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What Is Speech Therapy?

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Speech therapy is a form of healthcare that helps improve communication and speech. It can also help improve swallowing function and other behaviors related to feeding.

About one in 12 children in the United States has a speech or swallowing disorder. Disorders are most common in young children, but many adults have a related condition. For example, about one million adults in the United States have aphasia (difficulty expressing or comprehending written and verbal language).

Speech therapists (STs) or speech-language pathologists (SLPs) assess and treat people of all ages. They use various techniques to help people with challenges related to speech production, language comprehension, hearing, voice quality, fluency, and swallowing. 

What Does Speech Therapy Treat?

Speech therapy treats various disorders involving hearing, speech, language, literacy, social communication, voice quality, executive functioning (for example, memory and problem-solving), feeding, and swallowing.

Specific speech disorders include:

• Articulation disorders: Difficulty pronouncing words or sounds such as the “s” sound (for example, saying “thun” rather than “sun”). This can occur during childhood language development or with structural problems like tongue-tie. A tongue tie is when a small band of skin connects the tip of the tongue to the bottom of the mouth. It is congenital, meaning it's present at birth.
• Dysarthria: Slow, slurred, or unclear speech. This occurs with oral (mouth) muscle control decline due to neurological conditions (related to the brain or nervous system), such as multiple sclerosis (MS) —a condition that occurs when the immune system attacks myelin, the covering wrapped around nerve cells.
• Apraxia: Knowing what you want to say but having difficulty producing the correct sounds or words. Apraxia can cause slow, error-prone speech or the need to intentionally move your tongue and lips in order to produce sounds and words. Apraxia can be present at birth, but it can also occur as a result of brain injuries, brain tumors , or a stroke .
• Fluency disorders: Speech flow disruptions like stuttering. Stuttering is experiencing interruptions in speech and repeating sounds, syllables, or words. Researchers are still exploring possible causes of dysfluency, but they seem to include genetics, developmental components, neurological factors (how the brain processes), and brain injury. Many children outgrow fluency disorders, but they can persist into adulthood.
• Voice disorders: Vocal cord spasming (choppy voice), hoarseness, pitch problems, or voice fatigue are examples of voice disorders. This can result from infection, overusing the vocal cords, or neurological disorders. 

Language or communication disorders include:

• Aphasia : Aphasia is a language disorder in which you have difficulty expressing or comprehending written and verbal language. Receptive aphasia is difficulty understanding written or verbal words. Expressive aphasia is difficulty communicating thoughts and ideas with language components like vocabulary, grammar, and sentence formation. Aphasia can occur with childhood development, language impairment, autism spectrum disorder (ASD), brain injury, or neurological disorders.
• Pragmatic language disorder: This relates to social communication. Signs include misunderstanding social cues like eye contact, body language, and personal space. It can occur during childhood development or with underlying neurodivergence (brain variation), such as autism spectrum disorder (ASD) , a brain development condition that affects how a person perceives and socializes with other people.
• Accent or tone: While this is not a disorder, speech therapists can also work with people who wish to modify their accent or an unusual speech rhythm, pitch, or tone. For example, a high-pitched, sing-song, or robotic tone can occur with ASD.
• Executive functioning: Executive functioning challenges include difficulty with memory, planning, organization, problem-solving, and attention. This can occur due to brain injuries or conditions like ASD and attention-deficit hyperactivity disorder (ADHD) , a neurodevelopmental disorder characterized by inattention (being distracted), hyperactivity (feeling restless), and impulsivity (making hasty decisions).
• Auditory processing disorder: This is a neurological condition that makes it difficult to make sense of sounds. 

Feeding and swallowing disorders affect how you suck, chew, and swallow food and drinks. Difficulty swallowing is also known as dysphagia , which can result in choking during meals—and lung infections if food or liquid enters the airways.  It can occur with structural abnormalities, muscular weakness, or neurological conditions like a stroke.  

How Does Speech Therapy Work?

Speech therapy involves techniques like language practice, pronunciation exercises, voice therapy, and swallowing exercises. It begins with a thorough assessment, including observation of communication strategies, challenges, and frustrations.

Speech therapy for infants, toddlers, and children involves fun and engaging activities like play, language exercises, reading, picture cards, and modeling correct sounds. This helps make learning more enjoyable.  

Parents or caregivers often attend sessions and learn ways to support children at home. The ST or SLP will tailor the treatment plan to the child’s developmental stage. Early recognition and intervention (treatment) can help improve outcomes.

