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Missouri Speech-Language Pathology — Requirements & Free Practice

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Speech-Language Pathologist License

Ordinary independent-practice license. Current initial examination eligibility is governed by the August 28, 2026 version of 345.050; statutory reciprocity is separate.

Licensing authority: Missouri State Board of Registration for the Healing Arts · Application information

Licensure by examination

All of the following:

  • Speech-Language Pathology (5331)
  • Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists (practice unavailable)
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Clinical Fellowship
Provide supervisors' written evidence of a clinical fellowship completed after academic and practicum requirements under direct supervision of an SLP licensed in good standing.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Degree
Hold a master's or doctoral degree from a CAA-accredited or accreditation-candidate program, or another Board-approved accreditor in the area sought, under current 345.050(1).
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Jurisprudence
The Board's Test Compliance Verification states all SLP or audiologist licensure applicants must complete the individual open-book Missouri examination with a score of at least 75%.
National Score
Have ETS submit Praxis scores directly; the passing score follows the ASHA clinical-competence standard. Rule 4.020 provides Board approval and testing time limits.
Statutory Exemptions
RSMo 345.025 preserves its specifically enumerated practice exemptions, including qualifying pre-2016 DESE-certified public-school employees only within the exempt school employment; compensated work outside an exempt area is not covered.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Transcripts
Provide official transcripts establishing equivalent coursework and clinical practicum.
Internationally trained applicant by examination

All of the following:

  • Speech-Language Pathology (5331)
  • Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists (practice unavailable)
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Clinical Fellowship
Provide supervisors' written evidence of a clinical fellowship completed after academic and practicum requirements under direct supervision of an SLP licensed in good standing.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Credential Evaluation
For a non-ASHA-accredited foreign program, obtain a Commission-approved evaluation verifying equivalent professional education; provide required certified English translations.
Degree
Hold a master's or doctoral degree from a CAA-accredited or accreditation-candidate program, or another Board-approved accreditor in the area sought, under current 345.050(1).
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Jurisprudence
The Board's Test Compliance Verification states all SLP or audiologist licensure applicants must complete the individual open-book Missouri examination with a score of at least 75%.
National Score
Have ETS submit Praxis scores directly; the passing score follows the ASHA clinical-competence standard. Rule 4.020 provides Board approval and testing time limits.
Statutory Exemptions
RSMo 345.025 preserves its specifically enumerated practice exemptions, including qualifying pre-2016 DESE-certified public-school employees only within the exempt school employment; compensated work outside an exempt area is not covered.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Transcripts
Provide official transcripts establishing equivalent coursework and clinical practicum.
Expedited reciprocity for a resident or nonresident law enforcement spouse
No examination is required for this applicant pathway.
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Board Form Conflict
The lower-ranked Board Test Compliance Verification states: "The missouri State Board of Registration for the Healing Arts and the Advisory Commission for Speech-Language Pathology and Audiology requires that all applicants for licensure as a Speech-Language Pathologist or Audiologist, achieve a passing score on an examination on the missouri Licensure Act, Rules and Regulations.". The statutory mandatory spouse waiver controls this route; the Board form demand is retained here for the applicant.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
General Reciprocity Limits
Where 324.009 governs, the Missouri license is valid only in Missouri and does not confer interstate-compact eligibility; an applicant licensed in another state pursuant to an interstate compact is ineligible under 324.009. Fees, insurance, bonds and fingerprint requirements are not waived. The Board may evaluate whether prior disciplinary causes were corrected and resolved.
Good Standing
No disqualifying revocation, unresolved investigation, pending complaint, disqualifying discipline or criminal record; the license remains current and in good standing.
License Held
Hold a valid current license for at least one year in the same occupation and practice level in another qualifying United States jurisdiction or military branch; submit direct verification.
Qualification Review
The issuing jurisdiction verifies minimum education and applicable experience and supervision; the Board determines waiver eligibility.
Spouse Eligibility
Meet the applicable resident or nonresident military-spouse definition under 345.052 or military/law-enforcement-spouse definition under 324.009; hold the current qualifying license for at least one year and satisfy all remaining statutory eligibility limits.
State Exam Discretion
The express state-law examination reservation is in subdivision (1); subdivision (2) instead directs waiver of any examination for a qualifying spouse.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Waiver
The applicable statute directs the Board within thirty days to waive any examination, educational or experience requirement for an eligible spouse.

