Frequently Asked Questions: Speech-Language Pathology Assistants (SLPAs)

The American Speech-Language-Hearing Association (ASHA) has a Speech-Language Pathology Assistant Scope of Practice document, and a Practice Portal page regarding the Professional Issues Related to Speech-Language Pathology Assistants (SLPAs). SLPAs are to be used only to supplement—not supplant—the services provided by ASHA-certified speech-language pathologists. SLPAs are not trained for independent practice.

Defining Speech-Language Pathology Assistants

Using Speech-Language Pathology Assistants

Supervising Speech-Language Pathology Assistants

Credentialing Speech-Language Pathology Assistants

Training Speech-Language Pathology Assistants

Reimbursing Speech-Language Pathology Assistant Services

Fieldwork for Speech-Language Pathology Assistant Student Trainees

Defining Speech-Language Pathology Assistants

Who are speech-language pathology assistants?

Speech-language pathology assistants are support personnel who, following academic coursework, fieldwork, and on-the-job training, perform tasks prescribed, directed, and supervised by ASHA-certified speech-language pathologists.

Are there other forms of support personnel?

There are typically two levels of support personnel—aides and assistant, but the definitions of aides and assistants vary from state to state. ASHA distinguishes between these two levels based on level of training and responsibilities. Aides, for example, have a different, usually narrower, training base and more limited responsibilities than 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).

Will speech-language pathology assistants be used to replace speech-language pathologists?

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’s scope of practice for speech-language pathology assistants and state licensure laws, no one can employ a speech-language pathology assistant without a speech-language pathologist as supervisor. ASHA and most states limit the number of speech-language pathology assistants that a speech-language pathologist may supervise and define boundaries for how assistants are used.

Is there a need for speech-language pathology assistants?

Yes, more service providers are needed to serve a growing and more diverse client base and an expanding scope of practice. 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 ASHA-certified speech-language pathologists to focus more on professional-level clinical services (i.e., those that require ongoing clinical judgment) rather than on routine, day-to-day operational activities. Access the U.S. Bureau of Labor Statistics national job outlook for the professions of speech-language pathology and audiology. Access information on state occupational projections.

What is the demand for speech-language pathology assistants?

According to the ASHA 2009 Membership Survey, 42% of school-based speech-language pathologists and 32% of health care–based speech-language pathologists reported that their facility employed one or more speech-language pathology support personnel.

For speech-language pathologists currently using one or more support person, the mean number reported was one for both school-based SLPs and health care–based speech-language pathologists (ASHA 2015 Work Life Survey Report).

These SLPs indicated that support personnel assist in the following five ways:

  • Providing therapy services (77%)
  • Preparing for a session (61%)
  • Sharing information with patients, their families, or staff (40%)
  • Performing administrative tasks (38%)
  • Engaging in prevention activities (38%).

For school-based SLPs who currently use at least one SLP assistant, the mean number of assistants that they supervise remained at one in 2018 (ASHA 2018 Schools Survey Report).

What are the advantages to the speech-language pathologist in using speech-language pathology assistants in their practice?

In hiring an assistant, the ASHA-certified speech-language pathologist can then extend services (i.e., increase the frequency and intensity of services to patients or clients on their caseload), focus more on professional-level tasks, increase client access to the program, and achieve more efficient and effective use of their time and resources. According to the ASHA 2018 Schools Survey Report, almost one third (30%) of respondents who reported that they supervised speech-language pathology assistants indicated that this practice decreased their workload, whereas 36% of respondents indicated that this practice decreased their caseload.

According to the ASHA 2018 Schools Survey Report, 54% of respondents said that there were more job openings than job seekers in their type of employment facility in their geographic area.

According to the 2009 ASHA Membership Survey Report, two of the primary effects reported from the use of support personnel were having more time to work with patients or clients who have more complex needs (36% of speech-language pathologists) and having fewer clerical duties (33% of speech-language pathologists). Approximately one quarter of the speech-language pathologists who reported that they currently employ one or more support person at their facility indicated that other effects were to increase frequency or intensity of service and respond to personnel shortages.

