What's it like to be a speech language pathologist?
January 8, 2014 8:42 PM   Subscribe

I'm interested in going to graduate school to pursue a degree in speech language pathology. I've read a lot about the career online, but I'm interested to learn more about the daily realities for speech language pathologists (a.k.a. speech therapists) and their journeys building a career in the field. So: What's it like to be (and become) a speech language pathologist?

Bonus points if the answer delves into any of the following: degrees and types of disability in clients, day to day lifestyle, job prospects, variations between work settings, and whether most jobs are limited to nursing homes and helping people with swallowing issues (which I'm currently not very excited about).
posted by soundproof to Work & Money (7 answers total) 7 users marked this as a favorite
I'm a Speech Pathologist :-) I've been practicing for about 7 years. There are so many areas within Speech Language Pathology and different clientele/patients so you will probably get a wide variety of answers.

Brief background: I received my undergrad in Biology, wasn't really sure what to do so I worked in some non-SLP careers after graduating. I became bored and wanted to do something more interesting/rewarding. I volunteered as an ESL tutor, thought about going into that as a career but honestly wanted to earn more money. Talked to a PT friend of mine who thought I should talk to an SLP at her hospital. Seemed like a good combination of science, working with people, and problem-solving. I had to go back and get a post-bac (1 year) and then my Masters degree (2 years).

I've always, only, worked with adults. I never even considered working with children in the field. I don't think I'd even know what to with a child speech client :-)

Types of disability in clients: I primarily work with adults above the age of 50, though some younger patients 20-40. I work in a major hospital, and every day I do a little bit of acute care, rehab, and outpatient.

Day to day lifestyle: I work 10 hour days, and as stated above I work in all settings in the hospital. I love the variety, but it does get a bit crazy at times. I love acute care most, and I love dysphagia/swallowing. I love my patients to death, but when I get home I typically need a lot of quiet time - talking to patients and other medical providers all day long can be draining.

Job prospects: I feel fortunate that I think I will always be able to find a job. If not in a hospital, in a private clinic or a skilled nursing facility. A hospital will always be my number one choice, but if something were to happen to my job there seem to be a lot of SNF and contract jobs available.

Work settings: I'm only familiar with hospital settings, that's all I know.

Oh, I just saw your last sentence - well, you definitely don't have to work at a SNF if you want to work with adults. Although I love dysphagia, my rehab patients and outpatients also have aphasia, voice disorders, cognitive impairments, dysarthria, etc. That's why I like my varied setting - I have a very varied caseload. If you work in a SNF, yes the majority of your patients may have swallowing issues. Same goes with acute care.

Hope that helps! Feel free to ask more questions. Despite random frustrations, I LOVE my profession :-)
posted by canda at 9:46 PM on January 8, 2014

I'm a Speech and Language Therapist practicing in the UK.

I got into it because I did a degree with a specialism in psycholinguistics, then a PhD in a similar field. I found that I pretty much hated the isolating day to day reality of research but I loved the work with volunteers with aphasia. So it was this or clinical psychology, and clinical psychology would have required me to broaden out before specialising again.

In the UK you qualify by a 3-4 year undergraduate degree or a 2 year masters. I got a place on the 2 year masters after my related PhD, a substantial amount of voluntary work with a local SLT team and a nursery school and a ton of background reading. Around here places are extremely competitive.

The course was intellectually, emotionally and physically extremely hard, with little time off and insane expectations. From what I'm read, this is pretty similar in every country.

I've now been working for 3 years for the National Health Service in the UK. I work solely with adults, and we mostly don't see adults with learning disabilities as they are typically seen by specialists. I work in an acute hospital. My job supposedly involves both stroke and medical wards, but at the moment I am not doing any stroke work.

Most of my clients are severely disabled with acquired neurological problems or otherwise severely ill. On the medical wards this usually means moderate - severe dementia, Parkinson's, Motor Neurone Disease, Huntingdon's, Multiple Sclerosis, or various forms of lung disease. I see the occasional person with cancer affecting their head or neck, but they are mostly seen by specialists. On the stroke wards we do get some variation in level of disability, but those people with less severe strokes tend to leave pretty quickly. Those that stay for rehab are often facing long term significant disability.

On a day to day basis, I work approximately 8 hour days. I sometimes make time for lunch. There certainly isn't any time to sit down and have a cup of tea. I have lots of people who all feel I should be giving them more of my time. I find the job emotionally exhausting because our service do not have the resources to see people as often as they need, so I constantly feel I am letting everyone down. It's not uncommon to have nurses or doctors telling you off. I love my face to face work with clients and their families. Even in sad circumstances at the end of people's lives you can make a little bit of difference and that's why I do it. I spend far too much time writing about what I did rather than doing more of it, but as it's increasingly common for us to have to justify every decision we made with a particular client, it's important.

The job prospects aren't great in the UK at the moment. Newly qualified therapists find it takes a long time to get jobs. I suspect that as you're in a different country you will find information from your home country more relevant.

