Speech Pathology

Definition

The field of speech pathology, formerly known as speech therapy, is concerned with disorders of speech and language. A speech-language pathologist is a professional trained to diagnose and treat language and speech disorders.

Description

Speech pathology addresses the pathology of speech and language, meaning the "diseases" of speech and language and their functional effects on the affected person. Speech and language delays and disorders cover a wide range, from simple word substitutions in sentences to the inability to understand or use language for functional communication. The causes of speech and language disorders are wide and varied, including hearing loss, neurological disorders, traumatic brain injury, mental retardation, drug abuse, physical disabilities, and emotional abuse. Frequently, the cause is also unknown. In 1997–98, more than one million students were enrolled in special education programs designed by speech-language pathologists as a result of speech or language disorders.

Work settings

Speech-language pathologists work in a wide variety of settings ranging from private practice to the public sector and with agencies treating specific disabilities. Some examples are:

• kindergartens
• primary schools
• high schools
• nursing homes
• hospitals
• universities
• rehabilitation centers
• mental health centers
• community health centers
• private practice

In any of these work settings, a speech-language pathologist's typical workload may include:

• advising a mother on feeding a baby with a cleft palate
• helping a high school student who stutters
• helping a stroke victim to regain communication skills
• providing special training for teachers, doctors, or parents
• advising parents on the prevention of language disorders

• helping children and adults to learn to read
• treating people with brain injuries to regain language
• assisting people to develop control of vocal and respiratory systems for correct voice production

Due to the wide implications of speech and language disorders, speech-language pathologists usually work in close collaboration with other professionals such as medical specialists, educators, engineers, scientists, and other allied health professionals and technicians.

For example, in the vocational school context, speech-language pathologists collaborate with teachers and counselors in establishing communication goals related to the work experiences of students and propose strategies that are designed for the important transition from school to employment.

Education and training

Speech-language pathologists first complete a bachelor's degree which covers all aspects of communication development and disorders, followed by a master's degree. Many universities integrate both degrees into one sequence of training with the bachelor's degree providing the required background in theoretical and clinical areas and the master's program providing professional training for speech-language pathology careers.

A typical master's program in Speech-Language Pathology will usually include courses such as: Research Methods in Communication Disorders, Neuromotor Disorders of Speech Production, Disorders of Phonology, Neurologic Communication Disorders in Adults, Disorders of Speech Fluency, Language Intervention: from birth to age 21, Voice Disorders, Language Assessment from Childhood to Adulthood, and Augmentative and Alternative Communication (AAC).

Employment in speech-language pathology requires both a master's degree in a program of study accredited by the American Speech-Language-Hearing Association (ASHA) and a credential or license. These requirements vary from state to state. Completion of the master's program provides the training required for students to qualify for a state license as a speech-language pathologist and the state credential for working as a speech-language pathologist in the public school system. The ASHA issues the Certificate of Clinical Competence (CCC) in speech-language pathology.

In the United States, ASHA is the professional, scientific, and certification association for speech-language pathologists, audiologists, and speech, language, and hearing scientists. The Association holds that academic studies are not sufficient to prepare an individual to function as a fully competent professional able to provide high quality care in speech-language pathology. All applicants for the CCC are accordingly required to successfully complete a clinical fellowship as well as the national examination in speech-language pathology. The clinical fellowship is intended to enable individuals to obtain supervised professional clinical experience in order to qualify for the CCC. Professional experience includes direct patient contact, consultations, record keeping, and all other duties associated with clinical work. All nonpublic school work settings require ASHA-CCC and/or state license or certification. Each state's guidelines may require ASHA certification as well as state license in addition to educational certification for employment in public schools for speech-language pathology.

Advanced education and training

The ASHA sponsors continuing education programs for speech-language pathologists. The courses of advanced study are conducted by leaders in the field of speech pathology and designed to keep speech-language pathologists abreast of new research findings, clinical techniques, and treatment models. Recognized experts also lead discussions on important ethical and regulatory issues that affect speech pathology. Alternatively, speech-language pathologists may elect to pursue doctorate work at a university and further specialize in those areas of basic research that contribute directly or indirectly to the identification, treatment, and prevention of speech and language disorders. For example, they may conduct advanced research on how people communicate. Others may design and develop equipment or techniques for diagnosing and treating speech problems.

