What is a Speech-Language Pathologist (SLP)?

Often referred to as “speech therapists,” SLPs can diagnose and treat a wide array of speech and swallowing disorders. They work with a diverse population helping them overcome speech problems caused by premature birth, autism, learning disabilities, cleft palate, hearing loss, developmental delays, traumatic brain injury, or stroke.

Professionals in this field need strong analytical, critical thinking, and organization skills to be able to assess patient needs and write detailed treatment plans. SLPs also need to be compassionate and patient as the road to improving speech or swallowing skills can often be very slow.

Education for professionals in this field includes both an undergraduate and a master’s degree. Often SLP master’s programs have course prerequisites but rarely is a specific bachelor’s required. The Council on Academic Accreditation (CAA), part of the ASHA, is the accrediting organization for SLP master’s degrees. Students must graduate from a CAA-accredited program in order to be eligible for certification and many states require it to be licensed. Programs also must include supervised clinical experience or fellowships in order to give students hands-on experience and prepare them to enter the field.

The demand for professionals in this field is high and is on a steady upward trend. Because medical advancements have improved survival rates for premature infants and stroke victims and the population of the US is rapidly aging, there will be more than 41,000 new SLP jobs created between 2018 and 2028 around the U.S. Overall this will be a 27 percent increase in employment in the field during the next decade—well above the predicted 5 percent growth for all occupations.

Speech-language pathologists are typically employed in educational settings or private clinics, although there is a fair number employed by hospitals and residential care facilities as well. An SLP can expect to earn $82,000 per year on average, according to the Bureau of Labor Statistics (BLS May 2019). The top 10 percent of earners make more than $121,260 per year, while the bottom 10 percent make $49,840 or less.

Continue reading to learn about the history of speech-language pathologists, how to become one, licensing and certification requirements, and how this profession differs from that of an audiologist.

According to an overview of speech-language pathology history published in The ASHA Leader journal, SLP wasn’t a recognized field until the 1920s. Prior to that, practitioners in the field who claimed to be able to cure speech disorders were often seen as quacks or simply taking advantage of clueless patients.

Clinicians who truly wished to pursue this field and advance speech therapy began doing so establishing themselves in another field such as education or medicine and then simply provided recommendations rather than treatments. Often they were well versed in (or even professionals in) elocution, which is the art of formal speaking, pronunciation, tone, and delivery. In the 1870’s Alexander Melville Bell and his son, Alexander Graham Bell, utilized their experience as elocutionists to analyze speech and develop new ways of transmitting it.

While practitioners weren’t looked on so favorably in the States, American doctors who would travel found education and mentorship in European clinicians, known as “speech doctors.” Slowly more and more techniques emerged to remediate speech problems and a clinical journal discussing speech disorders called The Voice was published from 1872 to 1892.

By the early 1900s, there were several groups spread all across the country with their own methods and philosophies for addressing speech impediments. Eventually, in 1925, the organization that would become known as the American Speech-Language-Hearing Association (ASHA) was founded.

At first, it was called the American Academy of Speech Correction (AASC) and focused on only addressing speech issues. While they required a master’s degree in order to be a member, the degree could be in any field because so few graduate programs in speech correction existed. Their main objective at the start was to develop standardized diagnostic tools in order to approach treatment scientifically.

Since then, the field of speech-language pathology has grown and evolved. Psychology was introduced as part of assessment and treatment during the 1940s. In the 1960s language issues were recognized as being separate problems from speech and new research and treatment emerged. In the last 20 years, treatments have expanded to include more context of the patient’s history and life, including cultural, linguistics, and everyday communication components.

Certification for speech-language pathologists is very common. A Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP), can be earned through ASHA. While not all states require this certification for licensing, most do and obtaining one is an indicator of a high level of education and training.

Obtaining certification is a multistep process:

1. First, students must graduate with a master’s degree in speech-language pathology from a CAA-accredited program.
2. Next, applicants must take the Praxis exam which is a 132-question test that evaluates the ability of candidates to assess, diagnose, and develop treatment plans.
3. Upon passing the test with at least a score of 162 out of 200, prospective SLPs may submit their application to become a CCC-SLP.
4. After the application is submitted, the next step is to select an ASHA certified SLP mentor. Applicants are then required to complete a 36-week, 1260-hour, fellowship to finalize their training.

Once that is complete, all forms are submitted, and the ASHA conducts a thorough review, successful applicants are awarded the certification of CCC-SLP.

All states required that SLPs be licensed or registered. However, requirements can vary significantly by state.

Most states require SLPs to have completed at least a master’s degree in speech-language pathology and have completed a clinical fellowship. Obtaining a CCC-SLP can be a path to licensure in most states, although frequently there are additional requirements which can include proof of citizenship or residency, proof of English proficiency, a state-specific jurisprudence exam, additional education such as HIV prevention or record management, proof of malpractice insurance, and more.

Prospective SLPs should familiarize themselves with their state requirements at the start of their master’s education to ensure all requirements are met as they complete their degree and fellowship.

Speech-language pathologists work with children, adolescents, and adults in a variety of settings including long term care facilities, hospitals, clinics, and educational settings. While duties will vary based on clientele and place of employment, typical responsibilities include:

• Assessing speech, language, or swallowing difficulties
• Diagnosing speech, language, or swallowing conditions
• Developing individualized treatment plans
• Administering speech, language, or swallowing treatments
• Providing counseling to families and clients on how to manage communication, language, or swallowing difficulties
• Educating on social fluency including non-verbal communication
• Maintaining client records
• Assisting with insurance billing
• Writing evaluation reports

While some responsibilities of SLPs and audiologists may overlap, they are two distinct professions providing very different services.

SLPs work with individuals to improve communication, language or even swallowing. They hold at least a master’s degree in speech-language pathology and work in clinics, hospitals, schools, and long term care facilities. While they do work with those who have hearing loss, their clientele can have many other issues including premature birth, developmental delays, strokes, or dementia. Treatments that SLPs provide include vocalization exercises, speech control techniques, and swallowing practice.

Audiologists, on the other hand, work specifically with the ear, addressing issues of hearing or balance. They have typically earned a doctorate in audiology and have the necessary skills to examine and treat hearing loss, vertigo, or other auditory and sensory problems related to the ear. Audiologists are also trained to fit and prescribe hearing aids or other assistive devices. They may refer clients to an SLP to provide language or speech treatment related to hearing loss.