What is Speech-Language Pathology and How Does it Intersect with Applied Behavior Analysis?

Speech and language play a major role in our ability effectively communicate with others and with the world around us. When either is negatively impacted, our quality of life is also negatively impacted, and our ability to nurture relationships, grow emotionally, and express ourselves in meaningful ways suffers.

Speech-language pathologists (SLPs) are experts in communication and the stars of the show when it comes to speech, language, and swallowing disorders in children and adults of all ages. Their extensive, graduate-level education and training make them the go-to professionals for assessing these disorders and implementing scientifically proven strategies to treat them.

SLPs have also become valuable partners and collaborators in settings where applied behavior analysis (ABA) is being used, and many are now actively using ABA in their own practices, with great success. Speech-language pathology and ABA have overlapping scopes of practice, with both professionals working with clients that may struggle with communication as a result of both physiological and cognitive or developmental limitations.

SLP is often focused on overcoming physical limitations that get in the way of the mechanics of speech and swallowing, but not exclusively. There are also problem behaviors that result in communication problems, and this is where ABA can come into play. Of particular interest to any SLP who has struggled to keep a child motivated through a particularly tedious therapy session is the fact that many of the reward systems used as positive reinforcement in behavior therapy can also be very effective in working with children struggling with common speech and articulation problems.

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SLPs who use ABA in their practice can broaden their scope of practice, become better collaborators when working with behavior therapists, and specialize their careers.

What is Speech-Language Pathology? – Scope and Patient Populations

To best understand the role of speech-language pathologists, it’s important to first understand what speech-language pathology is and how it’s used.

Speech-language pathology is evidence-based treatment used to treat:

  • Speech Disorders: Includes difficulty producing speech sounds or with resonance (quality of voice)
  • Language Disorders: Includes difficulty understanding others or being able to properly use expressive language to convey thoughts, feelings, or ideas
  • Social Communication Disorders: Includes difficulties communicating in social settings; may include an inability to properly hold a conversation, tell a story, or otherwise effectively communicate with others
  • Cognitive Communication Disorders: Includes difficulties with problem-solving, remembering, paying attention, or organizing thoughts
  • Swallowing Disorders: Includes difficulties with feeding and swallowing

While many of the above disorders are related to developmental difficulties or disorders, they are also often seen in adults with traumatic brain injuries, cognitive diseases, and strokes.

According to the American Speech-Language-Hearing Association (ASHA), the speech-language pathology profession continues to grow due to a number of factors, such as:

  • A growing senior population, fueled by the Baby Boomer population
  • Large numbers of retirees expected in the coming years
  • Increased survival rates for premature infants, trauma and stroke victims, and more
  • Better methods of diagnosing and treating speech, language, and swallowing disorders

Speech-Language Pathologist Job Description –  Roles and Responsibilities

Speech-language pathologists are autonomous professionals who serve as the primary care providers of speech-language pathology services. In other words, SLPs are not supervised by any other professional. However, SLPs often collaborate with support personnel and other members of the healthcare/therapy team (behavior therapists, physicians, audiologists, psychologists, social workers, physical and occupational therapists, rehabilitation counselors, and educators) to implement a comprehensive course of treatment.

Their intensive education and training provide them with a comprehensive foundation of knowledge in the communication sciences and disorders and related disciplines. As such, they are qualified to provide a full range of services to people of all ages with communication and swallowing disorders, such as:

  • Apraxia: Difficulty making specific sounds or syllables
  • Dysarthria: Weakness in the muscles used for speech
  • Aphasia: Inability or difficulty to produce or understand speech
  • Phonological disorders: Difficulty or inability to use some of the speech sounds needed to form words

According to ASHA’s Scope of Practice in Speech-Language Pathology, there are eight domains that encompass the work of speech-language pathologists:

  • Collaboration
  • Counseling
  • Prevention and wellness
  • Screening
  • Assessment
  • Treatment
  • Modalities
  • Technology
  • Instrumentation
  • Populations and systems

ASHA also recognizes five domains of professional service:

  • Advocacy and outreach
  • Supervision
  • Education
  • Research and administration/leadership

Therefore, job duties of SLPs often include:

  • Educating parents, teachers, and other learning professionals about clinical markers of language impairment, the importance of early screening tools, and how to recognize the warning signs of developmental disorders
  • Designing and implementing effective screening tools and programs
  • Administering standardized tools for assessment
  • Reviewing medical records and interviewing patients and their families to discuss specific concerns
  • Observing patients to determine skill level in a natural setting
  • Utilizing endoscopy, videofluoroscopy, ultrasound, and other instruments for assessment purposes
  • Documenting assessment and treatment results
  • Providing training to family members and caregivers
  • Implementing augmentative and alternative communication (ACC) systems for individuals with severe language or speech disorders

The tools and techniques used by SLPs in their practice can be rather broad, with these professionals employing any number of strategies (both independently and in collaboration with other members of the healthcare/rehab team) that best meet the needs of the patient. For example, ABA has become a widely used therapy among SLPs.

The simple framework of antecedent-behavior-reinforcement—the foundation of behavior therapy—is actively used in speech-language pathology, making the use of ABA among these professionals a natural extension to their practice. For example, using ABA when working with a child to say the word “toy” may look like:

  • Antecedent: The SLP says, “Say toy.”
  • Behavior: The child says the word “toy.”
  • Reinforcement: The SLP hands the toy to the child.

Outside of the clinical setting, many SLPs work in advocacy and outreach, where they advise regulatory agencies and decision makers at the local, state, and national levels about the importance of continuum of care and about funding for research, education, and services for communication and swallowing disorders. Many still conduct basic and applied research.

SLPs work in a wide array of settings, including:

  • Private practice
  • Doctors’ offices
  • Hospitals
  • Long-term care facilities
  • Rehabilitation centers
  • Residential healthcare facilities
  • Schools (Early intervention, preschools, K-12 schools)
  • Research settings
  • Home-based settings
  • Tele-health settings

According to ASHA, the largest percentage of SLPs are employed in healthcare settings (39%), including hospitals, nonresidential and residential healthcare facilities, followed by private practice (19%).

How to Become a Speech-Language Pathologist

According to ASHA, the term ‘speech-language pathologist’ is reserved only for those professionals who hold the ASHA Certificate of Clinical Competency in Speech-Language Pathology (CCC-SLP), which requires earning a master’s, doctorate, or other recognized post-baccalaureate degree, completing a supervised, post-graduate professional experience, and passing a national examination.

Degree Requirements

The minimum educational requirement to earn ASHA certification as an SLP is a master’s degree that’s accredited by the Council on Academic Accreditation (CAA). The CAA currently accredits 262 speech-language pathology programs, and another 22 are currently seeking accreditation. A full list of accredited programs can be found here.

These programs often offer a variety of options for completion, including on-campus, online, or blended study, as well as evening and weekend classes. Speech-language pathology master’s degrees are rigorous programs that usually demand a two-year commitment and the completion of specific clinical practicums.

Admission Requirements

Most programs accept students from a number of undergraduate degree programs, although, according to ASHA, the majority of students in speech-language pathology master’s programs first earn a bachelor’s degree in a related area. Typical undergraduate degrees include:

  • BS in Communication Sciences and Disorders
  • BS in Speech-Language Pathology
  • BS in Speech Pathology and Audiology
  • BS In Speech and Hearing Science

Applicants without an undergraduate degree in speech-language pathology must complete specific undergraduate courses in communication sciences and disorders to qualify for admission into most programs.

Fellowship Requirements

Following the completion of a master’s degree in speech-language therapy, graduates must complete a fellowship (a period of supervised practice) to qualify for state licensure and the CCC-SLP designation.

The minimum fellowship experience required for the CCC-SLP is 1,260 hours and at least 36 weeks of full-time experience. Learn more about the requirements for completing a fellowship that meets ASHA requirements here.

Certification Requirements

Graduates of CAA-accredited speech-language pathology programs are eligible to take the National Examination in Speech-Language Pathology PRAXIS test, a requirement for earning the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) in some states and an optional endeavor in others.

