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.
Speech-language pathologists held about 158,100 jobs in 2020. The largest employers of speech-language pathologists were as follows:
- Educational services; state, local, and private - 38%
- Offices of physical, occupational and speech therapists, and audiologists - 22%
- Hospitals; state, local, and private - 14%
- Self-employed workers - 6%
- Nursing and residential care facilities - 4%
Most speech-language pathologists work full time. Some speech-language pathologists, such as those working for schools, may need to travel between different schools or facilities.
Education & Training Required
Most speech-language pathologist jobs require a master's degree. The Council on Academic Accreditation is an entity of the American Speech-Language-Hearing Association; it accredits postsecondary academic programs in speech-language pathology. While graduation from an accredited program is not always required, it is required by some States for licensure and is mandatory for professional credentialing from the American Speech-Language-Hearing Association. In 2009, about 240 colleges and universities offered graduate programs, at both the master’s and doctoral levels, in speech-language pathology accredited by the Council on Academic Accreditation. 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 may also learn to evaluate and treat speech, language, and swallowing disorders as part of curriculum in supervised clinical practicum.
In 2009, 47 States regulated speech-language pathologists. Typical licensing requirements are a master’s degree from an accredited college or university; a passing score on the national examination on speech-language pathology, offered through the Praxis Series of the Educational Testing Service; 300 to 375 hours of supervised clinical experience; and 9 months of postgraduate professional clinical experience. Most 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. For specific regulation and eligibility requirements contact your State’s regulatory board.
State regulation of speech-language pathologists may differ for pathologists practicing in schools. For information on State regulation of speech-language pathologists in public schools contact your State’s Department of Education. The Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) credential offered by the American Speech-Language-Hearing Association is a voluntary credential; however, the CCC-SLP meets some or all of the requirements for licensure in some States. To earn a CCC, a person must have a graduate degree from an accredited university, which typically includes a 400-hour supervised clinical practicum, complete a 36-week full-time postgraduate clinical fellowship, and pass the Praxis Series examination in speech-language pathology administered by the Educational Testing Service.
Other Skills Required
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.
How to Advance
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 of speech-language pathologists is projected to grow 29 percent from 2020 to 2030, much faster than the average for all occupations.
About 15,200 openings for speech-language pathologists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
As the large baby-boom population grows older, there will be more instances of health conditions such as strokes or dementia, which can cause speech or language impairments. Speech-language pathologists will be needed to treat the increased number of speech and language disorders in the older population.
Increased awareness of speech and language disorders, such as stuttering, in younger children should lead to a need for more speech-language pathologists who specialize in treating that age group. Also, an increasing number of speech-language pathologists will be needed to work with children with autism to improve their ability to communicate and socialize effectively.
In addition, medical advances are improving the survival rate of premature infants and victims of trauma and strokes, many of whom need help from speech-language pathologists.
The median annual wage for speech-language pathologists was $79,060 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $51,310, and the highest 10 percent earned more than $125,560.
In May 2021, the median annual wages for speech-language pathologists in the top industries in which they worked were as follows:
- Nursing and residential care facilities - $99,340
- Hospitals; state, local, and private - $95,620
- Offices of physical, occupational and speech therapists, and audiologists - $93,510
- Educational services; state, local, and private - $75,270
Most speech-language pathologists work full time. Some speech language pathologists, such as those working for schools, may need to travel between different schools or facilities.