than another.

While this progress is encouraging, bias against dialects remains deeply ingrained in American society. Educators, employers, and the media still perpetuate the idea that certain ways of speaking are more legitimate than others. This is why advocacy and education are so critical. Raising awareness about linguistic diversity and the historical context of dialectal variation can help dismantle harmful stereotypes. Until we have individuals in positions of power speaking openly with a wide range of dialects then there is still work to do. Until then, those of us who are straddling the fence can independently choose where we fit in and how best to do so. And sometimes, that means altering a little bit of how we sound to certain audiences just in the same way that a woman may get ready for an interview by putting on a little lipstick or a man may forego a beloved but brightly colorful jacket in favor of a standard navy when addressing the nation from the Oval Office. We are all playing the social language game the best we can.

Ultimately, the goal should not be to eradicate dialects in favor of a homogenized standard but to foster a culture of linguistic acceptance. Whether someone speaks Appalachian English, AAVE, Chicano English, or any other dialect, their voice deserves to be heard and respected. If we can move toward that future, we will not only preserve the beauty of these dialects but also create a society that values linguistic diversity as a vital part of our collective identity.

Maybe someday, sooner rather than later, we can all just be our authentic selves and our messages accepted regardless of how we sound or look.