← Risk register SOC 29-1127 · reviewed 2026-08-11

Speech-Language Pathologists

183,390 US workers · median $97,870/yr · Healthcare

SAFE

SLP work is hands-on and relational: positioning a stroke patient for a swallow study, cueing articulation in real time, coaxing a nonverbal three-year-old through play-based therapy, deciding whether a dysphagia patient is safe to eat by mouth. AI can draft evaluation reports, score standardized tests, transcribe sessions, and generate home practice materials — the documentation load, which is real, but not the treatment. State licensure plus CCC-SLP credentialing and personal accountability for aspiration and feeding decisions keep a human clinician on the chart.

10-year outlook: Demand grows with aging stroke and dementia populations and school caseloads; AI absorbs the paperwork and lets SLPs carry larger caseloads rather than shrinking the profession.

US employment, 2019–2025+18.8%
154,360183,390 workers

Dipped in 2020, then grew past where it started.

Median pay $79,120 → $97,870 -1.0% in real terms (nominal +23.7%, less ~25% US inflation over the period)

The job count is not the verdict

This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.

So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing. The marked year is 2020.

BLS projection, 2024–2034

+15% 187,400 → 215,500 on the projections basis

Hard to automate, and growing

The work resists current AI and the BLS projects +15% more of these jobs by 2034. Note that safe does not mean well paid — several of the fastest-growing resistant occupations are among the lowest paid on the register.

Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.

~13,300 openings a year on average, including replacing people who leave.

One email if this score changes. Watch as many occupations as you like from the same address — no account, and nothing is sent on a schedule, only when a verdict actually moves.

Also known as — 24 job titles this covers

Titles reported by people doing this work, from the US Department of Labor's O*NET survey. If your job title is here, this page is about your work even though the name doesn't match.

Oral TherapistSpeech ClinicianSpeech TherapistVoice PathologistSpeech PathologistLanguage PathologistSpeech-Language SpecialistSpeech and Language TeacherSpeech Language PathologistSpeech Correction ConsultantSpeech and Language ClinicianSpeech and Language TherapistPublic School Speech ClinicianPublic School Speech TherapistSpeech and Language SpecialistSpeech-Language Pathologist (SLP)School SLP (School Speech Language Pathologist)Travel SLP (Travel Speech Language Pathologist)SNF RN (Skilled Nursing Facility Registered Nurse)SLP CF (Speech Language Pathologist Clinical Fellow)Bilingual Speech-Language Pathologist (Bilingual SLP)Pediatric SLP (Pediatric Speech Language Pathologist)Pediatric Speech-Language Pathologist (Pediatric SLP)Home Health SLP (Home Health Speech Language Pathologist)

Score — 83/100 resistance

Holding it up: trust premium (18/20). Weakest point: embodiment (15/20).

Five dimensions, 0–20 each, summed. Higher means more protected. The arithmetic is shown so you can check it: 16 + 15 + 16 + 18 + 18 = 83. · Scored 2026-08-11, and re-examined when evidence accumulates rather than on a schedule.

Task resistance 16/20

Tasks largely resist digitisation The minute-to-minute work is contingent responding — you hear a distorted /r/, decide whether to cue placement or back off to a syllable level, and adjust within the same breath; standardized test scoring, IEP goal templating, and progress-note drafting are genuinely automatable, which is what keeps this at 16 rather than 19.

Embodiment 15/20

Hands-on in uncontrolled environments You are placing your hand under a child's jaw for oral-motor cueing, positioning a post-CVA patient upright at 90 degrees for a bedside swallow screen, suctioning a trach patient during a Passy-Muir trial, and doing it in NICUs, nursing-home dining rooms and elementary classrooms — physical and uncontrolled, though you're not lifting or in hazard gear, which is why this sits at 15 and not 18.

Liability shield 16/20

Licensed human required and personally liable State licensure is mandatory in all 50 states and the ASHA CCC-SLP plus Medicare Part B billing requires your NPI on the plan of care, so when a patient you cleared for a Level 2 dysphagia diet aspirates, the incident review names you — a 16 rather than a physician's 19 because you work under physician referral for medical dysphagia and don't hold independent prescriptive authority.

Trust premium 18/20

The human relationship is the product Therapy only works if the patient will produce an error sound in front of you or a parent will follow through on 15 minutes of home practice nightly, and that comes from months of twice-weekly sessions where you learned which reinforcer works for that specific child — the alliance is the intervention, not a delivery channel for it.

Judgment & accountability 18/20

Exists to be accountable for ambiguous calls You decide whether a MBSS finding means NPO, whether a stutter is developmental or warrants a fluency diagnosis at age four, whether a nonspeaking child needs AAC now versus more time on verbal targets, and whether to discharge — calls made on incomplete data with aspiration pneumonia or years of lost communication access on the other side.

Confidence: high · reviewed 2026-08-11 · how scoring works

What this job involves — and which parts are yours

The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.