Official no-examination sources

Effective from 2026-09-22.

Expedited reciprocity for a resident or nonresident military spouse
No examination is required for this applicant pathway.
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Board Form Conflict
The lower-ranked Board Test Compliance Verification states: "The missouri State Board of Registration for the Healing Arts and the Advisory Commission for Speech-Language Pathology and Audiology requires that all applicants for licensure as a Speech-Language Pathologist or Audiologist, achieve a passing score on an examination on the missouri Licensure Act, Rules and Regulations.". The statutory mandatory spouse waiver controls this route; the Board form demand is retained here for the applicant.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
General Reciprocity Limits
Where 324.009 governs, the Missouri license is valid only in Missouri and does not confer interstate-compact eligibility; an applicant licensed in another state pursuant to an interstate compact is ineligible under 324.009. Fees, insurance, bonds and fingerprint requirements are not waived. The Board may evaluate whether prior disciplinary causes were corrected and resolved.
Good Standing
No disqualifying revocation, unresolved investigation, pending complaint, disqualifying discipline or criminal record; the license remains current and in good standing.
License Held
Hold a valid current license for at least one year in the same occupation and practice level in another qualifying United States jurisdiction or military branch; submit direct verification.
Qualification Review
The issuing jurisdiction verifies minimum education and applicable experience and supervision; the Board determines waiver eligibility.
Spouse Eligibility
Meet the applicable resident or nonresident military-spouse definition under 345.052 or military/law-enforcement-spouse definition under 324.009; hold the current qualifying license for at least one year and satisfy all remaining statutory eligibility limits.
State Exam Discretion
The express state-law examination reservation is in subdivision (1); subdivision (2) instead directs waiver of any examination for a qualifying spouse.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Waiver
The applicable statute directs the Board within thirty days to waive any examination, educational or experience requirement for an eligible spouse.

Official no-examination sources

Effective from 2026-09-22.

Licensure by reciprocity under 345.052 and 324.009
Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists (practice unavailable)
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
General Reciprocity Limits
Where 324.009 governs, the Missouri license is valid only in Missouri and does not confer interstate-compact eligibility; an applicant licensed in another state pursuant to an interstate compact is ineligible under 324.009. Fees, insurance, bonds and fingerprint requirements are not waived. The Board may evaluate whether prior disciplinary causes were corrected and resolved.
Good Standing
No disqualifying revocation, unresolved investigation, pending complaint, disqualifying discipline or criminal record; the license remains current and in good standing.
License Held
Hold a valid current license for at least one year in the same occupation and practice level in another qualifying United States jurisdiction or military branch; submit direct verification.
Qualification Review
The issuing jurisdiction verifies minimum education and applicable experience and supervision; the Board determines waiver eligibility.
State Exam Discretion
345.052.3(1) and 324.009.3(1) preserve a state-law examination. The Board Test Compliance Verification requires the Missouri laws-and-rules examination of all SLP licensure applicants.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Waiver
National examination, education and experience requirements are waived for an eligible applicant; the Board application does not require Praxis scores, transcripts or fellowship evidence for reciprocity.
Late registration or reactivation after a lapse exceeding three years

All of the following:

  • Speech-Language Pathology (5331)
  • Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists (practice unavailable)
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Continuing Education
4.052(5)(B) requires sixty approved continuing-education hours within the last four years or compliance with 4.030 and other legal requirements.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Lapse
Previously held Missouri SLP license has been noncurrent for more than three years; submit the new application, reinstatement fee and activity and license-verification records.
National Discretion
345.055.1 and 4.030 authorize the Board to require national reexamination. If required, satisfy Board approval, score and any remedial education/experience conditions.
State Examination
The Board late-registration packet includes the laws-and-rules examination and Test Compliance Verification.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Late registration or reactivation after a lapse of three years or less
Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists (practice unavailable)
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Continuing Education
4.052(5)(A) requires thirty approved hours earned in the preceding two years, together with other requirements of law.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Lapse
Previously held Missouri SLP license has been noncurrent for three years or less; submit late-registration application, reinstatement fee, activity statement, license verifications and supporting documents.
State Examination
The specific Board late-registration packet includes the laws-and-rules examination and Test Compliance Verification.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Routine renewal of the ordinary license
No examination is required for this applicant pathway.
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Competence Discretion
345.051.3(2) permits additional continuing-competence methods, including an unidentified examination slot; neither it nor the implementing ordinary renewal rule identifies a currently offered licensing exam for routine renewal.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Continuing Education
The current Board instructions require thirty continuing-education hours in the prior three calendar years. The older rule says: "(1) Each licensee shall biennially complete and report at least thirty (30) hours of continuing education. A person holding licensure in both speech-language pathology and audiology shall biennially collect and report at least thirty (30) hours of continuing education in speech-language pathology and at least thirty (30) hours in audiology. The board shall not issue a renewal of a licensee’s certificate of registration unless the licensee documents completion of thirty (30) hours of continuing education in the immediately preceding reporting period. (2) The period for completion of the continuing education requirements shall be the twenty-four (24)-month period beginning January 1 and ending December 31 of each reporting period. Continuing education hours cannot be carried over into the next reporting period. A licensee who has failed to obtain and report, in a timely fashion, the required thirty (30) hours of continuing education shall not engage in the practice of speech-language pathology and/or audiology unless an extension is obtained and approved pursuant to rule 20 CSR 2150-4.054. (3) Each licensee shall certify by attestation, on his/her licensure renewal form, under penalty of perjury, that he/she has completed the required thirty (30) hours of continuing education, and that the continuing education obtained meets the qualifying criteria specified in rule 20 CSR 2150-4.053.". The applicant should follow the Board's operative triennial instructions and applicable approved-provider and documentation requirements.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Period
345.051 requires a renewal period of no less than three years; the Board current instructions state triennial January 31 renewal. Older biennial rule wording does not override the statute.
Renewal
Submit the renewal application and fee before expiration and disclose disciplinary history and present fitness.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.

Official no-examination sources

Effective from 2026-09-22.

Renewal while the ordinary license remains suspended
No examination is required for this applicant pathway.
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Competence Discretion
345.051.3(2) permits additional continuing-competence methods, including an unidentified examination slot; neither it nor the implementing ordinary renewal rule identifies a currently offered licensing exam for routine renewal.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Continuing Education
The current Board instructions require thirty continuing-education hours in the prior three calendar years. The older rule says: "(1) Each licensee shall biennially complete and report at least thirty (30) hours of continuing education. A person holding licensure in both speech-language pathology and audiology shall biennially collect and report at least thirty (30) hours of continuing education in speech-language pathology and at least thirty (30) hours in audiology. The board shall not issue a renewal of a licensee’s certificate of registration unless the licensee documents completion of thirty (30) hours of continuing education in the immediately preceding reporting period. (2) The period for completion of the continuing education requirements shall be the twenty-four (24)-month period beginning January 1 and ending December 31 of each reporting period. Continuing education hours cannot be carried over into the next reporting period. A licensee who has failed to obtain and report, in a timely fashion, the required thirty (30) hours of continuing education shall not engage in the practice of speech-language pathology and/or audiology unless an extension is obtained and approved pursuant to rule 20 CSR 2150-4.054. (3) Each licensee shall certify by attestation, on his/her licensure renewal form, under penalty of perjury, that he/she has completed the required thirty (30) hours of continuing education, and that the continuing education obtained meets the qualifying criteria specified in rule 20 CSR 2150-4.053.". The applicant should follow the Board's operative triennial instructions and applicable approved-provider and documentation requirements.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Period
345.051 requires a renewal period of no less than three years; the Board current instructions state triennial January 31 renewal. Older biennial rule wording does not override the statute.
Renewal
Submit the renewal application and fee before expiration and disclose disciplinary history and present fitness.
Suspension
Renewal preserves the license record but confers no authority to practice until reinstatement; comply with the suspension order.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.