With adults, the ST or SLP will begin with an assessment to identify specific challenges. They will then create a specific care plan that addresses underlying concerns such as:

• Medical conditions
• Accent modification
• Voice challenges
• Pronunciation
• Conversational language
• Problem-solving
• Memory exercises

What To Expect During Speech Therapy

Speech therapy can occur in a class, small group, online, or one-on-one. Speech therapists typically assign exercises to practice at home in order to reinforce what you learn. Activities might include:

• Vocal warm-ups like humming 
• Tongue twisters to improve articulation
• Breaking words into syllables to improve clarity
• Contrasting word exercises—for example, "ship" versus "sheep"
• “Pausing” practice (for stuttering)
• Repetition after listening to a native speaker 
• Repetition exercises for sounds like “s” 
• Speech rate control—for example, by tapping hands to a beat
• Pitch exercises
• Breathing and posture exercises

Receptive language exercises include:

• Memory or problem-solving exercises
• Reading comprehension (similar to a book report)
• Speech supplementation (written, gestural, voice amplifier, speech-generating devices)
• Word association
• Communication partner exercises, such as practicing eye contact and active listening

Exercises for swallowing and feeding include:

• Diet modification (pureed to solid foods)
• Oral muscle strengthening (like tongue “push-ups”)
• Swallowing exercises

Benefits of Speech Therapy

One of the main goals of speech therapy is to enhance a person’s ability to express thoughts, ideas, and emotions effectively. This can lead to a greater sense of self-expression, meaningful interactions with others, and less frustration. Other benefits include:

• Greater self-confidence: Gaining more control over language and communication can increase confidence and boost self-esteem. As a result, you might be more willing and excited to engage in social activities. 
• Improved academic or professional performance: Clear speech and language can lead to enhanced skills in comprehension, reading, and writing. This can support academic success. Better articulation, language, and presentation abilities can help with career development.
• Greater independence: Speech therapy can lead to greater self-reliance, especially if you have severe communication challenges. For example, augmented and alternative communication (AAC) methods , such as speech-generating devices (SGDs), can allow you to express yourself more independently.

How Successful Is Speech Therapy?

Speech therapy's “success” depends on your goals. The meaning of success can vary based on your underlying communication or medical condition and its severity, as well as your motivation and commitment to therapy, the therapist's expertise, and your support systems. The time it takes to reach your goals also varies based on underlying factors like these.

For example, you may define success as improved pronunciation, or you may work towards more effective communication, more skilled accent modification, or swallowing without choking. If you stutter, your goal might be improved fluency or feeling more comfortable communicating openly with a stutter. For most people, what’s most important is to set realistic expectations and recognize that any improvement in communication is a success.

How To Find a Speech Therapist

A qualified speech therapist or speech-language pathologist holds a master's degree in speech-language pathology and state licensure to practice in your area. You can find speech therapists in settings like:

• Home health agencies
• Rehabilitation centers
• Private practice
• Telehealth (online)

You can also ask for recommendations from healthcare providers or school personnel who may know local speech therapists. The American Speech-Language-Hearing Association (ASHA) also offers an online directory of certified speech therapies to help you locate someone in your area.

Check with your health insurance provider to see if they cover speech therapy. They can provide you with information about your co-payments and deductibles. If your insurance doesn't cover the cost, the clinic or speech therapist may offer payment plans. Some children may also qualify for:

• Individualized education programs (IEPs) that cover speech therapy costs as a service from the school district
• Early intervention (EI) or Preschool on Preschool Special Education (CPSE) programs for infants and toddlers for little or no cost to families
• State and federal programs, like Medicaid
• Financial assistance programs from non-profit and advocate organizations

A Quick Review

Speech therapy is a specialized healthcare field in which trained professionals help improve speech, language, hearing, swallowing, and feeding for people of all ages. Speech therapists (STs) and speech-language pathologists (SLPs) thoroughly assess and develop specific treatment plans for a wide range of conditions including difficulty communicating or processing language, stuttering, and voice disorders.

Speech therapy takes place in locations like schools, hospitals, and private practice. It can be one-on-one or in a group setting. Success depends on underlying factors such as the severity of the condition. It also depends on personal goals and your definition of success—which can vary widely from person to person.

Many people who have speech therapy experience powerful benefits that affect them in nearly every aspect of life, including greater self-confidence and self-reliance.

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, language .

Houtrow A, Murphy N. Prescribing physical, occupational, and speech therapy services for children with disabilities . Pediatrics ; 143 (4): e20190285. doi:10.1542/peds.2019-0285

American Speech-Language-Hearing Association. Who are speech-language pathologists, and what do they do? .

National Institute on Deafness and Other Communication Disorders. Stuttering .

American Speech-Language-Hearing Association. Stuttering .

Law J, Dennis JA, Charlton JJ. Speech and language therapy interventions for children with primary speech and/or language disorders . The Cochrane Database of Systematic Reviews . 2017 (1). doi:10.1002/14651858.CD012490

Krekeler BN, Weycker JM, Connor NP. Effects of tongue exercise frequency on tongue muscle biology and swallowing physiology in a rat Model . Dysphagia . 2020; 35 (6):918. doi:10.1007/s00455-020-10105-2

National Institute of Deafness and Other Communication Disorders. Speech and language developmental milestones .

National Institute of Health Clinical Center. Speech and language pathology .

American Speech-Language-Hearing Association. Dysarthria in adult

Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke . The Cochrane Database of Systematic Reviews . 2016 (6). doi:10.1002/14651858.CD000425.pub4

American Speech-Language-Hearing Association. Scope of practice in speech-language pathology .

American Speech-Language-Hearing Association. Help finding a professional .

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Rcslt and speech and language therapy history.

