What is a speech language pathologist?

Speech language pathologists (often abbreviated as SLP) are specialists in evaluating, treating, and preventing human communication disorders. To practice in Oregon and most other states, speech language pathologists must hold the master’s degree, be certified by the American Speech Language Hearing Association (ASHA) and be licensed by the particular state. The designation CCC after the clinician’s name and degree refers to the ASHA certificate. Speech language pathologists may also be called speech pathologists, speech therapists, or speech clinicians. Some SLPs are specialists, focusing on people with a particular type of communication disorder. Others are generalists, seeing adults and children with a wide variety of communication problems. It is important for people seeking the services of an SLP to ask questions about the person’s specialty area, if any, amount of experience, and whether the SLP sees primarily children or adults.

What is audiology?

Audiology is the discipline focused on evaluating and providing help for people with impaired hearing or deafness. It is important for children needing speech therapy to have their hearing assessed, since adequate hearing is essential for speech and language development and for optimum progress in speech therapy.

Where do speech language pathologists work?

Almost 60 per cent of certified speech language pathologists work in educational settings, including the public schools, in federally mandated, public- sponsored early intervention programs, or in colleges and universities. Others work in hospitals and clinics, nursing care facilities, and in private practice. There are currently over 150, 000 ASHA- certified speech language pathologists in the United States, according to the United States Bureau of Labor Statistics. The school-based speech language pathologist is usually employed by the school district or the education service district (ESD). There is a federal law, known as IDEA (Individuals with Disabilities Education Act) that requires speech language pathologists to be employed by schools in order to provide therapy for those children whose communication problems are affecting their academic progress. Increasingly, some school districts are contracting with private agencies to secure the services of speech language pathologists. The school SLP sees children from kindergarten through high school. To qualify for speech therapy services the student typically has to fall in the moderate to severe ranking on a standardized speech or language test. The school SLP most often sees children in small groups for therapy, 2 to 4 children at a time. School speech therapy sessions typically last 20 to 30 minutes, once or twice per week. Children can be referred to the public school speech language pathologist by the classroom teacher or upon request from the parent. Services from the public school or early intervention speech pathologist are provided at no charge to the family, as part of the school program. In addition to the communication disorders described below, the school speech language pathologist may be asked to help children who are having difficulty learning to read.

Speech language pathologists also work in hospitals, hospital out-patient clinics and in short term and long-term nursing care facilities. These clinicians, especially in the hospital and nursing care facilities, see primarily adults or older children with neurological disorders, including closed head injuries resulting in traumatic brain injury, patients who have suffered strokes and have brain damage to the areas of the brain responsible for communication, and patients with progressive neurological disease such as Parkinson’s disease or Lou Gehrig’s disease (ALS) Speech language pathologists working in a medical setting such as a hospital typically refer to those people they see as patients, while clinicians in clinics or private practice settings refer to the people they see as clients. In the school setting, children in speech therapy are usually referred to as students. When looking for a clinician, families need to ask if the SLP works primarily with children or adults. Fees are charged by the hospital or outpatient clinic for services provided by the SLP.

Speech-language pathologists also work in free-standing speech and hearing clinics or for multi-discipline agencies that employ a number of different professionals, including developmental pediatricians, child psychologists, and speech-language pathologists. A child may be referred to the clinic by his pediatrician or the family may call and self-refer. Again, fees are charged for speech language pathology services. Some health insurance plans cover speech evaluations and a certain amount of speech therapy.

Several hundred colleges and universities in the United States offer training programs in speech language pathology and sometimes audiology. The professors are speech language pathologists; most have PhD degrees and will be engaged in research as well as teaching. Most teaching universities in speech language pathology will have a speech and hearing clinic where community members can receive speech therapy provided by the graduate students under the supervision of the department staff.

Some speech-language pathologists work in a private practice setting. This typically means the clinician sets up an office or may travel to the family’s home to provide the speech therapy. Typically the SLP in private practice sees only one child at a time in sessions ranging from 20 to 60 minutes per visit or more. The SLP in private practice will charge fees. Again, some health insurance plans will pay for a portion of the speech therapy depending on the type of communication disorder.

What is a communication disorder?

A communication disorder is any problem that interferes with a person’s ability to understand or use speech or language to relate to other people. When hearing loss and deafness are included, approximately 10 percent of the population of the United States has a communication disorder (National Institutes of Health). Dr. Charles Van Riper, one of the founders of modern speech language pathology, in his classic text, Speech Correction: Principles and Methods, said that a communication disorder exists “when speech or language deviates so far from the norm of other people that it calls attention to itself, interferes with communication, or causes its possessor to be maladjusted” (Van Riper, Speech Correction: Principles and
Methods, 4th edition, p 16).

Speech language pathologists work with children and adults. Communication disorders include problems with articulation and phonology (the use of speech sounds to form words); delayed development in the ability to understand and use language; language disorders as a result of stroke, trauma resulting in brain damage, or progressive neurological diseases; problems with voice (tone, resonance, loudness, quality); and problems with fluency, also known as stuttering. Speech language pathologists work with people who want to modify their accents; those with difficulty with language pragmatics, the social aspects of communication (listening, making eye contact, taking turns in a conversation); those with swallowing disorders; and those needing augmentative or alternative methods to communicate.

What is language?

Language is the set of symbols we use to communicate. The symbols can be spoken words, or sign language, or dots and dashes in Morse code. The speech language pathologist is interested in two aspects of language, receptive language and expressive language. Receptive language is the person’s ability to understand what is being said. Developmentally it is the foundation for talking and will precede the development of expressive language. Receptive language is the hidden part of the iceberg, the unseen but critically important aspect of language. It includes vocabulary comprehension. Expressive language is the use of language to communicate. It includes spoken vocabulary, sentence length, grammar and syntax (word order in sentences) and content: do the words make sense according to the context of the conversation?

What is speech?

Speech or articulation is the act of shaping air from the lungs to make sounds. Speech sounds are made using the vocal cords, the jaw, the lips, teeth, tongue, the hard and soft palate, and the nose (in American English for the three nasal consonants “m, n, ing”).

What are language pragmatics?

Language pragmatics are the rules for social language use, the tools we use to communicate beyond the words themselves. They include looking at the person we are talking to, taking turns in conversation, choosing and maintaining a topic, learning how to listen, knowing how to keep a conversation going, knowing what to talk about and what not to talk about, knowing how to begin and end a conversation, and even knowing how close to stand to another person when we talk. The ability to use pragmatics is the ability to use language socially to have conversations. The child or adult with a language pragmatics disorder (often called a social/cognitive disorder) may call undue attention to himself due to an extreme focus on a favorite topic of conversation or because he or she asks inappropriate questions or has difficulty taking the perspective of the communication partner.