Using Speech-Language Pathology Assistants

What can speech-language pathology assistants do?

Assistants Code of Conduct

ASHA has established an Assistants Code of Conduct to guide certified assistants in their clinical practice. Preservation of the highest standards of integrity and ethical conduct is vital to the responsible practice of audiology assistants and speech-language pathology assistants (SLPAs). The intent of the Assistants Code of Conduct is to ensure the welfare of the consumer and to protect the reputation and integrity of the professions.  

Applicants for the ASHA-Certified Speech-Language Pathology Assistant (C-SLPA) credential and those who hold the C-SLPA are automatically subject to the jurisdiction of the ASHA Board of Ethics for complaint adjudication related to the Assistants Code of Conduct.

Provided that the training, supervision, and planning are appropriate, the SLPA should engage in the following activities when performing necessary tasks related to provision of speech-language services, as stated in the Speech-Language Pathology Assistant Scope of Practice (2022):

Service Delivery

  • self-identifying (e.g., verbally, in writing, signage, titles on name badges, etc.) as an SLPA to students, patients, clients, families, staff, and others;
  • exhibiting compliance with federal, state, and local regulations including: The Health Insurance Portability and Accountability Act (HIPAA), the Family Educational Rights and Privacy Act (FERPA); reimbursement requirements; and state statutes and rules regarding SLPA education, training, and scope of practice;
  • administering and scoring screenings for clinical interpretation by the SLP;
  • assisting the SLP during assessment of students, patients, and clients (e.g., setting up the testing environment, gathering and prepping materials, taking notes as advised by the SLP, etc.);
  • administering and scoring assessment tools that (a) the SLPA meets the examiner requirements specified in the examiner’s manual and (b) the supervising SLP uses to verify the SLPA’s competence in administration, exclusive of clinical interpretation;
  • administering and scoring progress monitoring tools exclusive of clinical interpretation if (a) the SLPA meets the examiner requirements specified in the examiner’s manual and (b) the supervisor has verified the SLPA’s competence in administration;
  • implementing documented care plans or protocols (e.g., individualized education plan [IEP], individualized family service plan [IFSP], treatment plan) developed and directed by the supervising SLP;
  • providing direct therapy services addressing treatment goals developed by the supervising SLP to meet the needs of the student, patient, client, and family;
  • adjusting and documenting the amount and type of support or scaffolding provided to the student, patient, or client in treatment to facilitate progress;
  • developing and implementing activities and materials for teaching and practice of skills to address the goals of the student, patient, client, and family per the plan of care developed by the supervising SLP;
  • providing treatment through a variety of service delivery models (e.g., individual, group, classroom-based, home-based, co-treatment with other disciplines) as directed by the supervising SLP;
  • providing services via telepractice to students, patients, and clients who are selected by the supervising SLP;
  • documenting student, patient, or client performance (e.g., collecting data and calculating percentages for the SLP to use; preparing charts, records, and graphs) and report this information to the supervising SLP in a timely manner;
  • providing caregiver coaching (e.g., model and teach communication strategies, provide feedback regarding caregiver-child interactions) for facilitation and carryover of skills;
  • sharing objective information (e.g., accuracy in speech and language skills addressed, participation in treatment, response to treatment) regarding student, patient, and client performance to students, patients, clients, caregivers, families and other service providers without interpretation or recommendations as directed by the SLP;
  • programming augmentative and alternative communication (AAC) devices;
  • providing training and technical assistance to students, patients, clients, and families in the use of AAC devices;
  • developing low-tech AAC materials for students, patients, and clients;
  • demonstrating strategies included in the feeding and swallowing plan developed by the SLP and share information with students, patients, clients, families, staff, and caregivers;
  • assisting students, patients, and clients with feeding and swallowing skills developed and directed by the SLP when consuming food textures and liquid consistencies.