Official no-examination sources

Effective from 2026-09-22.

Provisional Speech-Language Pathologist License

License for a clinical fellowship, valid for one year with one possible extension to complete supervised postgraduate experience.

Licensing authority: Missouri State Board of Registration for the Healing Arts · Application information

Single extension of provisional license to complete clinical fellowship
Speech-Language Pathology (5331)
Academic And Practicum
Meet accredited academic and practicum requirements and supply the program director's verification and the fellowship supervision plan; current 345.021.4 permits completing the master's or doctoral degree within twelve months of provisional issuance.
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Degree Form Conflict
Rule 4.055(6)(A) asks for proof of a master's or doctoral degree at application: "(A) Proof of receipt of a master’s or doctoral degree from an institution accredited by the American Speech-Language-Hearing Association accrediting body, in the area for which licensure is sought. Documentation shall be provided on the board-prescribed form and submitted directly to the board from the program director of the accredited institution;". Current 345.021.4 provides the twelve-month post-issuance degree deadline.
Duration
One year initially; one twelve-month extension solely to finish postgraduate clinical experience, with a maximum lifetime of two years.
Examination Timing
Under 345.021.3 pass the Board-approved examination within twelve months after initial issuance; passage of the national examination and a master's degree are conditions for extension. The exam is retained even though passage can follow initial issuance.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Prior Pass
Passing Praxis results must be submitted directly by ETS before extension; the currently offered examination remains a leaf although already passed.
Supervision
Use a supervisor holding current permanent Missouri licensure; provide the required fellowship schedule and notify the Board of changes in site, supervisor or weekly hours within four weeks.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.
Initial provisional clinical fellowship licensure

All of the following:

  • Speech-Language Pathology (5331)
  • Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists (practice unavailable)
Academic And Practicum
Meet accredited academic and practicum requirements and supply the program director's verification and the fellowship supervision plan; current 345.021.4 permits completing the master's or doctoral degree within twelve months of provisional issuance.
Application
Submit the Board application, fee, identifying information, license verifications and required supporting records; disclose disciplinary and personal history and provide required explanations. Do not practice until authorization is issued.
Conditional Issuance
Under 345.065.1 the Board may issue this license or registration subject to probation, restriction or limitation instead of refusing issuance or renewal; the individual order defines those conditions and the thirty-day hearing right.
Degree Form Conflict
Rule 4.055(6)(A) asks for proof of a master's or doctoral degree at application: "(A) Proof of receipt of a master’s or doctoral degree from an institution accredited by the American Speech-Language-Hearing Association accrediting body, in the area for which licensure is sought. Documentation shall be provided on the board-prescribed form and submitted directly to the board from the program director of the accredited institution;". Current 345.021.4 provides the twelve-month post-issuance degree deadline.
Duration
One year initially; one twelve-month extension solely to finish postgraduate clinical experience, with a maximum lifetime of two years.
Examination Timing
Under 345.021.3 pass the Board-approved examination within twelve months after initial issuance; passage of the national examination and a master's degree are conditions for extension. The exam is retained even though passage can follow initial issuance.
Fingerprints
RSMo 345.016 permits the Board to require fingerprints for state and federal criminal background checks.
Supervision
Use a supervisor holding current permanent Missouri licensure; provide the required fellowship schedule and notify the Board of changes in site, supervisor or weekly hours within four weeks.
Tax Compliance
Satisfy applicable Missouri income-tax payment and filing requirements stated in the application.

