Speech-language pathologists 

Nature of the Work

Speech-language pathologists, sometimes called speech therapists, assess, diagnose, treat, and help to prevent disorders related to speech, language, cognitive-communication, voice, swallowing, and fluency.

Speech-language pathologists work with people who cannot produce speech sounds or cannot produce them clearly; those with speech rhythm and fluency problems, such as stuttering; people with voice disorders, such as inappropriate pitch or harsh voice; those with problems understanding and producing language; those who wish to improve their communication skills by modifying an accent; and those with cognitive communication impairments, such as attention, memory, and problem solving disorders. They also work with people who have swallowing difficulties.

Speech, language, and swallowing difficulties can result from a variety of causes including stroke, brain injury or deterioration, developmental delays or disorders, learning disabilities, cerebral palsy, cleft palate, voice pathology, mental retardation, hearing loss, or emotional problems. Problems can be congenital, developmental, or acquired. Speech-language pathologists use special instruments and qualitative and quantitative assessment methods, including standardized tests, to analyze and diagnose the nature and extent of impairments.

Speech-language pathologists develop an individualized plan of care, tailored to each patient’s needs. For individuals with little or no speech capability, speech-language pathologists may select augmentative or alternative communication methods, including automated devices and sign language, and teach their use. They teach patients how to make sounds, improve their voices, or increase their oral or written language skills to communicate more effectively. They also teach individuals how to strengthen muscles or use compensatory strategies to swallow without choking or inhaling food or liquid. Speech-language pathologists help patients develop, or recover, reliable communication and swallowing skills so patients can fulfill their educational, vocational, and social roles.

Speech-language pathologists keep records on the initial evaluation, progress, and discharge of clients. This helps pinpoint problems, tracks client progress, and justifies the cost of treatment when applying for reimbursement. They counsel individuals and their families concerning communication disorders and how to cope with the stress and misunderstanding that often accompany them. They also work with family members to recognize and change behavior patterns that impede communication and treatment and show them communication-enhancing techniques to use at home.

Most speech-language pathologists provide direct clinical services to individuals with communication or swallowing disorders. In medical facilities, they may perform their job in conjunction with physicians, social workers, psychologists, and other therapists. Speech-language pathologists in schools collaborate with teachers, special educators, interpreters, other school personnel, and parents to develop and implement individual or group programs, provide counseling, and support classroom activities.

Some speech-language pathologists conduct research on how people communicate. Others design and develop equipment or techniques for diagnosing and treating speech problems.

Work environment. Speech-language pathologists usually work at a desk or table in clean comfortable surroundings. In medical settings, they may work at the patient’s bedside and assist in positioning the patient. In schools, they may work with students in an office or classroom. Some work in the client’s home.

Although the work is not physically demanding, it requires attention to detail and intense concentration. The emotional needs of clients and their families may be demanding. Most full-time speech-language pathologists work 40 hours per week. Those who work on a contract basis may spend a substantial amount of time traveling between facilities.

Training, Other Qualifications, and Advancement

A master’s degree is the most common level of education among speech-language pathologists. Licensure or certification requirements also exist, but vary by State.

Education and training. Most speech-language pathologist jobs require a master’s degree. In 2007, more than 230 colleges and universities offered graduate programs in speech-language pathology accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology. While graduation from an accredited program is not always required to become a speech-language pathologist, it may be helpful in obtaining a license or may be required to obtain a license in some States.

Speech-language pathology courses cover anatomy, physiology, and the development of the areas of the body involved in speech, language, and swallowing; the nature of disorders; principles of acoustics; and psychological aspects of communication. Graduate students also learn to evaluate and treat speech, language, and swallowing disorders and receive supervised clinical training in communication disorders.

Licensure and certification. In 2007, 47 States regulated speech-language pathologists through licensure or registration. A passing score on the national examination on speech-language pathology, offered through the Praxis Series of the Educational Testing Service, is required. Other usual requirements include 300 to 375 hours of supervised clinical experience and 9 months of postgraduate professional clinical experience. Forty-one States have continuing education requirements for licensure renewal. Medicaid, Medicare, and private health insurers generally require a practitioner to be licensed to qualify for reimbursement.

