Speech Therapist Evaluation & Treatments

What Do Speech Language Pathologists Evaluate and Treat?

Speech language pathologists (SLPs) evaluate and treat communication and swallowing concerns across the full life span, from early intervention and identification in infants to evaluations of adults who may be managing neurological changes in later life. According to ASHA's scope of practice, the core areas of SLP practice include speech production, language, fluency, voice and resonance, cognitive-communication, feeding and swallowing, social communication, and augmentative and alternative communication (AAC).

SLP services may include evaluation, clinical impressions or diagnosis where appropriate, treatment planning, direct therapy, caregiver education, and collaboration with teachers, physicians, families, and other clinicians. SLPs customize their approaches and intervention plans based on a variety of factors, including their client’s age, goals, developmental history, physical abilities, and more.

Preparing for an upcoming appointment with an SLP? See our guide on what to expect at your first SLP visit for help with what to bring and what questions to ask.

Emerson College

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Master of Science in Communication Disorders

Scholarships are available for Emerson College's online MS in speech-language pathology. With no GRE required to apply, you can complete your degree in as few as 20 months and prepare to become an SLP.

• Prepares you to pursue certification as an SLP generalist
• In-person clinical placements at faculty-approved partner sites
• As few as 20 months to complete

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Pepperdine University

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Master of Science in Speech-Language Pathology

Pepperdine University’s online Master of Science in Speech-Language Pathology program delivers excellence in its academic and clinical preparation programs, grounded in Christian values. The curriculum is designed to develop skilled, compassionate speech-language pathologists who are not only experts in the field, but are committed to serving and leading in their local communities. Choose between a full-time (five trimesters) or part-time (eight trimesters) program that consists of weekly online learning, three onsite campus experiences, and 400 supervised clinical hours.

• Full-time (five trimesters) or part-time (eight trimesters) options available.
• No GRE scores required.
• 400+ supervised, clinical learning hours are done at schools/clinics local to students
• Three onsite experiences build a sense of camaraderie and community throughout the program

Request more information

What Is the Difference Between an SLP Evaluation and SLP Treatment?

SLPs use both evaluation and treatment; these stages of care work together.

SLPs Complete Client Evaluations First

An SLP gathers information about a person’s communication or swallowing strengths, areas of difficulty, possible diagnoses or clinical impressions, safety concerns, and goals. This may involve interviews, case history review, observation, standardized tests, informal tasks, speech and language samples, feeding or swallowing observation, cognitive-communication assessment, or record review. The findings typically result in a report and recommendations.

Next, SLPs Begin Treatment Protocols

SLPs then use those findings from their evaluations to build treatment plans and set goals. Depending on the client’s needs, a treatment plan may include practicing new skills, using a supportive device, or taking new protocols home or to work to use in those settings. Because most speech language interventions take time, SLPs are careful to set measurable goals so they can monitor progress over multiple sessions and longer periods.

What Areas Do Speech Language Pathologists Evaluate and Treat?

Speech language pathologists work across several areas of communication, feeding, and swallowing. Some people see an SLP for one specific concern, such as a child who has trouble producing certain sounds or an adult whose voice has changed. Others may need support in more than one area. For example, a child with a speech sound disorder may also need language or literacy support, and an adult recovering from a stroke may need help with speech clarity, word-finding, swallowing, and cognitive-communication.

The sections below explain common areas SLPs evaluate and treat. Each person’s plan depends on their age, communication profile, medical or developmental history, daily needs, and goals.

Can SLPs Help With Speech Delays, Unclear Speech, Apraxia, or Dysarthria?

Speech sound concerns affect how clearly a person produces sounds and words. In children, these may include articulation or phonological patterns, such as omitting sounds, substituting one sound for another, distorting sounds, or using speech patterns that make it hard for others to understand.

Motor speech concerns involve the planning, coordination, strength, or control needed for speech. A child may have difficulty reliably sequencing speech movements, as in childhood apraxia of speech. An adult may develop slurred, weak, slow, or effortful speech after a stroke, brain injury, or neurological disease.

