Early in her career, Susan Toavs worked with a young boy whose communication skills were so poor that he had no friends. After several months of speech therapy, the boy's skills improved and treatment was discontinued.

"I will never forget what happened next," says Toavs, a speech-language pathologist at Gillette Children's Specialty Healthcare (www.gillettechildrens.org). "The boy was in the clinic for a check up, and his mom told me that he had just been invited - for the first time ever - to a classmate's birthday party!"

A wide-ranging field
Speech-language pathologists, also called speech therapists, evaluate and treat patients who have communication disorders or difficulty swallowing. Therapists work with a wide range of patients, from infants with feeding problems to older adults with Parkinson's disease.

At Gillette, Toavs works with children and teens who have brain or spinal cord injuries, brain tumors or complex medical conditions. "One of the things I like best about this job is that every day is different," she says.

An individualized approach
Working closely with physicians, nurses, occupational and physical therapists, Toavs tailors speech therapy to the child's needs and interests. With a 16-year-old girl who sustained head injuries in an automobile accident, Toavs focused on horses. Because the teen loved to ride, she was motivated to communicate.

Toavs also looks for ways that families can incorporate communication activities into a child's daily routine. She might, for example, create a game something like "Go Fish" that requires a child to use particular sounds. For a child who likes to attend his older siblings' baseball games, she might work on cheers he could yell from the bleachers.

Education and employment outlook
To be licensed in Minnesota, speech-language pathologists must complete a master's degree and pass a national exam to earn the Certificate of Clinical Competence from the American Speech and Hearing Association (www.asha.org).

Roughly half of all speech-language pathologists work in school systems. The rest work in healthcare settings. According to the Bureau of Labor Statistics, restrictions on reimbursement may limit opportunities in healthcare in the near term. In the long term, however, the demand for therapists should continue to rise.

Nancy Giguere is a freelance writer from St. Paul who has written about healthcare since 1995.