Speech-Language Pathology Specializations: What You Need to Know

If you're planning to pursue a career in speech-language pathology (SLP), you’ll have the opportunity to make a huge difference in the lives of people who are facing communication barriers ranging from speech disorders like dysarthria to language disorders such as aphasia.

The speech-language pathology field covers a wide range of disorders that impact a very diverse set of patients. That’s why many practitioners choose to further their SLP professional development by adding additional certifications and pursuing a specialization track. This allows them to hone in on a more specific set of skills and work in an area of practice they are passionate about.

Choosing the Right Specialization in the SLP Field

There are many factors to consider when choosing the right specialization. First and foremost, you should explore your reasons for wanting a career in speech-pathology.

Do you want to work with adults or children? Are you interested in language delays, stuttering, and proper speech communication? Do you want to focus on speech disorders caused by neurological conditions like aphasia? Or are you more interested in the social and communication issues that arise from autism or augmentative and alternative communication (AAC), where people cannot speak or have low language skills due to disorders?

Whether you choose to go into pediatric speech pathology or speech pathology for adults who have neurogenic communication disorders or neurological speech disorders that affect the voice, you can help meet a critical need and have a significant impact on your patients throughout your career.

The U.S. Bureau of Labor and Statistics (BLS) predicts that the job outlook for speech-language pathologists is strong, anticipating that it will grow 19% from 2022 to 20321. This is much faster than the average for all occupations. The median income for SLPs is $84,140, according to the BLS.¹

SLP specializations can further improve your employment outlook and enhance your salary. For example, the median salary for a pediatric speech pathologist is around $171,181.² When deciding on a career path, you should research specializations and their job opportunities in your region. It might also benefit you to seek guidance from mentors and experienced SLP professionals to see their recommendations for choosing specializations.

If you want to work with both adults and children, it is possible to be a certified specialist in both pediatric and adult neurogenic speech disorders. You must be willing and able to achieve the certifications and design your practice around serving both populations in those specialist capacities.

Many speech pathologists do not choose to specialize because they enjoy the generalist's path of working with a diverse client base of every age with a wide range of voice disorders.

The clinical experiences that are a part of your graduate education can give you a feel for different specializations and help you figure out where your passions lie and if there’s a specific path you might want to further explore down the line.

One of the biggest advantages of an SLP career is the flexibility it offers and the opportunities to add new specializations or focus areas along the way. For example, a clinician can spend years working in a school setting, and then switch gears to work in skilled nursing facilities.

Speech-Language Pathology Specializations: What You Need to Know

SLP Specializations

Below is a summary of popular speech-language pathology specializations you may want to pursue:

Pediatric Speech-Language Pathology — Pediatric SLPs typically focus on communication disorders in children, such as language delays or stuttering.

There is a consistent demand for pediatric speech-language pathologists, particularly in educational settings, healthcare facilities, and private practices. The need exists because of the prevalence of speech and language disorders in children and the emphasis on early intervention. Nearly 1 in 12 (7.7%) U.S. children ages 3-17 have had a disorder related to voice, speech, language, or swallowing.³

Conditions as varied as Down syndrome, fragile X syndrome, autism spectrum disorder, traumatic brain injury, and being deaf or hard of hearing are known to increase the potential for childhood speech and language disorders.⁴

Adult Neurogenic Speech Disorders — This specialization focuses on communication disorders caused by neurological conditions in adults such as aphasia language disorder and dysarthria speech disorder.

With an aging population, the demand for SLPs specializing in adult neurogenic speech disorders is growing in hospitals, rehabilitation centers, skilled nursing facilities, and outpatient clinics. Neurological conditions such as strokes, traumatic brain injuries, and neurodegenerative diseases contribute to this demand.

Voice Disorders — This SLP specialization focuses on working with individuals who have voice-related challenges stemming from voice changes, including but not limited to spasmodic dysphonia, polyps, nodules or cysts on the vocal cords, precancerous and cancerous growths, and vocal cord paralysis or weakness.

SLPs specializing in voice disorders can work in hospitals, voice clinics, ENT practices, and rehabilitation centers. Areas of demand include professional voice use, vocal rehabilitation, and working with individuals facing voice challenges due to medical conditions. In a study in the National Library of Medicine, approximately 1 in 5 Americans surveyed has had a voice disorder.⁵ Risk factors for voice disorders include teleconferencing technology, voice assistant use, and occupational factors.

Fluency Disorders — This specialization focuses on treating fluency disorders such as stuttering. It utilizes techniques and interventions for individuals with fluency challengeslike speechcontinuity, smoothness, rate, and effort in speech production. Fluency symptoms include repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks. Planning and executing stuttering interventions can play a crucial role in working with populations who are impacted by fluency disorders.

Demand for SLPs specializing in fluency disorders is high, due in part to the fact that more than three million Americans (about 1%) stutter⁶, and stuttering and related challenges affect individuals across all age groups.

Education and Professional Path Considerations for SLP Specializations

While a master's degree is needed to become a speech-language pathologist, many SLPs choose to pursue additional training and certifications so they can build on their skillsets and better serve specific populations.

If you have determined a specialty early on, talk to your academic advisor as you select your coursework. While most master's programs aren’t designed for individual specializations, you can begin to lean into areas of focus as part of your path to your degree that will help you when it comes time to choose a specialization and get certified.

It is also essential to create a professional network in your chosen specialization and participate in relevant conferences, workshops, and online communities to build a strong network as well as stay on the forefront of technology, resources, and research you need to be aware of to have continued success in your field. The job market values SLPs who actively engage in continued education and stay updated on the latest research and interventions in their specialty.