Only 12 States require this same license to practice in the public schools. The other States issue a teaching license or certificate that typically requires a master’s degree from an approved college or university. Some States will grant a provisional teaching license or certificate to applicants with a bachelor’s degree, but a master’s degree must be earned within 3 to 5 years. A few States grant a full teacher’s certificate or license to bachelor’s degree applicants.

In some States, the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) offered by the American Speech-Language-Hearing Association meets some or all of the requirements for licensure. To earn a CCC, a person must have a graduate degree from an accredited university, 400 hours of supervised clinical experience, complete a 36-week postgraduate clinical fellowship, and pass the Praxis Series examination in speech-language pathology administered by the Educational Testing Service. Contact your State’s Licensing Board for details on your State's requirements.

Other qualifications. Speech-language pathologists should be able to effectively communicate diagnostic test results, diagnoses, and proposed treatment in a manner easily understood by their patients and their families. They must be able to approach problems objectively and be supportive. Because a patient’s progress may be slow, patience, compassion, and good listening skills are necessary.

Advancement. As speech-language pathologists gain clinical experience and engage in continuing professional education, many develop expertise with certain populations, such as preschoolers and adolescents, or disorders, such as aphasia and learning disabilities. Some may obtain board recognition in a specialty area, such as child language, fluency, or feeding and swallowing. Experienced clinicians may become mentors or supervisors of other therapists or be promoted to administrative positions.

Employment

Speech-language pathologists held about 110,000 jobs in 2006. About half were employed in educational services, primarily in preschools and elementary and secondary schools. Others were employed in hospitals; offices of other health practitioners, including speech-language pathologists; nursing care facilities; home health care services; individual and family services; outpatient care centers; and child day care centers.

A few speech-language pathologists are self-employed in private practice. They contract to provide services in schools, offices of physicians, hospitals, or nursing care facilities, or work as consultants to industry.

Job Outlook

Average employment growth is projected. Job opportunities are expected to be excellent.

Employment change. Employment of speech-language pathologists is expected to grow 11 percent from 2006 to 2016, about as fast as the average for all occupations. As the members of the baby boom generation continue to age, the possibility of neurological disorders and associated speech, language, and swallowing impairments increases. Medical advances also are improving the survival rate of premature infants and trauma and stroke victims, who then need assessment and sometimes treatment.

Employment in educational services will increase with the growth in elementary and secondary school enrollments, including enrollment of special education students. Federal law guarantees special education and related services to all eligible children with disabilities. Greater awareness of the importance of early identification and diagnosis of speech and language disorders in young children will also increase employment.

In health care facilities, restrictions on reimbursement for therapy services may limit the growth of speech-language pathologist jobs in the near term. However, the long-run demand for therapists should continue to rise as growth in the number of individuals with disabilities or limited function spurs demand for therapy services.

The number of speech-language pathologists in private practice will rise because of the increasing use of contract services by hospitals, schools, and nursing care facilities.

Job prospects. The combination of growth in the occupation and an expected increase in retirements over the coming years should create excellent job opportunities for speech-language pathologists. Opportunities should be particularly favorable for those with the ability to speak a second language, such as Spanish. Job prospects also are expected to be especially favorable for those who are willing to relocate, particularly to areas experiencing difficulty in attracting and hiring speech-language pathologists.

Earnings

Median annual earnings of wage-and-salary speech-language pathologists were $57,710 in May 2006. The middle 50 percent earned between $46,360 and $72,410. The lowest 10 percent earned less than $37,970, and the highest 10 percent earned more than $90,400. Median annual earnings in the industries employing the largest numbers of speech-language pathologists were:

Nursing care facilities $70,180
Offices of other health practitioners 63,240
General medical and surgical hospitals 61,970
Elementary and secondary schools 53,110

Some employers may reimburse speech-language pathologists for their required continuing education credits.

Sources of Additional Information

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State licensing boards can provide information on licensure requirements. State departments of education can supply information on certification requirements for those who wish to work in public schools.

For information on careers in speech-language pathology, a description of the CCC-SLP credential, and a listing of accredited graduate programs in speech-language pathology, contact:

American Speech-Language-Hearing Association, 10801 Rockville Pike, Rockville, MD 20852. Internet: http://www.asha.org