The Guide to the ASHA Speech Pathology Scope of Practice

The ASHA scope of practice is an official policy document of the American Speech-Language-Hearing Association (ASHA), covering the breadth of practice in speech-language pathology. It defines the job of certified speech language pathologists (SLPs) in the United States—what they do, where they work, and how they help patients. Here’s a summary of the scope of practice—and what it means for you as an aspiring SLP.

What is the ASHA Scope of Practice for Speech Pathologists?

What is a scope of practice? Before getting into that, we first have to understand the role of the ASHA. Borrowing from its website, the ASHA is a “national professional, scientific, and credentialing association” covering a range of disciplines—including speech pathology. 

In brief, the ASHA’s scopes of practice details what licensed and certified practitioners are expected to do in their respective fields—and what they’re legally allowed to do in their profession. Adhering to scopes of practice are important, both for keeping patients safe and your license from liability. 

Focusing on speech pathology, the ASHA’s scope of practice covers the profession in detail. To quote from its website:

“The Scope of Practice in Speech-Language Pathology of the American Speech-Language-Hearing Association (ASHA) includes the following: a statement of purpose, definitions of speech-language pathologist and speech-language pathology, a framework for speech-language pathology practice, a description of the domains of speech-language pathology service delivery, delineation of speech-language pathology service delivery areas, domains of professional practice, references, and resources.”

Definitions of Speech Language Pathologist 

The ASHA defines speech language pathologists as:

 “..professional[s] who [engage] in professional practice in the areas of communication and swallowing across the life span.” 

Communication and swallowing disorders are central to an SLP’s work. These areas are defined below:

  • Communication. SLPs who focus on communication help clients and patients in a number of areas, including language, cognition, fluency, resonance, and hearing.
  • Swallowing. SLPs who focus on all aspects of swallowing, including feeding and related behaviors. 

Speech Language Pathology Framework for SLP Practice 

Speech language pathology involves helping individuals with swallowing and communication disorders to improve their quality of life. SLPs play a valuable role in their patients’ development and wellbeing. 

Practitioners in the field are expected to use high-quality and collaborative research and evidence to inform their decisions. Beyond that, practitioners work across the span of speech language pathology. In general, the ASHA scope divides SLP into service delivery and professional practice. 

Though service delivery and professional practice are interconnected—and both invaluable to the discipline at large—they approach SLP from slightly different angles. In brief, service delivery is how SLPs work directly with clients and patients, from direct counseling to screening for and treating medical conditions. The ASHA divides SLP service delivery into eight distinct areas:

  • Collaboration
  • Counseling
  • Prevention and Wellness
  • Screening
  • Assessment
  • Treatment
  • Modalities, Technology, and Instrumentation
  • Population and Systems

The professional practice aspect goes beyond clinical practice, encompassing research, education, and administration. This branch of SLP is ideal for individuals who want less direct relationships with patients but still want a lively career in the field. Per the ASHA’s scope of practice, professional practice includes the following five areas:

  • Advocacy and Outreach
  • Supervision
  • Education
  • Administration/Leadership
  • Research

Domains of Speech Pathology Service Delivery 

Working in SLP service delivery means being comfortable in different fields. Though not an exhaustive list, here’s an overview of the ASHA’s eight service delivery domain areas.

