Speech Implementer vs. Speech Language Pathologist


Do you know who is providing your child's speech/language therapy services?

Many times parents stop to ask what the difference is between a speech implementer, a speech-language pathology- assistant (SLP-A), and a speech-language pathologist (SLP).  We will try to clarify it here. 

Speech Implementer

The speech implementer model was designed as a temporary solution for for public schools who were having a difficult time finding licensed speech-language pathologists.  This model is meant be a "band-aid" for districts that have not be able to find a licensed speech-language pathologist (SLP) NOT a permanent solution to save on funds.  A school district must ask the Department of Elementary and Secondary Education (DESE) for permission to use this model annually.  They must be able to prove that they are actively searching to hire a certified SLP throughout the school year.

An implementer has the following credentials:

DESE issued educator certificate

Bachelors Degree in Elementary or Secondary Education

A valid MO teaching certificate 

An implementer MUST be supervised by a certified SLP.  The amount of supervision should be outlined in a child's Individual Education Plan (IEP).  The implementer may be described as (SPED Staff and/or SLP/Staff).  DESE described supervision as "periodic".

There is NO LIMIT on the number of implementers an SLP can supervise.

Implementer Duties:

Assists with the implementation of IEPs, screening, and documenting progress under the supervision of a licensed SLP.

Implementers CANNOT do the following: 

Conduct evaluations; determine eligibility; write, develop or modify IEPs; interpret data

Unable to bill Medicaid for services

A speech implementer can be a teacher of any kind (math, language arts, counselor, etc.).  They have not completed any coursework in speech-language pathology.  It does not matter if they have been an implementer for 3, 5, 10, or 20 years.  They are not therapists.  If your child is being seen by an implementer, please make sure you are aware of the number of hours/week they are being supervised, as well as the number of hours of direct contact with the licensed SLP.

Additional information can be found here:


Speech-Language Pathology-Assistant (SLP-A)

A speech-language pathology, assistant, has a bachelor's degree in the field of communication disorders and must have a license from the Missouri Board of Healing Arts.  

This is an appropriate delivery model for speech-language therapy services within a school district, outpatient therapy, home therapy, early intervention services, and/or private therapy.  There are restrictions when billing certain insurance companies, including Medicaid.

A licensed SLP can supervise a maximum of 3 SLP-As.  DESE places stricter restrictions on SLP-As than restrictions placed on implementers.   Direct supervision is required for SLP-As for initial student contact.  After initial contact, the SLP supervises one hour per week for each assistant or one out of every three student sessions. 

An SLP-A can perform the following duties:

Assist with the implementation of IEPs, screening, and documenting progress as well as other activities such as early intervening services and language-literacy activities with non-disabled students under the supervision of a licensed SLP 

An SLP-A CANNOT perform the following duties:

Conduct evaluations; determine eligibility; make case selection; interpret data; make referrals; write, develop or modify IEPs 

Additional information can be found:



Speech-Language Pathologist

A speech-language pathologist has obtained a master's degree in the field of communication disorders.  They have are required to maintain their license and certification through the Missouri Board of Healing Arts and American Speech-Language-Hearing Association.  

They are required to maintain their certification and license through completion of 30 continuing education hours every 3 years.  

Speech-language pathologists are able to evaluate and treat individuals from birth to death.  SLPs evaluate and treat any and all communication and swallowing disorders including:  hearing impaired, apraxia, receptive language deficits, expressive language deficits, dysphagia, dysarthria, fluency/stuttering, phonology, articulation, dyslexia, voice, cognition, feeding, social language, etc.  Therapists spend their careers adding to their therapy toolbox with certification in specialized assessment and treatment.  Speech-language pathologists are the most qualified to treat communication disorders.  

Find out more information:



Chatterbox Speech Therapy, LLC

At Chatterbox, all therapists are licensed and certified speech-language pathologists.  Their level of experience ranges from 2 years to 25 years.  Many therapists have had the opportunity to work with different populations, in a variety of settings and communication disorders.  Our therapists work at Chatterbox because they have a passion for pediatrics.  We take pride in offering comprehensive evaluations and specialized skilled therapy for each individual client.  Chatterbox encourages therapists to continue refining their skills and/or adding to their therapy toolbox through continuing education.  Click on the link below to learn more about our therapists.