Career Guide for Speech-Language Pathologists

A speech language pathologist, also known as a speech therapist, diagnoses and treats speech and language disorders. They work with people who cannot produce speech sounds or produce them clearly and assist them in solving their speech problem.

In this free career guide, you will learn how to have a successful career as a speech therapist.

Speech Therapist Summary

• About 48 percent worked in educational services; most others were employed by healthcare and social assistance facilities.
• A master’s degree in speech-language pathology is the standard educational requirement; almost all States regulate these workers, and licensing requirements vary.
• Favorable job opportunities are expected.

Working as a Speech Language Pathologist

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. About 20 percent of speech-language pathologists worked part-time in 2008. 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. 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.

Licensure and certification. 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 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 as a Speech Therapist

Speech-language pathologists held about 119,300 jobs in 2008. About 48 percent were employed in educational services. Others were employed in hospitals; offices of other health practitioners, including speech-language pathologists; nursing care facilities; home healthcare services; individual and family services; outpatient care centers; and child day care centers.

Nine percent of speech-language pathologists were self-employed in 2008. They contract to provide services in schools, offices of physicians, hospitals, or nursing care facilities, or work as consultants to industry.

Job Outlook

Faster than average employment growth is projected. Job opportunities are expected to be favorable.

Employment change. Employment of speech-language pathologists is expected to grow by 19 percent from 2008 to 2018, faster than 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. The 2004 Individuals with Disabilities Education Act is a Federal law that 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 healthcare 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 should increase because hospitals, schools, and nursing care facilities will contain costs by increasingly contracting out for these services.

Job prospects. In addition to job growth, a number of job openings in speech-language pathology will be due to retirements. Opportunities should be favorable, particularly for those with the ability to speak a second language, such as Spanish. Demand for speech-language pathologists can be regional so job prospects are expected to be favorable for those who are willing to relocate, particularly to areas experiencing difficulty in attracting and hiring speech-language pathologists.

Projections Data

Projections data from the National Employment Matrix

Occupational Title	SOC Code	Employment, 2008	Projected Employment, 2018	Change, 2008-18
				Number	Percent
Speech-language pathologists	29-1127	119,300	141,400	22,100	19
NOTE: Data in this table are rounded.

Earnings for Speech Therapists

Median annual wages of speech-language pathologists were $62,930 in May 2008. The middle 50 percent earned between $50,330 and $79,620. The lowest 10 percent earned less than $41,240, and the highest 10 percent earned more than $99,220. Median annual wages in the industries employing the largest numbers of speech-language pathologists were:

Some employers may reimburse speech-language pathologists for their required continuing education credits. About 40 percent of speech-language pathologists were union members or covered by union contract in 2008.