How to Become a Speech Therapist

To become a speech therapist requires dedication and a lot of study in a large field of issues related to speech problems. Speech therapists work with people who suffer from speech impediments and communications difficulties as a result of various medical conditions. Of all the therapeutic professions, speech therapy is among the most technically demanding. Treatments may continue for years, in some cases decades.

Education and training

To practice as a speech therapist requires a Masters Degree and a license in 47 US states. The Masters degree requires study of:

  • Physiology
  • Anatomy (specifically areas related to speech and associated anatomical structures)
  • Speech center development
  • Speech disorders
  • Communications psychology
  • Acoustics

The training involves supervised clinical practice in all aspects of speech therapy. This involves progressive development in evaluation of disorders, treatments, and clinical practices. This is a form of medical practice which requires excellent diagnostic skills, good communications skills, and advanced case management abilities.


  • Speech therapists are required to meet several licensing criteria in order to practice:
  • Passing score in the national examination for speech disorder pathology.
  • 300-375 hours of supervised clinical experience.
  • 9 months of postgraduate professional practice.
  • 41 US states require ongoing education for licensing purposes.
  • Medicare and Medicaid require licensing for reimbursement of fees.


The speech therapist's personal skills, as well as their professional skills, are important elements in effective practice. This is a case management working environment. Speech therapists often deal with difficult conditions in which progress is slow, and patients are often frustrated by their lack of progress. The all-important fundamental skills involved in basic speech therapy are best illustrated by a typical patient management scenario:

  • Diagnosis: Pathology, tests, checking any existing medical records. Speech therapists operate extremely sensitive equipment, and must be fully familiar with those systems and their use as diagnostic tools.
  • Discussion with the patient and associates: Counseling is one of the speech therapist's most important roles. It allows investigation of the condition and discussion of the requirements of the patient to be able to participate in treatment programs.
  • Planning a therapy strategy: May involve figuring out a workable regime for patients whose time has other commitments.
  • Operating a treatment program: These can be complex and repetitive, involving patience on the part of the therapist and patient alike.
  • Monitoring the patient's progress: More pathology, and measurement of patient achievements.
  • Modifying treatment regime as required: Many conditions involve complex treatments which need to be tuned to the patient's current needs over time.
  • Patient and associate feedback: Ongoing counseling, which may involve alterations to therapy, alternative management methods, and related information.


Speech therapists frequently specialize in particular areas of therapy. The general areas of specialization include:

  • Juvenile speech therapy, a very large, complex area of the field. 
  • Treatment of speech disorders created by medical conditions or injuries.
  • Specialists in particular forms of speech disorder.

Employment and career options

Speech therapists are generally employed in various sectors of the health industry. In the US, over 50% of speech therapists are employed in education. Others are employed in hospitals, clinical practices, as part of medical practices. Some speech therapists operate in private practices, but comprise a relatively small proportion of practitioners.