In 2020, the RCSLT celebrated its 75th anniversary. Jois Stansfield, emeritus professor at Manchester Metropolitan University, traces the development of the RCSLT from its founding in 1945 to the present day and explores key figures and moments in the profession’s history.

Page content

• 75 years of speech and language therapy 
• The history of the IJLCD
• Inspiring figures
• SLTs around the world

The Bulletin legacy

• The women who built us

From patients to service users

75 years of speech and language therapy.

Speech and language therapy in the UK became organised under a single professional body in 1945 as the College of Speech Therapists, now the Royal College of Speech and Language Therapists, which is planning celebrations for its 75th anniversary in 2020.

Exploring the history of speech and language therapy gives us the opportunity to understand where we have come from and recognise how this influences our current and future professional lives.

I am currently conducting an oral history project, which has involved interviewing SLTs who qualified between 1945 and 1969. This has been eye-opening in terms of how the profession has changed in numbers (from just over 200 members in 1945 to the most recent figure of 17,422 members, indicated in the RCSLT’s 2018-19 Impact Report), but also in terms of the methods, challenges and opportunities reported by the participants.

Full analysis is at an early stage, but during the conversations, participants provided all sorts of pictures and artefacts that reflected their experiences of work across the years.

Professional identity

Speech and language therapy thrives on both real and stereotyped professional identity. In my interviews, ‘twinset and pearls’ were mentioned on numerous occasions, and one participant said that, while studying at college, student SLTs “had to wear blazers with the colours round it, and the proper scarf”.

There were many references to the professional and statutory bodies; logos and publications produced by these organisations were seen as defining the profession.

Other items included qualification ‘parchments’, Licentiateship of the College of Speech Therapist (LCST) badges (the original LCST badge had the member’s number on the back) and Communicating Quality (1991, 1996 and 2006). Academic life was represented by examination papers, journals, key text books and photographs of fellow students.

In the 1950s there were no British standardised speech and language therapy assessments, and necessity was the mother of invention. One participant mentioned, for example, Joan van Thal’s invention of “a piece of apparatus which was a sort of jam jar for detecting nasal escape”.

The first standardised test to be published was probably the Coral Richards language test in the late 1960s, followed by the Renfrew Scales and the Reynell tests for children (which are still in use) and the Edinburgh Articulation Test.

Assessment of grammar was enhanced by the Language Assessment, Remediation and Screening Procedure (LARSP) in 1978, although many participants struggled with this at first because, as one said of their course in the 1950s, “we did phonetics, but linguistics wasn’t part of our curriculum”.

Adult assessment continued to use American materials, including the Boston Diagnostic Aphasia Examination, with the ‘cookie theft’ picture being one element of the more detailed assessment.

People listed a range of therapy essentials. In the words of one participant, who qualified in the early 1950s, she had only “one of these little wicker baskets… and in it, a set of small hand mirrors and a package of straws”. Others mentioned “a bunch of keys to entertain kids” (or, more soberingly, “a bunch of keys to a locked hospital ward”), as well as ping pong balls for blowing exercises, popular games, reward stickers and specifically designed therapy tools.

There are still firm favourites that make a regular appearance in many clinics (Pop-up Pirate, anyone?), but technology has changed the way speech and language therapy is delivered, and people mentioned both old and new approaches.

Older members of the profession recalled recording devices that were too heavy to carry, and ‘eye pointing picture charts’.

In stammering work, the electronic metronome and Edinburgh Masker have given way to altered auditory feedback (AAF) phone apps, while tools such as electro-palatography now support articulation therapy, and augmentative and alternative communication has become increasingly sophisticated.

On the move

Many people noted the difficulty they had moving materials, therapists and patients around. Early qualified therapists spoke of a range of transport necessities:

• “We used to walk everywhere, because we didn’t have a lot of money… we would walk from Buccleugh Place [in Edinburgh] over to the Royal Infirmary, and not always in ‘sensible’ shoes.”
• “I couldn’t have afforded a car. When it was quite far away, like Kincardine, which was about the furthest point out from Dumfermline, I would go on my bike.”
• “Half past seven in the morning I would catch a bus into Canterbury to catch another bus out of Canterbury to go to Folkestone or… the Margate area.”
• “I travelled the length and breadth of Argyll, and I had to work out things like boat and ferry timetables.”

Many therapists worked across a wide range of clinics and spoke of their cars being their offices, complete with case notes and therapy materials.

One participant reported that a school “hadn’t got a room for me to treat anybody in, so I packed two boys into the car, took them to [the next village] for the morning and treated them there. I did check the car insurance first.”

Another recalled gaining a mobile clinic thanks to a Blue Peter television appeal.

In November’s Bulletin Jois Stansfield dipped into the IJLCD : a history of innovation, science and research in the profession.

With regard to innovation, I found a very early example in the form of a model speech clinic featured in the 1946 issue of the journal, from two final-year students who won a College of Speech Therapists competition (image 1).

The following year there were instructions on how to construct a test to assess the mental level of children with delayed speech (image 2), no small feat when the usual speech therapy kit comprised little more than a set of hand mirrors, tongue depressors and some straws.

