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What to Expect in Speech Therapy

By Amalah


What is UP, girl, I haven’t written to you in AGES. You’re like my personal therapist that instead of prescribing pills prescribed wine and I love you and oh hell I’m rambling aren’t I?

I wrote to you about how to tell if your kid is speech delayed. You graciously answered me.

Then, I wrote to you about my Godd*** relatives not buying it when they SAID she was. You laid the smacketh downeth, and LO! They shut the eff up!

We reached a compromise: we’d give it a few months for her to catch up, and have her reevaluated.

I had her retested and OH SURPRISE! She’s speech delayed. And it’s getting worse! YAY! CELEBRATE! I TOLD U SO.

We’ve decided to start on the therapy route, and it’ll start next month. We haven’t a damn clue what to expect. They said they can go to her daycare or we can go to them. Aaaand, that’s about it. Do they drill words into her and tell her to repeat it? Play with her using words? I mean, I’m just lost here and I Googled and it. WOW. Tons of stuff out there that I don’t have time to look at, and I’m at the office right now and my boss considers looking at the internet like looking at smut.

Soooooooooo‚ Advice?

Thank you!

Well, first of all, and I’m sure you’ve already gleaned this from the FOUR BAJILLIONITY ELEVEN results on Google, there are many, many different approaches and takes on speech therapy. However, most speech therapy aimed at very young children is similar and rooted in play.

And because of this, I really, REALLY recommend that you do the therapy at a time and place where either you or your partner can attend, whenever possible. 45 minutes of therapy a week is NOT going to be what gets your daughter caught up — that’s going to come from you incorporating what YOU learn during the therapy for as much as possible, for the rest of the week.

And yes, that includes daycare providers, so it’s not a bad idea for them to sit in on the therapy, but realistically they might not be able to. They might need to simply hand your daughter off to the therapist for that time while they care for other children. You can ask your therapist for short, easy things she recommends that the daycare incorporate though, or make copies of any hand-outs or information sheets she gives you and pass these along. But I have always felt that early intervention therapies are just as much for us, the parents, as they are for our kids.

Because really, you’re probably going to be surprised at how subtle speech therapy is. No, it’s not flash cards or Henry Higgins-style pronunciation drills. Because think about it: If your daughter responded to stuff like, “Say ball, honey. How do you say ball? C’mon, SAY BALL!”…you probably wouldn’t be pursuing speech therapy in the first place, right?

When my first son, Noah, first started speech therapy, it involved a really nice lady coming to our house with a big bag of toys. She pulled out one toy and a time, speaking slooooowly, with very few words, and incorporating sign language whenever possible. There was usually one goal for the entire session — on a good session we might have one goal per toy or activity. These goals were anything from getting Noah to use a sign to make a request (like “open” or “more”), or getting him to repeat a simple sound (like “pop” for bubbles), or just generally demonstrate his expressive and receptive language skills (could he point to correct pictures in a book when asked, did he make a wide range consonant sounds, etc?).

The first few sessions are all about establishing trust, figuring out where your daughter’s development stands and what toys and activities engage her and will keep her involved. Everything you see your therapist do, file away for future mimicry: the way she talks and uses toys, how much silence she allows before supplying words, how much repetition of a single word or sound she’ll do and how she keeps your daughter’s interest…while gently pushing her towards participating in a rudimentary conversation, be it with signs or sounds or words, depending on your daughter’s skill level.

Noah LOVED speech therapy. It was his favorite day of the week. He didn’t know it was speech therapy, of course, but that’s the whole idea. His therapist taught him that signing and speaking to make his wants and needs known made a fun time EVEN FUNNER. And then she and I discussed anything that happened during the week that seemed important, or any additional concerns I had (his toe-walking, swallowing skills, texture sensitivity) and whether they warranted more looking into.

Now: We did at one point look into some private therapy at a particular speech-and-language center, and they preferred to have the parents sit out in the waiting room while the kids played with therapists in the back, although you were encouraged to watch the sessions through a one-way mirror. This was mostly for older children — age three and up, when sometimes having mom or dad around can negatively impact behavior. Now Noah receives the bulk of his therapy at school, though we are in near constant-contact with his teachers and therapists about what’s working and what’s not and what we can implement at home.

But for a young child just starting out, really: BE THERE WITH HER. You (and she) will get much more out of it if you do. The therapist is your resource and teacher too. If you ever feel like the therapist is not a good fit for whatever reason, call and request someone new. (It can be nothing against the therapist, even. Some kids just don’t click with certain adults.) Speech therapy is not a task you outsource, it’s bringing on additional members of Team Let’s Kick This Problem To The Curb, of which you are a charter member.

