Underpinning Knowledge

We see from the range of conditions that speech therapists assess and diagnose that therapists must possess wide knowledge in the fields of:

• linguistics
• phonetics
  
• neurology
• anatomy
  
• physiology
• human development
• human behavior
  
• psychology

Generalist Speech Therapist

After completing an approved education program, a speech therapist typically starts his or her speech therapy career as a generalist therapist, gaining experience in assessing, diagnosing and intervening across the full range of communication (and swallowing) disorders. This work is often carried out with people of all ages (although some generalist posts may involving working solely with children or with adults, for example).

Over time, and with more experience, many speech therapists choose to specialize in a particular area of work. For example:

• Some speech therapists choose to specialize in working with a particular age group: e.g. working with elderly persons (geriatrics); adults; children and young people.
• Others take up speech pathology jobs that allow specialization in particular conditions irrespective of the age of the client or the presenting communication disorder, e.g. neurological impairment; physical impairment.
• Still others may choose to work solely with particular communication disorders such as voice disorders, speech disorders or stuttering (irrespective of the age of the client or the underlying impairment which may have caused the particular communication difficulty).
• Some speech-language pathologists specialize in the general field of rehabilitation while others choose to follow a speech therapy career pursuing research.

Specialist Speech Therapist Jobs

The possibilities for specialization are extensive and which particular specialist areas of practice are available in any geographical area will depend on many factors, including:

• the health profile of the local population
• whether the service takes referrals from other parts of the country (or from abroad)
• the budget available
• etc...

By way of example, a Speech and Language Therapy Department that I managed for several years in the UK, and which served a population of around 120,000 people, included the following specialist posts:

• Highly Specialist Speech and Language Therapist in Pediatric Special Needs
• Highly Specialist Speech and Language Therapist in Hearing Impairment
• Highly Specialist Speech and Language Therapist in Alternative and Augmentative Communication
  
• Highly Specialist Speech and Language Therapist in Pediatric Stuttering
• Highly Specialist Speech and Language Therapist in Voice
• Highly Specialist Speech and Language Therapist in Mainstream Pediatrics
• Highly Specialist Speech and Language Therapist in Dysphagia 

Note: In the UK, specialist speech and language therapists working in the National Health Service (NHS) are usually called Highly Specialist Speech and Language Therapists.

Post-graduate Training

Of course, specialist therapists will also have undertaken additional specialized training courses to support their increased expertise and their focus on a particular age group, condition, or communication disorder. For example, a speech-language pathologist who specializes in working with people with cleft palate will most likely need to undertake additional training in phonetic transcription, i.e. a notation system for writing down an accurate representation of the sounds a person makes when speaking. All speech and language therapists can carry out so-called phonemic transcription but people with cleft palate often produce non-standard sounds and additional notational symbols need to be learnt in order to represent these in writing. Similarly, a speech and language pathologist who specializes in swallowing difficulties (dysphagia) will need to undertake additional post qualification training in assessing, diagnosing and treating eating and swallowing difficulties. Anyone specializing in research will need to undertake post-graduate training in research methods.