Administrative Support

  • Depending on the setting, adequate training, and guidance from the supervising SLP, the SLPA may:
    • assist with clerical duties and site operations (e.g., scheduling, recordkeeping, maintaining inventory of supplies and equipment);
    • perform safety checks and maintenance of equipment;
    • prepare materials for screening, assessment, and treatment services.

Prevention and Advocacy

  • Depending on the setting, adequate training, and guidance from the supervising SLP, the SLPA may:
    • present primary prevention information to individuals and groups known to be at risk for communication disorders and other appropriate groups; promote early identification and early intervention activities;
    • promote early identification and early intervention activities;
    • advocate for individuals and families through community awareness, health literacy, education, and training programs to promote and facilitate access to full participation in communication—including the elimination of societal, cultural, and linguistic barriers;
    • provide information to emergency response agencies for individuals who have communication and/or swallowing disorders;
    • advocate at the local, state, and national levels for improved public policies affecting access to services and research funding;
    • support the supervising speech-language pathologist in research projects, in-service training, public relations programs, and marketing programs;
    • participate actively in professional organizations.

State laws vary and may differ from ASHA’s guidelines and requirements. Check specific state regulations to determine which tasks are outside the scope of practice for assistants in a particular state.

Is it acceptable for SLPAs to assist with service delivery via telepractice?

ASHA’s Speech-Language Pathology Assistant Scope of Practice includes the following as a responsibility that is within the SLPA scope of practice: “Providing services via telepractice to students, patients, and clients who are selected by the supervising SLP."

Check with both your supervising speech-language pathologist and with your state department of education or health, licensing boards, state boards of education, school districts, and individual schools or other workplaces for existing regulations and requirements that address both the use of assistants and the acceptability of telepractice. Practices differ by state and by work setting.

Every payer also makes its own determination for service provision by SLPAs and for telepractice, so you’ll need to check any requirements for your setting, as well—if applicable.

Related Resource: State-specific guidance to employees and families about use of assistants and telepractice is available at ASHA’s State-by-State webpages.

What is outside of speech-language pathology assistants' scope of responsibilities?

According to ASHA's Speech-Language Pathology Assistant Scope of Practice, which applies across all practice settings, a speech-language pathology assistant should NOT engage in the following:

  • representing themselves as the SLP;
  • interpreting assessment tools for the purpose of diagnosing disability, determining eligibility or qualification for services;
  • administering or interpreting feeding and/or swallowing screenings, checklists, and assessments;
  • diagnosing communication and feeding/swallowing disorders;
  • developing or determining the feeding and/or swallowing strategies or precautions for students, patients, and clients;
  • disclosing clinical or confidential information (e.g., diagnosis, services provided, response to treatment) either orally or in writing to individuals who have not been approved by the SLP to receive information unless mandated by law;
  • writing, developing, or modifying a student's, patient's, or client's plan of care in any way;
  • making referrals for additional services;
  • assisting students, patients, and clients without following the individualized plan of care prepared by the ASHA certified SLP;
  • assisting students, patients, and clients without access to supervision;
  • selecting AAC systems or devices;
  • treating medically fragile students, patients, and clients without 100% direct supervision;
  • performing procedures that require specialized knowledge and training (e.g., vocal tract prosthesis shaping or fitting, vocal tract imaging);
  • providing input in care conferences, case conferences, or any interdisciplinary team meeting without the presence or prior approval of the supervising SLP or other designated SLP;
  • providing interpretative information to the student, patient, client, family, or others regarding the student’s, patient’s, or client’s status or service;
  • signing or initialing any formal documents (e.g., plans of care, reimbursement forms, reports) without the supervising SLP’s co-signature;
  • discharging a student, patient, or client from services.

State laws vary and may differ from ASHA’s guidelines and requirements. Check specific state regulations to determine which tasks are outside the scope of practice for assistants in a particular state.

What is the average salary for speech-language pathology assistants?

The 2021 ASHA Audiology Assistant and SLPA Survey found the average reported salary of full-time SLPAs to be $46,000. The hourly rate has a median of $28 full-time, $29.50 part-time. Average salary varies by state and region.

