Speech-language therapy
Speech therapy is much bigger than saying sounds. Speech-language pathologists support communication, language, literacy, AAC, voice, fluency, cognition, feeding, and swallowing across the lifespan.
The short version
An SLP may be legally qualified to work in many areas and still specialize in only a few. Ask whether the clinician regularly treats your child’s specific need and what those sessions actually look like.
What an SLP may help with
- Understanding and using spoken language
- Speech sounds, phonology, and motor-speech disorders such as childhood apraxia of speech
- Stuttering and other fluency differences
- Voice and resonance
- Social communication and self-advocacy
- Reading, spelling, and written language
- AAC, from gestures and picture boards to robust speech-generating devices
- Cognitive communication, including organization, memory, and executive-function supports
- Feeding and swallowing, when the SLP has appropriate training and competence
No one SLP is automatically an expert in all of these areas.
What it may look like
For a young child, therapy may look like play, movement, books, songs, sensory-rich routines, and caregiver coaching. An AAC session may happen throughout real activities while the therapist models language on the device. Motor-speech treatment may include carefully selected words and repeated movement practice. Feeding or swallowing therapy may involve eating and drinking while the clinician observes safety and skill.
For an older child, teen, or adult, therapy may focus on conversation, self-advocacy, literacy, voice, fluency, executive-function strategies, workplace or school communication, or access to a communication system.
The activity should connect to the goal. A fun-looking session is not automatically child-led, and a structured session is not automatically harmful. Ask why the approach fits this person.
Good-fit signs
- The SLP honors every reliable form of communication.
- Goals are not built around masking, forced eye contact, or making harmless differences disappear.
- AAC is offered when useful without requiring a child to “earn” it or fail at speech first.
- The clinician can explain the difference between a speech sound, phonological, language, motor-speech, and oral-motor problem.
- Practice is purposeful without overwhelming the child.
- The therapist notices strengths, follows interests, and adjusts support while still working toward clear goals.
Education and basic credentials
Most U.S. SLPs enter practice with a master’s degree, supervised graduate clinical experience, a national examination, a mentored Clinical Fellowship, and a state license. CCC-SLP is ASHA’s national Certificate of Clinical Competence. Tennessee also licenses speech-language pathologists.
A clinical fellow has completed graduate school and is working through the mentored post-graduate experience required for the CCC-SLP. An SLPA is an assistant who may carry out parts of an SLP’s plan under supervision; the assistant does not independently diagnose, select an AAC system, write the plan of care, or determine feeding and swallowing strategies.
The credential matters, but so does the person’s actual caseload, mentoring, continuing education, and ability to recognize when a referral is needed.
Advanced national specialty credentials
- BCS-CL: Board Certified Specialist in Child Language and Language Disorders.
- BCS-S: Board Certified Specialist in Swallowing and Swallowing Disorders.
- BCS-F: Board Certified Specialist in Fluency and Fluency Disorders.
These require expertise beyond the CCC-SLP. They are meaningful advanced credentials, but they are not required for an SLP to practice in those areas.
Relationship-based and early-language approaches
- DIRFloortime: ICDL offers progressive Basic, Proficient, Advanced, and Expert certificates. DIR 101 is introductory education and does not make someone a DIRFloortime provider. Ask for the exact level completed.
- Hanen: Program-specific certification for parent coaching, including It Takes Two to Talk, More Than Words, and TalkAbility. Ask which program the SLP is certified to provide and whether the certification is current.
Autism, GLP, and AAC
- Meaningful Speech / GLP-NLA course: A course with assessment and a certificate of completion; clinicians may appear in its NLA Trained Clinician Registry. Describe this as course-trained, not as a state license or board specialty. Ask how the clinician combines the framework with individualized assessment and current evidence.
- LAMP: Language Acquisition through Motor Planning is an AAC approach using consistent motor patterns on a speech-generating device. Attending a LAMP workshop is different from becoming a LAMP Certified Professional, which requires advanced training, mentoring, and demonstration of competence through cases.
- AAC experience: There is no single credential that makes every clinician an expert in all AAC systems, access methods, and funding routes. Ask which systems the SLP evaluates, whether several robust options will be trialed, and how the child will communicate during the evaluation process.
Motor speech and childhood apraxia
- PROMPT: Introduction, practicum, Bridging, and full PROMPT Certification are different levels. Full certification generally takes years and includes observed case work. Ask for the clinician’s exact level.
- Kaufman Speech to Language Protocol (K-SLP): A treatment method used for childhood apraxia and other motor-speech needs. Ask what training the clinician completed and how K-SLP is selected for an individual child.
- DTTC: Dynamic Temporal and Tactile Cueing is a motor-based treatment with research support for severe childhood apraxia. Clinicians may complete formal DTTC education without holding a branded “DTTC certification.” Ask about training, supervised practice, and current CAS caseload.
Literacy
- Structured Literacy credentials: CERI offers professional credentials such as Structured Literacy/Dyslexia Interventionist and Structured Literacy/Dyslexia Specialist. Program-specific Orton-Gillingham training may also be useful. Ask whether training included a supervised practicum and whether the clinician teaches decoding, spelling, morphology, and connected text—not only phonological-awareness games.
