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Speech-Language Pathologists
Significant Points
* About half work in educational services, and most others
were employed by health care and social assistance facilities.
* A master’s degree in speech-language pathology
is the standard credential required for licensing in most States.
* Employment is expected to grow because the expanding
population in older age groups is prone to medical conditions that result in
speech, language, and swallowing problems.
* Excellent job opportunities are expected.
Nature of the Work
Speech-language pathologists, sometimes called speech therapists, assess,
diagnose, treat, and help to prevent speech, language, cognitive-communication,
voice, swallowing, fluency, and other related disorders.
Speech-language pathologists work with people who cannot produce speech sounds,
or cannot produce them clearly; those with speech rhythm and fluency problems,
such as stuttering; people with voice disorders, such as inappropriate pitch
or harsh voice; those with problems understanding and producing language; those
who wish to improve their communication skills by modifying an accent; and
those with cognitive communication impairments, such as attention, memory,
and problem solving disorders. They also work with people who have swallowing
difficulties.
Speech, language, and swallowing difficulties can result from a variety of
causes including stroke, brain injury or deterioration, developmental delays
or disorders, learning disabilities, cerebral palsy, cleft palate, voice pathology,
mental retardation, hearing loss, or emotional problems. Problems can be congenital,
developmental, or acquired. Speech-language pathologists use qualitative and
quantitative assessment methods, including standardized tests, as well as special
instruments, to analyze and diagnose the nature and extent of speech, language,
and swallowing impairments. Speech-language pathologists develop an individualized
plan of care, tailored to each patient’s needs. For individuals with
little or no speech capability, speech-language pathologists may select augmentative
or alternative communication methods, including automated devices and sign
language, and teach their use. They teach these individuals how to make sounds,
improve their voices, or increase their oral or written language skills to
communicate more effectively. They also teach individuals how to strengthen
muscles or use compensatory strategies to swallow without choking or inhaling
food or liquid. Speech-language pathologists help patients develop, or recover,
reliable communication and swallowing skills so patients can fulfill their
educational, vocational, and social roles.
Speech-language pathologists keep records on the initial evaluation, progress,
and discharge of clients. This helps pinpoint problems, tracks client progress,
and justifies the cost of treatment when applying for reimbursement. They counsel
individuals and their families concerning communication disorders and how to
cope with the stress and misunderstanding that often accompany them. They also
work with family members to recognize and change behavior patterns that impede
communication and treatment and show them communication-enhancing techniques
to use at home.
Most speech-language pathologists provide direct clinical services to individuals
with communication or swallowing disorders. In medical facilities, they may
perform their job in conjunction with physicians, social workers, psychologists,
and other therapists. Speech-language pathologists in schools collaborate with
teachers, special educators, interpreters, other school personnel, and parents
to develop and implement individual or group programs, provide counseling,
and support classroom activities. Some speech-language pathologists conduct
research on how people communicate. Others design and develop equipment or
techniques for diagnosing and treating speech problems.
Working Conditions
Speech-language pathologists usually work at a desk or table in clean comfortable
surroundings. In medical settings, they may work at the patient’s bedside
and assist in positioning the patient. In school settings they may work with
students in an office or classroom. Some deliver services in the client’s
home. While the job is not physically demanding, it requires attention to detail
and intense concentration. The emotional needs of clients and their families
may be demanding. Most full-time speech-language pathologists work 40 hours
per week; about 1 in 5 work part time. Those who work on a contract basis may
spend a substantial amount of time traveling between facilities.
Training, Other Qualifications, and Advancement
In 2005, 47 States required speech-language pathologists to be licensed if
they worked in a health care setting, and all States required a master’s
degree or equivalent. A passing score on the national examination on speech-language
pathology, offered through the Praxis Series of the Educational Testing Service,
is needed as well. Other requirements typically are 300 to 375 hours of supervised
clinical experience and 9 months of postgraduate professional clinical experience.
Forty-one States have continuing education requirements for licensure renewal.
Medicaid, Medicare, and private health insurers generally require a practitioner
to be licensed to qualify for reimbursement.
Only 11 States require this same license to practice in the public schools.
The other States issue a teaching license or certificate that typically requires
a master’s degree from an approved college or university. Some States
will grant a temporary teaching license or certificate to bachelor’s
degree applicants, but a master’s degree must be earned in 3 to 5 years.
A few States grant a full teacher’s certificate or license to bachelor’s
degree applicants.
