Wait. What Even Is Speech Language Pathology?
- Kristen Knowsley
- Mar 1
- 5 min read
It’s a mouthful. And a really cool title. But sometimes, admittedly, I think it just doesn’t cover it. There are nine (9) different areas that speech-language pathologists (SLPs) provide treatment or intervention.
Articulation
Language
Fluency
Voice and Resonance
Feeding and Swallowing
Aural Rehabilitation
Cognition
Social Communication
Augmentative and Alternative Communication (AAC)
In graduate school we learn a little about a lot. ! I think I speak for many SLPs when I say that none of us feel ready to take on every single one of these categories and their many sub-categories with full confidence. I know I don’t. In fact several of these categories would have me making a referral to a more qualified SLP–and that’s okay! Another great thing about private practice is that I don’t have to work with any and every disorder or deficit that walks in the door (unlike other settings). There is no shame in referring out, staying in your lane, and only providing the services you can provide most ethically. Let’s see what they’re all about in a nutshell, shall we?
Articulation
Articulation or speech sound production is the area of SLP covering speech sound disorders including but not limited to articulation disorders (one or two errors that are not age appropriate); phonological processing disorders (an entire class(es) of sounds are effected); and motor speech disorders (like apraxia of speech, which is best described as the brain’s inability to quickly and accurately tell the mouth what to do in order to produce speech).
Language
Language is generally split into two categories: receptive and expressive. Receptive language covers how well one understands language (what is said to us), while expressive language covers how well one is able to use and express language in order to communicate their wants/needs/thoughts/ideas/etc. SLP’s help young children develop language skills that may be delayed and can also help adults regain or recover language skills lost to a neurological incident (like a stroke).
Fluency
Fluency is characterized by the continuity, smoothness, rate, and effort of speech production. All speakers have moments of dysfluency, and others may have more frequent dysfluencies that disrupt their speech. SLP’s can help folks manage frequent dysfluent moments if it is their desire to change this aspect of their speech.
Voice and Resonance
Voice and resonance therapy addresses deficits related to voice production, which includes the areas of respiration, phonation, and resonance. Voice disorders might occur as a result of overuse (think singers, coaches, speakers without voice training to protect their vocal folds from nodules), or in co-occurrence with neurodegenerative disorders (think Parkinson’s). Resonance issues occur when there is too little or too much nasal quality present and could be the result of structural abnormalities and differences, like a cleft palate. This is also the area of SLP which can support transgender folks in achieving the voice that affirms their gender.
Feeding and Swallowing
Feeding and swallowing therapy addresses any difficulty with food or liquid through all of the phases of swallowing: voluntary (oral) and involuntary (pharyngeal, the swallow itself; esophageal, moving food to the stomach). Therapy that centers developing the oral motor skills and tolerance to manage a variety of textures and viscosities is the “feeding” side. Generally, participation in feeding therapy means the swallowing mechanism and motility of the esophagus are functioning as they should be, or are being managed, making food by mouth a safe option. An impaired swallow, formally referred to as Dysphagia, requires intervention specifically addressing the function and an individual’s swallow. There are literal strengthening exercises that improve swallow function and timing (so cool). Dysphagia is often seen after a neurological incident or as a comorbidity to a neurodegenerative disease. Please know that this is a literal crash course and there is SO MUCH more to unpack here (and in all of these really)!!
Aural Rehabilitation
Aural Re/habilitation involves working with individuals who have hearing impairments. Whether the client is a child or an adult, the objective of aural re/habilitation is largely about managing hearing loss through environmental adjustments and management of devices that aid in hearing. In children, it is referred to as aural habilitation because therapy centers developing skills such as training in auditory perception, learning to use visual cues, improving speech clarity, developing language skills, and managing communication and any associated devices. In adults it is aural rehabilitation because we are restoring a skill that was once had and is now lost. Therapy with adults focuses on reducing the impact of hearing loss on communication and participation in daily life and activities.
Cognition
Cognition covers a variety of skills and is most often a category associated with adults. After neurological events such as a stroke, or the development of neurodegenerative diseases like Dementia or Parkinson’s, SLP’s have a key role to play. Orientation to their environment, maintenance or recovery of lost communication and language skills, and caregiver education about how to support loved ones through these challenges are just a few of the responsibilities of the SLP in this role. There are also SLP’s who specialize in executive dysfunction (think difficulty with planning, organization, and inhibition), which shows up in children and adults.
Social Communication
Social Communication involves the pragmatic features of communication. In other words, the way we use language to interact with others. Social communication rules are learned from your family and the environments in which you find yourself. Most of the rules are unspoken and followed without explicit instruction. Think about how you talk to your best friend vs your boss, even your grandmother vs a sibling. How you behave at home vs an art museum vs a concert. The ability to recognize and follow social rules and norms helps to develop and maintain relationships with the people around us. Now, don’t take this to mean that individuality isn’t important–it is! But it’s difficult for all people when their communication partner never lets them get a word in, doesn’t know to acknowledge that they’ve been spoken to, or doesn’t understand common figuratives that aren’t literal like “costs an arm and a leg”. SLPs can help children or adults seeking this support to recognize and practice following these rules in various settings to improve personal or professional relationships.
Augmentative and Alternative Communication
Augmentative and Alternative Communication feels like a fancy way of saying “by any means necessary”. In other words, SLPs support their client’s communication efforts and styles by any means necessary. This could be using sign language, a sheet of paper with yes or no icons, a more complex picture communication system, a button that speaks a word or phrase, all the way to a high tech device that has an extensive vocabulary available and can be operated with touch or even the client’s eye gaze. Every person is different, and, in my opinion, it takes some time to figure out which system will be the most effective to learn and build upon. AAC is not a replacement for verbal speech and does not delay it, it simply gives a person access to their voice in the meantime, or becomes their voices if AAC is in fact their preferred communication method.
As you can imagine, all of these areas span a wide variety of settings in which SLPs can work with individuals from birth through the lifespan. Some of those include: public and private schools; early intervention; home health; acute care and in-patient hospital settings; out-patient hospital and clinical settings; skilled nursing and assisted living facilities; specialty clinics; private practice. SLPs also take positions in roles related to the above categories through the lens of advocacy, management (like a rehab director), or sales and support (like for AAC devices). Many SLP’s also go on to be professors at colleges and universities or educators for other professionals and parents in their specialty areas, offering courses online or in-house. This extensive variety was another draw to the field for me–it feels like we can work anywhere!
Are you curious about something above? Send me an email at kknowsley@cradletotable.com or comment below. Let’s talk about it!
Additional Resources:
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