Work settings vary tremendously. I can't tell you about working with children, but with adults, when I worked with outpatients it was like a totally different job. I saw a different client group (mostly those people who were highly motivated to work on their voice or their speech or their language) and the balance of work was different (mostly speech rather than mostly swallow). But I found I missed the highly collaborative nature of the hospital environment.

At the moment, 90% of my job is about helping people with swallowing problems. That's the nature of acute hospital work. It's often what's keeping them in hospital or contributing to their illness, and while they can't eat and drink, speaking is quite a low priority. When I'm on stroke this changes, but it's still the case that swallowing gets priority because when a client can swallow, they're much more likely to be able to go home.

I do like my job, but I do also hate bits of it. I find it exhausting and I can't imagine doing days longer than 8 hours of a regular basis (I also do a 2 hour commute). The clients are mostly great but you're often fighting against a system that doesn't allow what you need it to do. You also see a lot of inequality and the worst bits of life. Also, most of my clients will eventually die in my care or shortly afterwards. If I get burnt out, I will probably move to more domiciliary settings, which will have their own different pressures.
posted by kadia_a at 11:04 PM on January 8, 2014 [1 favorite]

My wife is an SLP. She is the Director of Therapy Services in a private residential school, where she oversees speech therapy, physical therapy, occupational therapy, and some other staff. She also has a private practice where she sees patients in their homes in the evenings and weekends. In both cases, she's focused on young children (ages 3-22, but mostly on the younger side) who have severe autism or other disabilities that impact their ability to communicate.

Her B.S. is in Communication Disorders, and she has a M.S. in Speech-Language Pathology, and an Ed.S. in Applied Behavior Analysis. The undergrad and masters seem common for most of her colleagues and staff. The SLP/ABA combination is relatively uncommon in the field, from what I understand.

She's made a couple job changes since I've known here, and didn't seem to have much difficulty finding opportunities, but this is largely going to be geographic-specific (we're in the Boston area).
posted by NotMyselfRightNow at 4:50 AM on January 9, 2014

I am a student working toward a master's in SLP, so I can't speak to your job questions but I can speak to a couple of other things. From what I've read, about 2/3 of SLPs in the US work in school settings with kids; the others work in medical settings, private practice, and so on. It looks like the money is better in medical settings but the hours are longer.

Job prospects are excellent. When I told my son's SLP what I was doing, she said, "Well, you'll never be unemployed." If you check the website for any graduate program in speech language pathology, you'll see that they post their employment statistics. Nearly every one I've looked at has in-field placement rates of 100%. The others were 97% or above.

I am currently in a post-baccalaureate program to get my prerequisites to apply for a master's program. I have two preveious master's degrees and the classes in the post-bac program have been among the hardest I've ever taken. YMMV if you majored in mathematics or a hard science, but I've never had to study so hard in my life. Coursework includes anatomy, acoustics, audiology, and speech science, as well as courses on language development, adult and childhood language disorders, assessment and treatment.
posted by not that girl at 5:01 AM on January 9, 2014

Best answer: I'm a SLP and a PhD candidate in the USA. I've been in the field for about 8 years. I had an undergrad degree in Brain and Cognitive Sciences and also had to do the "post bacc" coursework to get into a master's program (like not that girl.) I've worked in nearly every setting imaginable through some excellent jobs, so I'll summarize. I presume you've already looked at ASHA (or your local equivalent?) I find it important to note that most schools train you as a genearlist to prepare you for whatever you might do in the future. SOME schools offer tracks, e.g. a medical track, or an education track, etc. I would think carefully about what you want before you decide to do a track like that; I liked that I had options. If I had done a medical track, moving to a school would have been difficult. And, if you do an education track, it might be nearly impossible to move to a medical setting in the future.

The beauty of this field is that once you are out of school and working, you can choose what you'd like to do based on the job you get. Don't want to do swallowing? No problem! Get through the coursework and pass the Praxis, and you can choose a job that either minimizes or does not require the need to do dysphagia. Really love doing cognitive therapy with adults? You can find jobs that do that. Love to work with kids with severe disabilities? There's a job for that, too. Pretty much, if you can study it, you can specialize in it. The field puts a strong emphasis on self-study. You must do continuing education in order to maintain your credentials.

That said, you'd probably have to move in order to have that kind of selectivity. I think it's easier to have options in cities (e.g. Boston, NYC etc.) than in rural areas. So, if you live somewhere without a high number of healthcare facilities or clinics, you might have to suck it up and do swallowing so that you get to work with your preferred adult population, or you might have to work in a school to work with kids with cerebral palsy. Job prospects are generally excellent: schools are always looking for therapists. I know of three colleagues who've set up their own practices and they are so busy they are turning away clients. Colleges and Universities are short PhDs to teach courses, and so there is a major need if you decide to work in academia.

You asked about types of clients, and there's no easy answer to your question. The simplest is "whoever needs your services." It might be "neurotypical" people with a dysfluency, it might be a non-verbal child with CP who needs a communication device in order to communicate, it might be a teacher who needs help in adapting her curriculum for a new student in her class who is dyslexic. The duties vary greatly. I've worked with adults and children with a variety of disorders, including older children who transition to supportive living after graduation. If you have questions about a specific population, feel free to MeMail me.

