When four-year-old Tyler started speech therapy, he was completely non-verbal, using simple cues – smiling, pointing – to communicate with his speech-language pathologist. In the course of just a few months, the work between Tyler and his SLP began paying off. Tyler began progressing to simple words – yes, no – and then to basic sentences that allowed him to communicate with his friends, teachers, and family. In six months, Tyler’s vocabulary increased to more than 250 words. These real, positive changes have enriched Tyler’s life, allowing him to form friendships with peers and flourish in both his home and school environments.
Tyler’s story is not unique. Thanks to the tireless work of SLPs, children and adults with a variety of speech, language, communication, and feeding/swallowing disorders are able to reach their potential and communicate with confidence and ease. So, is speech pathology a good career? For most, the answer is a resounding yes!
A Closer Look at a Speech and Language Pathology Career
Speech-language pathologist is a broad job title that includes working with clients with speech delays, speech disorders, or those who have difficulty:
- With voice tone or quality
- Understanding others (receptive language)
- Expressing thoughts, ideas, or feelings (expressive language)
- Using language in socially appropriate ways
- Using verbal and nonverbal communication for social purposes
- Following rules for conversation and story-telling
- Organizing thoughts, paying attention, remembering, planning, and/or problem-solving
- Swallowing and feeding disorders
According to the American Speech-Language-Hearing Association (ASHA), it’s the job of SLPs to assess, diagnose, and treat speech, language and swallowing disorders with a biological cause, as well as communication challenges that are of a social or cognitive-nature. When possible, they are even involved with interventions meant to prevent these kinds of problems before they start.
SLPs work with children and adults of nearly every age who have speech and language difficulties as a result of premature birth, injury, illness, surgery, or dementia. Clients are often those who have suffered a stroke or sustained traumatic brain injury or those with developmental disorders like autism spectrum disorder (ASD), progressive neurological disorders like ALS, language delays, or articulation, phonology, and/or motor speech disorders. The work of SLPs also extends to aural rehabilitation for clients who are deaf or hard of hearing.
SLPs are also involved with providing augmentative and alternative communication (ACC) systems for clients who are largely nonverbal. ACC systems may be unaided – sign language, gestures, or facial expressions that help nonverbal clients, or aided – any type of tool or device that’s used to communicate. Aided systems can be rather basic (a board with letters, words, or pictures on it that the client can point to) or advanced (high-tech systems that include speech-generating boards).
An SLP’s job duties range from evaluating clients to treating them to providing training and education to family members and caregivers. Speech-language therapy is usually part of a collaborative, interdisciplinary care plan that includes working with other professionals like behavior therapists, social workers, teachers, physicians, psychologists, audiologists, and physical and occupational therapists. Therefore, it’s quite common for SLPs to coordinate care with other providers and work with families and caregivers to continue or support the therapies they introduce.
While the majority of SLPs treat clients with specific disorders, some will specialize in areas like professional voice development, accent or dialect modification, and transgender voice modification.
Because of the wide range of clients they serve, SLPs work in a variety of settings, including:
- Schools: The work of SLPs can be found in early intervention programs, K-12 schools, and preschools, where they conduct screenings and evaluations, work one-on-one, and provide small group or classroom services. They work alongside educators and other pros within the school setting to develop individualized family service plans (IFSPs) and individualized education programs (IEPs). They also develop and execute programs aimed at strengthening communication and social skills, and they often serve as consultants to educators and others.
- Healthcare: You’ll find many SLPs working in healthcare settings that include:
- Nursing homes
- Skilled nursing facilities
- Inpatient/outpatient rehabilitation centers
- Speech/hearing clinics and doctors’ offices
- Home healthcare
In specialty hospitals (e.g., rehabilitation, psychiatric), SLPs usually provide their services on an outpatient basis, and in some settings (e.g., VA hospitals, children’s hospitals), they focus their services on a specific population.
Their work in residential facilities, such as nursing homes, is largely focused on functional skills needed to achieve or regain independence, so SLP therapy in these settings is usually longer-term than those provided in hospital settings.
SLPs providing services in the home are usually employed by home healthcare agencies and may work as part of state-funded early intervention programs.
Many SLPs choose to work independently or as part of an SLP group. In these settings, SLPs enjoy more control over their careers, which includes managing their own schedules and caseloads, choosing a specialty, and increasing their earning power.
Should I Be an SLP?
So, you’re probably wondering, is there a high demand for speech pathologists? The answer is a big, resounding, yes! Even with 158,100 SLPs practicing throughout the US as of May 2020 according to the US Bureau of Labor Statistics, another 45,400 are expected to graduate with the right credentials and join the workforce in the ten-year period leading up to 2030. That represents a very strong 29 percent job growth rate, much faster than the average across all healthcare and non-healthcare professions.
If you’re still wondering, is becoming a speech pathologist worth it? If earning a master’s degree so you can access a career where the national median salary is $80,480, and the highest paid in the field make more than $122,790, then for most people looking for a practical answer to that question, yes, it is most definitely worth it. But you can’t put a price on the kind of rewards that come from helping a kid struggling with speech and the social challenges that come it get to a place where they can comfortable and confidently articulate their thoughts and needs. That’s an invaluable reward that by itself makes all the hard work involved in becoming an SLP well worth the effort.
Specialties in Speech-Language Pathology
Many SLPs find more career opportunities and better earning potential when they specialize. Specialization in SLP may be according to a specific demographic (seniors, school-aged children, etc.) or a specific condition (swallowing disorders, fluency disorders, etc.). You’ll also find that most SLPs gravitate toward either working in an education/community setting or in a medical setting.
