Everything you always wanted to know about Speech Pathology, but were afraid to ask!

Over the course of my 30+ career as a Speech-Language Pathologist, I've been asked many questions by parents and those interested in getting into the field. Here, in no particular order, are some of the most common.


What is Speech Pathology? 

Speech pathology, or speech-language pathology, is the study and treatment of speech and language problems. It can be extremely rewarding for those of us who love to help others overcome obstacles, build confidence and develop communication abilities that allow them to connect with others. In cases where progress is difficult or extremely limited, or when the client is going through other things related to their speech difficulties, it takes a hearty soul to keep up with the work. 

What do speech pathologists do?

Speech pathologists meet with people one on one or in groups to overcome hurdles in communication. There are many physical, cognitive and developmental factors that lead to speech difficulties, with different techniques needed to overcome them. The work a speech pathologist does generally falls under the blanket term of “speech therapy.” 

In a group setting, a speech pathologist may develop games or activities where clients practice speech in a fun yet strategic way. One on one, they may use flash cards to practice different elements of speech, or they may turn the lesson into a conversation where the same work is done in a more organic way. A speech pathologist may specialize in treating a specific disorder or work with a certain age group.

What is the difference between a speech pathologist and speech-language pathologist (SLP)?

“Speech pathology” and “speech-language pathology” are two ways of describing the same field. “Speech pathology” refers to challenges to speech itself—difficulty making certain sounds or saying a sentence all together. “Speech-language pathology” is a broader term referring to the wider field of communication. A speech-language pathologist doesn’t just work on articulation, they may help a child with autism to recognize facial expressions, or work with an older person recovering from a stroke to say the words they’re thinking of. Pronunciation is also a big part of speech pathology, but the causes of difficulties vary widely, from physical disabilities to phonological disorders to dysfluency. 

While more people are familiar with the term, “speech pathology,” many of those in the field prefer the phrase “speech-language pathology” because it describes the whole scope of the work. 

What do speech pathologists treat?

The disorders covered by speech pathology can be loosely categorized into physical, cognitive and developmental difficulties. 

Physical difficulties include dysarthria, a weakness of the muscles used in speech that is generally caused by paralysis. An SLP helps clients with dysarthria to strengthen their muscles through vocal exercises, so their words come out crisp and clear. Speech pathologists also treat swallowing disorders where excess saliva makes it difficult to speak clearly. An SLP can help a client with a swallowing disorder to find and use the muscles needed to swallow, just like they do with making different speech sounds. 

Cognitive difficulties affect the communication between the brain and the body, and often occur as a result of a stroke. Aphasia makes it difficult to use and understand words, and apraxia makes it difficult to make the sounds in a word. A speech pathologist helps a person with these disorders to practice the elements of speech and communication, allowing them to regain these skills. 

Developmental difficulties include delays in making certain speech sounds, often linked to a phonological disorder. Every child is ready to learn different sounds at different rates, progressively learning the simplest to most complex sounds in their language. To protect kids and families from frustration when the child is not ready to learn the sound, it is not recommended to start speech therapy until the child is officially developmentally late for the particular sound. In addition to making certain sounds, children may have trouble pronouncing clusters of consonants (like the "st" in "star") or have other speech patterns linked to a phonological disorder or delayed speech. A speech pathologist will work with children individually or in groups to progressively learn the tongue movements and sounds, followed by saying the sounds in a word then in a sentence, until the child uses the sound without thinking about it. 

Other conditions speech pathologists work with include autism, which is linked to both delayed speech and struggles with social cues. Here a speech pathologist’s work branches out to include facial expressions, taking turns and other forms of communication. See The Best Learning Toys for Nonverbal Children. A speech pathologist also supports learning for people with dyslexia and other disorders that affect communication, and helps with speech disorders such as stuttering. 

Where do speech pathologists work? 

There is a need for speech pathologists in many settings, from schools to hospitals to individual homes. A speech pathologist may work independently, with an agency, or at a business. Some may prefer to have a private practice: You make your own hours, can work with clients in their homes or at your office, and there is no one to report to. However, this can be intimidating to start with and many speech pathologists work with a company while getting their bearings even if they plan to work independently later on. If an SLP specializes in a particular speech disorder or age group, they may work in a location to match, such as an elementary school or rehabilitation center. 

What do you need to become a speech pathologist? 

To become a speech pathologist in the United States, you must complete a Master’s or Doctorate degree in Speech-Language Pathology, complete a 36-week clinical fellowship, pass the Praxis Examination in Speech-Language Pathology, and be certified by the American Speech-Language-Hearing Association (ASHA). You may also need a state license. 

The clinical fellowship is a chance to try out working in different settings and develop an idea of where you will thrive as a speech pathologist. It’s also an opportunity to work independently while still having an experienced mentor. Following the fellowship, testing and certifications, a speech pathologist is ready to work alone or with a group of peers. 

What drives people to become speech pathologists?

People fall in love with speech pathology for many reasons, from helping children have a great start in life to supporting people recovering from a stroke, to exploring the building blocks of speech and communication. What drives a speech pathologist ultimately helps them to find their niche. Speech pathology has one of the longest career-retention rates, between about 11 and 35 years, as speech pathologists develop a passion for their work and continue to hone their skills for years to come.