Recently, published salary data for audiologist assistants and SLPAs. Although the data are not exhaustive (this is based on a survey of individuals currently working in the position that respond to a salary survey), the information can still provide a sense of the overall trends of salaries in the states that utilize support personnel. Occupational and physical therapy data show that assistants in those fields make about 60% to 75% of professional-level salaries.

Who is responsible for services provided by a speech-language pathology assistant?

The fully qualified, ASHA-certified supervising speech-language pathologist is responsible for the services provided by assistants. In states that regulate speech-language pathology assistants, speech-language pathologists who hold full, unrestricted licenses assume these responsibilities for persons working under their direction.

Will caseloads expand when assistants are used?

As has always been the case, caseload size of ASHA-certified speech-language pathologists may or may not increase depending on client needs and the nature of the services provided. If speech-language pathology assistants are used appropriately, and if they are adequately supervised, ASHA-certified speech-language pathologists' caseloads may decrease to permit sufficient time to supervise staff working under their direction; however, workload may increase as the speech-language pathologist assumes responsibilities for training and supervising assistants. Speech-language pathology assistants do not carry their own caseloads. Assistants help to provide services as directed for the caseloads of speech-language pathologists.

Supervising Speech-Language Pathology Assistants

Who can supervise speech-language pathology assistants?

Supervisors and SLPAs need to consider three different forms of requirements and regulations:

  • State regulations, which may include licensure or registration
  • ASHA guidelines in addition to the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC) requirements, which are recommendations for practice
  • CFCC requirements for SLPA certification

The supervising speech-language pathologist must meet the following CFCC requirements:

  • hold the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) from ASHA and/or possess the necessary state-credentials;
  • completion of a minimum of 9 months of experience after being awarded ASHA certification (i.e., completion of the 9-month Clinical Fellowship followed by 9 months of experience);
  • completion of a minimum of 2 hours of professional development in clinical instruction/supervision;
  • adherence to state guidelines for supervision of the SLPA;
  • It is recommended that the professional development course taken in clinical instruction or supervision include content related to the supervision of SLPAs.

As stated in the Assistants Code of Conduct, SLPAs are not independent practitioners and must be supervised by appropriately credentialed speech-language pathologists consistent with state licensing laws (state licensed) and/or with ASHA’s Code of Ethics (i.e., the supervising speech-language pathologist must be ASHA certified). Also, the supervision must be sufficient to ensure the welfare of the client, patient, or student. Applicants should verify that their clinical educator or supervisor meets the above requirements by using the certification verification portal

May supervision of SLPAs be conducted remotely?

ASHA’s Speech-Language Pathology Scope of Practice defines direct supervision to include supervision via telecommunications. That said, telesupervision requirements vary by state.

Related Resource: State-specific guidance to employees and families about use of assistants and telepractice is available at ASHA’s State-by-State webpages.

Should the supervisor of a student in a speech-language pathology assistant training program in an external fieldwork placement hold a current Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) from ASHA, or can they hold state licensure only?

To meet ASHA certification requirements, the speech-language pathology assistant student must complete 100 clinical hours under the supervision of an ASHA-certified SLP. To ensure compliance with state requirements, the student should contact their state regulatory agency

How many years of experience does the supervisor need to supervise a speech-language pathology assistant student?

According to ASHA's new Speech-Language Pathology Assistant Scope of Practice, a speech-language pathologist may supervise support personnel if the SLP is certified by ASHA and has been practicing for a minimum of 9 months following ASHA certification, has completed two (2) hours of continuing professional development in supervision training prior to supervision of an SLPA, and is licensed and/or credentialed by the state (where applicable) in which the SLP is employed. It is recommended that the professional development course taking in clinical instruction or supervision include content related to the supervision of SLPAs.

What supervision-related resources does ASHA offer?

The ASHA Speech-Language Pathology Assistant Scope of Practice includes information regarding supervision of support personnel.