Examination on the Licensure Act, Rules and Regulations for Speech-Language Pathologists and Audiologists

Provider
Missouri State Board of Registration for the Healing Arts
Format
Individual open-book written examination; multiple-choice and true/false questions
Passing score
75%
Practice scope

Inferred from the examination name; the authority has not published an examination outline.

  • RSMo Chapter 345 — Speech Pathologists and Audiologists
  • 20 CSR 2150-1 — Organization
  • 20 CSR 2150-4 — Licensing of Speech-Language Pathologists and Audiologists
Examination sources

Speech-Language Pathology (5331)

Provider
Educational Testing Service (ETS); computer delivered at a test center or at home (online); ASHA announces a transition to PSI, a wholly owned ETS subsidiary, on January 11, 2027, with availability through ETS and Prometric through December 31, 2026
Format
Computer-delivered selected-response questions; the test may contain some questions that do not count toward the score; the score is based on the number of questions answered correctly
Exam questions
132 selected-response questions (approximately 44 in each of the three content categories)
Time limit
150 minutes
Passing score
States, institutions, and associations that require the test set their own passing scores; the passing score for purposes of ASHA certification is 162 on a 100-200 scale
Exam fee
$146.00
Examination outline
  • I. Foundations and Professional Practice (approximately 44 questions; approximately 33% of examination). Speech-language pathologists must have strong foundational knowledge about typical communication development, as well as common characteristics of communication and swallowing disorders and potential factors impacting communication. SLPs must also understand the professional practice requirements that support the provision of services. Knowledge about these requirements ensures that ethical, culturally competent services are provided within the framework of legislative and regulatory requirements and are founded in research.
    • A. Foundations — 1. Typical development and performance across the lifespan: a. developmental norms; b. speech sound and phonology; c. receptive and expressive language (–– syntax and morphology; –– semantics; –– pragmatics/social language); d. fluency; e. voice, resonance, and motor speech; f. feeding and swallowing; g. cognition; h. processing; i. motor and linguistic processes
    • A. Foundations — 2. Factors that influence communication, feeding, and swallowing: a. medical; b. cultural and ethnic; c. linguistic; d. psychological; e. anatomy/physiology; f. environmental; g. genetics; h. auditory
    • A. Foundations — 3. Epidemiology and characteristics of common communication and swallowing disorders: a. speech sound and phonology; b. syntax and morphology; c. semantics; d. pragmatics; e. fluency; f. voice, resonance, and motor speech; g. feeding and swallowing; h. cognition; i. processing
    • B. Professional Practice — 1. Wellness and prevention: a. prevention terminology, practices, and public education; b. risk factors for communication disorders
    • B. Professional Practice — 2. Culturally and linguistically appropriate service delivery: a. understanding, respecting, and responding to explicit and implicit cultural factors that influence communication; b. identifying the impact of assimilation and acculturation on communication patterns; c. communication differences between speakers of the same language
    • B. Professional Practice — 3. Counseling, collaboration, and teaming: a. interpersonal communication and counseling techniques; b. integration of other professionals into the assessment and treatment process; c. communication with patient/client/student, families, and other professionals
    • B. Professional Practice — 4. Documentation: a. legal and regulatory requirements; b. purposes of documentation; c. privacy requirements; d. official records
    • B. Professional Practice — 5. Ethics: a. standards of ethical practice (–– permissions, referrals, and record keeping; –– client/patient/student privacy; –– supervisory requirements; –– conflicts of interest; –– professional competence)
    • B. Professional Practice — 6. Legislation and client advocacy: a. federal laws and regulations impacting delivery of services; b. reporting requirements of governmental agencies; c. licensing requirements and standards
    • B. Professional Practice — 7. Research methodology and evidence-based practice: a. criterion for test selection; b. determining reliability of assessment procedures; c. models of research design; d. test construction principles; e. tenets of evidence-based practice