SLPs evaluate the person’s speech patterns, intelligibility, consistency, oral structures, language background, and functional communication needs. Treatment may include targeted sound practice, motor planning work, pacing strategies, intelligibility supports, and AAC when speech alone is not sufficient.

SLPs are trained and support clients through ASHA’s clinical guidance on speech sound disorders, dysarthria in adults, and acquired apraxia of speech. Speech sound disorders, or SSDs, are not the same as accents, dialects, or multilingual speech patterns.

Can SLPs Help With Language Delays, Word-Finding Problems, or Aphasia?

Language is not just about speaking. SLPs evaluate how a person understands language and uses it to communicate, including words, questions, directions, stories, conversations, reading, and writing. SLPs may diagnose and provide interventions for spoken language disorders or aphasia.

For children, language concerns may include using fewer words than expected, difficulty following directions, limited vocabulary, or trouble keeping up in classroom language activities. For adults, language concerns may present themselves after a traumatic event like a stroke or brain injury. Challenges may include word-finding difficulties, spoken comprehension difficulties, or difficulty easily participating in conversations after a stroke or brain injury.

SLP treatment may include vocabulary and sentence work, comprehension strategies, or word-finding. They may work with clients on reading and writing support or broader communication partnering. Children’s goals may connect to play, school, family routines, or peer interaction. Adult goals may focus on everyday conversation, medical appointments, work, independence, or communication with family and caregivers.

Can SLPs Help With Stuttering or Other Fluency Concerns?

Fluency refers to the flow and rhythm of speech. SLPs may evaluate fluency disorders through repetitions, prolongations, blocks, tension, avoidance behaviors, and the impact of fluency on school, work, relationships, confidence, and daily communication.

Children may be seen for preschool or school-age stuttering, especially when the pattern includes tension, struggle, avoidance, or emotional impact. Teens and adults may seek services when stuttering affects classroom participation, work, social situations, public speaking, or personal confidence. Parent and caregiver education is often part of treatment for young children.

Treatment may include fluency strategies, stuttering management, communication confidence, self-advocacy, parent education, and support for participation in meaningful speaking situations. Fluent speech is not the only valid outcome of fluency treatment. For many people who stutter, effective therapy also focuses on reducing avoidance, easing struggle, and helping them communicate more freely.

Can SLPs Help With Hoarseness, Vocal Strain, or Voice Disorders?

SLPs can help with a variety of voice-related concerns, such as vocal quality, pitch, loudness, endurance, and even comfort. To diagnose and treat voice disorders and resonance disorders, SLPs may evaluate hoarseness, vocal strain, vocal fatigue, pitch or loudness changes, and voice changes that affect daily communication.

For children, this might include persistent hoarseness, frequent voice loss, or vocal strain that affects school or social participation. For adults, voice concerns may affect teachers, singers, coaches, performers, clergy, call-center workers, or others who rely heavily on their voices. Adults may also seek SLP support for voice changes related to Parkinson’s disease, illness, surgery, or prolonged vocal demands.

Treatment may include voice therapy, vocal hygiene education, breath and coordination strategies, loudness work, and more efficient voice use. Persistent, unexplained, or suddenly changing voice concerns may warrant medical evaluation before or alongside therapy. SLPs often collaborate with ENTs or laryngologists when a voice concern may have a medical cause.

Can SLPs Help With Memory, Attention, or Communication After a Brain Injury?

Cognitive-communication involves how thinking skills affect communication. These skills may include attention, memory, organization, planning, problem-solving, executive function, safety awareness, and the ability to manage conversations or daily routines.

In children and teens, cognitive-communication concerns may occur after traumatic brain injury, concussion, illness, or neurological change. A student may have trouble organizing spoken or written information, keeping track of assignments, participating in class discussions, or explaining what they need. In adults, cognitive-communication changes may follow stroke, traumatic brain injury in adults, brain tumor, dementia, or neurological disease. A person may struggle to follow conversations, remember information, manage appointments, return to work, or communicate safely in daily life.