State Licensure Requirements

All speech-language pathologists must be state licensed to practice. The majority of states either require the CCC-SLP for licensure or have licensure requirements that are similar to the CCC-SLP designation. In other words, in most states, achieving the CCC-SLP also qualifies candidates for state licensure.

Learn more about state licensing requirements here.

Options for Further Education

While a doctorate isn’t required or generally pursued for practice in the field, it may be required for those interested in focusing their speech-language pathology career in a specific area.

Doctorate Degrees

The clinical doctorate in speech-language pathology (CScD, SLPD) is designed to prepare master clinicians, educators, and administrators. This degree program usually takes about two to three years beyond the master’s degree to complete.

The research doctorate (PhD) in communication sciences and disorders is designed for a career as a faculty-researcher. This program takes between three and five years beyond the master’s degree to complete.

Specialty Certification

SLPs can also strengthen their resume and skillset by pursuing voluntary national certification.

Specialty clinical certificates beyond the CCC-SLP allows SLPs to identify as a Board Certified Specialist (BCS) in a specific area of clinical practice. Options for specialty certification are available through the following boards:

  • American Audiology Board of Intraoperative Monitoring
  • American Board of Child Language and Language Disorders
  • American Board of Fluency and Fluency Disorders
  • American Board of Swallowing and Swallowing Disorders

ABA Education/Certification

Completing a course of education in applied behavior analysis (ABA) is a great way to expand or even specialize your speech-language pathologist services.

Currently, the Behavior Analysis Certification Board’s Board Certified Behavior Analysis (BCBA) credential requires candidates to complete either (1) a master’s degree in psychology, education, or behavior analysis that includes a verified course sequence (VCS) or (2) a VCS that’s completed either during or after the completion of a master’s degree in one of these three fields.

But in 2022, the BACB will remove the degree restrictions, opening up the BCBA to a wide variety of practitioners in the human services field. In anticipation of this change, many schools that offer the VCS (either as a stand-alone course sequence or as a graduate certificate) have already removed the degree restrictions, allowing SLPs and other professionals to complete this comprehensive course of study in ABA.

If you complete the VCS now, you’ll be able to begin reaping the rewards of this foundation of knowledge in ABA and then, in 2022, you’ll have the option of completing the experiential and exam requirements and earning the BCBA.

Salaries for Speech-Language Pathologists

ASHA’s 2019 Annual Salary Report provides some of the most current information on what SLPs are earning. The median salary for SLPs in 2019 was $78,000.

Further salary breakdowns, according to median salary, include:

  • Clinical service providers: $74,000
  • Administrators or supervisors: $100,000
  • SLPs in skilled nursing facilities: $95,000
  • SLPs in outpatient clinics or offices: $73,500
  • SLPs in home health care: $76,000
  • SLPs in general, medical VA facilities: $85,798
  • SLPs in pediatric hospitals: $78,000
  • SLPs in rehabilitation facilities: $79,000

SLPs earned the following median salaries according to years of experience:

  • 1-3 years: $66,000
  • 4-6 years: $72,000
  • 7-9 years: $78,000
  • 10-12 years: $78,000
  • 13-15 years: $87,500
  • 16-18 years: $82,000
  • 19-21 years: $100,000

According to the U.S. Bureau of Labor Statistics, the average salaries for SLPs at the 25th, 50th, 75th, and 90thpercentiles, as of May 2018, were:

  • 25th: $60,570
  • 50th: $77,510
  • 75th: $97,770
  • 90th: $120,060

The states with the highest mean salaries for SLPs at this time were:

  • New Jersey: $95,000
  • Washington, D.C.: $93,570
  • California: $93,510
  • Connecticut: $92,280
  • Colorado: $90,980

 

Salary and employment data compiled by the United States Department of Labor’s Bureau of Labor Statistics in May of 2018 (https://www.bls.gov/oes/current/oes291127.htm). BLS salary data represents state and MSA (Metropolitan Statistical Area) average and median earnings for the occupations listed and includes workers at all levels of education and experience. This data does not represent starting salaries. Employment conditions in your area may vary.

Individual job listings with educational requirements and salary information accessed directly from internet job boards and directly from the sites of employing agencies and do not constitute offers of employment.

All salary and job growth data accessed in October 2019.