AI already does these at usable quality

These still need a person

Active moats on the surviving side: embodiment, licensure, trust

How to future-proof this job

Where to go deeper on what this job runs on: Khan Academy — reading and vocabulary, all levels, free free · Coursera — active listening and communication skills free to audit · Coursera — critical thinking and logic, audit free free to audit · Coursera — communication and interpersonal skills free to audit · Purdue OWL — the standard reference for professional writing free · Toastmasters — public speaking practice at local clubs worldwide low

All 35 skills ranked by how many jobs they open →

What would move this back up — beyond any one person

The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 92/100, still SAFE.

5 specific changes that would raise this score
  • already happening liability shield +2

    Malpractice carriers or hospital credentialing bodies requiring named-clinician attestation on any AI-assisted evaluation report or aspiration-risk determination, mirroring radiology AI attestation requirements now appearing in insurer policies

  • already happening task resistance +2

    Task-mix shift: if AI absorbs the routine tier (standardized test scoring, IEP/eval report drafting, session notes, home-program generation, Medicare productivity documentation), the residual job is disproportionately instrumental swallow interpretation, AAC device candidacy decisions, tracheostomy/ventilator patients, and behaviorally complex pediatric cases — all judgment tier. This raises task_resistance without any new law

  • plausible liability shield +2

    CMS conditions of participation or state licensure rules explicitly requiring a licensed SLP (not an aide, not a software output) to personally sign dysphagia diet-level recommendations and instrumental swallow study interpretations (MBSS/FEES), plus state boards restricting delegation of swallowing evaluation to SLPAs — ASHA already lobbies on SLPA scope, and several states (e.g., Texas, Florida) have codified SLPA supervision limits

  • plausible judgment accountability +2

    Formal designation of the SLP as the accountable clinician on interdisciplinary dysphagia and airway teams (NPO decisions, PEG-tube recommendations), and IDEA due-process rulings that hold the evaluating SLP — not the district or its software — accountable for eligibility determinations

  • plausible trust premium +1

    Little headroom: buyers are already overwhelmingly payers (Medicare, Medicaid, school districts) who purchase the licensed credential rather than a specific person. The only realistic route is growth of private-pay pediatric and accent/voice practices where parents select a named clinician, plus school-district contracts that bar teletherapy-vendor substitution — some state legislatures (e.g., teletherapy caps in school SLP contracts) have moved this way

The limit. Already at 83; the realistic ceiling is high-80s. The main downside risk is not AI replacing treatment but payers substituting cheaper labor tiers — SLPAs, teletherapy platforms with high caseload ratios — under an AI-assisted supervision model. That would erode trust_premium and liability_shield even as task_resistance holds.

These are conditions, not forecasts — what would have to happen, not what will. Specific rules, cases and bills are named so you can go and check whether they exist and where they stand; verify before relying on any of them. Nothing here is legal or financial advice.

Where this work is, and what it pays there

BLS metro figures for 369 areas. The verdict above does not change by city — the rubric judges what the work involves, not where it happens — but pay and headcount do, and the national median hides a very wide range.

Most of these jobs

New York-Newark-Jersey City, NY-NJ 15,260 $107,860 +10%
Chicago-Naperville-Elgin, IL-IN 7,150 $98,490 +1%
Dallas-Fort Worth-Arlington, TX 4,800 $99,540 +2%
Los Angeles-Long Beach-Anaheim, CA 4,800 $109,740 +12%
Houston-Pasadena-The Woodlands, TX 3,780 $100,400 +3%
Boston-Cambridge-Newton, MA-NH 3,720 $102,810 +5%
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 3,330 $100,080 +2%
Washington-Arlington-Alexandria, DC-VA-MD-WV 3,140 $99,960 +2%

Best paid

El Centro, CA 70 $133,760 +37%
San Jose-Sunnyvale-Santa Clara, CA 890 $132,720 +36%
Boulder, CO 320 $131,620 +34%

Percentages are against this occupation's national median of $97,870. Counts are jobs in that metro, not vacancies. Metros where the BLS suppressed the cell are absent rather than shown as zero.

Who is actually doing this — nobody, on the record

We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.

That is worth saying out loud next to a score of 83. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.

Read that as a gap in the reporting we can see, not proof of absence — the dispatch runs on English-language feeds and misses plenty. If you know of a case, tell us, or add a field report from inside the job.

Quick take — do you do this job?

Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.

Self-reported and unverified — a sentiment signal, not a survey. One response per person per occupation; you can change your answer.

Field reports — what people say has changed

No field reports yet. A written account takes a paragraph rather than a tap, goes to an editor before it appears, and is the one thing on this page the rubric cannot produce on its own.

File a field report

Concrete beats general: a tool that arrived, a task that moved, a headcount decision you watched happen. Don't include anything that identifies you or your employer if that would put you at risk.

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