  • ASHA offers a video series of ASHA Professional Development Supervision Courses in which supervisors and supervisees from various settings come together to learn about the supervision process from A to Z.
  • ASHAWire is ASHA’s publishing platform for the ASHA Journals, The ASHA Leader, and Perspectives of the ASHA Special Interest Groups. Search on “supervision of SLPAs.”
  • ASHA Continuing Education offers professional development opportunities in supervision. Search their course listings by keyword.
  • Visit the ASHA Store to purchase courses and publications on the topic of supervision.

How much supervision is recommended?

The ASHA Speech-Language Pathology Assistant Scope of Practice states the minimum requirements for the frequency and amount of supervision of support personnel as follows:

Supervision requirements may vary based on a variety of factors. The amount and type of supervision required must be consistent with (a) the SLPA’s skills and experience; the needs of the students, patients, and clients; (c) the service setting; (d) the tasks assigned; and (e) the laws and regulations that govern SLPAs. To ensure adequate and appropriate supervision, the supervising SLP should outline their expectations in collaboration with the SLPA. As the relationship continues to develop over time, the SLP/SLPA team can decide how and to what extent supervision is needed.

Before the SLPA begins to provide support independently, the supervising SLP must have first contact with all individuals on the caseload. “First contact” includes establishing rapport, gathering baseline data, and securing other necessary documentation to begin (or continue) the plan of care for the student, patient, or client. As the SLP/SLPA team dynamic continues to develop beyond the initial onboarding, minimum ongoing supervision must always include documentation of direct supervision provided by the SLP for each student, patient, or client at least every 30–60 days (depending on frequency of visits/sessions and setting).

The SLP can adjust the amount of supervision if they determine that the SLPA has met appropriate competencies and skill levels in treating students, patients, and clients who have a variety of communication disorders. Data on every student, patient, and client serviced by the SLPA should be reviewed by the supervisor in regular intervals and can be considered “indirect supervision.” Supervisors should arrange designated days and times of day (morning or afternoon) in such a way that all students, patients, and clients receive direct contact with the supervising SLP.

The supervising SLP must accurately document and regularly record all supervisory activities, both direct and indirect. Further, 100% direct supervision (synchronous or “live” telesupervision is acceptable) of SLPAs for medically fragile students, patients, or clients is required.

The supervising SLP is responsible for designing and implementing a supervisory plan, which ensures that the SLP maintains the highest standard of quality care for students, patients, and clients. A written supervisory plan is a tangible way to document progress and outline the practices of the supervising SLP and the SLPA. Care of the student, patient, or client remains the supervisor’s responsibility.

Direct supervision means in-view observation and guidance while the SLPA is performing a clinical activity. This can include the supervising SLP viewing and communicating with the SLPA via telecommunication technology as the SLPA provides clinical services, this scenario allows the SLP to provide ongoing immediate feedback. Direct supervision does not include reviewing an audio or video recorded session later.

Supervision feedback should provide information about the quality of the SLPA's performance of assigned tasks and should verify that clinical activity is limited to tasks specified in the list of an SLPA's ASHA-approved responsibilities. Information obtained during direct supervision may include, but is not limited to, data relative to (a) agreement (reliability) between the SLPA and the supervisor on correct or incorrect recording of target behavior, (b) accuracy implementing assigned treatment procedures, (c) accuracy recording data, and (d) ability to interact effectively with the student, patient, or client during presentation and implementation of assigned procedures or activities.

Indirect supervision does not require the SLP to be physically present or available via telecommunication while the SLPA is providing services. Indirect supervisory activities may include (a) reviewing demonstration videos; (b) reviewing student, client, or patient files; (c) reviewing and evaluating audio or video recorded sessions; and/or (d) conducting supervisory conferences either in person or via telephone and/or live, secure virtual meetings. The SLP will review each care plan as needed for timely implementation of modifications.

An SLPA may not perform tasks when a supervising SLP cannot be reached by personal contact, that is, phone, pager, or other immediate or electronic means. If, for any reason (i.e., maternity leave, illness, change of jobs) the supervisor is no longer available to provide the level of supervision stipulated, then the SLPA may not perform assigned tasks until an ASHA-certified and/or state-licensed SLP with experience and training in supervision has been designated as the new supervising SLP.