By 1950, a paper described ‘a new aid to speech therapy’, which was a blowing bottle used to displace water (image 3).

In 1965 an article appeared debating the (short-lived) initial teaching alphabet (ITA) (image 4) as a medium for speech therapy, concluding, unsurprisingly that ‘it depends’ but may be of value.

Over the years SLTs showed themselves to be a resourceful lot. One paper, for example, reported getting permission directly from the Bank of England to take an increased dollar allowance to the USA, when there was a £50 cap on what could be taken out of the UK (1964). While there were fewer personal stories in later years, the various editorials continued to demonstrate this resourcefulness across the profession.

Scientific advances were traced in some papers. 1954 saw the journal’s first colour image, demonstrating the use of the electroencephalogram (EEG) with speech disorders (image 5).

Some other technology appears very strange looking indeed to the modern eye – an item in the 1959 journal resembles a makeshift bomb, but is in fact an early laryngeal vibrator for laryngectomy patients (image 6).

Between 1945 and 65 there were 11 papers on instrumental technology, with a further 35 between 1966 and 2010. In 1950 the first advertisement for speech recording appeared (image 7).

The ability to record is one area where major change has taken place, moving from machines which required almost a whole room to function, through to reel-to-reel recorders, cassette recorders, mini-discs, CDs and present-day miniature digital technology.

Research came to the fore in the journal very gradually, however successive editors have continued to raise the research standing of the journal. Early research papers from medics, psychologists, and audiologists have gradually been superseded by those from SLTs, both from the UK and abroad.

Across the years, developmental speech and language disorders, aphasia and dysfluency appeared most often. Increasing rigour in researching and in reviewing has led to both quantitative and qualitative reports which contribute considerably to the knowledge base of the profession.

Going forward, I hope to see a journal that is inclusive, supporting good quality research across the profession, whether it be basic science, technological developments or clinical practice, so that it continues to reflect the best our profession can achieve.

Jois reflects on some of the figures who inspired her passion for speech and language therapy history.

Denyse Rockey

Denyse Rockey, a life member of the RCSLT, published the only full-length book on the speech therapy of 19th-century Britain (Rockey, 1980). The book focuses on stuttering, at the time seen as closely related to natural speaking and oratory, while being an exemplar of other disabling speech difficulties.

Rockey considers the people who stuttered, the professional responses to the condition, and the many and various approaches attempting to cure or alleviate the condition.

Her comment that stuttering was “open to numerous interpretations and antidotes yet strangely elusive to all” (1980: 253) could still be said to be the case in the 21st century.

It is the first and, to date – despite being 40 years old – the only, comprehensive academic study of British speech therapy in the 19th century.

Margaret Eldridge

Margaret Eldridge, a founder member of both the UK and Australian professional bodies, gives an erudite overview of speech therapy history internationally, considering parallel developments in the UK, eastern and western Europe, Australia and the US (Eldridge, 1968).

She traces the profession moving from trial and error, to increasing professionalism in the 1930s, becoming part of wider established health systems during and after the Second World War. What is striking from Eldridge’s book is the similarity in direction across almost all the countries considered (despite the interruptions of war).

Unfortunately Rockey’s and Eldridge’s books are out of print, but both can be found on the second-hand market.

George Sykes

In 1962, George Sykes produced a dissertation on the history of British speech therapy over the first half of the 20th century (featured in Bulletin in May 1971 and again in August 2015 when he was finally reunited with a copy).

His work included interviews with the heads of every school of speech therapy then in existence and an index of the CST journals (logged, he said, on “an Olivetti Letera 32 typewriter, a double drawer of handwritten index cards, and a shoe box of Hollerith punched cards for the statistics”). The dissertation, part of the RCSLT archive, comes highly recommended as an in-depth view of the profession’s history by an outsider.

So why are these people inspirational? For me, their work opened the door to completely new perspectives on our profession. They demonstrated attention to detail, amazing tenacity in the days before easy access to data via the internet, and a passion that enables those of us interested in professional history today to locate obscure and often forgotten material that enriches our understanding of where we have come from.

Speech and language therapy in the UK owes a lot to our international predecessors.

Europe in particular produced people who formed the knowledge base upon which we built our practice. In the 19th century, these were predominantly men, reflecting the structure of society at the time.

Paul Broca (1824-1880) from France, and Carl Wernicke (1848-1905) from Germany both identified areas of the brain vital for language.

Manuel Garcia (1805-1906), a Spanish baritone and subsequently voice teacher and innovator, worked in France, inventing the laryngoscope in 1854 to observe the vocal cords directly.

Theodor Billroth carried out the first laryngectomy in 1873, with Carl Gussenbauer creating artificial larynxes for his patients.

Adolf Kussamaul published Die Storungen Die Sprache (Disorders of Speech) in 1877.

Hermann Gutzmann (1865-1922) had a speech and language therapy service in Berlin by the beginning of the 1900s and published a number of books on ‘dysphemia’, or stuttering.

The final name of note in this small selection is Emil Froeschells (1884 -1972) from Austro-Hungary. Following his medical qualification in 1907 he worked with children with speech problems and his Viennese clinic became world famous, offering informal education to interested people from around the world until, as a Jew, he and many others found it necessary to escape from Europe in the 1930s.