Photo by barron

Published March 17, 2010. Last updated April 18, 2017.
About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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  • Muirnait

    March 17, 2010 at 12:30 pm

    Amy, you’re my favourite. Great advice! And I totally agree about asking for someone else if necessary – a good therapist shouldn’t be insulted when asked for a switch; the best ones will be 100% about helping your child and you.

  • Jen

    March 17, 2010 at 2:08 pm

    My son started speech therapy when he was 2, and our options were at home and at the speech therapy center. It worked much better at the speech therapy center because he wasn’t on “his turf.” At home, when he didn’t want to engage he would walk away or turn his back, which didn’t happen at the center for some reason. Not sure if this would have happened at his daycare center as well, but there is something to be said for taking the home-field advantage away from him. Otherwise, I echo what Amy says — go into sessions with him and copy what happens at the sessions at home.

  • obabe

    March 17, 2010 at 2:22 pm

    okay, so my kid was different, but he didnt do well at all in speech when i was around. this may have had to do the fact that we had a nanny, so he wasnt used to me being around during the day, but after two sessions of him not LOOKING at our therapist (who we loved and clicked with immediately) and instead burying his head in my shoulder, we decided for her to come when i wasnt there (or i would sit on the stairs leading to our basement to listen but not be seen!), and she would follow up each session with an email of what they did together and what to work on. we had a fairly minor delay – it was once a week for 6 months and then he was talking up a storm (from 18 mnth to 2 years old) and that was the end of our speech therapy journey. and now at 6.5 he DOES NOT STOP TALKING EVAH. good luck!

  • CS

    March 17, 2010 at 5:13 pm

    My son started private therapy for a speech delay at 18 months; I sat in on the first two sessions, and from then on, watched on a cc tv from the waiting room. It was hard to be removed from the action, but like a previous commenter, I found that he was MORE communicative in my absence. His therapist made time at the end of every session to debrief with me and to give me strategies and skills to practice at home. Like you, Heidi, I had NO idea of what to expect, but I found her directions/instructions clear and precise; it might be helpful to note, though, that the things his therapist asked me to do at home were not things that she did in therapy–they were home practice skills, as opposed to actual therapy. It made me relax to realize that I didn’t have to be my son’s therapist, just his advocate.

  • Anonymous

    March 17, 2010 at 7:02 pm

    I just wanted to put out there that I was in speech therapy when I was young. Not the same, I had a stutter and a lisp and went to therapy for about a year when I was in 1st grade.
    I just want any parents reading this to know that denying your child needs help is the wrong thing to do. My parents worked with the school and got me the help I needed to progress.
    I remember being picked on for speaking weird and it was hurtful as a young child. However I got the help I needed and now I speak perfectly. As a matter of fact I majored in theater and currently teach public speaking on the college level.
    It is not a failing of the parents. Seek professional consultation and see what they can do for you. It changed my life!

  • Hannah

    March 17, 2010 at 7:11 pm

    I’m 22 and no where NEAR ready for kids, but I thought I’d give a different perspective on it. I was in speech therapy when I was 4. My parents knew I would definitely need it, and they tried it when I was 2, but I was WAY too shy and had no interest in it. So, they waited a couple years, and at 4 I LOVED IT. It’s definitely not noticeable to the child what is going on. Although it’s been years, I still remember we played a lot of “Chutes and Ladders” and “Memory” among other things, and I never knew I actually was learning how to correctly pronounce words while we played. I did private sessions twice a week for 30 minutes at a time and it was just me and the speech therapist. My mom stayed in the waiting room, but I’m assuming they talked so that she would know what to work on at home.

  • LJP

    March 17, 2010 at 7:50 pm

    Amy, as I speech-language pathologist, I applaud you on that description! Its true that there are different approaches, but the play based/Floortime/Hanen model is so effective. Many parents I see wonder why they can’t sit in the waiting room reading a magazine while I “fix” their child. If only. Would a child get really good at piano or hockey if they practiced for 40 mins a week? The work you do at home is the most important. Great advice, as always.

  • Megan

    March 18, 2010 at 6:20 pm

    My daughter began speech therapy at two and half and I typically sat in the room, but away from her and not in her direct line of site, so she wouldn’t be distracted. I found it super helpful to observe the therapist and mimic her at home. One of the side effects of my daughter’s therapy was that my son, who was three years younger, began talking really early and really well because I unconsciously used all the techniques I had learned on him.