A mother’s eyes glimmer with joy as her child utters the first word — three years later than expected.
A child speaking their first words is often a special occasion. However, for families of children with speech and hearing disorders, it can be a source of anxiety, and the shortage of speech-language pathologists (SLPs) in BC is limiting families’ opportunities to receive timely intervention.
The Government of Canada’s 2021 Job Bank found that around 1,500 SLPs and audiologists served a population of 5 million people in BC.
According to data collected from 2019–2023 by the Canadian Institute for Health Information, BC’s ratio of SLPs to residents was fourth-to-last in Canada, with 26.3 per 100,000 residents.
Delays in accessing these services can affect children’s developmental stages. Around eight to twelve per cent of Canadian preschoolers have some form of language impairment, and seven per cent of Canadians have developmental language disorders, which can lead to communication difficulties that persist beyond childhood, impairing social relationships and learning abilities.
“There's a shortage of both SLPs and audiologists in the province, and that shortage is leading to a lot of families not being able to access services,” said Chelsey Chichak, an SLP and president of Speech and Hearing BC, an association of SLPs and audiologists advocating for lifelong speech and hearing services.
According to Chichak, wait times for families to access speech services can be up to one year, even in densely populated areas like the Lower Mainland. In rural or northern BC, some children aren’t able to access support before kindergarten, sometimes waiting up to three years for public services, with some communities not having any private services as a possible alternative. Indigenous communities are especially affected by the shortage of SLPs due to many reserves being in remote locations.
Government-funded speech and language services provide free screenings for children up to five years old. Due to long waitlists for public services, Chichak sees many families forced to turn to private services — because speech, language and swallowing services are not covered under BC’s Medical Services Plan, the rates can sometimes reach hundreds of dollars per hour out of pocket.
“We hear from families [on the waitlist] that they're often stuck in limbo … not knowing what they could do to be able to support their children,” said Chichak.
However, those who can afford private services aren’t often more optimistic.
“It’s rough out there,” said Annika Fong, who graduated from UBC’s master’s of speech-language pathology in 2024 and is currently an SLP in a private practice, primarily working with children. She notices that many families, even after receiving free assessments for children under five, still rely on private services to address their children’s conditions. The waitlists for private practices can take just as long as the ones for public services do, she says — and even if a family can afford a few private sessions, speech therapy usually takes time to produce results.
“A lot of the time, when we see these kids, they're going to need therapy not just for the $600 or $1,000 that the parents get from their benefits, but for a lot longer,” said Fong. “For especially low-income families, that's really hard … It’s really sad.”
The importance of early intervention
Speech and language development skills are formed during the first few years of life, with language development starting prenatally. Children who have access to speech and language therapy earlier tend to have better results than those who access it later, so early intervention by SLPs and audiologists in a child's communication is crucial for ensuring proper development.
Dr. Paola Colozzo, an associate professor and interim director of UBC’s School of Audiology and Speech Sciences, says the goal of early intervention is to help children develop their ability to communicate, regardless of the modality.
Courtesy Paola ColozzoSome children will use their natural voice. Other children might use sign language or might use other means of communication. So that's the goal of early intervention — to help that child gain those supports and to continue to develop their communicative abilities.
According to Colozzo, as children are exposed to multiple environments, they develop communication skills for social interactions, ranging from listening and speaking to reading and writing, which enable them to develop friendships and participate in daily activities. She stresses the importance of helping a child find a communication system that works for them.
“Some children will use their natural voice. Other children might use sign language or might use other means of communication. So that's the goal of early intervention — to help that child gain those supports and to continue to develop their communicative abilities,” said Colozzo.
Even if a child appears to have normal speech patterns, there could be issues flying under the radar — for instance, a child may be able to say phrases, only for parents to realize they’re copying things they’ve heard on their favourite TV shows and not actually producing their own phrases. Fong sees many parents and caregivers who don’t fully understand what neurodevelopmental disorders like autism look like and are unable to identify potential signs in their child’s behaviour. By the time they’ve caught on to the fact that there may be an underlying condition to look into, the child is already in elementary school and has missed the period where they could’ve accessed a free assessment.
Courtesy Annika FongEarly intervention isn't about correcting children. It’s about affirming their way of being and ensuring the adults around them know how to connect and really listen and support their children.
Even after making it through the waitlist, speech therapy itself can be a long process, and it may take some time before parents start to see results. Fong says that parents tend to come into an appointment believing that SLPs are “some sort of miracle worker” who can immediately correct their child’s speech. But Fong has to help them realize that they won’t see immediate change, and that verbal communication isn’t always the end goal. For non-verbal children, she might try to introduce an augmentative and alternative communication device to the child — this could be low-tech, like photos or an alphabet board, or high-tech, like a program on a tablet or laptop. Overall, she wants to meet kids where they’re at by finding a way they can proficiently communicate, even if not verbally.
