DEFINING
SPEECH-LANGUAGE PATHOLOGY ASSISTANTS

Speech-language pathology assistants are one category of support personnel in speech-language pathology.  Support personnel are people who, following academic and/or on-the-job training, perform tasks as prescribed, directed, and supervised by certified speech-language pathologists.  There are different levels of support personnel based on training and scope of responsibilities.  Aides, for example, have a different, usually narrower, training base and a more limited scope of responsibility relative to speech-language pathology assistants.  States may use different terminology to refer to support personnel in speech-language pathology (e.g., communication aides, paraprofessionals, service extenders).

Speech-language pathology assistants have been used and regulated by many states since the 1970s.  ASHA has had guidelines for the use of support personnel since 1969.  The most recent version of the guidelines was approved by ASHA's Legislative Council in 1995.   Currently, attention to the use of assistants has increased as professionals seek mechanisms for expanding services.

No.  Assistants cannot replace qualified speech-language pathologists.   Rather, they can support clinical services provided by speech-language pathologists.  ASHA guidelines were developed to ensure that speech-language pathology services provided to the public are of the highest quality and that speech-language pathologists continue to be responsible for maintaining this quality of service.  According to ASHA guidelines and state licensure laws, no one can employ a speech-language pathology assistant without a speech-language pathologists as supervisor.  ASHA guidelines and most state laws limit the number of speech-language pathology assistants a speech-language pathologist may supervise and define boundaries for how assistants are used.

To serve a growing and more diverse client base and an expanding scope of practice, more service providers will be needed.  In an era of heightened demand for cost efficiency, some tasks may be more appropriate for support personnel than for professional level providers.  The use of assistants may allow more focus by speech-language pathologists on professional-level clinical services, i.e., those that require ongoing clinical judgment rather than routine day-to-day operational activities.

ASHA does not have data specific to the demand for speech-language pathology assistants; however, 72% of the responding speech-language pathologists reported a moderate or high degree of need for support personnel (ASHA Omnibus Survey, 1992).  Those in hospital settings reported the greatest need for support personnel; those in residential health care facilities reported the least need.  According to the 1993 ASHA Omnibus Survey, 66% of the speech-language pathologists who responded indicated that they would support ASHA in developing programs to credential speech-language pathology assistants.  The demand for speech-language pathology assistants is likely to grow as the population base for speech-language pathology services continues to increase.

The speech-language pathologist may extend services (i.e., increase the frequency and intensity of services to patients or clients on his/her caseload); focus more on professional level tasks; increase client access to the program; and have more efficient/effective use of time and resources.