Speech-language pathology

Speech-Language Pathology
MeSH D013066

Speech-language pathology is a field of expertise practiced by a clinician known as a speech-language pathologist (SLP), also called speech and language therapist,[1] or speech therapist, who specializes in the evaluation and treatment of communication disorders, cognition, voice disorders, and swallowing disorders.

A common misconception is that speech-language pathology is restricted to correcting pronunciation difficulties, such as helping English speaking individuals enunciate their "s" and "r" sounds, and helping people who stutter to speak more fluently. In fact, speech-language pathology is concerned with a broad scope of speech, language, swallowing, and voice issues involving communication,[2] some of which are:

The components of speech production include:

The components of language include:

Primary pediatric speech and language disorders include receptive and expressive language disorders, speech sound disorders, childhood apraxia of speech, stuttering, and language-based learning disabilities.[4]

Swallowing disorders include difficulties in any system of the swallowing process (i.e. oral, pharyngeal, esophageal), as well as functional dysphagia and feeding disorders. Swallowing disorders can occur at any age and can stem from multiple causes.[5]

The profession

Speech-language pathologists (SLPs) provide a wide range of services, mainly on an individual basis, but also as support for individuals, families, support groups, and providing information for the general public. Speech-language pathologists work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults.[6] Speech services begin with initial screening for communication and swallowing disorders and continue with assessment and diagnosis, consultation for the provision of advice regarding management, intervention and treatment, and provision counseling and other follow up services for these disorders. Services are provided in the following areas:

Speech, language, and swallowing disorders result from a variety of causes, such as a stroke,[8] brain injury,[9] hearing loss,[10] developmental delay,[11] a cleft palate,[12] cerebral palsy,[13] or emotional issues.[14]

Multi-discipline collaboration

Speech-language pathologists collaborate with other health care professionals, often working as part of a multidisciplinary team, providing referrals to audiologists and others; providing information to health care professionals (including physicians, dentists, nurse practitioners, nurses, occupational therapists, dietitians), educators, behavior consultants (applied behavior analysis) and parents as dictated by the individual client's needs.

In relation to auditory processing disorders,[15] collaborating in the assessment and providing intervention where there is evidence of speech, language, and/or other cognitive-communication disorders.

The treatment for patients with cleft lip and palate has an obvious interdisciplinary character. The speech therapy outcome is even better when the surgical treatment is performed earlier.[16]

Working environments

Speech-language pathologists work in a variety of clinical and educational settings. SLPs work in public and private hospitals, skilled nursing facilities (SNFs), long-term acute care (LTAC) facilities, hospice,[17] and home healthcare. Speech-language pathologists may also work as part of the support structure in the education system, working in both public and private schools, colleges, and universities.[18] Some speech-language pathologists also work in community health, providing services at prisons and young offenders' institutions or providing expert testimony in applicable court cases.[19]

Subsequent to the American Speech-Language-Hearing Association's (ASHA's) 2005 approval of the delivery of Speech-Language Pathology services via video conference, or telepractice,[20] SLPs have begun delivering services via this service delivery method.


Speech-language pathologists conduct research related to communication sciences and disorders, swallowing disorders, or other upper aerodigestive functions.

Education and training

United States

In the United States, speech-language pathology is a Master's entry-level professional degree field. Clinicians must hold a master's degree in Communicative Disorders/Speech-Language Pathology (e.g. M.A., M.S., or M.Ed.) that is from a university that holds regional accreditation and from a communicative sciences and disorders program that is accredited by the American Speech-Language-Hearing Association (ASHA), the profession's national governing body as well as individual state's governing board. Programs that offer the M.Ed. degree are often housed within a university's College of education, but offer the same education and training as programs with a M.A. or M.S. degree. Beyond the master's degree, some SLPs may choose to earn a clinical doctorate in Speech Language Pathology (e.g. CScD or SLP.D), or a doctoral degree that has a research and/or professional focus (e.g., Ph.D., or Ed.D.). All degrees must be from a university that holds regional accreditation, but only the master's degree is accredited by the American Speech-Language-Hearing Association (ASHA).

All clinicians are required to complete 400 clinical hours (25 observation hours often completed during the undergraduate degree and 375 hours of graduate Clinical Practicum).[21] They must pass multiple comprehensive exams also called Knowledge and Skills Acquisition (KASA) exams.

