What is a Speech Pathologist Really?
Valid question! Speech-language pathology is pretty niche, and in my opinion our professional title is a misnomer
Terminology Key
For the sake of my word count and our brains, I will use the abbreviation “SLP” to refer to speech-language pathology in this article, but here is a breakdown of the terminology jumble:
Speech therapist = speech pathologist = speech-language therapist = speech-language pathologist
Pathologist: is a professional who makes diagnoses
Therapist: is a professional who treats the features of a diagnosis
All SLPs are both pathologists and therapists. We identify, diagnose and treat communication disorders, and apparently don’t know how to summarize this duality in a title.
Speech and language are skills that need support
The best way to get a sense of what an SLP really is is to know that our closest professional collaborators are Physical Therapists (PT) and Occupational Therapists (OT). To oversimplify vast knowledge bases and years of schooling: PTs help people use their legs for mobility, OTs help people use their arms and hands for daily activities, and SLPs help people use their head, throat and mouth.
SLPs are sort of like the lesser known cousins of the therapy world. It is easy to recognize and connect with the physical experiences of being human, and the need for PT is a bit more ubiquitous than the need for speech therapy. Let’s just say that we are all very lucky that we don’t lose our ability to talk as easily as we pull a muscle. But just as walking and tying your shoes are skills that sometimes need help, speech and language can as well.
To add a little dash of complexity, because why not: SLPs are also feeding and swallowing specialists. These are mouth functions, okay?! To understand more about an SLPs role in feeding and swallowing, check out this blog.
What is the difference between speech and language?
This is a very important distinction.
Speech refers to the coordination of movements from your lungs, vocal cords, tongue, lips and jaw to make sounds and words. Speech is impacted when you are numb from the dentist.
Language refers to the brain’s storage and retrieval of vocabulary, and the use of grammar to communicate and understand messages. You are experiencing a difficulty with language when a word is “on the tip of your tongue”.
Speech is very physical, and language is more conceptual. Think of them in terms of an English speaker studying Spanish. Speech is perfecting the accent, whereas language is learning the words for things and constructing sentences.
When do people need to see a speech therapist?
SLPs work with people across the entire lifespan. There is a phrase that feels quite crass, but is (was?) used in the field when talking about our scope of practice: From womb to tomb. Don’t love it, but you get the idea.
SLPs work to support feeding and swallowing in NICUs with premature babies, and in nursing homes with the wiser among us. We work with people of any age who are recovering from strokes, brain injuries, or neurological illnesses that impact their ability to communicate. Most commonly we work with children who are having trouble talking, or who’s speech is hard to understand.
What are the conditions that speech pathologists diagnose and treat?
I have just the list:
Late Development of Communication Milestones in toddlerhood
Expressive and Receptive Language Disorders
Articulation & Phonological Speech Disorders
Apraxia of Speech
Myofunctional Deficits
Disfluency, or stuttering
Voice Disorders
Communication Challenges of Autism Spectrum Disorders
Difficulties With Reading and Writing
Executive Function Skills
Aphasia
Dysphagia (Swallowing)
Sensory Based Feeding Difficulties
Cognitive-Communication Disorders from Neurological Illness and Injury
Check out our blog page for more specifics about these.
A Hill I Will Die On: Speech Therapy is a Misnomer
As you can see from the presence on the above list of things like “executive function skills”, literacy, and swallowing difficulties, us SLPs don’t just treat talking. More broadly, we treat disorders of communication.
Communication is speaking, listening, reading, writing, gesture, and using voice output devices. Successful communication does not happen without the executive functions of attention, inhibition, planning and problem solving. And we treat those too.
I love the idea of referring to us SLPs as communication therapists, but this exposes the difficulty: What about feeding and swallowing?!
I guess this is why the field has gone with something…vague. If you want to take it to the source, or learn more about the world of speech therapy, here is a link to the American Speech-Language Hearing Association (ASHA). They make the rules.