Reflections — July 26, 2012 at 12:21 am

How may I assist you? Life as an SLP-A


by Christine Botelho, BA

I have been a Speech Language Pathology Assistant for over 20 years, licensed in Massachusetts for 4 years (not all states require licensure). Use of Speech Language Pathology Assistants is not allowed in all areas of the Speech and Language field and it is not an easy position to acquire. I have been fortunate to have met Speech Language Pathologists who have given me the opportunities that I have had. I have worked in acute rehab settings, nursing homes, day hab programs, schools and private practice.

As an SLP-A , I have always worked with Speech Language Pathologists. Initially it is difficult to work with a new, unfamiliar SLP because of different treatment styles and expectations. I have found that the speech and language field can be extremely subjective.  A patient, given the same tests and acquiring the same results may have different goals and objectives created by different therapists.  The therapists may desire the same outcome yet approach the treatment from different directions.  Having had the opportunity to work with numerous Speech Language Pathologists has given me countless treatment strategies to refer to while I am working my patients.  Every SLP has their own style of treatment and each patient is an individual- what works for one patient may not work for the other.  It has been helpful to have multiple strategies to try.

My overall responsibility as an SLP-A is to comprehend the recommendations, goals and objectives of the supervising SLP and implement the treatment to maximize the patient’s success. An SLP-A needs to have a basic understanding of the disabilities they are working with. However, their greatest strength is in knowing what materials are available, with an ability to modify and create novel ones in order to motivate their patients.  I feel the optimal use of an SLP-A is to accomplish the “drill work” needed to attain the goals the SLP created.  Therefore, the needs of the patient and their rate of progress determines the ratio of SLP to SLP-A treatment.   ASHA has guidelines for supervision of SLP-A’s and I believe it is important to adhere to these in order to assure the best outcomes. In addition, as this website shows, it’s lonely out there! We need SLPs to bounce ideas off of and to make sure we are on the right track. Our training and experience only gets us so far. The SLP has the education and the responsibility to drive the treatment plan.

Often I look back over my career and remember my patients from the early days and think how much more I could help them, knowing what I know now. If my career has taught me anything it’s that we have to have an appreciation for what we don’t know with the courage to ask questions and continue to search for answers even in the most challenging situations. It is becoming too easy to blame the patients and families for a lack of progress instead confronting our own limitations. I enjoy learning new things in order to help my patients. One reason I like being an SLP-A is that you always have someone to consult and brainstorm with. It is harder to feel defeated when you are part of a team. My best experiences have been working with SLPs that share my ideology and philosophy.

As our field continues to grow and change, I would like to see SLP-A’s working with SLP’s all settings with services reimbursed by all insurances in order to reach as many patients as possible. After all, I bet everyone could use a little assistance.

About the Author

Christine Botelho is an SLP-A with a Bachelor’s Degree in Communication Disorders from Bridgewater State College. When not amazing her school based caseload with a variety of original materials, fun reinforcers and tireless energy, Chris can be found in southeastern Massachusets enjoying time with her family and learning archery.
Contact Chris at

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