Pediatric Traumatic Brain Injury: Speech-Language Pathologists Must Have a Seat at the Table

PURPOSE: This viewpoint aimed to highlight gaps in the integration of speech-language pathologists (SLPs) within pediatric traumatic brain injury (TBI) care pathways and to suggest strategies to strengthen SLP involvement across health care and educational settings. For example, we understand that young children who experience concussion or mild TBI may not be seen for assessment or treatment. Although cognitive-communication disorders are common after pediatric TBI and fall within the scope of speech-language pathology practice, referral and involvement remain inconsistent. This viewpoint synthesizes insights from practicing clinicians and researchers across health care and educational settings in the United States and Canada, informed by discussions at the Fifth Biannual International Cognitive-Communication Disorders Conference in January 2026. Themes were identified through synthesis of author perspectives, guided by targeted questions informed by group discussion, to highlight key issues in care and strategies for improving SLP integration across systems. CONCLUSIONS: SLPs are uniquely trained to address cognitive-communication consequences of pediatric TBI but remain underutilized. Improving SLP integration requires coordinated efforts across health care and educational systems, including earlier referrals, better interdisciplinary collaboration, and an increased awareness of SLPs' role in cognitive-communication intervention. Coordination and follow-up support the identification of long-term effects of TBI as children develop. Ensuring that SLP expertise is consistently involved within pediatric TBI care pathways is essential to providing children and adolescents with timely support that promotes academic success, social participation, and long-term functional outcomes.