What is a speech-language pathologist?
What do they do?
A speech-language pathologist (SLP) is a highly skilled medical provider who assesses, provides diagnoses, and treats speech, voice, language, social-communication, cognitive-communication, fluency, and swallowing disorders in children and adults. SLPs also provide assessment and treatment for individuals who are non- or minimally-verbal by determining alternative-augmentative communication (AAC) needs. You can think of a SLP as a communication and swallowing specialist. SLPs work autonomously, which means they are able to diagnose and treat communication and swallowing disorders without direct approval of a physician. However, in many cases, SLPs or insurance plans will request prescriptions from a physician prior to authorizing SLP evaluations or treatment to ensure a collaborative, team-based approach to healthcare.
How do you become a Speech-Language Pathologist?
A SLP holds, at minimum, a master’s degree in the field of Speech-Language Pathology. During the SLP’s undergraduate and/or graduate training, they will generally need to complete coursework in (but not limited to) statistics, neuroanatomy and neurophysiology, physics of speech and sounds, hearing screening, diagnostics/treatment for aphasia/language disorders, diagnostics/treatment for speech/articulation disorders, diagnostics/treatment for dysphagia/swallowing disorders, and speech and language development. All SLP graduate training programs also require a minimum of 300-400 supervised clinical clock hours during the time a SLP is in graduate school. Upon graduation, SLPs must then complete a post-graduate clinical fellowship where they will accrue another 1,260+ clock hours of supervised work. Following all of the above, A SLP is then required to sit for a national board examination which they must pass before being allowed to apply for a state SLP license. After all of this, a SLP is eligible to work independently but will need to continually update their training by engaging in at least 30 hours of CEUs (continuing education units) every 2-3 years.
What do they treat?
Common diagnoses SLP’s evaluate and treat include:
Articulation DisorderS
An articulation disorder involves difficulties producing specific speech sounds, usually consonants. This may be characterized by a child producing the “w” for “r” (wabbit for rabbit) or a child with a lisp. Other times, children may have difficulties with entire sound categories and/or processes, and as a result produce a greater number of errors which significantly impairs their ability to be understood by familiar and unfamiliar listeners alike. This is sometimes given a more specific diagnosis known as a phonological disorder.
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Language DisorderS
This is a disorder which impairs a person’s ability to formulate, process, and express their thoughts and ideas out loud or in written form. “Language” is actually more of an umbrella term, as it encompasses many specific skills including prelinguistic skills (e.g., joint attention, sharing interest), para-linguistic skills (e.g., gestures, signs, body language), listening, understanding vocabulary, reading and literacy, using words appropriately, producing age-appropriate phrases or sentences, engaging with peers socially, and using age-appropriate grammar. Some children with language disorders may only have difficulty in one or two of these skill areas, while other children may need more supports.
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Fluency DisordeRS
This is frequently referred to as “stuttering” and is characterized by a disrupted flow of someone’s speech, such as repetition of sounds and words and frequent pauses in someone’s speech.
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Apraxia of Speech
This is another kind of articulation disorder, but this type of disorder is actually known as a motor-speech problem. Children with Apraxia of speech know what they want to say, but have difficulties getting the parts of their mouth to move in the correct manner to say words. This disorder is not the result of a muscle weakness, but due to a breakdown between their brain and their articulators. These children make errors on not only consonant sounds, but vowels, too. Sounds are often distorted in a different manner each time so the same word may sound different when it is repeated. These children may have an easier time saying shorter words and may also be better at saying rote/memorized information, like singing “happy birthday”.
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Cognitive-Communication Disorders
This is a disorder which impacts one’s memory, attention, problem solving, and executive function. This is not a frequent stand-alone diagnosis you may see in children as it is usually given to adults who have suffered significant brain trauma. Cognitive skills may be addressed in treatment sessions as these skills may be impaired in children with medical disorders such as Attention-Deficit Disorder (ADD/ADHD) and Autism.
Feeding Disorders
A feeding disorder may or may not be accompanied with problems swallowing but typically include picky eating, behaviors disruptive to meal-times, aversions to certain food textures or types of foods, failure to use developmentally appropriate utensils, and less than typical growth or weight.
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Swallowing Disorders
Also called dysphagia, involves difficulties at the various phases of swallowing (e.g., oral, oral-pharyngeal, pharyngeal, esophageal) and can lead to aspiration pneumonia, if left untreated. Aspiration pneumonia refers to liquid or food entering one’s airway/lungs. Causes of dysphagia may be delayed or disordered chewing, limited sensation, difficulties drinking. This could be accompanied by symptoms of gagging or vomiting and clients may also have a diagnosis of gastroesophageal reflux disorder (GERD) along with poor nutrition/malnutrition. Children with swallowing disorders also frequently develop extreme oral aversions as a result of untreated difficulties swallowing.
