Speech-Language Pathologists

• About half work in educational services, and most others were employed by health care and social assistance facilities.
• A master’s degree in speech-language pathology is the standard credential required for licensing in most States.
• Employment is expected to grow because the expanding population in older age groups is prone to medical conditions that result in speech, language, and swallowing problems.
• Excellent job opportunities are expected.

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

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 qualitative and quantitative assessment methods, including standardized tests, as well as special instruments, to analyze and diagnose the nature and extent of speech, language, and swallowing 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 these individuals 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.

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 school settings they may work with students in an office or classroom. Some deliver services in the client’s home. While the job 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; about 1 in 5 work part time. Those who work on a contract basis may spend a substantial amount of time traveling between facilities.

In 2005, 47 States required speech-language pathologists to be licensed if they worked in a health care setting, and all States required a master’s degree or equivalent. A passing score on the national examination on speech-language pathology, offered through the Praxis Series of the Educational Testing Service, is needed as well. Other requirements typically are 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 11 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 temporary teaching license or certificate to bachelor’s degree applicants, but a master’s degree must be earned in 3 to 5 years. A few States grant a full teacher’s certificate or license to bachelor’s degree applicants.

In 2004, 239 colleges and universities offered graduate programs in speech-language pathology that are 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. Courses cover the anatomy, physiology, and the development of the areas of the body involved in speech, language, and swallowing; the nature of disorders; 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.

Speech-language pathologists can acquire the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) offered by the American Speech-Language-Hearing Association. To earn a CCC, a person must have a graduate degree and 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 (ETS).

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.

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.

Speech-language pathologists held about 96,000 jobs in 2004. 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.

Employment of speech-language pathologists is expected to grow about as fast as the average for all occupations through the year 2014. 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 are also improving the survival rate of premature infants and trauma and stroke victims, who then need assessment and possible treatment. An increased emphasis also has been placed on early identification of speech and language problems in young children. 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.

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

Employment in educational services will increase along with 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 will also increase employment.

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

Median annual earnings of speech-language pathologists were $52,410 in May 2004. The middle 50 percent earned between $42,090 and $65,750. The lowest 10 percent earned less than $34,720, and the highest 10 percent earned more than $82,420. Median annual earnings in the industries employing the largest numbers of speech-language pathologists in May 2004 were:

According to a 2003 survey by the American Speech-Language-Hearing Association, the median annual salary for full-time certified speech-language pathologists who worked on a calendar-year basis, generally 11 or 12 months annually, was $48,000. Certified speech-language pathologists who worked 25 or fewer hours per week had a median hourly salary of $40.00. Starting salaries for certified speech-language pathologists with one to three years of experience were $42,000 for those who worked on a calendar-year. According to a 2004 survey by the American Speech-Language-Hearing Association, the median annual salary for speech-language pathologists in schools was $50,000 for those employed on an academic year basis (usually 9 or 10 months).

Speech-language pathologists specialize in the prevention, diagnosis, and treatment of speech and language problems. Workers in related occupations include audiologists, occupational therapists, optometrists, physical therapists, psychologists, and recreational therapists. Speech-language pathologists in school systems often work closely with special education teachers in assisting students with disabilities.

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/

• Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2006-07 Edition,