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Speech Pathology

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Field description

Speech-language pathologists in a medical setting assess, diagnose, treat and help to prevent oral motor, swallowing, cognitive-linguistic, speech, and language disorders.

Speech pathologists work with individuals whose oral motor, swallowing, cognitive-linguistic, speech, or language skills have been affected by a neurological event/disease, head/neck cancer, or possibly debilitation related to an underlying medical disease process. This includes individuals:

  • With speech articulation and fluency difficulty such as dysarthria
  • With voice quality problems, such as inappropriate pitch or harsh voice possibly related to vocal abuse or cancer
  • With cognitive-communicative impairments, including underlying attention, memory, abstract reasoning, or problem-solving deficits possibly related to a stroke, brain injury, or underlying medical disease process
  • With aphasia (a language disorder) or apraxia (a motor planning disorder)
  • Who have oropharyngeal weakness that places them at risk for "aspiration" or food/liquid entering the airway when swallowing that can lead to respiratory complications

Oral motor, swallowing, cognitive-linguistic, speech, and language disorders can result from a variety of neurological events, including brain injury, stroke, seizure, progressive disease, cancer, and/or debilitation related to other medical diseases. Speech-Language pathologists use physical examination, instrumental technology, and standardized cognitive-linguistic and language tests to diagnose and guide treatment.

Speech-language pathologists develop an individualized plan of care, tailored to each patient's needs. Speech-language pathologists may recommend alternate nutrition based upon aspiration risk when swallowing, recommend diet level modification to reduce aspiration risk when swallowing, design an individualized augmentative communication system or prescribe a speech generating device for individuals with nonfunctional speech. They provide education to patients, their family members and caregivers regarding impairments, disease processes, and compensatory strategies. They develop daily home programs unique to each individual's strengths and weakness that facilitate maintenance of swallowing, cognitive-linguistic, speech, or language skills at an optimal level. In addition to clinical practice, medical speech pathologists also participate in research.

Career opportunities

Speech-language pathologists held about 88,000 jobs in the United States in 2000. About one-half of jobs were in preschools, elementary and secondary schools, or colleges and universities. Others were in offices of speech-language pathologists and audiologists, hospitals, offices of physicians, speech, language and hearing centers, home health agencies or other facilities.

A small number of speech-language pathologists and audiologists are self-employed in private practice. They contract to provide services in schools, physician's offices, hospitals, or nursing homes, or work as consultants to industry.

Employment of speech-language pathologists and audiologists is expected to grow much faster than the average for all occupations through the year 2010, because the growing population in older age groups is prone to medical conditions that result in speech and hearing problems. In addition, medical advances are also improving the survival rate of premature infants and trauma and stroke victims, who then need assessment and possible treatment.

Employment in schools 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, language and hearing disorders will also increase employment.

The number of speech-language pathologists and audiologists in private practice will rise due to the increasing use of contract services by hospitals, schools and nursing homes.

Earning potential

Median annual earnings of speech-language pathologists were $52,410 in 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.

Speech-language pathologists with doctorate degrees who worked 11 or 12 months annually earned $62,500.

Professional organizations

Visit the following Web sites to learn more about speech pathology:

American Speech-Language-Hearing Association
10801 Rockville Pike
Rockville, MD 20852
American Academy of Audiology
8201 Greensboro Dr., Suite 300
McLean, VA 22102
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