  • II. Screening, Assessment, Evaluation, and Diagnosis (approximately 44 questions; approximately 33% of examination). Speech-language pathologists use a variety of tools and strategies to gather information about clients with communication and swallowing disorders. They must synthesize and analyze the information to develop appropriate management plans. This section will focus on screening, assessment, evaluation, and diagnosis of communication and swallowing disorders. Topics include how SLPs use and interpret various screening and assessment tools to determine whether additional formal evaluation is indicated, as well as issues related to the selection of appropriate tools and approaches for screening, assessment, and evaluation. Identification of relevant factors from the case history, determining an appropriate assessment protocol, and interpretation of findings to determine a diagnosis and formulate recommendations are covered in this section of the exam, as well.
    • A. Screening — 1. Communication disorders: a. role of the SLP in screening for speech, language, and hearing disorders; b. screening procedures and approaches; c. identification of clients/patients and characteristics requiring further evaluation; d. knowledge of populations at risk for communication disorders
    • A. Screening — 2. Feeding and swallowing disorders: a. role of the SLP in screening for feeding and swallowing disorders; b. screening procedures and approaches; c. identification of clients/patients and characteristics which require further evaluation; d. knowledge of factors leading to increased risk of swallowing and feeding disorders in various populations
    • B. Approaches to Assessment and Evaluation — 1. Developing case histories: a. reviewing records for pertinent information; b. interviewing techniques to obtain pertinent information; c. integrating critical factors identified in the case history
    • B. Approaches to Assessment and Evaluation — 2. Selecting appropriate assessment instruments, procedures, and materials: a. identifying factors that influence test/procedure selection; b. identifying factors that require adaptation of traditional assessment procedures, instruments, and materials; c. selecting instrumental approaches that can be utilized to evaluate various communication and swallowing disorders (e.g., imaging, acoustic, aerodynamic, etc.)
    • B. Approaches to Assessment and Evaluation — 3. Assessing factors that influence communication and swallowing disorders: a. cultural and ethnic factors; b. linguistic factors; c. medical factors (e.g., stable versus progressive conditions, early versus late onset, etc.); d. developmental and cognitive factors; e. psychological factors; f. environmental factors
    • B. Approaches to Assessment and Evaluation — 4. Assessment of anatomy and physiology: a. assessment of pertinent anatomy, physiology, and neural substrates for: –– respiration; –– phonation; –– speech sound production; –– resonance; –– speech/language perception and processing; –– feeding and swallowing
    • C. Assessment Procedures and Assessment — 1. Speech sound production: a. standard and nonstandard assessment procedures; b. parameters of assessment of speech sound production; c. instrumental assessment of speech sound production; d. differential diagnosis of speech sound disorders; e. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 2. Fluency: a. standard and nonstandard assessment procedures; b. parameters of assessment of fluency; c. instrumental assessment of fluency disorders; d. differential diagnosis of fluency disorders (e.g., stuttering versus cluttering); e. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 3. Voice, resonance, and motor speech: a. standard and nonstandard assessment procedures; b. parameters of assessment of voice, resonance, and motor speech disorders; c. instrumental assessment of voice, resonance, and motor speech disorders; d. differential diagnosis of voice, resonance, and motor speech disorders; e. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 4. Receptive and expressive language: a. standard and nonstandard assessment procedures; b. parameters of assessment of receptive and expressive language disorders; c. instrumental assessment of language disorders; d. differential diagnosis of language disorders; e. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 5. Social aspects of communication, including pragmatics: a. standard and nonstandard assessment procedures; b. parameters of assessment of social aspects of communication, including pragmatics; c. differential diagnosis of social communication disorders and pragmatic disorders; d. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 6. Cognitive aspects of communication: a. standard and nonstandard assessment procedures; b. parameters of assessment of cognitive communication disorders; c. differential diagnosis of cognitive communication disorders; d. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 7. Augmentative and alternative communication: a. standard and nonstandard assessment procedures; b. low tech and high tech instrumental assessment procedures; c. parameters of assessment for augmentative and alternative communication; d. interpretation of assessment data
