This article provides an overview of current American Speech-Language-Hearing Association (ASHA) policies for the appropriate use and supervision of speech-language pathology assistants with an emphasis on the need to preserve the role of fully qualified speech-language pathologists in the service delivery system. Seven challenging issues surrounding the appropriate use of speech-language pathology assistants are considered. These include registering assistants and approving training programs; membership in ASHA; discrepancies between state requirements and ASHA policies; preparation for serving diverse multicultural, bilingual, and international populations; supervision considerations; funding and reimbursement for assistants; and perspectives on career-ladder/bachelor-level personnel. The formation of a National Leadership Council is proposed to develop a coordinated strategic plan for addressing these controversial and potentially divisive issues related to speech-language pathology assistants. This council would implement strategies for future development in the areas of professional education pertaining to assistant-level supervision, instruction of assistants, communication networks, policy development, research, and the dissemination/promotion of information regarding assistants.