In 2004, 239 colleges and universities offered graduate programs in speech-language
pathology that are accredited by the Council on Academic Accreditation in Audiology
and Speech-Language Pathology. While graduation from an accredited program
is not always required to become a speech-language pathologist, it may be helpful
in obtaining a license or may be required to obtain a license in some States.
Courses cover the anatomy, physiology, and the development of the areas of
the body involved in speech, language, and swallowing; the nature of disorders;
acoustics; and psychological aspects of communication. Graduate students also
learn to evaluate and treat speech, language, and swallowing disorders and
receive supervised clinical training in communication disorders.
Speech-language pathologists can acquire the Certificate of Clinical Competence
in Speech-Language Pathology (CCC-SLP) offered by the American Speech-Language-Hearing
Association. To earn a CCC, a person must have a graduate degree and 400 hours
of supervised clinical experience, complete a 36-week postgraduate clinical
fellowship, and pass the Praxis Series examination in speech-language pathology
administered by the Educational Testing Service (ETS).
Speech-language pathologists should be able to effectively communicate diagnostic
test results, diagnoses, and proposed treatment in a manner easily understood
by their patients and their families. They must be able to approach problems
objectively and be supportive. Because a patient’s progress may be slow,
patience, compassion, and good listening skills are necessary.
As speech-language pathologists gain clinical experience and engage in continuing
professional education, many develop expertise with certain populations, such
as preschoolers and adolescents, or disorders, such as aphasia and learning
disabilities. Some may obtain board recognition in a specialty area, such as
child language, fluency, or feeding and swallowing. Experienced clinicians
may become mentors or supervisors of other therapists or be promoted to administrative
positions.
Employment
Speech-language pathologists held about 96,000 jobs in 2004. About half were
employed in educational services, primarily in preschools and elementary and
secondary schools. Others were employed in hospitals; offices of other health
practitioners, including speech-language pathologists; nursing care facilities;
home health care services; individual and family services; outpatient care
centers; and child day care centers.
A few speech-language pathologists are self-employed in private practice. They
contract to provide services in schools, offices of physicians, hospitals,
or nursing care facilities, or work as consultants to industry.
Job Outlook
Employment of speech-language pathologists is expected to grow about as fast
as the average for all occupations through the year 2014. As the members of
the baby boom generation continue to age, the possibility of neurological disorders
and associated speech, language, and swallowing impairments increases. Medical
advances are also improving the survival rate of premature infants and trauma
and stroke victims, who then need assessment and possible treatment. An increased
emphasis also has been placed on early identification of speech and language
problems in young children. The combination of growth in the occupation and
an expected increase in retirements over the coming years should create excellent
job opportunities for speech-language pathologists. Opportunities should be
particularly favorable for those with the ability to speak a second language,
such as Spanish.
In health care facilities, restrictions on reimbursement for therapy services
may limit the growth of speech-language pathologists in the near term. However,
over the long run, the demand for therapists should continue to rise as growth
in the number of individuals with disabilities or limited function spurs demand
for therapy services
Employment in educational services will increase along with growth in elementary
and secondary school enrollments, including enrollment of special education
students. Federal law guarantees special education and related services to
all eligible children with disabilities. Greater awareness of the importance
of early identification and diagnosis of speech and language disorders will
also increase employment.
The number of speech-language pathologists in private practice will rise due
to the increasing use of contract services by hospitals, schools, and nursing
care facilities.
Earnings
Median annual earnings of speech-language pathologists were $52,410 in May
2004. The middle 50 percent earned between $42,090 and $65,750. The lowest
10 percent earned less than $34,720, and the highest 10 percent earned more
than $82,420. Median annual earnings in the industries employing the largest
numbers of speech-language pathologists in May 2004 were:
Offices of other health practitioners $57,240
General medical and surgical hospitals 55,900
Elementary and secondary schools 48,320
According to a 2003 survey by the American Speech-Language-Hearing Association,
the median annual salary for full-time certified speech-language pathologists
who worked on a calendar-year basis, generally 11 or 12 months annually, was
$48,000. Certified speech-language pathologists who worked 25 or fewer hours
per week had a median hourly salary of $40.00. Starting salaries for certified
speech-language pathologists with one to three years of experience were $42,000
for those who worked on a calendar-year. According to a 2004 survey by the
American Speech-Language-Hearing Association, the median annual salary for
speech-language pathologists in schools was $50,000 for those employed on an
academic year basis (usually 9 or 10 months).
Suggested citation: Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook, 2006-07 Edition, Speech Therapists, on the Internet
at http://www.bls.gov/oco/ocos080.htm (visited September 08, 2006).
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