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However, formal recognition alone does not ensure that individuals can obtain timely, affordable, coordinated, and sustainable care across the life course. The use of the rights\u2010based Availability, Accessibility, Acceptability, and Quality (AAAQ) framework remains limited in comparative policy research on SLT access. England (UK), Sweden, Australia, and the United States were purposively selected to capture contrasting arrangements in statutory coordination, financial protection, payer structure, and telehealth codification. The objective of this study was to compare how T\u00fcrkiye and these four settings translate formal SLT entitlement into operational access conditions across the AAAQ dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Procedures<\/jats:title>\n                    <jats:p>A comparative policy analysis was conducted using a structured document\u2010mapping approach. Primary evidence sources comprised official legislation, statutory instruments, regulations, ministry and agency guidance, reimbursement and coding rules, official standards, and selected official implementation materials. Searches were conducted between 1 June and 20 September 2025, with update verification through 27 November 2025. Twenty\u2010four eligible evidence sources were included. Data were extracted using a standardized form and analysed through directed qualitative content analysis with AAAQ as the deductive framework. Findings were subsequently synthesized across three cross\u2010cutting policy axes: life\u2010course continuity, the education\u2013health interface, and telerehabilitation implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Results<\/jats:title>\n                    <jats:p>All five settings recognized SLT as a health benefit, an education entitlement, or both, but differed markedly in how entitlement was translated into implementable access conditions. England (UK) showed the strongest statutory continuity for children and young people through the SEND framework. Official patient\u2010facing and regional sources from Sweden indicated comparatively transparent outpatient fee and high\u2010cost protection arrangements. Australia and the United States illustrated how reimbursement codification and documentation rules can support administrative traceability and tele\u2010enabled delivery. In T\u00fcrkiye, the main issue was not the absence of normative entitlement, but the extent to which access remained sensitive to dispersed reimbursement definitions, administrative interpretation, less explicit cross\u2010sector procedures, and limited codification of tele\u2010SLT within the reviewed reimbursement architecture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Implications<\/jats:title>\n                    <jats:p>Access to SLT should be understood not simply as service presence, but as a system\u2010design issue shaped by financing, documentation, coordination, and quality\u2010governance arrangements. For T\u00fcrkiye, policy development may depend less on further recognition of SLT\u2010related need and more on strengthening implementation architecture through clearer reimbursement itemization, more explicit education\u2013health coordination, and tele\u2010SLT coding linked to documentation and reporting standards. More broadly, the findings suggest that equitable and sustainable SLT access requires attention to how entitlement is operationalized across the life course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT THIS PAPER ADDS<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What is already known on the subject<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Access to speech and language therapy is often discussed in terms of service availability or formal entitlement. However, less is known about how entitlement is translated into practical access conditions across health and education systems, particularly from a comparative rights\u2010based perspective.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What this paper adds to the existing knowledge<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Using the Availability, Accessibility, Acceptability and Quality (AAAQ) framework, this study shows that differences in SLT access across T\u00fcrkiye and four comparator settings lie not simply in whether services are formally recognized, but in how entitlement is operationalized through financing, documentation, cross\u2010sector coordination and telehealth arrangements. Three system\u2010level mechanisms emerged as particularly important: life\u2010course continuity, the education\u2013health interface and the operationalization of tele\u2010SLT through reimbursement and reporting arrangements.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What are the potential or clinical implications of this work?<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>For SLT practice, service planning and policy, improving access requires attention to implementation architecture as well as formal entitlement. Clearer reimbursement and documentation rules, stronger education\u2013health coordination and explicit tele\u2010SLT coding may support more predictable, traceable and equitable access across the life course.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1460-6984.70334","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:06:32Z","timestamp":1789463192000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Life\u2010Course Access to Speech and Language Therapy: A Rights\u2010Based AAAQ Policy Mapping in T\u00fcrkiye and Four Comparator Settings"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4169-4286","authenticated-orcid":false,"given":"Harun","family":"Ayas","sequence":"first","affiliation":[{"name":"Rectorate Yalova University  Yalova T\u00fcrkiye"},{"name":"Department of Speech and Language Therapy Faculty of Health Sciences, Istinye University  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4161-8117","authenticated-orcid":false,"given":"M\u00fcge M\u00fczeyyen","family":"\u00c7iyiltepe","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy Faculty of Health Sciences, Istinye University  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.129"},{"key":"e_1_2_11_3_1","unstructured":"American Speech\u2010Language\u2010Hearing Association. n.d.Pediatric Feeding and Swallowing.https:\/\/www.asha.org\/practice\u2010portal\/clinical\u2010topics\/pediatric\u2010feeding\u2010and\u2010swallowing\/."},{"key":"e_1_2_11_4_1","unstructured":"American Speech\u2010Language\u2010Hearing Association.2016.Scope of Practice in Speech\u2010Language Pathology.https:\/\/www.asha.org\/policy\/sp2016\u201000343\/."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12721"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2021.106111"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)32340\u20100"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.70018"},{"key":"e_1_2_11_9_1","unstructured":"Committee on Economic Social and Cultural Rights.2000.General Comment No. 14: The Right to the Highest Attainable Standard of Health (E\/C.12\/2000\/4). 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