Any supervising SLP who will not be able to supervise an SLPA for more than 1 week will need to (a) inform the SLPA of the planned absence, (b) notify the employer or site administrator that other arrangements for the SLPA's supervision of services need to be made while the SLP is unavailable, and (c) inform the students, patients, or clients that their speech-language services will be rescheduled.

In some instances, multiple SLPs may supervise the SLPA. Those doing so must give special consideration to, and think carefully about, the impact that this supervisory arrangement may have on service providers. It is recommended that the SLPA not be supervised by more than three SLPs..

State laws vary and may differ from ASHA’s guidelines and requirements. Check specific state regulations to determine amount of supervision required and qualifications for supervisors of assistants in a particular state.

Credentialing Speech-Language Pathology Assistants

Does ASHA credential speech-language pathology assistants?

In 2017, the ASHA Board of Directors voted to move forward with the creation of an Assistants Certification Program that will allow audiology assistants and speech-language pathology assistants to become certified practitioners. The first certifications will be awarded in late 2020.

How does one become a certified speech-language pathology assistant?

ASHA’s Speech-Language Pathology Assistant Scope of Practice provides minimum recommended qualifications, which include the following:

  • Completion of an approved course of academic study. The academic course of study must include or be equivalent to an associate degree from a technical training program with a program of study designed to prepare the student to be a speech-language pathology assistant or a bachelor’s degree in a speech-language pathology or communication disorders program.
  • Fieldwork under the supervision of an ASHA-certified and/or licensed SLP. The fieldwork includes successful completion of a minimum of 100 hours of supervised fieldwork experience or its clinical experience equivalent.
  • On-the-job training specific to SLPA responsibilities and workplace behaviors.
  • Demonstration of competency in the skills required of an SLPA.

How do individual states credential speech-language pathology assistants?

Because the requirements for speech-language pathology support personnel vary across the country, persons interested in serving as speech-language pathology assistants should check with the state of intended employment for that state's specific requirements.

State agencies (licensure boards) currently regulating support personnel have training requirements that range from a high school diploma to a baccalaureate degree plus graduate credit hours—as well as a variety of differing requirements for the people supervising these individuals.

In addition to state regulatory agencies, state education agencies may credential support personnel to work solely in schools to support service delivery provided by a qualified speech-language pathologist. Several states do require annual continuing education for assistants.

Is the use of speech-language pathology assistants permitted in every state?

No. Some states that regulate speech-language pathology do not permit the use of speech-language pathology support personnel. In addition, state departments of education may credential speech-language pathology support personnel. Some school districts hire assistants under the classification of teacher assistants. If a state regulates speech-language pathology support personnel (i.e., under the term of assistant, aide, paraprofessional, apprentice, etc.), then individuals who wish to become employed in that state must meet the state requirements for practice under a licensed and ASHA-certified speech-language pathologist. Call the state licensure board or department of education for specific state regulations. Addresses and phone numbers can be obtained through the ASHA State-by-State pages.

Training Speech-Language Pathology Assistants

Is this a career ladder?

There is the potential for a career continuum—from SLPA to SLP—depending on the state and work setting regulations in place for the intended state of practice. Traditionally, the support personnel career continuum has not been specifically intended as such because the associated course work and field work experiences required in the SLPA program may differ from those at the bachelor's, pre-professional, or master's levels.

Anyone interested in pursuing academic course work and field work as an assistant prior to entering the field of speech-language pathology should check with bachelor's degree programs and master's degree programs in speech-language pathology in his or her state to determine if any courses taken in the associate degree speech-language pathology assistant program will be credited for future studies.

What information is available to help a training institution start a speech-language pathology assistant training program?

ASHA does not accredit undergraduate or technical training (associate degree) programs at this time.

In developing a new program, ASHA recommends that the curriculum follow the guidelines listed Speech-Language Pathology Assistant Scope of Practice, as it provides minimum recommended qualifications for SLPA education.

