• Employment of speech-language pathologists is expected to grow rapidly because the expanding population in older age groups is prone to medical conditions that result in speech, language, and swallowing problems.
• About half worked in educational services, and most others were employed by healthcare and social assistance facilities.
• A master’s degree in speech-language pathology is the standard credential.
  

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 make speech sounds, or cannot make them clearly; those with speech rhythm and fluency problems, such as stuttering; people with voice quality problems, 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; those with cognitive communication impairments, such as attention, memory, and problem solving disorders; and those with hearing loss who use hearing aids or cochlear implants in order to develop auditory skills and improve communication. They also work with people who have swallowing difficulties.

Speech and language difficulties can result from a variety of causes including stroke, brain injury or deterioration, developmental delays, cerebral palsy, cleft palate, voice pathology, mental retardation, hearing impairment, or emotional problems. Problems can be congenital, developmental, or acquired. Speech-language pathologists use written and oral tests, as well as special instruments, to diagnose the nature and extent of impairment and to record and analyze speech, language, and swallowing irregularities. 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 language skills to communicate more effectively. Speech-language pathologists help patients develop, or recover, reliable communication skills so patients can fulfill their educational, vocational, and social roles.

Most speech-language pathologists provide direct clinical services to individuals with communication or swallowing disorders. In speech and language clinics, they may independently develop and carry out treatment programs. In medical facilities, they may work with physicians, social workers, psychologists, and other therapists. Speech-language pathologists in schools develop individual or group programs, counsel parents, and may assist teachers with classroom activities.

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.

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

Working Conditions

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 participate in classroom activities. 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 between 35 and 40 hours per week; some work part time. Those who work on a contract basis may spend a substantial amount of time traveling between facilities.

Employment

Speech-language pathologists held about 94,000 jobs in 2002. About half of jobs were in educational services, including preschools, elementary and secondary schools, and colleges and universities. Others were in hospitals; offices of other health practitioners, including speech-language pathologists; nursing care facilities; home healthcare services; individual and family services; outpatient care centers; child day care services; or other facilities.

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.

Training, Other Qualifications, and Advancement

Of the 46 States that regulate licensing, almost all require a master’s degree or equivalent. A passing score on a national examination on speech-language pathology offered through the Praxis Series of the Educational Testing Service is needed, as well. Other requirements are 300 to 375 hours of supervised clinical experience and 9 months of postgraduate professional clinical experience. Thirty-eight 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.

About 233 colleges and universities offer graduate programs in speech-language pathology. Courses cover anatomy and physiology of the areas of the body involved in speech, language, swallowing, and hearing; the development of normal speech, language, swallowing, and hearing; the nature of disorders; acoustics; and psychological aspects of communication. Graduate students also learn to evaluate and treat speech, language, swallowing, and hearing 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 375 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 clients. They must be able to approach problems objectively and provide support to clients and their families. Because a client’s progress may be slow, patience, compassion, and good listening skills are necessary.

Job Outlook

Employment of speech-language pathologists is expected to grow faster than the average for all occupations through the year 2012. Members of the baby boom generation are now entering middle age, when the possibility of neurological disorders and associated speech, language, swallowing, and hearing 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. Many States now require that all newborns be screened for hearing loss and receive appropriate early intervention services.

In health services facilities, the impact of proposed Federal legislation imposing limits on reimbursement for therapy services may adversely affect the short-term job outlook for therapy providers. 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, language, swallowing, and hearing 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. In addition to job openings stemming from employment growth, a number of openings for speech-language pathologists will arise from the need to replace those who leave the occupation.

Earnings

Median annual earnings of speech-language pathologists were $49,450 in 2002. The middle 50 percent earned between $39,930 and $60,190. The lowest 10 percent earned less than $32,580, and the highest 10 percent earned more than $74,010. Median annual earnings in the industries employing the largest numbers of speech-language pathologists in 2002 were as follows:

Offices of other health practitioners $53,090
General medical and surgical hospitals 52,940
Elementary and secondary schools 46,060

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. For those who worked on an academic-year basis, usually 9 or 10 months annually, the median annual salary was $44,800. 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 experience were $42,000 for those who worked on a calendar-year basis and $37,000 for those who worked on an academic-year basis.