Careers in: Speech-Language Pathology

Could helping people regain their verbal communication be the career for you?

by Molly Joss

Speech-language pathologists (SLPs), or speech therapists as they are often called, work with people who have difficulties talking or swallowing. They evaluate and treat a wide variety of problems related to speech and language, including problems stemming from disease, injury, development disabilities and birth defects.

SLPs also work with people who wish to modify or eliminate accents, stop stuttering, improve their communication skills or to alter the tone or pitch of their voices. Speech therapists use their skills in government or corporate positions doing research or developing speech-loss prevention programs.

Unless they are conducting research or developing programs, SLPs work directly with clients on a one-to-one basis. To assess problems, they use written or oral tests as well as special instruments to record and analyze speech difficulties. To treat patients, they develop an appropriate treatment plan, which they may pass along to another SLP or implement themselves.

Some SLPs work independently, providing services to clients in a private clinic or office setting in much the same way as other medical specialists. They work with individuals or can set up contract arrangements with institutions such as schools, hospitals and elder care facilities. Others work as staff people in medical facilities and work as part of a team of doctors, social workers, psychologists and other therapists.

How to Succeed

To be happy and successful in their work, SLPs must be patient and detail-oriented. In some cases, a patient might be capable of only limited (or no) improvement despite months or years of therapy. SLPs must be willing to put in the time to document cases thoroughly, especially long-term cases that require substantial insurance reimbursement.

A typical day for an SLP employed on staff at a major medical facility might include a staff meeting, meetings with other practitioners to discuss specific cases, evaluating a head trauma patient, and counseling a patient with multiple sclerosis on what changes he can expect in his speech capabilities as the disease progresses.

An SLP who works for a school system might spend the day traveling from school to school to discuss suspected speech problems of special needs students with teachers or setting up and conducting evaluations of students. Part of the day might be spent reviewing or updating individual treatment plans for students with speech difficulties.

In private practice, the SLP could spend an hour or two coaching someone with a speech impediment or accent on how to pronounce specific sounds, then travel in the afternoon to a nursing facility to visit clients there. An SLP who works in research might be involved in an evaluation program for a new computerized hearing aid or analyzing data from a multiple-client study.

Career Outlook

According to the Federal government's Bureau of Labor Statistics (BLS), about 94,000 people held jobs as SLPs in 2002. About half of these people worked for, or in, educational institutions-including public schools, colleges and universities. Most of the others worked in clinical settings inside of hospitals or nursing homes or provided services through health care facilities such as outpatient or home health care centers, and a few worked in private practice.

The Bureau estimates that employment prospects for SLPs will grow faster than the average job growth rate through the year 2012. The average annual growth rate for all jobs is less than two percent, but that figure takes into account jobs that are disappearing. The BLS says that health care related employment opportunities are among the fastest growing areas of employment.

Information gathered from state labor projection organizations estimates that about 5,000 new SLP positions will open between now and 2012, plus people will be needed to fill existing slots as people retire or leave the field for other reasons. The states with the biggest percentage change are Nevada, Utah and Idaho, followed by many of the Southern states. According to these figures, all of the percentage increases are double-digit with a maximum of 49% in Nevada.

You can easily understand that anyone involved in working with the elderly will find increased job opportunities as the Baby Boom generation continues to get older. As people age, they can experience problems with their hearing for several reasons, including strokes. SLPs will find ample opportunities to work with older people during the next several decades.

The BLS also expects SLP job opportunities to open up within elementary and secondary school systems as more children are evaluated for disabilities. Federal law guarantees that all children with special needs receive appropriate evaluation and treatment, including children with speech-related disabilities.

In addition, children with attention-deficit disorder often have some sort of speech related disability such as auditory processing problems (difficulties understanding spoken speech). These children can also benefit from working with SLPs.