After all the above requirements have been met during the SLP's path to earning the graduate degree:

Maintaining licensure through continuing education:

Continuing education and training obligations:

Professional suffix:

Salary information

Salaries of SLPs depend on a variety of factors. These include: educational background, work experience, and location. According to the ASHA 2014 Schools Survey, the median salary for a speech-language pathologist working during the academic year at a school was $61,000.[25] However, salaries can range from $40,000–90,000. In Australia, it has been found that the basic salary that a speech pathologist/therapist would earn in Australia is an estimate of $59,500 Australian dollars.[26]

Methods of assessment

For many parents, the decision of whether or not to enroll students into school-based speech therapy or privately practiced therapy is challenging. Because school-based speech therapy is run under state guidelines and funds, the process of assessment and qualification is more strict. To qualify for in-school speech therapy, students must meet the state's criteria on language testing and speech standardization. Due to such requirements, some students may not be assessed in an efficient time frame or their needs may be undermined by criteria. For a private clinic, students are more likely to qualify for therapy because it is a paid service with more availability.

For more details on this topic, see Speech and language assessment.

Clients and patients

Speech-language pathologists work with clients and patients who may be present with a wide range of issues.

Infants and children

In the US, some children are eligible to receive speech therapy services, including assessment and lessons through the public school system. If not, private therapy is readily available through personal lessons with a qualified Speech-Language Pathologist or the growing field of telepractice.[32] Teleconferencing tools such as Skype are being used more commonly as a means to access remote locations in private therapy practice, such as in the geographically diverse south island of New Zealand.[33] More at-home or combination treatments have become readily available to address specific types of articulation disorders. The use of mobile applications in speech therapy is also growing as an avenue to bring treatment into the home.

In the UK, children are entitled to an assessment by local NHS Speech and Language Therapy teams, usually after referral by health visitors or education settings, but parents are also entitled to request an assessment directly.[34] If treatment is appropriate, a care plan will be drawn up. Speech therapists often play a role in multi-disciplinary teams where a child has speech delay or disorder as part of a wider health condition.

Children and adults


See also


  1. Brady, MC; Kelly, H; Godwin, J; Enderby, P (May 16, 2012). "Speech and language therapy for aphasia following stroke.". The Cochrane database of systematic reviews. 5: CD000425. doi:10.1002/14651858.CD000425.pub3. PMID 22592672.
  2. American Speech-Language-Hearing Association (2016). "Scope of practice in speech-language pathology [Service Delivery Areas]". www.asha.org/policy. Retrieved September 10, 2016.
  3. Block, Frances K.; Amie Amiot; Cheryl Deconde Johnson; Gina E. Nimmo; Peggy G. Von Almen; Deborah W. White; Sara Hodge Zeno (1993), "Definitions of Communication Disorders and Variations", Ad Hoc Committee on Service Delivery in the Schools, ASHA, doi:10.1044/policy.RP1993-00208, retrieved 2010-08-07
  4. Weeks, Katie (July 12, 2016). "Speech and Language Disorders". Speech SF.
  5. "Scope of Practice in Speech-Language Pathology". 2016. Retrieved September 21, 2016.
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  8. Richards, Emma (June 2012). "Communication and swallowing problems after stroke". Nursing and Residential Care. 14 (6): 282–286. doi:10.12968/nrec.2012.14.6.282.
  9. Editors, Nathan D. Zasler, Douglas I. Katz, Ross D. Zafonte, Associate Editors, David B. Arciniegas, M. Ross Bullock, Jeffrey S. Kreutzer (2013). Brain injury medicine principles and practice (2nd ed.). New York: Demos Medical. pp. 1086–1104, 1111–1117. ISBN 9781617050572.
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  12. Bauman-Waengler, Jacqueline (2011). Articulatory and phonological impairments : a clinical focus (4th ed., International ed.). Harlow: Pearson Education. pp. 378–385. ISBN 9780132719957.
  13. "Speech and Language Therapy". My Child at cerebralpalsy.org. Retrieved 2 May 2016.
  14. Cross, Melanie (2011). Children with social, emotional and behavioural difficulties and communication problems: there is always a reason (2nd ed.). London: Jessica Kingsley Publishers.
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  19. "What is speech and language therapy?".
  20. "ASHA Telepractice Position Statement". Asha.org. Retrieved 2010-04-15.
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  24. "Roles and Responsibilities of Speech-Language Pathologists in Schools".
  25. American Speech-Language-Hearing Association. (2014). 2014 Schools Survey report: SLP annual salaries and hourly wages. www.asha.org/research/memberdata/schoolssurvey/.
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  29. https://www.nidcd.nih.gov/health/voice/pages/autism.aspx
  30. http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm
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Further reading

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