Speech-language pathologists are the professionals who diagnose and treat disorders of speech, language, and swallowing. Thus, the assessment and diagnosis of apraxia of speech, as well as all other speech sound disorders, are within the scope of professional responsibilities of SLPs. While other professionals, such as physicians, educators, occupational or physical therapists, may provide essential information that contributes to the assessment, speech-language pathologists have the responsibility for integrating assessment results and for differentiating apraxia of speech from other speech and/or language disorders.
There has been some controversy about the issue of diagnosis as it relates to apraxia of speech for several reasons. First, the term “apraxia” implies a neurological cause to the disorder. However, as Shriberg pointed out in the March 2001 issue of this newsletter, a definite cause for AOS in children has yet to be established. A second reason for this controversy has to do with conflicting opinions about the nature of the speech disturbance and its possible linguistic, motoric, or cognitive underpinnings. Regardless of the controversy, the term developmental apraxia of speech is used to describe a fairly specific pattern of speech symptoms in children and there is some agreement among practitioners as to the nature, type, and treatment of these patterns.
ASHA’s revised Scope of Practice (ASHA, 2001) states that “the roles of speech-language pathologists include prevention of communication and upper aerodigestive disorders as well as diagnosis, habilitation, rehabilitation, and enhancement of these functions.” The Scope of Practice document, which emphasizes the breadth of speech-language pathology practice also indicates that individual speech-language pathologists may have limitations: “It is recognized that levels of experience, skill, and proficiency with respect to the activities identified within this scope of practice vary among individual providers. It may not be possible for a speech-language pathologist to practice in all areas of the field. As the ASHA Code of Ethics specifies, individuals may only practice in areas where they are competent based on their education, training, and experience. However, speech-language pathologists are not limited from expanding their current level of competence. Certain situations may necessitate that speech-language pathologists pursue additional education or training to expand their personal scope of practice. The current ASHA Scope of Practice in SLP can be found at:
(Dr. Alex Johnson is former Vice President for Professional Practices in Speech-Language Pathology for the American Speech-Language-Hearing Association [ASHA]. Dr. Johnson is also Professor and Chair of the Department of Audiology and Speech-Language Pathology at Wayne State University in Detroit, Michigan.)