Feeding and swallowing
- SOS Approach to Feeding: A clinician may be SOS Trained after the foundational course or SOS Certified only after the program’s additional mentorship, advanced education, clinical review, and examination. Ask which level was completed.
- BCS-S: An advanced board specialty in swallowing and swallowing disorders.
- Other feeding courses can be valuable, but the practical questions are whether the SLP can assess oral-motor skill and swallowing safety, recognize medical or nutritional concerns, and collaborate with OT, dietetics, medicine, dentistry, and other specialists.
License: The state’s legal permission to practice a profession. Verify that it is current.
National professional credential: A credential such as CCC-SLP, OTR, or BCBA showing that national education, examination, and other requirements were met. State licensure may still be required.
Advanced specialty credential: Usually requires experience, additional study, and an assessment of specialty knowledge or skill. Examples include BCP, PCS, BCS-CL, BCS-S, RPT, and ATP.
Method-specific certification: Shows that the clinician completed one organization’s competency process for one approach, such as LAMP Certified, PROMPT Certified, Certified PCIT Therapist, or Certified CO-OP Therapist.
Course or certificate of completion: Shows that someone completed training. It can be valuable, but it is not the same as a license, board specialty, or demonstrated certification. Ask what level they completed, whether their skills were observed, and how often they use the approach.
Assistant or technician credential: SLPAs, COTAs/OTAs, PTAs, BCaBAs, RBTs, interns, and temporary licensees may provide excellent care, but their supervision and decision-making responsibilities differ. The family should know who evaluates, writes the plan, changes goals, and supervises treatment.
The useful question is not “How many certificates do you have?” It is “How does your training help you understand and support my child?”
SLPs diagnose communication and feeding/swallowing disorders within their competence. That may include language disorders, speech-sound disorders, childhood apraxia of speech, stuttering, voice disorders, and written-language disorders.
Dyslexia: Reading and written language are within SLP scope, and ASHA identifies dyslexia as a word-reading disorder. An appropriately trained SLP can assess the language and literacy skills involved and may diagnose a written-language disorder. Whether a specific dyslexia label is accepted for school eligibility, insurance, or another purpose can depend on the setting, local rules, and the full evaluation team.
Autism: SLPs play an important role in autism screening and diagnosis, often as part of an interdisciplinary team. Whether an SLP independently makes an autism diagnosis depends on state law, the clinician’s competence, the setting, and payer requirements. Do not assume every SLP provides autism evaluations simply because autism is within the profession’s broader scope.
An SLP license alone does not authorize medical diagnosis, prescribing medication, psychological testing, or practice outside communication and swallowing unless the clinician holds another qualifying license.
Questions to ask an SLP
- What part of your caseload looks most like my child?
- What do you think is driving this difficulty, and what else should be ruled out?
- How will you support communication right now—not only work toward future speech?
- If my child uses AAC, how will you model it throughout the session and across settings?
- What will you do if my child communicates no, avoids a task, or needs a break?
- How will goals improve participation or quality of life outside the clinic?
- Which specialty methods are you trained in, at what level, and why are you recommending this one?
- When would you involve an audiologist, OT, PT, dietitian, psychologist, physician, dentist, or school team?
Scope and licensing rules can change. These guides were researched for Tennessee in September 2026; always verify a provider’s current license and ask whether they regularly treat your child’s specific need.
- ASHA Scope of Practice in Speech-Language Pathology: https://www.asha.org/policy/SP2016-00343/
- ASHA 2020 CCC-SLP standards: https://www.asha.org/certification/2020-slp-certification-standards/
- Tennessee Board of Communication Disorders and Sciences: https://www.tn.gov/health/licensure/cds.html
- ASHA Scope of Practice for SLP Assistants: https://www.asha.org/policy/slpa-scope-of-practice/
- ASHA Written Language Disorders: https://www.asha.org/practice-portal/clinical-topics/written-language-disorders/
- ASHA Autism Practice Portal: https://www.asha.org/practice-portal/clinical-topics/autism/
- ASHA Clinical Specialty Certification: https://www.asha.org/Certification/Clinical-Specialty-Certification/
- ASHA Pediatric Feeding and Swallowing: https://www.asha.org/practice-portal/clinical-topics/pediatric-feeding-and-swallowing/
- ICDL DIRFloortime training levels: https://www.icdl.com/courses/education
- PROMPT training process: https://www.prompt.org/the-prompt-training-process
- Hanen It Takes Two to Talk certification: https://hanen.org/workshops/it-takes-two-to-talk
- Meaningful Speech course bundle: https://www.meaningfulspeech.com/bundle
- LAMP approach: https://www.aacandautism.com/lamp/
- LAMP certification: https://aacandautism.com/lamp-certification/lamp-certification-for-individuals
- Kaufman Speech to Language Protocol: https://www.kidspeech.com/kslp/
- DTTC: https://childapraxiatreatment.org/dttc/
- CERI Structured Literacy credentials: https://effectivereading.org/about-ceri/
- SOS training versus certification: https://sosapproachtofeeding.com/sos-conference/
- OT Potential SLP specialty overview supplied by the site owner; use as a lead, not the authority for scope or licensure claims: https://otpotential.com/blog/slp-certifications-and-specialties