Future outlook

The outlook for the field of speech pathology is very promising due mainly to the extraordinary advances in computer technology. Computers are being used for a wide variety of speech-language pathology applications. For example, computer programs are available for articulation and voice therapy that provide visual displays of speech: voicing, loudness, pitch, and articulation. Speech capture programs are being developed to assist the evaluation of speech/language patterns and for use in the treatment of disorders. Speech-language pathologists can use such programs, adjusting settings to provide visual reinforcement of the patient's attempts to correctly produce the target sound. Increasingly, programs and software are becoming available for testing and monitoring all major speech elements such as articulation, pitch, rhythm, duration, volume, and stress. This improved and greater use of computer technology has enabled speech-language pathologists to better serve those with speech-language disorders. There are improved augmentative devices for those with neuromuscular diseases and head injuries. For those with difficulty comprehending spoken language, the technology exists and is being used to modify the human speech signal and improve listening and comprehending skills which are fundamental for learning to read and write. For both children and adults, computer-based treatment programs exist for home use, making treatment more efficient.

Major areas of speech-language pathology software development include:

• Word-retrieval programs. These programs are mainly used to treat people affected by aphasia, a language disorder caused by damage to the areas of the brain responsible for language function. Speech-langauge pathologists use them to treat aphasias at the word or sentence level.
• Speech production software. This type of software is being developed for teaching purposes, for example to teach the proper sounds of vowels, and also for voice analysis purposes in the clinical setting.
• Reading comprehension programs. These are programs that can teach word relationships interactively and monitor the level of functional reading.
• Cognitive exercises software. This type of software is used to test logic and deduction patterns, the ability to follow directions, and the understanding of traffic signs or of word associations.

Speech-language pathology is a very dynamic field. According to the U. S. Department of Labor, employment of speech-language pathologists is expected to grow at a much faster rate than the average for all occupations up to year 2008.

KEY TERMS

Aphasia— Acquired language disorder caused by damage to the areas of the brain responsible for language function.

ASHA— The American Speech-Language-Hearing Association. In the United States, the association that regulates and provides credentials for speech-language pathologists, audiologists, and speech, language, and hearing scientists.

Communication disorder— Disorder characterized by an impaired ability to communicate. Communication disorders include language, speech, and hearing disorders. They are associated with a wide variety of physical and psychological causes.

Language disorder— Communication disorder characterized by an impaired ability to understand and/or use words in their proper context, whether verbal or nonverbal. The disorder can be either developmental or acquired.

Phonology— The science of speech sounds and sound patterns.

Speech disorder— Communication disorder characterized by an impaired ability to produce speech sounds or by problems with voice quality.

Speech pathology— The field of speech pathology, formerly known as speech therapy, is concerned with disorders of speech and language. A speech pathologist is a professional trained to diagnose and treat language and speech disorders.

Resources

BOOKS

Gunning, T. G. Assessing and Correcting Reading and Writing Difficulties. Boston: Allyn & Bacon, 1997.

Hegde, M. N. Pocketguide to Assessment in Speech-Language Pathology. San Diego: Singular Publishing Group, 2001.

Moore-Brown, B. J., and J. K. Montgomery. Making a Difference for America's Children: Speech-Language Pathologists in Public Schools. Eau Claire, WI: Thinking Publications, 2001.

Shipley, K. G., and J. G. McAfee Assessment in Speech-Language Pathology: A Resource Manual. San Diego: Singular Publishing Group, 1998.

Simon, C. S. Assessment of Classroom Communication and Study Skills (ACCSS). Eau Claire, WI: Thinking Publications, 2001.

Simon, C. S. Evaluating Communicative Competence. Eau Claire, WI: Thinking Publications, 2001.

PERIODICALS

Leung, A. K., and C. P. Kao. "Evaluation and Management of the Child with Speech Delay." American Family Physician 59 (June 1999): 3121-3128.

ORGANIZATIONS

American Speech-Language-Hearing Association (ASHA). 10801 Rockville Pike, Rockville, MD 20852. (800)638-8255. 〈http://www.asha.org/〉.

OTHER

National Center for Voice and Speech Website. 〈http://www2.shc.uiowa.edu/〉.

Net Connections for Communication Disorders and Sciences. A Guide to Communication Disorders and Science Sources on the Internet. 〈http://www.mankato.msus.edu/dept/comdis/kuster2/welcome.html〉.

The SLP Homepage. Internet Searches and Resources on Speech Language Pathology. 〈http://members.tripod.com/Caroline_Bowen/slp-eureka.htm〉.