SLPs with dual or multiple language proficiencies should find ample work opportunities serving communities or areas where multiple languages are spoken routinely. Medical service providers in such areas are finding it difficult to adequately provide for the needs of the population. According to information published in Advance, a magazine for SLP professionals, the Hispanic population has increased 300% in Georgia during the last decade. Within ten states in the South, the Hispanic population has increased almost 200% on average during that time. SLPs who are bilingual in Spanish and English should find increased job opportunities working in all settings in these areas.

Pay Day

Annual salaries for SLPs are less than those of general medical practitioners or medical specialists, but the earnings are respectable. Plus, SLPs are seldom asked to work nights and weekends or long shifts. Typical working hours are office hours and a normal workweek is 35 to 40 hours with no on-call work.

The BLS latest compensation figures are from 2002 and indicate that on average SLPs earned about $50,000 that year. The middle range (50%) earned anywhere from $39,930 to $60,190. The highest salaries were about $75,000 and the lowest about $33,000. SLPs who worked with other health practitioners or in medical environments made more on average than SLPs who worked in elementary or secondary schools-about six thousand dollars a year more.

The American Speech-Language-Hearing Association (ASHA), one of the biggest associations for SLPs, conducted a salary survey of its members in 2003 that gives more detail about SLP compensation. According to the survey, the median salary for full-time certified SLPs who worked year-round (as opposed to working on an academic year basis) was $48,000. SLPs who worked nine to ten months and in academic settings made slightly less, about $44,800.

These figures are national averages and represent all experience levels. They will be lower in less populated areas and lower all-around for people who are starting their careers. The ASHA's survey indicated that the national average for starting salaries for people with one to three years of experience was $42,000 for those who worked on a calendar-year basis and $37,000 for those who worked on an academic year basis.

Education and Training

To work as an SLP, you will need a graduate or doctorate in a related doctrine; usually people start with a graduate degree in speech-language pathology. Some people who work as SLPs have graduate degrees in audiology or speech-language science.

You don't need an undergraduate degree in SLP to get into an appropriate graduate program, but you do need a bachelor's degree, and having a major in a related health field is a definite plus. A program with an emphasis or a major in communication sciences and disorders or communicative disorders is an excellent foundation for later SLP education and training.

More than 200 colleges and universities offer graduate or doctorate programs in speech-language pathology. Some of these offer undergraduate programs that relate to these degrees, as well. If you want to search for such programs, start with the online location service on the ASHA site at www.asha.org/gradguideA. This service is organized on a state-by-state basis and allows you to locate programs accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology.

If you are interested in a program with an emphasis in minority issues or a bilingual focus, the ASHA site contains a list of programs run by Historically Black Colleges and Universities, as well as minority/bilingual emphasis programs. For example, San JosŽ State University's graduate program in SLP is one of the programs listed on the ASHA Web site, and information on the University's Web site explains how SJSU interprets and implements diversity in the program: "The program curriculum integrates the various aspects of diversity and its corresponding issues, including practical information regarding working in a multicultural environment, communicating effectively with interpreter/translators, and interacting with clients from a variety of cultural and linguistic backgrounds in hospitals, schools, clinics, and the department's on-campus clinic."

The ASHA site lists more than two-dozen colleges and universities with such programs. Two more examples are Washington State University, which has an SLP program with an emphasis on working with Native Americans, and Florida International University, which offers a bilingual specialty track in its SLP graduate degree programs with such courses as Cultural and Linguistic Diversity in Communication Disorders and Assessing the Bilingual Child with Communication Disorders.

The Council of Academic Programs in Communication Sciences and Disorders maintains its own list of undergraduate and advanced degree programs in SLP in the United States, Canada, Puerto Rico and New Zealand.

If certification is important to you, then you need to have a degree from an ASHA certified program, so read through the information on the list carefully. This list is organized by name and by state/location. The list can be found online at www.capcsd.org/cgi-bin/caplist.exe.

Expand Your Horizons

While you are working on your undergraduate degree, look for opportunities to expand your education beyond the classroom. You will be able to put theory into practice, and you will be better able to evaluate if you want to pursue a career in working with people with speech difficulties.