In the 20th century the USA became increasingly influential, leading the way on children’s speech disorders through the work of Edward Scripture (1864-1945) and Sara Stinchfield (1885-1977), and in stammering therapy through Charles van Riper (1905-95, who also wrote fiction as Cully Gage).

Judy Duchan hosts a website on US (and wider) speech and language therapy history for those interested.

The early British speech therapy registers indicate that a small number of therapists moved abroad, mainly (although not exclusively) to English-speaking countries, contributing to the development of the profession in Australia, New Zealand and Canada.

Meanwhile Bulletin and Journal indicated an interest in international developments over the years, with articles on Fiji, Ghana, India, Indonesia, Kenya, Nicaragua, Russia, Pakistan, Paraguay, St Lucia, Singapore, Sri Lanka, Tanzania and Uganda, as well as (other) English-speaking and European countries.

The profession formed national and international bodies to offer professional support.

The International Association of Logopedics and Phoniatics (IALP), whose current President is Professor Pam Enderby, was formed in 1924, with early membership from Austria, Germany, the UK and the Netherlands. Today it represents national associations almost from A to Z: Australia to the USA (although disappointingly not Zambia or Zimbabwe) by way of Brazil, Egypt, the Philippines and Taiwan.

More recently (1988), European colleagues formed the Comité Permanent de Liason des Orthophonists-Logopèdes de l’UE, more easily known by its acronym CPLOL (recently renamed ESLA – the European Speech and Language Therapy Association ). Both of these organisations run conferences bringing together a multitude of colleagues, languages and ideas.

Cultural competence is essential in any speech and language therapy service, and there is a growing body of literature from across the world on what works where.

International communication, whether face to face or virtually (more necessary in recent times), can benefit our services by opening our eyes to different approaches and beliefs.

Charting the history of the RCSLT’s professional magazine.

The College of Speech Therapists (CST) had a difficult gestation and birth, drawing together two competing organisations: the Society of Speech Therapists and the Association of Speech Therapists, which were both established in the 1930s.

The journal Speech , founded in 1935, had taken the role of both academic journal and news bulletin for the Society of Speech Therapists, and as the Association of Speech Therapists had no similar publication, the CST agreed to adopt Speech as the professional journal. Following several name changes, Speech became known as the International Journal of Language and Communication Disorders .

At the time, a need for a less formal publication was recognised, and this resulted in the CST News Bulletin , first published in March 1945.

Formality is a relative concept, and by today’s standards the first editions of the News Bulletin are very formal indeed. Meetings and votes of thanks are reported in earnest and tedious detail. No first names were seen, unless someone had recently married, with married women being known by their husbands’ names (eg Mrs John Smith).

The first edition of Bulletin was characterised by exhortations to members to be collegiate, and to contribute to the CST and Bulletin alike.

Due to the wartime restriction on paper, this first edition was published on four sides of foolscap paper, with dense text, no illustrations and, of course, no colour. Each of the 1945 editions were edited by a different person, but themes rapidly emerged.

Editorials requested contributions and bemoaned poor responses, reports of Area (formal, prestigious) and District meetings (still formal but apparently less important), seem to reflect the divisions of the CST’s predecessors, and there was a how-to-do-therapy article from a senior contributor in each issue.

The editor of the third edition was from Glasgow and this was reflected in the emphasis on Scotland, the ordering of the Area news (Scotland first) and two articles by Dr Anne McAllister, the founder of the Glasgow School of Speech Therapy, written to ensure her contribution to the profession was recognised.

The fourth edition listed membership of all the CST committees, appearing to include a good half of the registered therapists. It was also the first to publish letters to the editor, with one taking exception to the contents of an earlier therapy article, while another thanked members for their entry to a competition to design a model speech therapy clinic. A ‘personal’ column was also suggested and established from 1946 – something that has continued in the magazine in the decades following.

Over the decades Bulletin has had many facelifts, and today the range of material would be unrecognisable to the founders of the CST. Nevertheless, Bulletin then, as now, reflected members’ interests. Tracing the changes made to the magazine helps us to see how the profession has viewed itself during the past 75 years.

Download a timeline of speech and language therapy ‘firsts’ (PDF)

Covers through time

Shining a light on some of the strong women who helped to build the speech and language therapy profession as we know it today.

Many of the pioneers of the speech and language therapy profession, including all 18 of the RCSLT founder fellows, were women. International Women’s Day, recognised on 8 March, provides a great opportunity to celebrate our place as a strong, female-led profession, and the women who helped to make it that way.

Elsie Fogerty

Elsie Fogerty (1865-1945) established what is now the Royal Central School of Speech and Drama at the Albert Hall in London in 1906. She came from a privileged background, but had to find a way to earn a living when her father became ill and unable to support the family.

By 1912 she was teaching about elocution, voice production and ‘speech defects’, and began working as a speech therapist in St Thomas’s Hospital. She was involved with the school until her retirement in 1942.

