What to Expect at Your Child's First Speech Therapy Visit

Booking your child's first speech therapy appointment can bring up a mix of relief and nerves. What will happen? Will your child cooperate? What should you bring? Knowing what a first visit usually involves can make the day feel much more manageable, for you and for your child. Here's an overview based on published guidance from the American Speech-Language-Hearing Association (ASHA) and other organizations.

Is the first visit an evaluation or a therapy session?

A first visit is often an evaluation, which gives a speech-language pathologist (SLP) a picture of your child's current skills before any therapy is planned. According to ASHA, an assessment may result in a diagnosis, a description of the characteristics and severity of any disorder, recommendations for intervention and support, or a referral to other professionals as needed.^[2] It can also result in a finding that no further evaluation or intervention is needed. For example, ASHA notes that an assessment may find "a cultural and linguistic difference only."^[2] For speech sounds specifically, ASHA lists "determination that their speech is appropriate for their age and/or linguistic community" as one possible outcome.^[3]

At Speech Me Therapy, families start with a free 15-minute phone consultation, and no referral is needed. You can read more about what we cover on our evaluations page.

What happens during a speech and language evaluation?

Every evaluation is tailored to the child's age and the reason for the visit, but ASHA describes common components.^{[2, 3]}

1. Talking with you (case history)

NIDCD notes that the SLP "will talk to you about your child's communication and general development."^[1] ASHA lists the kinds of information SLPs gather, including birth, medical, and developmental history; family history of cognitive, speech, language, reading, or academic difficulties; the family's concerns; and which languages or dialects the child uses.^[2] For toddlers, ASHA notes that SLPs gather information "through parent and caregiver report and interviews, developmental observations, and language sampling."^[4]

2. Watching your child play and talk

CHSA explains that SLPs "will observe your child play and interact with others," and check things like whether a child follows directions and names objects or actions.^[5] So for young children, parts of the evaluation may look a lot like play.

3. Structured activities and tests

NIDCD notes that the SLP "will also use special spoken tests to evaluate your child."^[1] ASHA explains that assessment uses "a variety of measures and activities, including both formal and informal assessment tools."^[2] Depending on the concern, this can include:

• Language: how your child understands and uses words, sentences, and conversation.^[2] Our post on receptive vs. expressive language explains the difference.
• Speech sounds: testing sounds in single words and in connected speech.^[3] CHSA notes that the SLP "listens to how your child says sounds and watches how lips, jaw, and tongue move."^[6]
• Stimulability: ASHA describes this as "the child's ability to accurately imitate a model of the target speech sound that the child currently misarticulates."^[3]
• Oral mechanism exam: a look at the structure and movement of the lips, jaw, tongue, and palate.^{[2, 3]}

4. Hearing

According to NIDCD, "a hearing test is often included in the evaluation because a hearing problem can affect speech and language development."^[1] ASHA lists a hearing screening as part of a comprehensive assessment if one wasn't already completed.^[2]

What should I bring to my child's first speech therapy appointment?

Because the case history is such a big part of an evaluation, it helps to gather information ahead of time.^[2] Useful things to bring or have ready include:

• Notes on your child's birth, medical, and developmental history, and any family history of speech, language, or reading difficulties^[2]
• Any past hearing test results, since hearing is part of the picture^{[1, 2]}
• Reports from teachers, previous evaluations, or school services, if you have them^[2]
• A list of the languages your child hears and uses, and where^[2]
• A completed CDC milestone checklist, which the CDC offers to print or fill out online^[8]
• Notes on your specific concerns, including examples of words, phrases, or sounds you've noticed^[2]

Can the first visit be done by telehealth?

It can be. ASHA defines telepractice as using telecommunications and internet technology to connect SLPs with clients and families "for screening, assessment, intervention, consultation, and education."^[7] ASHA states that clinicians are responsible for ensuring that telepractice services are "safe, effective, and equivalent in quality to in-person care," and that decisions about telepractice consider things like a family's comfort with technology, internet access, and having a quiet space.^[7] ASHA also describes the role of a "facilitator" who supports the client on their end of the call, and notes that family members and care partners can serve in this role when appropriately trained.^[7] You can learn more on our telehealth page.

What happens in the first therapy sessions?

If therapy is recommended, early sessions focus on the goals that came out of the evaluation. At Speech Me Therapy, sessions are 25 or 50 minutes. ASHA describes speech sound therapy as moving through stages, from "eliciting target sounds and stabilizing production" to using them in "increasingly challenging levels," such as words, sentences, and conversation.^[3]

Families are part of the process. ASHA notes that many children with spoken language disorders "can benefit from interventions that are family-centered," which it describes as "a collaboration between the clinician, the client, and their family."^[2] ASHA also describes a strengths-based approach that affirms neurodiversity, including identifying a child's strengths and presuming competence.^[2] Our parent coaching page describes how families can be involved.

Questions parents can ask the speech-language pathologist

ASHA's list of what an assessment may produce is a helpful guide for questions to ask.^{[2, 3]} For example:

• Is what you're seeing typical for my child's age and the languages they speak?
• Is there a diagnosis, and how would you describe its characteristics and severity?
• What are your recommendations, and what would goals look like?
• Would you recommend any other evaluations or referrals, such as a hearing test?
• How can I support these skills at home between sessions?

It's also reasonable to ask practical questions about scheduling, session length, and cost.

The bottom line

A first visit is mostly about gathering information: talking with you, watching your child play and communicate, and using activities or tests to get a clear picture. It doesn't always lead to therapy, and every family's path looks a little different. If you have questions about your child's communication, a conversation with a speech-language pathologist is a gentle place to start.

Speech Me Therapy

Pediatric Speech-Language Therapy · Phoenix, AZ

Articles from Speech Me Therapy, a pediatric speech-language therapy practice in North Phoenix serving Scottsdale, Paradise Valley, and families across Arizona by telehealth. Our posts summarize published guidance from professional and public health organizations; sources are listed at the end of every article.