If you want to focus your SLP career on working with children in a school setting, for example, you may choose to specialize your practice on child language and language disorders or phonological and articulation disorders, while if you want to focus on working in hospitals and inpatient rehabilitation facilities, you may choose to specialize your work on swallowing and swallowing disorders, motor speech disorders, or serving as a feeding specialist for NICU patients.
Just a sampling of other areas in which you’ll find specializeed SLP careers include: bilingual specialization, aphasia, assistive communication, dementia/memory impairment, motor speech disorders, traumatic brain injury, vocal cord dysfunction, and much more.
Your choice of specialty will largely depend on your personal likes and dislikes. Some SLPs prefer working in the school setting for better hours and summers off (they usually work on a nine- or ten-month contract); some SLPs enjoy the challenge of working in a clinical setting; and others enjoy the flexibility and freedom that come with working in home healthcare. Regardless of the setting in which you work, the majority of your time will be spent on direct client care, with the remaining time focused on paperwork and program planning and assessment.
ASHA’s Clinical Specialty Certification options provide practicing SLPs with the opportunity to become a Board Certified Specialist (BCS) in a specific area of clinical practice. To earn these advanced credentials, you’ll need to meet specific educational, experiential, and clinical requirements. Specialty certification options currently available include:
- American Audiology Board of Intraoperative Monitoring
- American Board of Child Language and Language Disorders
- American Board of Fluency and Fluency Disorders
- American Board of Swallowing and Swallowing Disorders
A Day in the Life Of a Speech-Language Pathologist
A typical day for an SLP includes back-to-back assessments, program development and evaluation, and SLP therapy sessions. But their overall duties tend to differ based on the setting they work in.
For example, SLPs in a school setting must make time for meeting with other teachers and the interdisciplinary healthcare team, lesson planning, and evaluating and revising care plans. Many smaller school districts may only employ one or two SLPs, so traveling between schools throughout the week is standard fare. A day in the life of a school-based SLP may including conducting schoolwide hearing tests in the morning, working with children either one-on-one or in small groups to treat everything from stuttering problems to speech delays in the afternoon, and then catching up on paperwork at the end of the day.
A hospital-based SLP’s schedule looks markedly different from those in school-based settings. Caseloads for hospital-based SLPs may range from 15-30 patients at any given time, so managing a strict schedule is important in the hospital-based setting. A day in the life of a hospital-based SLP may include assessing an ICU patient’s ability to eat normally once a feeding tube is removed in the morning, performing a swallowing assessment for a recent stroke patient with aphasia before lunch, and introducing speech therapy to a laryngeal cancer patient in the afternoon. It’s a constantly changing environment in a hospital setting, and to succeed here you must thrive in a high-paced setting.
In an outpatient setting, such as a clinic or rehab center, an SLP’s schedule is more reliable, usually consisting of a series of appointments that involve providing assessments and conducting therapy sessions. A day in the life of an SLP in an outpatient setting involves working with clients in 30-minute increments throughout the day.
Home-based SLPs must also perform assessments, create plans of care, and implement therapies designed to help their clients reach specific goals. However, their schedules are not usually as rigorous, given that they must include travel to and from each client’s home.
Opportunities and Challenges For Today’s SLPs
Ask any SLP and they’ll tell you the best part of their job in the client interaction. It’s a rewarding career that comes with gratification when your clients reach their goals and gain or regain their independence. Whether you’re working with preschoolers or seniors, you’ll find the one-on-one interactions will provide you with a great sense of personal and professional fulfillment.
And that’s good news for a career where you’ll spend the better part of your day working with clients. But like any other clinician, you’ll be mired in paperwork, record-keeping, and insurance documentation. It’s a reality in today’s clinical environment; and for many, it’s one of the toughest parts of the profession.
You may be required to meet specific patient quotas, which can add significantly to the stress of the job, or you may work in an environment where client numbers are simply too high and you don’t feel as if you can provide your clients with an optimal level of care or personal attention.
It’s also important to note that the COVID pandemic has forced many SLPs online. A rise in telepractice (referred to telepractice instead of telehealth because it includes providing services to clients outside of the healthcare setting) has forced many SLPs to forgo personal appointments and instead provide their services remotely. Today’s SLPs providing online services must understand the appropriate models of technology; they must be able to select clients who are appropriate for these services; they must be able to select and implement interventions that are appropriate for telepractice; and they must be familiar with the tools and methods needed to evaluate the effectiveness of these online SLP interventions.
Is speech pathology hard? It’s certainly challenging and reserved only for those with equal parts determination, dedication, and compassion for those they provide care for. You’ll work hard as an SLP, and you’ll find that no two patients are alike, which will keep you on your toes and always fully engaged. The benefits of being a SLP far outweigh the negatives for most pros in this profession, though, which makes the challenges of becoming an SLP well worth it.
Speech-language pathology is a constantly changing and evolving therapy that demands clinicians who stay on top of recent advancements in the field and are willing to make continuing education an important part of their career.
While both ASHA and state licensing boards require continuing education to ensure that SLPs are always relying on an evidence-based approach to care and are familiar with the newest developments in the profession, the most successful pros in the field seek learning opportunities that far exceed what is required to maintain certification and state licensure.
- Emerson College offers a Master's in Speech-Language Pathology online - Prepare to become an SLP in as few as 20 months. No GRE required. Scholarships available.
- NYU Steinhardt's Master of Science in Communicative Sciences and Disorders online - ASHA-accredited. GRE and bachelor's degree required. Graduate prepared to pursue licensure.
- Calvin University’s online Master of Speech-Language Pathology degree program - Prepares you to become a certified speech-language pathologist.