Treatment may include memory supports, attention strategies, conversation routines, problem-solving frameworks, visual supports, calendars, apps, notebooks, caregiver training, and practice with real-life communication tasks.

Can SLPs Help With Autism, Social Communication, or Conversation Skills?

Social communication is about how people use communication in social contexts. It may involve turn-taking, topic maintenance, repairing communication breakdowns, understanding nonliteral language, using tone or gestures, adapting communication across settings, and participating in conversations or group activities.

For children, social communication goals may focus on joining play, participating in conversations, building self-advocacy skills, or communicating more effectively in school and community settings. For children with autism, goals should be based on the child’s own communication needs and priorities, not on forcing one expected communication style. For adults, social communication changes may follow traumatic brain injury or may involve support for workplace, community, or relationship communication.

Treatment may include conversation strategies, communication repair, self-advocacy, participation goals, and coaching for family members, peers, caregivers, teachers, or communication partners. Helpful therapy in this area should support meaningful participation and autonomy.

Can SLPs Help With Swallowing, Feeding Problems, or Dysphagia?

SLPs evaluate and treat feeding and swallowing concerns in both children and adults. These concerns can affect nutrition, hydration, safety, comfort, health, and participation in meals.

For children, feeding and swallowing concerns could present as difficulty chewing, coughing, or even gagging during eating or drinking. Sometimes this also includes trouble transitioning to new textures or very limited foods being palatable. There may also be increased challenges or stress during feeding times due to related medical needs, developmental markers, or sensory and structural concerns. In adults, dysphagia may occur after a stroke or other trauma. Signs may include coughing during meals, trouble swallowing pills, or a wet or gurgly voice after eating or drinking.

To evaluate these conditions, an SLP may review the case history, observe eating and drinking, conduct an oral-motor examination, perform a clinical swallowing evaluation, or even perform an instrumental assessment. Treatment for feeding and swallowing conditions could include a range of interventions, such as swallowing strategies, positioning adjustments, food or liquid modifications, and customized exercises. SLPs will also work with caregivers to provide education on these strategies, coordinate with physicians, dietitians, occupational therapists, and even nurses or feeding teams, ensuring a comprehensive plan to address and improve these challenges.

Can SLPs Help When Someone Needs AAC or a Communication Device?

AAC stands for augmentative and alternative communication. It includes tools and strategies that help people communicate when speech alone is not enough. AAC can include a range of items or strategies like gestures, signs, pictures, communication boards, writing, typing, tablets, or speech-generating devices. Some people use AAC temporarily after an accident or trauma, while others may rely on a range of devices or interventions more long-term.

For example, an SLP may recommend AAC for a pediatric client to use at school to comment, answer, participate, or reduce frustration. An adult with ALS or a brain injury may use AAC to support conversation, medical decision-making, family communication, work, or independence.

AAC does not mean giving up on speech. It gives a person more ways to communicate. SLP services may include AAC evaluation, tool or device trials, vocabulary planning, access method support, training for the AAC user, and coaching for communication partners.

What Does SLP Treatment Actually Look Like?

Much like counseling or other forms of behavioral intervention, speech language treatment is not a universal approach applied the same way to each client. SLPs receive advanced training and clinical practice to create individualized processes and care plans based on informed research and methods, but shaped to each client's goals, age, needs, and limitations.

Therapy sessions may look quite different from one person to the next. Some sessions involve structured practice, working through a specific task with clear feedback and repetition. Others are naturalistic and embedded in real-life activities, conversation, or play. Many combine both. An SLP might work directly with the person, coach a caregiver or family member, consult with a teacher, coordinate with a physician or occupational therapist, or do all of these things in the same week, depending on the setting and the goals.