    • C. Assessment Procedures and Assessment — 8. Hearing: a. assessment approaches; b. considerations related to age, developmental status, medical condition, etc.; c. interpretation of assessment (e.g., audiograms and tympanograms) and identification of indicators for referral
    • C. Assessment Procedures and Assessment — 9. Feeding and swallowing: a. instrumental and noninstrumental assessment procedures; b. considerations related to age, developmental status, medical/surgical history, etc.; c. differential diagnosis of feeding and swallowing disorders; d. interpretation of assessment data and indications for referral
    • D. Etiology — 1. Genetic: a. modes of inheritance; b. genetic conditions associated with communication disorders and feeding/swallowing disorders, including common syndromes; c. features of common syndromes and their impact on communication and feeding/swallowing (e.g., Trisomy 21, 22q11.2 deletion syndrome, Fragile X syndrome, etc.)
    • D. Etiology — 2. Developmental: a. developmental delay; b. congenital and acquired conditions associated with developmental communication and feeding/swallowing disorders
    • D. Etiology — 3. Disease processes: a. childhood (e.g., congenital vocal fold paralysis, cystic fibrosis); b. acquired (e.g., Bell’s palsy, iatrogenic); c. progressive (e.g., amyotrophic lateral sclerosis, myopathy)
    • D. Etiology — 4. Auditory problems: a. congenital and childhood hearing loss; b. acquired hearing loss
    • D. Etiology — 5. Neurological: a. congenital (e.g., cerebral palsy); b. acquired (e.g., TBI, neoplasms, stroke)
    • D. Etiology — 6. Structural and functional: a. congenital (e.g., craniofacial anomalies); b. acquired (e.g., head and neck surgery, trauma, and iatrogenic causes); c. functional causes (e.g., velopharyngeal mislearning, vocal misuse)
    • D. Etiology — 7. Psychogenic
  • III. Planning, Implementation, and Evaluation of Treatment (approximately 44 questions; approximately 33% of examination). Speech-language pathologists are responsible for designing and implementing evidence-based treatments to help clients maximize their functioning in communication and/or swallowing. Consequently, the test includes a range of items that pertain to treatment planning, implementation, and evaluation. This topic area includes issues related to the development and evaluation of treatment plans, as well as evidence-based principles and procedures associated with specific communication and swallowing disorders.
    • A. Treatment Planning — 1. Evaluating factors that can affect treatment: a. evaluating the evidence base associated with a particular treatment strategy or approach; b. evaluating the role of client factors such as age, disorder type, disorder severity, concomitant disorders, personal goals/aspirations, and sociocultural background when planning and implementing treatment goals; c. evaluating the role of external factors such as caregivers’ interactions with the client, school or workplace policies, public laws, medications and iatrogenic, and societal stereotypes when planning and implementing treatment goals
    • A. Treatment Planning — 2. Initiating and prioritizing treatment and developing goals: a. processes and procedures for developing comprehensive, appropriate treatment goals; b. processes and procedures associated with integrating assessment results, caregiver or client/patient/student preferences, and treatment outcomes research; c. factors that affect when to begin, modify, or terminate a treatment plan; d. factors that affect the order in which treatment goals are addressed
    • A. Treatment Planning — 3. Determining appropriate treatment details: a. factors related to treatment scheduling (e.g., number and duration of sessions, time and location of sessions); b. factors related to treatment delivery (e.g., individual versus group sessions, sequential or simultaneous targeting of goals); c. personnel requirements (e.g., extent to which caregivers, teachers, peers, etc., are involved with treatment); d. training requirements (e.g., extent to which caregivers, teachers, peers, etc., need to be trained prior to participating in treatment or implementing generalization activities)
    • A. Treatment Planning — 4. Generating a prognosis: a. considering/accounting for client/patient/student factors (e.g., age, motivation, nature of disorder) that can affect treatment outcome; b. considering/accounting for external factors (e.g., family support, availability of services) that can affect treatment outcome
