Working with a Communication Health Assistant (CHA)

Many families and adults need speech therapy but worry about cost, scheduling, or finding enough therapy time. Working with a Communication Health Assistant (CHA) can be an excellent way to receive more therapy while keeping services more affordable.

At Mercury Speech & Language, every client is assessed by a registered Speech-Language Pathologist (SLP). Your goals, treatment plan, and progress monitoring are directed by the SLP. A CHA helps carry out parts of the treatment plan under the SLP's supervision.

This team approach allows many clients to receive high-quality therapy more often while paying a lower rate than they would for every session with an SLP.

What Is a Communication Health Assistant?

A Communication Health Assistant (CHA) is a trained team member who helps deliver speech and language therapy activities designed by an SLP.

You may have heard similar titles such as:

  • Speech-Language Pathology Assistant (SLPA)

  • Communicative Disorders Assistant (CDA)

The role is very similar. Depending on their background, a CHA may have formal education, workplace training, mentorship, specialized courses, or a combination of these experiences.

At Mercury Speech & Language, every CHA receives ongoing training, mentoring, and supervision from a registered SLP.

How Does Supervision Work?

Your SLP remains involved throughout the entire therapy process.

The SLP:

  • Completes the assessment

  • Determines whether CHA services are appropriate

  • Creates therapy goals

  • Designs treatment plans

  • Monitors progress

  • Makes clinical decisions

  • Updates goals when needed

A CHA helps deliver therapy activities that follow the plan created by the SLP.

In many cases, clients may work with a CHA independently for approximately 6-7 sessions before participating in a joint session with both the CHA and supervising SLP. This allows the SLP to review progress, make adjustments, answer questions, and ensure therapy remains effective.

What Can a CHA Do?

Under SLP supervision, a CHA may:

  • Lead therapy activities

  • Practice speech sounds

  • Support language development

  • Help clients use communication strategies

  • Support social communication goals

  • Practice cognitive-communication skills

  • Carry out home program activities

  • Collect data during therapy sessions

  • Report observations to the supervising SLP

A CHA can work with both children and adults when the supervising SLP determines it is appropriate.

What Can a CHA Not Do?

According to professional guidelines from organizations such as the Speech-Language & Audiology Canada (SAC) and the American Speech-Language-Hearing Association (ASHA), a CHA cannot:

  • Diagnose communication disorders

  • Complete independent assessments

  • Develop treatment goals independently

  • Change treatment plans without SLP approval

  • Discharge clients from therapy

  • Make clinical recommendations independently

  • Interpret assessment results independently

  • Practice without supervision from an SLP

The supervising SLP remains responsible for all clinical decisions.

Does Working with a CHA Actually Work?

Research on speech-language support personnel, including SLPAs and similar assistant roles, has shown positive outcomes for many clients when services are appropriately supervised.

Studies have found that assistants can effectively help deliver therapy programs developed by SLPs. Research has also shown that therapy intensity matters for many communication goals. When families can access more practice opportunities, progress often improves.

The key factor is not whether the person leading the activity is an SLP or a CHA. The key factor is whether the therapy plan is evidence-based, individualized, and supervised appropriately by an SLP.

A CHA can help clients:

  • Receive therapy more consistently

  • Access more treatment sessions

  • Practice skills more often

  • Maintain progress between SLP visits

  • Reduce financial barriers to care

Benefits of Working with a CHA

More Affordable Speech Therapy

CHA sessions are offered at a lower rate than SLP sessions. This allows many families and adults to receive ongoing support that may otherwise be out of reach financially.

More Therapy Time

Communication skills improve through practice. A lower session cost may allow clients to attend therapy more frequently.

Greater Flexibility

CHA appointments often provide additional scheduling options, making it easier to fit therapy into busy family and work schedules.

A Team-Based Approach

You benefit from the expertise of an SLP while also receiving regular support from a trained therapy team member.

Stronger Skill Carryover

More opportunities to practice can help clients apply new skills in daily life, at home, at school, in the community, or at work.

Frequently Asked Questions about working with a communication health assistant

  • CHA services may be a great option for:

    Children who:

    • Need regular practice of speech sounds

    • Are working on language goals

    • Benefit from repetition and routine

    • Have established therapy goals

    Adults who:

    • Have aphasia

    • Have cognitive-communication difficulties

    • Are recovering from stroke or brain injury

    • Need support practicing communication strategies

    • Want more therapy opportunities between SLP visits

    Families who:

    • Want affordable speech therapy options

    • Are looking for ongoing support

    • Want increased therapy intensity

  • Some situations may require direct SLP involvement more frequently.

    This may include:

    • Complex diagnostic questions

    • Initial assessments

    • Rapidly changing medical conditions

    • Highly specialized treatment needs

    • Situations where goals are still being identified

    In these cases, your SLP will discuss the best service model for your needs.

  • No.

    You are still receiving services directed by a registered Speech-Language Pathologist. The assessment, treatment planning, clinical decision-making, and supervision remain with the SLP.

    A CHA helps deliver the therapy plan created by the SLP.

    For many clients, this model provides an excellent balance of quality, affordability, and access to care.