Child’s first speech therapy session

What to expect and how to prepare for your child’s first speech therapy session

A speech therapist’s job is to take all that the child CAN do to communicate, and use it to build and improve on what may be a challenge (no matter how small or big).

I have never taken a child to speech therapy, so I’m not sure what it feels like. My experience as a speech pathologist though, has taught me a few things about what tends to make attending speech therapy a little easier.

Here are just some basic ideas on how to make the experience of attending the first speech therapy session as smooth as possible:

Before the first session:

• A good night’s sleep is recommended, but don’t stress if this, for one reason or another, doesn’t work out.
• Bring a favourite toy (or 2), a drink and maybe snacks. More often than not, food is avoided in speech and language sessions, but pre and post it may be useful. It is a good idea to keep the favourite toy out of sight in a bag. It may be used in the session or not at all.
• If your child is coming for concerns about feeding, bringing samples of some frequently consumed food and drink is helpful. It is also useful to bring foods that are challenging for your child. If your child is using specific utensils, it is helpful to bring those along too.
• Depending on the age of your child, talking about the session prior to it in a positive manner can help prepare your child. Pre-school and school aged children especially like to know what’s going on and why. Remember to avoid negative phrasing (e..g ‘because you can’t talk properly’, ‘because your speech is bad’, or similar). Keep it positive.
• If siblings are coming along to the session, explain to them what is happening, why it’s happening and bring along something for them to do. Most clinics will have activities for them to do, but I find most siblings use things they bring from home , or, more recently, spend the time on an iPhone (with headphones).
• Bring copies of other health professional reports you may have, and/or referral information.

A few things to think about:

The session will include a discussion between you and the SLP regarding your child’s medical history, developmental history and current communication strengths and needs. Your speech pathologist will need to be fairly comprehensive in order to establish an accurate picture of your child’s communication skills and environment. Prior to the appointment, it would be helpful to start considering some of the following.

1. Medical History:

• Any complications during pregnancy or birth
• Any family history of speech, language, hearing, learning difficulties.
• Results of prior hearing assessments
• Any medical conditions e.g. recurrent ear infections

2. Developmental milestones:

Consider how old your child was (even if it’s just approximately) when they started to:

• Babble “baby talk”
• Crawl
• Stand up
• Walk
• Say first words (e.g. mumma, dada)
• Say two words together (e.g. more juice)

3. If your child is attending for feeding concerns, consider listing foods that are ‘easy’ and foods that present a challenge.

4. Consider how you would describe your child’s communication concerns. Depending on your child’s age, good questions to ask yourself include:

• Is it difficult to understand what they say?
• Do they use many words?
• Do they put words together into phrases/sentences?
• How do they interact with peers and adults?
• Do they have a clear voice or is it raspy/hoarse/breathy
• Have you noticed any stuttering behaviour?

Your speech therapist will be able to determine the nature of your child’s communication difficulties, but information from parents is extremely valuable (vital even). Parents are the experts in how their children communicate.

During the session:

The session will generally consist of two types of assessment or testing: indirect and direct. Indirect assessment can look a lot like play or just friendly conversation – this process lets the speech pathologist glean vital information about how your child interacts and communicates in ‘informal’ real life situations. It’s also an important process in helping your
child feel comfortable with the speech therapist and begin establishing a rapport.

Direct testing will usually involve a more formal assessment. Your child may be required to answer questions, point to pictures, name items or follow directions. Don’t stress if your child has difficulty completing some of the items on the assessment. Information gathered from assessments is used to establish areas of strengths and areas to work on.

After the assessment, the speech pathologist will usually be able to give you initial feedback about your child’s performance on the assessment. Sometimes more detailed assessments will need additional time to score, so feedback can occur in the next session (or however you decide with your speech pathologist). Full written reports are usually available and can be valuable information resources for schools, families and other health professionals.

Things to be mindful of:

• Parents and carers are a vital part of a child’s speech therapy program.
• Don’t stress or worry about potential tantrums or other behaviours. Speech pathologists are trained to work with children and with that comes certain skills in helping to calm and redirect. Behaviours can also be a child’s way of communicating, which is useful for a speech pathologist to observe.
• Try to sit back and observe during the formal assessment portion of the session.
• Answering or prompting for your child on the assessment may negate the assessment and will make it difficult to see how your child would have answered.
• Sometimes the speech pathologist may ask you to jump in and assist during formal assessment, but they should direct you on the right things to say (wording of questions can very specific in speech therapy assessments).
• Ask as many questions as you like. Don’t worry if they seem basic. The more information you gather, the better you are equipped to support your child.