  • Collaboration. SLPs are expected to work with colleagues to create a collaborative culture. In practice, that involves encouraging communication and sharing decision-making—both with other professionals and with patients and their families. When working in a team, you’ll be expected to ensure colleagues have the skills and experience to make a difference.
  • Counseling. SLPs educate, guide, and support individuals and their families. The best service delivery SLPs will therefore approach their work sensitively—giving emotional support to patients as they battle communication disorders, feeding and swallowing disorders, or related diseases.
  • Prevention and Wellness. SLPs often promote prevention and wellness activities—aimed either at preventing disorders before they appear or mitigating their impact once they have. Public awareness is vital here, with SLPs often working to educate people about communication disorders and swallowing problems.
  • Screening. SLPs are experts at screening people for possible communication or swallowing disorders. Train as a SLP in service delivery, and you’ll use a range of tools to sharpen screening, including coordinating screening programs and analyzing medical records.
  • Assessment. Speech language pathologists are experts in diagnosing different types of communication and swallowing disorder. They understand that some conditions occur developmentally, while others happen in isolation, without any obvious underlying condition. SLPs use a range of techniques to make diagnoses, from interviewing patients and their families to understanding their personal backgrounds. 
  • Treatment. Speech language services are aimed at helping individuals’ ability to communicate and swallow—improving their quality of life. How treatment looks in practice depends on the patient, but SLPs may find themselves integrating academic research into their therapies, or working with colleagues in related fields. 
  • Modalities, Technology, and Instrumentation. SLPs use the latest technologies to evaluate and care for people with communication and swallowing disorders. Endoscopy and fibre-optic machines are commonly used to assess swallowing, while ultrasound and other biofeedback systems can help with speech or voice production. 
  • Population and Systems. Apart from direct care responsibilities, SLPs also have a broader social role. Some focus on education and relating to the public. Others work to reduce the cost of care, liaising with partners to implement case management strategies.

Speech Pathology Service Delivery Areas 

What do SLPs actually do in practice? A career in service delivery means helping patients across a range of areas, from fluency to resonance. What exactly you work on will depend on your interests and job, but here’s an overview.

  • Fluency and Speech Production. From stuttering to cluttering, helping individuals with fluency is a crucial part of SLP. Speech production is important too, with articulation, motor planning, and phonology all key service delivery areas.
  • Language. Encompassing both spoken and written communication, SLPs help people across the spectrum of language. This includes working on literacy, syntax, semantics, phonology, morphology, among other areas. 
  • Cognition. SLPs often help people with cognitive difficulties. Attention and memory are two common areas of focus, as are problem solving and executive functioning.
  • Voice. Supporting patients with phonation quality, pitch, and loudness are important parts of a SLP’s work. Helping them overcome alaryngeal disorders are too.
  • Resonance. Service delivery SLPs will be expected to help individuals’ resonance, with hypernasality and hyponasality both pillars of the field. Treating cul-de-sac resonance and forward focus resonance are important areas too. 
  • Feeding and Swallowing. Service delivery SLPs cover all three phases of swallowing—oral, pharyngeal and esophageal. They’re also expected to deal with atypical eating disorders, including food refusal and negative physiologic responses.
  • Auditory Habilitation/Rehabilitation. Hearing loss and deafness can negatively affect an individual’s speech, language, or communication. SLPs are there to help—and support auditory processing in general.
  • Elective Services. Though most SLP services are a standard part of the job, more specialized focuses are available too. For instance, some choose to work on transgender communication, while others deal with business communication. Helping people change their accent or dialect is another popular option.

Domains of SLP Professional Practice

Working in SLP professional practice offers a range of career paths, across advocacy, administration, leadership, and more. Here’s a summary of the ASHA’s list of SLP professional practice domains.

  • Advocacy and Outreach. From academic literacy to training programs and political action, SLPs promote their profession in a variety of ways. Their ultimate goal is to reduce social and linguistic barriers in SLP—recruiting colleagues from diverse backgrounds and lobbying for funding and recognition from policymakers. 
  • Supervision. SLPs are responsible for supervising colleagues in the field—from trainees and assistants to clerical staff and other administrative support staff. This work requires strong social skills, as SLPs are expected to promote a collegial atmosphere in their workplace, and support individual growth while providing guidance and support.
  • Education. SLPs are often educators, teaching students in universities and colleagues in the workplace. This formal teaching dovetails with educating individuals, their families, caregivers, and policymakers about communication and swallowing.
  • Research. Research is crucial to a SLP’s work. Whether focusing on cognition, communication, pragmatics, literacy, and feeding and swallowing, there are plenty of areas to explore—either in specific facilities or across different institutions. 
  • Administration and Leadership. SLPs administer programs in schools, universities, healthcare settings, and more. Their responsibilities may include making financial and personnel decisions, designing programs, ensuring regulatory compliance, and cooperating with outside agencies.

DIsclaimer: The information in this content is from the American Speech-Language Hearing Association as of August 2020. SpeechPathologyMastersPrograms.com is not responsible for changes that may occur after this date. Check ASHA’s website for the most up-to-date information.