Winifred Kingdon Ward

The Great War decimated the male population in the UK, and between the wars around a fifth of women of ‘marriageable age’ remained single throughout their lives. Many of these women turned their energy to forging careers for themselves, including many early speech therapists.

Winifred Kingdon Ward (1884-1979) was one such SLT. She studied singing and speech and worked with injured servicemen during the Great War, subsequently establishing not one, but two schools of speech therapy. The first, in 1929, was at the West End Hospital (now University College London).

She left in 1935, ostensibly to travel, but also following a disagreement with one of the senior staff, of whom she disapproved because of his ‘irregular’ (ie adulterous) relationship with a woman described as either his laboratory assistant or an SLT.

The London Hospitals School (now at City, University of London), her second establishment, was founded in 1942. Winifred demonstrated huge tenacity by achieving all of this in the middle of wartime London, and went on to author a number of important publications.

Anne McAllister

Anne McAllister (1892-1983) was a Scot whose work as a phonetician in Glasgow morphed into speech therapy.

‘Dr Anne’, as she became known, first started teaching about speech disorders in 1919, and established the Glasgow School of Speech Therapy (celebrating 85 years this year) in 1935.

As with so many other women in the field, Anne was renowned for being highly intelligent and knowledgeable, but she did not hold back when she was displeased.

Joan van Thal

Joan van Thal (1900-1970) was of Dutch and English heritage, and educated in England. She had wanted to become a doctor, but was not accepted to study medicine owing to her poor eyesight. Under the guidance of Elsie Fogerty after the Great War, Joan became an expert on cleft palate, publishing a book on the topic in 1934.

Her greater claim to fame, however, is that during World War II she appears to have been the catalyst in bringing together the two competing speech therapy associations formed in the 1930s, resulting in the establishment of the College of Speech Therapists (now the RCSLT).

There are so many other impressive women who built this amazing profession – the stars in my own ‘speech therapy sky’ include Betty Byers Brown, Caroline Dunsmore (my wheelchair-using, polio-surviving boss in Canada), Brenda Kellett and Pam Enderby.

When the College of Speech Therapists was established in 1945, service users were known as ‘patients’. For many that was an accurate description, as they needed to wait patiently for the limited speech therapy service that was available, and many areas of the country had no service at all.

The register of 1945-6 listed 46 SLTs practising in London, 12 in Lancashire (which included all of Manchester, Liverpool and the rest of the county) and one in Norfolk.

Scotland was relatively well served with 39 therapists, but Wales listed only one, and Northern Ireland none. This was pre-NHS of course, but even when free speech therapy became available in principle, the service grew very slowly during the 1950s and 60s.

The Quirk Report of 1972 made sweeping changes to the level of service provision, recommending six therapists per 100,000 in the population – a quadrupling of full-time equivalent SLTs at the time.

Later, Enderby and Phillip increased this recommendation further to 23 therapists for the same population, and today there are almost 19,000 therapists for a population of nearly 68 million. You can work out the ratio!

Over the years, our ability to recognise the needs of service users has also changed. Many older SLTs speak of being trained mainly to work with ‘articulation’ difficulties, and it was not until the late 1960s that linguistics raised its head in the speech therapy world, with pragmatics coming later still.

On my own course, we had only one hour a week of linguistics for three terms. My ‘finals’ case book from 1972 described 13 ‘patients’ in detail (present-day students take note, 13!).

There is little evidence anywhere in the case book that this linguistic theory was put into practice, although language tests were reported (the Watts vocabulary test, the recently published Reynell scales and, for adults, the Minnesota Test), as was working with people to increase language, and articulation, voice and fluency skills.

What that case book also shows is how the age range of patients (they were still patients in 1972) has changed. Most of the children were at school and the oldest adult was only 63. Today I would expect ‘birth to 100-plus’ to be a more accurate reflection of our service users’ ages.

I smiled when I realised that I had included a thank you note from the parents of one child, whose family included 11 children, five of whom had some ‘speech’ difficulty. I am astonished and impressed in retrospect that this child was brought to clinic every week without fail and the parents followed advice on what to practise as homework.

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Types of Speech Therapy

Different speech therapy approaches and techniques are used for various issues

• List of Types
• For Late Talkers
• For Apraxia
• For Stuttering
• For Aphasia
• For Swallowing

Frequently Asked Questions

Speech therapy is not one thing. There are different types of speech therapy, each of which involves approaches and techniques that are specific to the issue that needs addressing. That could be related to speech itself—e.g., therapy for people who stutter—or it could relate to problems with memory swallowing, and more.

A speech-language pathologist (SLP), often just called a speech therapist, will perform assessments to determine which type(s) of speech therapy is right for you.

This article reviews the different types of speech therapy and the various disorders each one can be used to treat.

Types of Speech Therapy Used by Speech Therapists

A speech-language pathologist can use different types of speech therapy to help people with problems related to:

• Fluency (e.g., stuttering, and cluttering)
• Speech (e.g., articulation)
• Language (e.g., ability; comprehension of spoken and written language)
• Cognition (e.g., attention, memory, ability to solve problems)
• Voice (e.g., characteristics of vocal tone)
• Swallowing (e.g., stroke, congenital disorders)

In addition to different speech therapy techniques, SLPs may also provide auditory habilitation & auditory rehabilitation for people with hearing problems or disorders.

