Speech and Language Therapy Career Guide

Speech and language therapists not only treat problems with speech development and communication, they also assess and support patients with poor swallowing function, often as a result of a stroke or neurological injury.This career guide will examine speech therapy in the UK and the US (where the job is titled speech-language pathologist), focusing on two job roles: speech and language therapist (adult) and children’s speech and language therapist.

Potential Roles in Speech and Language Therapy

Most speech therapists tend to specialise by age group, working with either adults or children. Although the basic principles of speech and language therapy are the same, these patient groups tend to experience different medical problems and symptoms and present their own clinical challenges.

Speech and language therapists working with adults spend a lot of their time rehabilitating people who have suffered a stroke, brain injury, trauma or surgery that has resulted in impaired swallowing function (dysphagia). Poor swallowing prevents the patient from eating and drinking safely and increases the risk of chest and breathing complications due to food and drink entering the windpipe.

A speech and language therapy job involves visiting patients in their homes, hospitals, rehabilitation centres and nursing homes. The speech therapist assesses the patient’s swallowing function and creates a care plan for consuming food and drinks safely and building up the swallow action. The patient, their families, and/or carers follow the recommended advice, and the therapist returns regularly to reassess and offer support.

Children’s speech and language therapists work with under-18s who have speech and language disorders or learning disabilities that impair their language development and communication. These problems can be due to issues such as learning difficulties, physical disabilities, cleft palate, language delay, stammer or speech disorder.

A children’s speech and language therapist job requires a positive attitude, excellent interpersonal skills to communicate with children and their parents, and the clinical knowledge to deliver effective interventions. You might see children at home, in a school, hospital, clinic or nursery centre.

Salary and Career Progression

Salaries in speech and language therapy can vary between the UK and the US. Many UK professionals work within the NHS and its structured pay bands. Salaries in the US tend to be higher but can vary from state to state.

Speech and language therapists typically have the same salary and career prospects, whether they choose to work with adults or children. In the UK, they usually start out working in the NHS, at pay Band 5, which has a salary of around £27,000 per year. Senior speech therapists can earn around £47,000 if they work up to a Band 7 level. Private practice attracts similar or slightly higher pay than NHS employment.

In the US, average salaries are around $85,000, although cities and specialist healthcare provisions often provide opportunities for higher wages. In both the UK and US, career progression happens through continued training and experience, including specialising in one focused area.

Qualifications, Education and Experience

Speech and language therapists must complete recognised qualifications to practice. The following qualifications, education and experience are necessary or beneficial:

UK

• 4-5 GCSEs at grades 4-9
• 3 A Levels or equivalent to access university
• A relevant course to become a qualified practitioner, such as:
  • An undergraduate degree, preferably in Speech and Language Therapy and approved by the Royal College of Speech and Language Therapists as well as the Health and Care Professions Council
  • If you hold a degree in a different subject, you can access an accelerated 2-year postgraduate course in speech and language therapy
  • A degree apprenticeship (currently only available at selected universities)
• Once qualified, registration with the Health and Care Professions Council is mandatory to practice
• Successful pass of an enhanced criminal records check
• Continued learning throughout your career

US

• High School Diploma or a General Education Development (GED) certificate to access a degree course
• Your chosen university may require a SAT or ACT
• Bachelor’s degree in communication science or similar subject
• Master’s degree in speech-language pathology recognised by the Council on Academic Accreditation in Audiology and Speech-Language Pathology
• You will also be required to complete supervised practice for up to a year in a Clinical Fellowship
• Completion of the Praxis Examination in Speech-Language Pathology
• After the above, you can apply for certification from the American Speech-language Hearing Association
• Licensure to practice in your chosen state
• Continued learning throughout your career

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Skills

Speech and language therapists need a wide range of skills to be successful, including the following:

• Excellent communication and listening skills
• A pleasant and approachable nature
• A positive attitude and willingness to think outside the box
• Empathy and a non-judgmental and sensitive approach
• Self-motivated
• Attention to detail
• Patience and perseverance, as some patients may be challenging to treat or resist intervention
• Flexibility
• Can work well under pressure
• Adaptable and able to change tasks according to priority
• Assertiveness and confidence
• Organisation and good time management to manage your own workload
• Team player and willingness to help and support the colleagues in your team
• IT skills to use software programmes in your field
• Children’s therapists must be very comfortable working with children and able to support the patient’s family and carers alongside the patient

Working Hours

Speech and language therapists typically work standard hours of 9am to 5pm, Monday to Friday, with weekends and holidays off. However, hospital work may involve on-call duties covering 24 hours.

Notable Locations

Although speech therapists work in all communities, cities typically provide more opportunities, scope for variety, and specialist work.

• Rochester, MN, US
• Boston, MA, US
• Baltimore, MD, US
• London, UK
• Manchester, UK

Notable Companies

• Mayo Clinic: World-renowned US medical facility that provides speech-language pathology care for inpatients and outpatients
• Massachusetts General Hospital: Linked to Harvard Medical School and known for the Speech, Language, and Swallowing Disorders Program
• John Hopkins Hospital: Provides specialist speech therapy services from its Department of Otolaryngology-Head and Neck Surgery
• Great Ormond Street Hospital: Specialist paediatric hospital that offers excellent speech and language therapy provision
• The Royal Manchester Children’s Hospital: Provides a holistic, multidisciplinary approach to speech and language therapy for children, many of whom have complex needs
• The Michael Palin Centre for Stammering: Part of the Whittington Health NHS Trust, offers world-leading therapy treatments for stammering

Next Steps

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