Incorporating the prerequisite coursework and clinical hours listed in the ASHA Assistants Eligibility pathways and using the SLPA Exam Blueprint [PDF] for course development would provide the opportunity for the graduate to apply for ASHA Assistants certification upon graduation.

Can an institution establish a speech-language pathology assistant training program in a state that prohibits the use of speech-language pathology assistants?

Such decisions are under the purview of state agencies that have degree-granting authority and that regulate the professions. Consult with the appropriate state entity that performs such oversight to determine if starting such a program is permissible under postsecondary requirements in place and whether the program would be at variance with state law and regulations for the profession.

How can I find qualified speech-language pathology assistants?

Call states that regulate them. Addresses and phone numbers of state licensure boards and regulatory agencies can be obtained from the ASHA State-by-State pages. Another option is to call associate’s degree programs and institutions that train and graduate speech-language pathology assistants. A list of speech-language pathology assistants who are ASHA Associates may be obtained via the mailing list requests page.

How many training programs are there for speech-language pathology assistants?

As of April 2020, there are 32 operational associate degree programs for speech-language pathology assistants. Some of these programs offer training opportunities through distance learning and collaborations between community colleges and higher education institutions. For a list of speech-language pathology assistant training programs, please visit ASHA’s webpage, Training Programs for Speech-Language Pathology Assistants.

Reimbursing Speech-Language Pathology Assistant Services

Can speech-language pathologists receive reimbursement for speech-language pathology assistant services?

Medicare policy currently does not recognize speech-language pathology assistants—regardless of the level of supervision—and does not reimburse for speech-language pathology assistant services.

Medicaid reimbursement of speech-language pathology assistants varies from state to state. Visit their websites for additional information.

Private insurers may cover licensed or registered speech-language pathology assistants.

  • Query each payer to verify coverage.
  • Private insurers may or may not provide a different rate of reimbursement for services provided by a speech-language pathologist as opposed to the services provided by a speech-language pathology assistant.

Fieldwork for Speech-Language Pathology Assistant Student Trainees


The questions and answers below are provided to assist technical training programs for speech-language pathology assistants in establishing fieldwork arrangements that provide speech-language pathology assistant students with the technical skills for supervisors to verify their technical proficiency. This section is applicable to speech-language pathology assistant student trainees, not necessarily assistants in the employment setting.

Should the fieldwork hours completed by speech-language pathology assistant students be performed at specific types of settings or distributed across specific age groups or disorders?

ASHA does not specify types of settings for fieldwork or distribution of hours, but recommends that the fieldwork provides speech-language pathology assistant students with a variety of experiences with individuals with communication disorders. The intent is for training programs to have flexibility in arranging their fieldwork, and to provide speech-language pathology assistant students with experience with both children and adults in more than one setting; however, ASHA policies do not suggest a specific distribution.

Does the minimum of 100 clock hours of fieldwork include observation hours?

No. ASHA guidelines recommend a minimum of 100 clock hours of fieldwork that includes direct and indirect client contact activities covering all of the job responsibilities of a speech-language pathology assistant, but no observation hours. ASHA recommends that observation hours be undertaken before starting the 100 fieldwork hours. It is up to the training program to set the appropriate number of observation hours.

When speech-language pathology assistant students are engaged in patient/client contact, does ASHA recommend that they receive direct supervision or indirect supervision for the specified minimum of 50% of the time?

When students are engaged in patient/client contact, ASHA recommends that the speech-language pathology assistant student be supervised a minimum of 50% of the time. The patient/client contact refers to direct supervision of the speech-language pathology assistant student, which is defined as on-site, in-view observation and guidance.

When speech-language pathology assistant students are placed in fieldwork settings, can they be supervised by more than one speech-language pathologist?

Yes. ASHA recommends that each speech-language pathologist supervising the student complete a technical proficiency or skills competency checklist [PDF] (or whatever specific format your institution uses for fieldwork assessments) for that particular student.

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