The methods SLPs use are similarly varied. Treatment might involve evidence-based techniques for teaching specific skills, compensatory strategies that help a person work around a difficulty, environmental modifications that reduce barriers to communication, or tools and devices that expand how someone can express themselves. Swallowing therapy may include exercises, positioning adjustments, or dietary modifications. AAC therapy focuses on building real communicative competence with a device or system, not just operating it. Cognitive-communication therapy often works through functional routines — the actual daily tasks where attention, memory, or organization matter most.

For young children, therapy frequently looks playful, which is by design. Play-based and naturalistic approaches are well-supported for early communication goals, and families are often active participants rather than observers. For school-age children, therapy may connect directly to classroom demands: understanding directions, organizing an explanation, and participating in a group discussion. For adults, goals are typically anchored in what matters most to that person: returning to work, communicating with a grandchild, eating safely at meals, or managing a conversation after a stroke or injury. Progress is monitored, goals are adjusted, and the process is expected to evolve as the person does.

Where Do SLPs Work?

The setting shapes the goals, evaluation approach, team, and documentation involved in SLP services. SLPs work across a wide range of environments, as described by the ASHA public SLP overview and the BLS Occupational Outlook Handbook for SLPs.

How Do SLP Goals Differ for Children and Adults?

SLP goals depend on the person’s age, needs, and daily life. For children, therapy commonly supports communication as they grow, learn, play, and build relationships, especially how all of this impacts their ability to participate and engage at home and at school. Goals might focus on being understood, using words or sentences, understanding language, communicating with peers, eating more comfortably, or using AAC when speech alone is not enough.

For adults, goals are usually tied to independence, health, work, relationships, and daily routines. An SLP may help someone communicate after a stroke, manage voice changes, use memory or organization strategies, swallow more safely, or rebuild confidence in conversations with family, coworkers, caregivers, or medical providers.

Across ages, the point is the same: SLP services should help people communicate, participate, and function more safely and effectively in real life.

When Should Someone Ask About an SLP Evaluation?

An SLP evaluation may be worth discussing when communication, feeding, or swallowing concerns start to affect daily life. For a child, that might mean speech that is hard for unfamiliar listeners to understand, frequent frustration when trying to communicate, difficulty following directions, stuttering with tension or distress, persistent hoarseness, feeding difficulties, or communication challenges that affect school, play, or participation. Families can also use the CDC’s developmental milestones as a general reference point when deciding whether to ask a pediatrician, school team, early intervention program, or SLP about next steps.

For adults, an SLP evaluation may be appropriate after a stroke, brain injury, illness, surgery, neurological diagnosis, or other change that affects speech, language, voice, cognition, or swallowing. Examples include slurred or effortful speech, word-finding difficulties, trouble understanding or reading, persistent voice changes, coughing during meals, difficulty swallowing pills, or changes in memory and organization that affect work, caregiving, relationships, or independence. ASHA’s public guide to speech language pathologists explains that SLPs work with communication and swallowing concerns across the lifespan.

Sudden or severe symptoms need medical attention first. If someone has sudden changes in speech, facial drooping, arm weakness, confusion, breathing difficulty, choking, or another urgent safety concern, seek emergency care rather than waiting for a routine SLP appointment. The American Stroke Association’s B.E.F.A.S.T. stroke warning signs can help readers recognize common stroke symptoms that require immediate action.

If an evaluation is already scheduled, reviewing our first SLP visit guide can help readers prepare for what to bring, what to expect, and what questions to ask.

What Should You Know Before Seeing an SLP?

SLP evaluation and treatment should be individualized. The right plan depends on the person’s age, communication or swallowing needs, medical or developmental history, daily routines, and goals. Depending on the setting, families, caregivers, teachers, physicians, or other providers may be involved in the process.

Effective goals should connect to real life. For a child, that might mean communicating during play, participating in school, eating more comfortably, or using AAC across daily routines. For an adult, it might mean communicating with family, returning to work, managing swallowing safety, using memory supports, or participating more confidently in medical and community settings.

Progress varies. Therapy outcomes can depend on the condition being treated, the person’s health, age, goals, practice opportunities, support system, and access to services. Insurance coverage, referral requirements, school eligibility decisions, and provider availability may also vary by setting and location.