“[We] need to shift the conversation,” said Fong. “Early intervention isn't about correcting children. It’s about affirming their way of being and ensuring the adults around them know how to connect and really listen and support their children.”
Expanding the pathway at UBC
As of 2025, the only speech-language pathology master’s program in the province is at UBC, where students are offered a mix of theory and practice to prepare for their career. Students apply after completing a four-year undergraduate degree at an accredited university, passing prerequisite courses and gaining experience shadowing SLPs and audiologists. The program, which spans two years, allows students to take graduate coursework in human communication and clinical speech-language pathology while completing clinical practicums in community settings supervised by qualified professionals.
In a province with a population of over 5.7 million as of 2025, UBC has a huge demand to meet as the only formal SLP training program. Fong said that everybody in her cohort at UBC was hired before graduation, with employers in both public and private services trying to “snatch [them] up.”
After receiving a funding increase from the provincial government in 2014, the program jumped from 23 to 36 seats — a 56 per cent increase in capacity — and remained at that number until just last year.
In 2024, it was announced that the program would be expanding again, but in a new format. In partnership with the University of Victoria, UBC now has a master’s of speech pathology cohort of eight additional students who receive their training in Victoria, bringing the total number of seats from 36 to 44. Students in both the Vancouver and Victoria cohorts cover the same material — there’s also a digital element to the classes which allows students and instructors on both campuses to interact in real time.
Colozzo is excited about the increased capacity of the master’s program, also noting that having a presence on Vancouver Island is an asset. She believes that the new teaching spaces and equipment, along with the expanded network of clinicians across BC, will allow students to have rich learning experiences in diverse communities.
According to Colozzo, the vast majority of graduates remain in the province for employment, with many having served communities outside of the Lower Mainland for the last decade. Clinical placements take place all over the province — like in Campbell River, Nelson, Kitimat, Quesnel, Fort St. John, Dawson Creek and Haida Gwaii, to name a few — as a way to try and address the lack of SLPs in northern BC. Many graduates tend to work where they trained, she said, with many students gaining more awareness of the option to work in certain areas during these rural placements.
Organizations like Speech and Hearing BC partner with UBC to make sure the program can access placements in all their desired areas. Chichak said that because burnout is common among SLPs, it can be difficult to ask someone to take on the extra responsibility of working with a student. However, she believes UBC offers “a wide variety of classes and opportunities, both on the practical side of things and on the research side of things,” that sets students up for success and puts them in a position to actually be an asset to the SLP they’re assisting.
Reducing the burden
As part of her role as president of Speech and Hearing BC, Chichak advocates for systemic changes that would increase access to communication, hearing and swallowing care. This involves working with members of the organization to reach out to local MLAs, health authorities and UBC administrators — anyone who plays a role in increasing access to treatment possibilities and training future SLPs. The organization also engages with policymakers — namely the Ministry of Education, Ministry of Health and Ministry of Children and Family Development, Chichak said — to discuss ways the provincial government can be supporting SLPs.
Courtesy Chelsey ChichakWe still need to look at supporting programs up in the North, because the barrier of being able to move and attend school down on the West Coast is going to be a challenge for a lot of families and a lot of people who might be wanting to join our profession.
Chichak believes that in order to increase access to services going forward, training is key, so an additional expansion in northern BC is needed.
“We still need to look at supporting programs up in the North, because the barrier of being able to move and attend school down on the West Coast is going to be a challenge for a lot of families and a lot of people who might be wanting to join our profession,” she said.
“The hope from there would be that those individuals would then return back to their community … That would help with some of our retention and recruitment in the North, [as] it's really hard to be able to support people in moving there and staying there … We need to support people in their communities.”
But while increasing the capacity of the UBC master’s program would be ideal, Chichak believes it won’t be happening anytime soon. In the meantime, she proposes that being able to access services from internationally-trained professionals could help decrease wait times. Currently, SLPs who were trained outside Canada and wish to practice in BC must undergo a full assessment by the College of Health and Care Professionals of BC, including meeting certain academic requirements and completing practicum hours; Chichak believes this process should be expedited, as the length and cost of the application are only further exacerbating BC’s shortage. Not only would the increase in internationally-trained SLPs shorten wait times — it could also reduce SLP workload and prevent burnout, which would increase retention rates.
Similarly, Fong hopes to eventually see more funding from the government to increase SLP services for families. She emphasized the importance of establishing funding structures that can support flexibility in how SLP services are delivered — she believes allocating resources toward virtual care could make it easier to connect with clients in rural areas. Fong also pointed out that people working with an SLP are sometimes concurrently seeing a counsellor, occupational therapist or other health professional, but it’s difficult for the care team to find the time to actually collaborate, and it would be worth investing in making this possible for more families.
“I just hope we can move toward a model of universal or tiered access to communication support, one where children don't need a diagnosis or wait 18 months just to be seen,” she said. “We need more publicly-funded SLP positions in community health [and] early childhood settings.”