SLP Supplemental Certifications Recognized by ASHA

To become a licensed practitioner, most SLPs earn the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP), a certification from the American Speech-Language-Hearing Association (ASHA), considered the national gold standard for excellence in the profession.

Additionally, the ASHA offers distinction as a Board-Certified Specialist (BCS) to a practitioner who "demonstrates advanced knowledge, skills, and experience in a specified area of practice."

There are three types of BCS certifications for SLPs, each awarded by independent boards that the ASHA has approved:

Board Certified as a Specialist in Child Language (BCS-CL)

The American Board of Child Language and Language Disorders offers this to SLPs who demonstrate "advanced knowledge, skills, leadership, and experience in child language." According to the ASHA, common issues in this field include:

Selective mutism: A child does not speak in specific scenarios
Speech sound disorders: A child has trouble saying sounds clearly
Learning disabilities: A child has difficulty reading, writing, or spelling

A candidate for the BCS-CL must have worked as an SLP for five years and document 100 hours of continued education in child language.

Board Certified Specialist in Fluency (BCS-F)

The American Board of Fluency and Fluency Disorders offers this to SLPs who "have demonstrated in-depth knowledge of the nature and treatment of stuttering and other fluency disorders." In addition to stuttering, these specialists often help clients with "cluttering," when speech becomes hard to understand because of rapid speed, erratic rhythm, or poor grammar.

A candidate for the BCS-F must have 500 hours of clinical activity and document 60 hours of training in stuttering or cluttering.

Board Certified Specialist in Swallowing and Swallowing Disorders (BCS-S)

The American Board of Swallowing and Swallowing Disorders offers this to SLPs who "have distinguished themselves via research, administrative, and/or educational accomplishments" in treating dysphagia or difficulty swallowing. These specialists use medical technology to track the swallowing process as a client eats or drinks. They offer strategies involving food changes, body posture, and behavioral maneuvers that can preclude the need for surgical intervention.

The ABSSD has a three- to five-year track to receive the BCS-S that includes working under a mentor, continued education, and focusing on a specific area of swallowing disorders.

Certification in Special Techniques

SLPs can also supplement their skillsets by learning techniques that help a specific kind of client. Many of them are cost-efficient and can be completed online or in workshops.

Certification in Augmentative and Alternative Communication: Available through the AAC Institute, this enables you to help clients communicate through alternative means, such as sign languages and computers. These approaches are common with clients who have suffered a traumatic brain injury or had a stroke.
Lee Silverman Voice Treatment: Named for a woman who lived with Parkinson's disease (PD), this method helps clients with PD or progressive supranuclear palsy use their voice at a more normal level of loudness. Through training, clients can recalibrate their perception of their voice so they know how loud they sound to other people and can speak with confidence.
Prompts for Restructuring Oral Muscular Phonetic Targets: This is an integrated approach to address apraxia, a neurological disorder that affects the muscle coordination needed to speak, and dysarthria, weakness in the muscles needed to speak. In addition to helping clients better use their jaw, lips, and tongue, it also considers social aspects of communication, such as the patient's relationship with the speaker, and cognitive-linguistic aspects, such as interpreting words and how they perceive their environment.
Picture Exchange Communication System (PECS): Used with clients who face cognitive challenges in speaking, this system uses visual symbols to teach clients how to communicate their needs better. Clients request what they want by handing the instructor a picture symbolizing what they need, and the request is honored. They can then go on to learn more complex messaging. A key strength of PECS is its lack of verbal cues from the instructor, which helps the client learn to do things without being prompted by an instructor.

What Are the Challenges That Come with an SLP Specialization?

As with any career that requires years of advanced education and training, being a speech-language pathologist who specializes in a specific practice area can come with its own unique set of challenges. These can include:

Specialization Complexity: The wide range of assessment and intervention approaches observed may indicate the absence of established best practice guidelines and a need for more consistency in recommended best practices within the broader field.

Collaboration: Learning to work with interdisciplinary teams can promote more standardized clinical decision-making processes. Learning how to work closely with all stakeholders, including clinicians, caregivers, family members, and patients, can be difficult. Still, it is vital to success in this role.

Continuing Education: Various certifications and licensures are required within any speech and language career, whether you choose to be a generalist or a specialist. Even when busy with your practice or job, you will still need to find the time to keep your licenses current and stay on top of new research and advancements in the field.

Telepractice: Telepractice is becoming more prevalent, providing opportunities for SLPs to offer specialized services remotely. While this ultimately is and will be a benefit to your ability to practice and meet with patients more comprehensively, the technical aspect may bring a new measure of complexity to your ways of working.

Can SLPs Change Their Specialization Later in Their Careers?

Yes, speech-language pathologists can change their specialization later in their careers. SLPs can acquire additional training, certifications, and expertise to transition from one specialization to another. This adaptability allows professionals to explore different areas of speech-language pathology and respond to evolving personal interests or emerging trends. Continuous learning and professional development enable SLPs to expand their skills and knowledge, making it feasible to pursue a different specialization as their career progresses.

Get Started in Speech-Language Pathology

Becoming a speech-language pathologist or pursuing a specialty in a field such as pediatric speech-language pathology or adult neurogenic speech or voice disorders can lead you into a career where you can positively impact your patients' lives.

Bradley University’s online Bachelor of Science in Speech Language and Communication Sciences is a great way to lay the foundation for a career in speech-language pathology and explore the profession. Contact us today to learn how an integrated, hands-on approach to learning can open up a world of opportunities.

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