Participate in hands-on work as much as possible even if the only opportunity in a clinical setting is to observe or to handle paperwork. People pursuing a graduate degree in speech-language pathology must make a greater effort to do clinical work because experience is part of the certification requirement.

Students can gain experience through summer internships or even volunteer work. ASHA runs summer camps around the country for people (especially children and teens) with speech difficulties and is always looking for people to help at the camps.

If you are working on an undergraduate degree in communication sciences and disorders and decide not to pursue an SLP-related advance degree, you can still put the degree to use.

You can work as a SLP aide or assistant. Assistants must be supervised by SLPs, but under their guidance may be allowed to perform many of the evaluations and execute treatment plans. State regulations govern what aides can and can't do and regulations do vary.

You do not need a bachelor's degree to work as an aide (a two-year degree from a technical school in SLP is enough in some states) although employers do typically prefer a bachelor's degree. As an aide, you also don't need to be certified or continue your education through course work beyond your degree. SLP aides with several years of experience make about 60% to 70% of what an SLP with comparable experience would earn.

Licensing and Certification

To be a full SLP, you must (in most states) obtain a license and part of the licensing requirement is an applicable master's degree. You will also be required to pass a Praxis exam and a national exam on SLP, which is offered by the Educational Testing Service. A certification from a major industry association such as ASHA may also be required.

Other requirements include several hundred hours of supervised clinical experience and nine months of postgraduate professional clinical experience. To keep a license current, 38 states require ongoing education to earn continuing education credits. Most private health insurance companies require practitioners to be licensed to qualify for payments, as do Medicare and Medicaid.

The ASHA certification program offers certificates of clinical competence (CCCs) that are recognized and accepted nationwide. In some states, a CCC is all you need to satisfy that state's SLP licensing requirements, and in most states the CCC is one of the requirements. To gain the certification, you will need to have passed the Praxis exam, gained the hundred hours of clinical experience, and have accumulated the necessary continuing education credits from an ASHA-approved CE provider or through approved independent study. Re-certification is necessary every three years.

While still in school, you should consider becoming a member of the National Student Speech Language and Hearing Association (NSSLHA). To join you must be a student enrolled in a part- or full-time degree program related to communication disorders. When you join you have access to print journals and profession-related discounts. Most important of all, membership gives you access to invaluable networking opportunities that will make it much easier to get experience while you're in school and land a job when you're completed your studies.

To get more information, log onto their Web site at www.nsslha.org/nsslha.

Related Professions

SLPs often work with other health care professionals such as medical doctors and psychologists. However, the closest related health care occupations to SLPs are audiologists and speech language and hearing scientists. Audiologists work with people who have hearing or balance disorders. Some people have speech and hearing problems, requiring the expertise of audiologists and SLPs.

The training, experience, certification requirements and day-to-day work duties of an audiologist are similar to those on an SLP-with the exception of the nature of the problems the client exhibits. Audiologists also make about as much money as SLPs.

A speech, language and hearing (SLH) scientist needs a research doctorate degree in a related doctrine. Certification is not required to conduct research, but some scientists do acquire the relevant ASHA certification.

SLH scientists usually pick an aspect of the discipline to focus their research efforts. Within this area of focus, they spend their time researching biological, physical and physiological communication processes. Or, they spend their time researching the psychological or social effects of SLH disorders on affected individuals. Usually these scientists work in a university or college environment, but some do private research funded by corporations.

Sound Benefits

Becoming a degreed professional in the SLP field gives you the opportunity to have a satisfying career helping others while you earn a first-rate salary. The top earning prospects go to those who have graduate and doctorate degrees, but even someone with the appropriate two-year degree can gain entry to the field.

Demand for SLPs will increase during the next decade and in some areas demand will exceed supply; experienced licensed practitioners can look forward to having their choice of job opportunities. Continuing education requirements and re-certification are a must for those who remain in the field more than a few years, but this slight disadvantage is outweighed by the bright outlook and career opportunities that abound in this exciting field.

Molly Joss is a free-lance writer, analyst and consultant who writes about career and job issues, among other topics of note.