    • A. Treatment Planning — 5. Communicating recommendations: a. procedures, requirements, and best practices for communicating treatment-related recommendations to clients/patients/students and (when appropriate) their family members; b. procedures, requirements, and best practices for communicating treatment-related recommendations to other professionals who are involved in the client/patient/student’s treatment plan; c. principles of interprofessional practice
    • A. Treatment Planning — 6. General treatment principles and procedures: a. general principles and procedures to consider when selecting a treatment (e.g., age, disorder, sociocultural background, severity of impairment, nature of disability)
    • B. Treatment Evaluation — 1. Establishing methods for monitoring treatment progress and outcomes to evaluate assessment and/or treatment plans: a. procedures associated with identifying appropriate measures of treatment progress and treatment outcomes; b. methods associated with measuring baseline performance; c. methods associated with measuring progress while treatment is ongoing; d. procedures associated with modifying progress measures, if necessary, while treatment is ongoing; e. methods associated with evaluating performance when treatment concludes (e.g., short- and long-term outcomes); f. methods associated with determining the social validity of treatment outcomes and the impact of treatment outcomes on a client/patient’s quality of life
    • B. Treatment Evaluation — 2. Follow-up on post-treatment referrals and recommendations
    • C. Treatment — 1. Speech sound production: a. principles and characteristics of interventions used in the treatment of disorders that affect speech sound production; b. strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with speech sound production disorders or differences
    • C. Treatment — 2. Fluency: a. principles and characteristics of interventions used in the treatment of fluency disorders; b. strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with fluency disorders
    • C. Treatment — 3. Voice, resonance, and motor speech: a. voice (–– principles and characteristics of interventions used in the treatment of voice disorders; –– strategies and procedures for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with voice disorders); b. resonance (–– principles and characteristics of interventions used in the treatment of resonance disorders; –– strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with resonance disorders); c. motor speech (–– principles and characteristics of interventions used in the treatment of motor speech disorders; –– strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with motor speech disorder)
    • C. Treatment — 4. Receptive and expressive language: a. principles and characteristics of interventions used in the treatment of receptive and expressive disorders; b. strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disabilities associated with receptive and expressive language functioning
    • C. Treatment — 5. Social aspects of communication, including pragmatics: a. principles and characteristics of interventions used to treat social aspects of communication, including pragmatics; b. strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with social aspects of communication
    • C. Treatment — 6. Communication impairments related to cognition: a. principles and characteristics of interventions used to treat communication impairments that are related to cognitive functioning; b. srategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability associated with cognitively based communication impairments
    • C. Treatment — 7. Treatment involving augmentative and alternative communication: a. factors involved in determining candidacy for AAC approaches; b. factors involved in selecting an appropriate AAC approach; c. principles and characteristics of AAC options/strategies; strategies for preventing, reducing, or eliminating communicative and/or related (e.g., educational, occupational) disability in those who use AAC
    • C. Treatment — 8. Hearing and aural rehabilitation: a. principles and characteristics of interventions used in the treatment of hearing loss; b. strategies for preventing, reducing, or eliminating speech-language and/or related (e.g., educational, occupational) disability associated with hearing impairment
    • C. Treatment — 9. Swallowing and feeding: a. rationale for selection of interventions used in the treatment of swallowing and feeding disorders based on evaluation data; b. other factors (outside of evaluation data) affecting the likelihood of success for a given treatment for feeding/swallowing disorders; c. strategies for preventing, reducing, or eliminating swallowing and feeding disorders; d. strategies for reducing the common health-related adverse consequences of swallowing and feeding disorders
Examination sources