Some SLPs specialize in other services including professional voice development, accent or dialect modification, transgender voice therapy , business communication modification, and voice hygiene.

Speech Therapy for Late Talkers

A common speech therapy method is used to help children who have reached the expected age for speech development but have not started talking .

If your infant or toddler should be talking by now but isn't, they may be referred to a speech therapist. The therapist will likely try different things to encourage your child to talk, including playing with him. Sometimes, withholding a favorite toy until a child asks for it motivates small children to talk, but this depends on the circumstance.

For some children, other types of communication, such as sign language or picture cards, might be introduced. Speech therapists may also refer your child for further evaluation, such as hearing tests if necessary.

Speech Therapy for Kids With Apraxia

Certain speech therapy techniques are helpful for kids with apraxia.

Children with apraxia of speech have difficulty saying certain syllables or making certain sounds. Your child knows what they want to say, but it doesn't seem to come out right. Speech therapists are qualified to evaluate children for apraxia by using several tests, including:

• Oral-motor assessment to check for muscle weakness in the jaw, lips, or tongue
• Melody of speech assessment during which the therapist listens to see if they can appropriately stress certain syllables and use pitch and pauses at the appropriate place in a sentence
• Speech sound assessment further determines how well the child can pronounce sounds, including vowels, consonants, and sound combinations. This includes determining how well others are able to understand the child's conversational speech

If your child is diagnosed with apraxia , they will probably need speech therapy on a one-on-one basis several times per week. This therapy will likely consist of intensively practicing their speech. The therapist will try to help your child understand auditory feedback as well as visual or tactile cues.

One way a therapist might do this is to have your child look at themselves in a mirror while speaking, or record them speaking and then playing it back. Many children enjoy this.

Since successful treatment for apraxia involves a lot of time and commitment, your therapist may give you assignments to practice with your child at home.

Speech Therapy for Stuttering

Speech therapy techniques can be applied to help treat stuttering.

Stuttering is a problem that typically develops during childhood but can develop during adulthood as well. Stuttering is usually considered a type of behavioral problem. Speech therapists will try to teach your child who stutters behavioral modification techniques that in turn may help control their stuttering.

A common method that may be used on your child is to teach them to control the rate of speech since speaking too quickly can make stuttering worse for some people. Practicing speech in a slower, more fluent manner can be helpful. It can also be helpful to monitor breathing.

Even after treatment, people who stutter may require follow-up sessions with their speech therapist to keep the problem from recurring.

Speech Therapy for Aphasia

Some speech therapy methods help people with aphasia . Speech therapy assessments can also help determine if someone has the condition.

Aphasia is a condition that causes difficulty speaking as a result of some sort of damage to the brain. The condition can also consist of difficulty listening, reading, and writing. Aphasia happens to many adults after they have experienced a stroke .

Speech therapists play a crucial role in diagnosing aphasia by evaluating an individual's ability to understand others, express themselves, and even swallow. There are many different things a speech therapist might do to help a person with aphasia, including:

• Drills to improve specific language skills
• Group therapy to improve conversational skills
• Gestures and writing to augment their communication skills

Speech Therapy for Swallowing Difficulty

Speech therapy techniques can also be used to help people who are not able to swallow when they eat or drink.

Your child may experience difficulty swallowing for a variety of reasons. A speech therapist may help your child with swallowing difficulty by assisting them with exercises to make her mouth strong, increase tongue movement, and improve chewing.

A speech therapist may also make recommendations about the consistency of food. For infants, a speech therapist may assist in coordinating her suck-swallow-breath pattern. As previously mentioned these are only some of the things that a speech therapist might do. There are many other conditions and methods used to evaluate those in need.

There are different types of speech therapy that can be used to treat various disorders affecting speech, hearing, and swallowing. Children and adults with speech delays, apraxia, swallowing problems, and certain medical conditions may benefit from working with a speech therapist.

A speech therapist evaluates, diagnoses, and treats speech issues and communication problems, as well as swallowing disorders. They provide various services, from teaching articulation and clear speaking to helping strengthen muscles used to talk and swallow.

The four types of articulation disorders are substitution, omission, distortion, and addition. Speech-language pathologists use the acronym SODA to remember them.

Childhood Apraxia of Speech: Treatment . Asha.org.

Chang S, Synnestvedt A, Ostuni J, Ludlow C. Similarities in speech and white matter characteristics in idiopathic developmental stuttering and adult-onset stuttering .  J Neurolinguistics . 2010;23(5):455-469. doi:10.1016/j.jneuroling.2008.11.004

Stuttering . Asha.org.

American Psychological Association. APA Dictionary of Psychology - Definition of Articulation Disorder .

Scope of Practice in Speech-Language Pathology . American Speech-Language-Hearing Association website.

Childhood Apraxia of Speech . American Speech-Language-Hearing Association website.

Feeding and Swallowing Disorders (Dysphagia) in Children . American Speech-Language-Hearing Association website.

