Speech-language pathology is the pathology (science) of speech and language (less formally referred to as speech therapy). It falls under the communication sciences and disorders discipline, which also include the closely aligned—but separate—study of audiology.
Speech-language pathology is focused on a range of human communication and swallowing disorders affecting people of all ages.
According to The American Speech-Language-Hearing Association, the following disorders fall under the umbrella of speech-language pathology:
- Speech Disorders: Occurs when individuals have difficulty producing speech sounds correctly or fluently (e.g., stuttering)
- Language Disorders: Occurs when individuals have difficulty understanding others, sharing thoughts, feelings, and ideas, and/or using language in functional and socially appropriate ways; language disorders may also be in the written form
- Social Communication Disorders: Occurs when individuals have trouble with the social aspect of verbal and nonverbal communication. Individuals with autism spectrum disorders struggle with social communication, as do many individuals with traumatic brain injuries. Those with social communication disorders have difficulty:
- Communicating with others socially (e.g., greeting others, asking questions, etc.)
- Changing their way of communicating depending on the listener or setting
- Following socially acceptable rules of conversation and story telling
- Cognitive-Communication Disorders: Occurs when individuals have difficulties paying attention, planning, problem-solving, or organizing their thoughts. Many times, these disorders occur as a result of a traumatic brain injury, stroke, or dementia.
- Swallowing Disorders: Occurs when individuals have difficulty eating and swallowing. Swallowing disorders are often a result of an illness, injury, or stroke.
The practice of speech-language pathology includes those who want to learn how to communicate more effectively, such as those who want to work on accent modification or improve their communication skills. It also includes the treatment of people with tracheostomies and ventilators.
Speech-Language Pathology: The Synthesis of Two Fields of Study
Language differs from speech, which is why speech-language pathology is actually the study of two fields.
Speech is the verbal means of communication. It consists of:
- Articulation: How speech sounds are made
- Voice: The use of breathing and vocal cords to produce sounds
- Fluency: The rhythm of speech
Speech problems often occur because a person has difficulty producing sounds due to the incorrect movement of the lips, tongue, and mouth.
Speech problems include:
- Childhood speech apraxia: Neurological childhood speech sound disorder resulting from neuromuscular difficulties, such as abnormal reflexes or abnormal tone
- Adult speech apraxia: Speech disorder caused by neuromuscular difficulties, such as abnormal reflexes or abnormal tone; usually as a result of stroke, traumatic brain injury, dementia, or other progressive neurological disorders
- Dysarthia: Impaired movement of the muscles used for speech production, including the vocal cords, tongue, lips, and/or diaphragm
- Stuttering: Involuntary repetition of sounds
- Speech sound disorders: Includes articulation and phonological processes difficulties
- Orofacial myofunctional disorders: Tongue moves forward in an exaggerated way during speech or swallowing (called tongue thrusts)
- Voice disorders: Includes vocal cord nodules and polyps, vocal cord paralysis, spasmodic dysphonia, and paradoxical vocal fold movement
Language consists of socially shared rules that include how to put words together, how to make new words, what words mean, and what word combinations are best in what situations. Language disorders include:
- Difficulty understanding others: receptive language disorder
- Difficulty sharing thoughts, ideas, and feelings: expressive language disorder
Although speech and language disorders can occur by themselves, they often exist together, which is why speech-language pathology is a combined field of study.
Speech and language disorders are often a result of medical conditions, such as:
- Amyotrophic Lateral Sclerosis (ALS)
- Huntington’s Disease
- Multiple sclerosis (MS)
- Laryngeal and oral cancers
- Right hemisphere brain injury
- Traumatic brain injury
In children, this may also include selective mutism and language-based learning disabilities resulting from:
- Attention deficit/hyperactivity disorder
- Syndromes, such as Down’s syndrome and Fragile X syndrome
- Cerebral palsy
- Failure to thrive
- Low birth weight or premature birth
- Hearing loss
- Intellectual disabilities
- Fetal alcohol spectrum disorder
- Stroke/brain injury
- Cleft lip/palate
What is a Speech-Language Pathologist?
Speech-language pathologists evaluate, diagnose, and treat speech, language, communication, and swallowing disorders. These highly trained clinicians work as part of a collaborative, interdisciplinary team of professionals, which includes physical therapists, occupational therapists, social workers, teachers, physicians, audiologists, and psychologists, among others.
Their job duties include:
- Developing and implementing treat plans based on their professional assessment and recommendation from members of the interdisciplinary team
- Monitoring their patients’ progress and adjusting their treatment plans accordingly
- Documenting patient care and writing reports regarding patient evaluation, treatment, progress, and discharge
- Ordering, conducting, and evaluating hearing, speech, and language tests and examinations
- Educating patients and family members on treatment plans, communication techniques, and strategies for coping with speech/language barriers
- Designing, developing, and employing diagnostic and communication devices or strategies
- Developing and implementing speech and language programs
Though a majority of speech-language pathologists are involved in direct patient care, these professionals also fulfill a number of other roles in areas such as:
- Program coordination and administration
- Teaching at the post-secondary level
- Product development and evaluation
Speech-Language Pathologist Education and Certification
Speech-language pathologists are highly educated and trained clinicians, educators, researchers, and administrators. Speech-language pathologists, at a minimum, hold a master’s degree in Communication Sciences and Disorders (CSD).
Most master’s degrees in CSD are Master of Arts (MA) or Master of Science (MS) programs. Master of Education (MEd) programs prepare speech-language pathology educators.
National certification and states licensure require the completion of a program that has been accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CAA).
In most states, additional state licensure requirements include completing a supervised postgraduate professional experience and passing a national exam.
Language-speech pathologists can earn the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) through the American Speech-Language-Hearing Association. Certification requirements are similar to state licensing requirements, so state licensed language-speech pathologists generally qualify for the CCC-SLP designation.
The History of Speech-Language Pathology
Speech-pathology as a recognized field of study had its origins in the early part of the twentieth century, when the scientific, academic, and clinical foundations began to take shape and a number of organizations (such as the American Academy of Speech Correction in 1926) focused on speech disorders and speech correction were established.
From 1945 to 1965, speech-language pathology began to evolve, thanks to the introduction of a number of assessment and therapy approaches focused on underlying communication disorders. It was during this time that speech-language pathology researchers and clinicians began focusing their attention on the many WWII soldiers returning from war with brain injuries resulting in aphasia.
This period also gave rise to brain studies, technological advances, and the development of standardized testing procedures, including receptive and expressive language assessment and treatment techniques.
Between 1965 and 1975, advancements in linguistics spurred researchers to begin distinguishing language disorders from speech disorders. Their work enhanced the work of speech-language pathologists, allowing them to begin more effectively treating a variety of language delays and disorders.
Today, speech-language pathology continues to evolve as high-quality research evidence is integrated into practitioner expertise and clinical decision making. The increased national and international exchange of professional knowledge, information, and education in communication sciences and disorders continues to strengthen research collaboration and improve clinical services.
Speech-Language Pathology Resources
- Council on Academic Accreditation in Audiology and Speech Language Pathology (CAA)
- American Speech-Language-Hearing Association
- American Academy of Private Practice in Speech Pathology and Audiology
- International Clinical Phonetics and Linguistics Association
- National Student Speech Language Hearing Association
- National Aphasia Foundation
- Childhood Apraxia of Speech Association of North America
- The Cherab Foundation
- The Voice Foundation
- Selective Mutism Foundation
- Stuttering Foundation of America
- National Institute on Deafness and Other Communication Disorders