What Does a Speech-Language Pathologist Do? Conditions They Treat and How They Help

Speech and language are central to human experience. The ability to communicate allows individuals to convey needs, develop relationships, express their personality, and engage in a healthy quality of life. When any of these areas are affected, a speech-language pathologist (SLP) provides clinical assessment and treatment to help clients develop, restore, or optimize communication and swallowing function.

The scope of SLP practice spans healthcare and education settings, supporting individuals whose communication or swallowing difficulties stem from causes including:

• Developmental delays and congenital conditions
• Neurological injury or disease (stroke, TBI, dementia)
• Psychological and emotional factors affecting communication
• Age-related changes in speech, language, or swallowing

Scope of Practice Areas for Speech-Language Pathologists

According to the American Speech-Language-Hearing Association (ASHA), a broad range of topical areas are included in the SLP scope of practice. Clinical approaches to therapy integrate multiple practice domains, nine of which are broken down below. Effective speech-language pathologists tailor a treatment plan to an individual’s needs and goals for optimal communication, thereby improving quality of life.

Articulation

Speech-language pathologists deliver services in speech production, and articulation is one of the major focus areas. To articulate a word, motor planning is often a first step in therapy. Motor planning is the ability to remember and coordinate the physical movements required to produce speech. Articulation is the physical ability to produce the sounds of the language being spoken.

Articulation is often coupled with phonological aspects of therapy, which involve the way the language sounds when speech is articulated. When articulation difficulties are motor-based, an SLP works systematically on each sound that differs from the expected patterns of the language being spoken.

Fluency

Stuttering is the most common fluency problem that speech-language pathologists treat. A person who stutters will typically know what they are trying to communicate but struggle to produce the words. Stuttering is characterized by difficulty executing speech and manifests as repetition of sounds or syllables, along with possible stretching or prolonging of sounds. Cluttering is another fluency disorder like stuttering, but a person who clutters may have fast or irregular pacing to their speech.

The goal of addressing fluency is to improve the flow, smoothness, continuity, and ease with which the intended communication is produced. When working with fluency disorders, an SLP will help the client make connections between the sounds and syllables of a word or phrase to produce fluent sentences.

Voice and Resonance

Voice disorders may be treated by speech-language pathologists when the sound, pitch, loudness, or other characteristics of a person’s voice are different from what is expected or appropriate for a person’s culture, gender, language, or age. These disorders are categorized as follows:

• Organic disorders (physical structure and/or neurological function is impaired)
• Functional disorders (inefficient use of vocal structures in the presence of normal anatomy and physiology)
• Psychogenic disorders (voice quality is affected by psychological stressors)

Likewise, resonance disorders can have roots in structural, functional, or learning issues where the treatment plans to improve the balance of sound energy in a person’s voice are tailored to the specific cause of the disorder.

Receptive and Expressive Language

Children and older adults may experience language development delays or difficulties in expressive and receptive forms. Expressive language affects a person’s ability to express or communicate what they intend to say or convey, whereas receptive language affects the ability to understand communication from others.

SLPs work with children experiencing language developmental delays, and often, there are deficiencies in both receptive and expressive language occurring together (i.e., mixed expressive and receptive delays). In adults, acquired language disorders (most commonly aphasia following stroke or traumatic brain injury) can affect expressive and receptive communication in similar ways.

Cognitive Aspects of Communication

Cognitive functions are intricately connected to communication. Assessments of the cognitive aspects of communication focus on skills including:

• Attention
• Memory
• Planning
• Reasoning

For example, a person may benefit from an SLP treatment plan to improve working memory, which is the ability to remember and execute multi-step processes. A person’s orientation to their name, time, date, and place can signal deficiencies in the cognitive aspects of communication.

Cognitive communication disorders range from mild impairment to total inability to communicate, depending on the cause and severity of the problem. Speech-language pathologists may treat cognitive communication disorders resulting from:

• Traumatic brain injury
• Dementia
• Aging
• Hypoxic brain damage (e.g., stroke)
• Infection

While the core focus of speech-language pathology is communication, hearing and swallowing are closely related areas that also fall within SLP scope of practice.

Hearing

Hearing loss affects the development of speech and language skills, so it makes sense that sspeech-language pathologists work with the deaf and those who are otherwise hard of hearing to support communication — developing listening skills, spoken language, and alternative communication strategies in the context of hearing loss. Screening for hearing loss is a regular part of the initial SLP assessment and impairment can affect individuals of all ages.

For clients who are deaf or hard of hearing, SLPs may incorporate AAC (augmentative and alternative communication) to support communication. AAC is also commonly used with clients who have autism spectrum disorder, complex communication needs, or other conditions that affect spoken language.

Examples of low-tech and high-tech AAC options include:

• Gestures
• Writing and drawing
• Communication apps
• Speech-generating devices

SLPs are trained to incorporate AAC into speech therapy to maximize natural language and communication, thereby enhancing and optimizing speech development rather than replacing these skills.

Swallowing

Imaging can assist SLPs in the diagnosis and treatment of swallowing disorders, particularly when the issue can be visualized as an anatomical impairment. Likewise, the physiological function of swallowing mechanics is assessed when difficulty swallowing (dysphagia) is present. A speech-language pathologist may conduct swallowing studies to record and observe throat function as a client consumes liquids and foods of varying consistencies.

Therapeutic exercises to improve the mechanics of swallowing may be recommended by a speech-language pathologist to help rehabilitate and optimize throat function. Improvements in swallowing may have far-reaching implications on the nutritional status of children and adults as well as the social aspects of communication, like eating meals with others.

Social Aspects of Communication

Part of SLP practice involves understanding a person’s unique context and goals for social interaction. Cultural norms, conflict resolution, styles of conversation, and other relational pragmatics fall within the realm of social communication.

A speech-language pathologist can aid clients in the skills needed to appropriately engage in social communication within contexts such as employment, hobby groups, family dynamics, schooling, and many other types of social situations. Diverse communication modalities may be useful to achieve social communication goals.

Communication Modalities

Multiple communication modalities may be used in speech therapy. An approach that incorporates signing, pointing, speech assistive devices, and verbal abilities may yield a higher quality of life than therapy using one communication modality alone.

The Role of SLPs in Education and Healthcare

Speech-language pathologists may provide direct client care or teach the principles of clinical practice to students and clinicians in educational settings. An SLP working in an educational setting, such as an elementary school, will typically focus on the pediatric population. As a result, the SLP in an education setting may have a primary role in helping develop a child’s speech and language to encourage academic learning, while also fostering the social aspects of communication.

In healthcare settings, speech-language pathologists focus on responsibilities such as preventive wellness, screening, patient advocacy, and the differential diagnosis of communication and swallowing disorders. Examples of day-to-day activities for SLPs in clinical practice include:

• Comprehensive assessments
• Behavioral observation
• Formulation of treatment plans
• Integration of academic material and client goals into therapy
• Referrals to other disciplines when appropriate

Become a Speech-Language Pathologist at Ithaca College

Ithaca College offers an immersive and supportive curriculum to prepare graduates for a fulfilling SLP career. The online Master of Science in Speech-Language Pathology boasts exceptional program outcomes from a rich heritage of quality SLP education.

Program features include:

• 100% online coursework
• Dedicated clinical placement services
• Immersive virtual simulations — no campus visits required
• Connection with peers from across the United States
• CAA-accredited through ASHA's Council on Academic Accreditation

The curriculum includes content on language disorders affecting children and adults while integrating relevant material on theories, legislation, and speech therapy delivery systems. Research methods and analysis in speech-language pathology and audiology are also included to help students focus on problem-solving through the scientific method.