By Kristin Hayes, RN Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.

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Role of the Speech & Language Therapist

The information below about the role of a speech and language therapist (SLT) has been adapted from information provided by the Royal College of Speech and Language Therapists (RCSLT) ,  Association of Speech and Language Therapists in Independent Practice (ASLTIP)  and NHS Careers .

What does a speech and language therapist (SLT) do?

The  Royal College of Speech and Language Therapists (RCSLT) describe speech and language therapy as helping manage disorders of speech, language, communication and swallowing in children and adults.

Speech and language therapists assess and treat a person with specific speech, language and communication problems to enable them to communicate to the best of their ability. They work directly with people of all ages. As allied health professionals they also work closely with parents, carers and other professionals, including teachers, nurses and occupational therapists.

There are around 13,000 practising SLTs in the UK and around 2.5 million people in the UK have a speech or language difficulty:

• 5% of children enter school with difficulties in speech and language
• 30% of people who have had a stroke have a persisting speech and language disorder

In the  US  the term used is  speech and language pathologist  (SLP).

Examples of when an SLT can help

• early play and communication skills
• feeding and swallowing difficulties
• mild, moderate or severe learning difficulties
• physical disabilities
• language delay
• specific language impairment
• specific difficulties in producing sounds
• hearing impairment
• cleft palate
• autism/social interaction difficulties
• voice disorders
• selective mutism
• swallowing difficulties
• communication and swallowing problems following acquired neurological impairments and degenerative conditions, including stroke, head injury, Parkinson’s disease and dementia
• head and neck cancer
• voice problems
• mental health issues
• learning difficulties

Where do speech and language therapists work?

• community health centres
• hospital wards
• outpatient departments
• children’s centres
• day centres
• clients’ homes
• young offenders’ institutions
• independent/private practice

Speech and language therapy also has support roles such as assistant practitioner, assistant speech and language therapist, support worker and bilingual co-worker.

How can I find a speech and language therapist?

You can refer yourself to your local NHS speech and language therapy service. Or ask your GP, district nurse, health visitor, nursery staff or teacher to make a referral. Contact your local primary care trust (PCT) or GP surgery for the phone number of your local NHS speech and language therapy service. For more information visit: RCSLT online directory .

NHS therapists are members of The Royal College of Speech and Language Therapists (Cert. MRCSLT) and must be registered with the Health and Care Professions Council (HCPC) .

You can find a private SLT at the Association of Speech and Language Therapists in Independent Practice (ASLTIP) .

ASLTIP members are certified members of The Royal College of Speech and Language Therapists (Cert. MRCSLT) and must be registered with the Health and Care Professions Council (HCPC) .

Royal College of Speech and Language Therapists 2 White Hart Yard London SE1 1NX Tel: 020 7378 1200 Email: [email protected] Website: www.rcslt.org.uk

Health and Care Professions Council (HCPC) 184-186 Kennington Park Road London SE11 4BU Tel: +44 (0)20 7582 5460 Website: https://www.hcpc-uk.org

• Careers Leaflet available to download from NHS Careers

Although we believe this information to be accurate, we strongly advise you to make your own independent enquiries.

• Factsheet – Causes of Dysarthria
• Factsheet – Dysarthria and Dysphasia
• Factsheet – Funding for communication aids
• Factsheet – Role of the Occupational Therapist
• Factsheet – Role of the Speech & Language Therapist
• Factsheet – The right communication aid?
• Factsheet – What is a communication aid?
• Factsheet – What is a stroke?
• Factsheet – What is Aphasia?

Understand how audiologists, speech-language pathologists help kids reach milestones

ROANOKE, Va. (WDBJ) - Communication is a key milestone in a child’s development and the professionals who support that growth provide families the tools for success.

This month is National Speech-Language-Hearing month and Kidable Therapy is using this time to celebrate the work of audiologists and speech-language pathologists.

Rachel Greene is a speech-language pathologist with Kidable Therapy. She joined Here @ Home to explain the signs families can look for to see if their child needs extra support in their growth.

While Kidable Therapy focuses on children, speech-language pathologists support people of all ages and treat things like speech sounds, stuttering, swallowing and reading and writing.

Beyond Kidable Therapy there are other resources for parents to help them determine if they should see a speech-language pathologist. One of those organizations is Bright by Text and the other is American Speech Language Hearing Association.

Copyright 2024 WDBJ. All rights reserved.

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Who: We serve clients 0 - 21 years of age What: Language, articulation, Autism Spectrum Disorder, and more! Where: In the comfort of your own home within the city of Irvine, or via telehealth. …

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I feel so lucky that Talk of the Town was recommended to me. Ms. Talia works so well with my four-year-old son. He has made such wonderful improvements in his language skills. I'm so pleased with his progress and the individual care Talia has provided. She is professional, timely, and a great communicator. Everything you want and need in a speech therapist.

Great experience, easy to reach and super professional. Have been looking for someone close by and this is the place. Definitely Recommend!

I am so thrilled with Talk of the Town Speech Therapy. Ms. Talia really knows what she is doing. My daughter has made so much progress. I highly recommend this practice

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