That's the therapy side. Then there's the side that nobody tells you about in graduate school. Most of the posters here have already touched on most of it: paperwork is a big one, which includes writing notes, IEPs, evaluation, insurance approval request, etc. etc. etc. Day-to-day quality of life will vary greatly depending on where you are working. For example, I used to work in a speech clinic that did nearly everything for a small community hospital: outpatient services, inpatient swallowing and cognitive eval and tx, contracts with local early intervention agencies and visiting nurse associations AND hopsice services AND local preschools AND school contracts and modified barium swallow studies (!). It was great for my skill development, but the productivity requirements and the paperwork were nearly soul-crushing; I worked 40 hours a week with an unwritten expectation of 100% productivity (e.g. 8 hours of scheduled payable time), and reports/documentation were written on my own time. That's not the norm (my supervisor was "old school"), but it might be close these days. That said, the schools present their own challenges: meeting and paperwork requirements are intense, and your quality of life will vary greatly depending on the support you get from administration. And, although I had an amazing supervisor who did not want me to bring work home with me, the reality is that I did, often.

I don't say these things to be a downer, I say it to make this point: if you really LOVE the field, you will be able to navigate the paperwork, the meetings, the productivity requirements, insurance companies, etc. If, at the end of the day, you get a little teary when a child says to his mother "I love you" for the first time, or when a wife can tell her husband what she wants for dinner fluently, it's all worth it in the end. Figure out if you LOVE it. If you do, you're in good shape. I actually talked a student OUT of the field because I could tell she really didn't like it; she was only interested in it for the job security. When she said, "I don't like swallowing or the language stuff" I suggested she think about psychology instead, or business, because she did like "working with people." This field will chew up and spit out people who aren't naturally curious about communication or swallowing.

I LOVE this field, I love what I do, I love the services we provide, and so I think it's a great job. Feel free to MeMail me if you like. :)
posted by absquatulate at 6:58 AM on January 9, 2014 [1 favorite]

My mom is an SLP (she has an MS and is all but dissertation on her Ph.D. work) and she's done a variety of things that were not "nursing homes and helping people with swallowing issues," so don't worry about that. She is not into that either. In all of these roles, her hours were really regular and it was a pretty good lifestyle for her even when she was a single parent. Here are the things that she has done:

*worked in private practice with her professor (liked helping people, but the cases were not especially interesting or varied -- lots of stuttering and people recovering from strokes)

*worked at a Level 1 trauma hospital (liked the interesting cases, but did not like the intensity of the practice and the hospital bureaucracy and the inability to see a case through; this had lots of swallowing work if I recall correctly)

*worked at an elementary school with a lot of ESL and low-income children (this was most of her career; she loved working with kids, because of the school population there was a great variety of kinds of cases, and she enjoyed being an advocate for the kids and bringing a rigor to school practice that she felt was missing; she did not like the IEP and other school bureaucracy or politics)

*works now in private practice limited to accent modification (she likes this a lot; mostly high-powered professionals who speak English well but want to be better understood in the language)
posted by *s at 8:06 AM on January 9, 2014 [1 favorite]

I am not an SLP but I work closely with some and have asked them a lot of questions as I am interested in their field of work. Both work exclusively with kids but there's a lot of variation within their jobs.

SLP #1 works in a clinical setting; we have seen her both in clinic and in hospital. I believe she works only with feeding issues, with patients all the way up to age 18. We see her for everything from video fluoroscopy studies to general feeding therapy. She works 10-12 hour days, 4 days a week in clinic. I'm not sure what her hospital rounding schedule is. She works closely with a team, and in fact the only time I have ever seen her alone is when we were in-patient. Normally I see her along with a nurse practitioner, occupational therapist, and registered dietician. Her approach is clinical and scientific focused on the end result of helping my daughter learn to eat by mouth (we are dealing with swallowing issues and oral aversion). She has a lot of medical knowledge and I wish I had known to bring her in earlier when we were having serious problems.

SLP #2 works for our school district as part of their early intervention program. She sees babies and toddlers up to age three for both feeding and speech therapy, and works the same schedule as teachers - five days a week, off holidays and summers. She seems able to take a more creative approach to her work along with setting her own schedule a bit. She also works in conjunction with the rest of our early intervention team but more in an information-sharing way than showing up at appointments together. She has a holistic whole-family food-based approach to our situation, and feels like a closer member of our team (after all, she is in my home on a regular basis, eating with my daughter, and has seen me in my pajamas sobbing and trying to breastfeed). While her ultimate goal is also to have my daughter eat by mouth, her main focus right now is to make the path to getting there as pleasant as possible for the whole family.

Both women enjoy their jobs and are essential members of our medical team. One of the things that intrigued me about the occupation is what different jobs are available with the same background - and that's just within the narrow view of pediatric feeding issues!
posted by peanut_mcgillicuty at 10:07 AM on January 9, 2014 [1 favorite]

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