Hi! What does it take to be ASHA certified? Is every CCC-SLP ASHA certified? Is it just sending in your money to be ASHA certified? Does it require passing a particular test?  Are you required to fulfil continuing ed requirements, follow certain rules, ethics, etc?

Dear Dr Bowen: I have a 9 year old son who breaths thru his nose and has a tongue thrust. I have been trying to get him into a speech pathologist, but have hit road blocks due to sinus problems. I had him seen by the school speech therapist. She is willing to work with my son but liked the idea of him seeing a pathologist.  Here is the issue. The state of Utah offers a one day clinic in my town for children with special needs, but it has been expressed that this issue could be resolved with the school speech therapist. What is the difference between a speech pathologist and a therapist? Am I wrong in wanting my son seen by a pathologist?  Thanks for your time.

Usually, the title "Speech Therapist" in the US implies that the person is NOT a CCC-SLP. But you do need to check by asking the Speech Therapist what her qualifications are. Some SLPs actually call themselves "speech therapists"! Confusing, isn't it?

CCC stands for Certificate of Clinical Competency.  If an SLP has these initials after his or her name, they have (1) received a masters degree in Speech/Language Pathology (2) passed a national exam in speech/language pathology, (3) completed a 9 month clinical fellowship year under a qualified supervisor. 

Once you have received your C's, you have to pay an annual fee to renew. As well you are required by ASHA to attain 30 hours of continuing education units (CEUs) every 3 years in order to maintain CCC status. The practice of continuing education has long been recommended by ASHA, but not actually required, until January 2005. 

In order to receive an ACE award, you must attend 70 clock hours of continuing education over a 36 month period.  If an SLP does not have an ACE award, it does not mean that that person has not been earning CEUs.

In some states of the USA, SLPs are also required to be licensed. For example in Pennsylvania SLPs working in the public school system have to maintain state licensure and this requires 20 hours of continuing education every 2 years.

Dear Dr Bowen, My 4 year old son has a phonological speech disorder and also an element of poor tongue muscle, his vocabulary has improved dramatically this year, but pronunciation is still poor, I am constantly looking for advice. We recently moved here (Bermuda) from England where he had therapy, and are commencing therapy here. He is a clever little boy with no other development problems, but is quite conscious of his inability to communicate as well as his peers, so is shy. Any advice would be welcomed. What could have caused this?

Hello! What causes developmental phonological disorder and what can I do at home to help my 4 1/2 year old daughter with this diagnosis?

RESPONSE: The causes of developmental phonological disorders are uncertain
What causes developmental phonological disorders? We don't know precisely. Research to date suggests five possible causes, which may occur singly or in combination. You will notice that each of these five causes relates to factors within the child (not to the way they are being raised).
1. the child finds the sound patterns of language totally confusing and cannot make out sound details form the overall pattern of sounds in language.
2. the child's speech maturation (readiness) may be severely delayed;
3. the restricted speech system becomes "habit", suppressing further speech maturation;
4. the child has poor perception and awareness of how their speech sounds, and the difficulty other people have understanding them when they talk;
5. the child has a specific difficulty initiating changes in their sound
system, and knowing how to organise their sound system in a consistent way.

The book, Developmental Phonological Disorders: A Practical Guide for families and Teachers, includes strategies to apply at home and at pre-school. There is information here too.

RESPONSE: How the terms 'speech-language disorder' and 'communication disorder' are used
"Communication Disorder" is a cover term for human voice, speech, language, fluency and pragmatic disorders. A speech disorder is an impairment of voice, articulation of speech sounds, and/or fluency. These impairments are observed in the transmission and use of the oral symbol system. 

A language disorder is the impairment or deviant development of comprehension and/or use of a spoken, written, and/or other symbol system. The disorder may involve (1) the form of language, (2) the content of language, and/or (3) the function of language in communication in any combination. 

Each disorder is treated differently, and every client is different, so there is no "standard" answer to your question regarding treatment. These are questions you are entitled to raise with your SLP, starting with "What is ___'s speech-language pathology diagnosis? There is information here.

Assessment, diagnosis and treatment planning by a speech-language pathologist of any communication disorder is a serious undertaking, and therefore has to be done IN PERSON, over time. I am afraid there are no quick answers. 

RESPONSE: Lisps
The /s/ sound is normally produced correctly by 4 years 6 months. There are at least 4 different types of lisp, so general advice or "exercises" without a face-to-face assessment by a speech-language pathologist is not only inappropriate and unhelpful, but also unethical. Have your son's speech assessed by a speech-language pathologist. The SLP will advise you what to do once the assessment is complete.

Page updated 04 Feb 2010

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