SLPs must meet state license requirements to practice. Many also hold ASHA’s Certificate of Clinical Competence in Speech-Language Pathology, or CCC-SLP. The CCC-SLP is a professional certification issued under standards set by ASHA’s Council for Clinical Certification in Audiology and Speech-Language Pathology; it does not replace a required state license. For more on credentialing, see our state SLP licensing hub and CCC-SLP guide.

Emerson College

Ad

Master of Science in Communication Disorders

Scholarships are available for Emerson College's online MS in speech-language pathology. With no GRE required to apply, you can complete your degree in as few as 20 months and prepare to become an SLP.

• Prepares you to pursue certification as an SLP generalist
• In-person clinical placements at faculty-approved partner sites
• As few as 20 months to complete

Request more information

Pepperdine University

Ad

Master of Science in Speech-Language Pathology

Pepperdine University’s online Master of Science in Speech-Language Pathology program delivers excellence in its academic and clinical preparation programs, grounded in Christian values. The curriculum is designed to develop skilled, compassionate speech-language pathologists who are not only experts in the field, but are committed to serving and leading in their local communities. Choose between a full-time (five trimesters) or part-time (eight trimesters) program that consists of weekly online learning, three onsite campus experiences, and 400 supervised clinical hours.

• Full-time (five trimesters) or part-time (eight trimesters) options available.
• No GRE scores required.
• 400+ supervised, clinical learning hours are done at schools/clinics local to students
• Three onsite experiences build a sense of camaraderie and community throughout the program

Request more information

Frequently Asked Questions

Do SLPs Only Work With Children?

No. SLPs work with infants, children, teens, adults, and older adults. The specific concerns, goals, and settings vary significantly across the life span.

Is Speech Therapy Only for Speech Sounds?

No. SLPs work on speech sounds, language, fluency, voice, cognition, social communication, AAC, feeding, and swallowing. Speech sound therapy is one part of a much broader scope of practice.

What Is the Difference Between Speech and Language?

Speech is how sounds and words are physically produced. Language is how people understand and use words and sentences to convey meaning. Someone may have strong speech clarity but difficulty with language comprehension or expression, or vice versa.

Can SLPs Help With Swallowing?

Yes. SLPs evaluate and treat feeding and swallowing concerns in children and adults, often working alongside physicians, dietitians, occupational therapists, and other members of a medical or care team.

Can Adults See an SLP?

Yes, adults also benefit from speech language pathology interventions. While their needs can span the full scope of practice for SLPs, this may include voice disorders, communication changes after an injury, or speech changes related to neurological conditions like dementia.

What Is Cognitive-Communication Therapy?

Therapy that addresses how attention, memory, organization, problem-solving, or executive function affects communication and daily life. It is commonly relevant after stroke, traumatic brain injury, dementia, or other neurological events.

What Is AAC?

AAC (augmentative and alternative communication) includes tools and strategies that support communication when speech alone is not enough, such as gestures, pictures, communication boards, tablets, or speech-generating devices.

Does Using AAC Stop Someone From Talking?

No. Research and clinical practice support AAC as a communication-access tool that can be used alongside speech. AAC does not replace speech development or use; it provides more ways to communicate.

Does Speech Therapy Always Involve Talking Practice?

Not necessarily. Depending on the concern, therapy may include swallowing strategies, AAC support, caregiver coaching, voice therapy, cognitive-communication strategies, or environmental supports.

How Does an SLP Decide What Treatment Someone Needs?

The SLP uses evaluation findings, the person’s goals, medical and developmental history, communication needs, and setting to recommend a treatment plan. Treatment is individualized, not one-size-fits-all.

When Should I Ask for an SLP Evaluation?

Ask about an evaluation when speech, language, voice, fluency, swallowing, feeding, cognition, or communication changes are affecting daily life, school, work, safety, or participation. For sudden or urgent symptoms, seek medical care first.