In this series, we’ve been discussing your child’s first speech therapy visit. So far you’ve learned what goes on during this evaluation visit and what to bring with you. You may have a lot on your mind at the first visit , and it may help to have questions in mind ahead of time. The following are just a few of the questions you’ll want to ask, but remember that you know your child best. So you may have additional questions based on your child’s needs and your family’s situation. Five questions I recommend you ask the speech therapist are
- What are the results of my child’s testing?
- What is my child’s prognosis?
- What is the recommended frequency and intensity of services?
- In what setting will services be provided (home, clinic, daycare, etc.)?
- When will we reexamine my child’s progress?
1. What are the results of my child’s testing?
Right off the bat, you will probably want to ask the SLP if your child is now eligible for services. Since much of the direct testing will involve your child answering a certain number of questions incorrectly before discontinuing testing, parents sometimes feel their child did worse than they actually did. Starting off with a question like this will help you understand the next steps. If your child is not eligible, your speech therapist may recommend a few things you can work on at home with your child. If the SLP doesn’t bring it up, ask.
If your child is eligible, ask your SLP to explain to you the criteria used to make your child eligible. Depending on the program your SLP works in, they may have certain criteria they need to adhere to. Some programs may use a percent delay, while others use a standard score or percentiles. No matter which criteria they use, they have one thing in common – they all compare your child’s results to other kids the same age.
Many programs will also be able to use “clinical judgment” to make a child eligible for services. This is done when the child’s results do not meet the cut-off scores for services, but the SLP has other – often more subjective – evidence that a child would still benefit from therapy.
2. What is my child’s prognosis?
Most of the time, when your SLP goes over your child’s results, they will describe the extent of your child’s delay using words such as mild, moderate, severe, or profound. You may want to also ask the speech therapist’s personal clinical opinion on how treatable your child’s issue is. Some children’s test results may originally be described as severe; however, the SLP may say that your child’s particular issue is relatively treatable. Other areas of difficulty may not have greatly affected your child’s test results, but may require more time or a greater intensity of therapy to address.
3. What is the recommended frequency and intensity of services?
Next, you’ll want to know how long and how often your child will receive services. You may initially think more is better, but that is not always the case. Depending on the types of speech, language or feeding concerns your child is demonstrating, fewer but longer sessions may be recommended and more beneficial. Some children need longer sessions to warm up before diving into the harder work in their sessions. Other kids need lots of little breaks in between activities to benefit from each area they’re working on. In other cases, shorter, but more frequent sessions may be required to make a difference in your child’s skills. Shorter, more frequent sessions may be good for children with attention issues, children who fatigue easily, or children who may have a hard time retaining information they are learning from session to session. It’s always okay to ask the SLP to explain their rationale for how often and how long your child will be in therapy.
4. In what setting will services be provided?
Clinic, early intervention, hospital, and school settings may each have different options for the environments in which your child can receive services. Some kids may need more structure. Other kids may need to learn in the same environments in which they’ll use their newfound speech, language, and/or feeding skills.
For some children, individual sessions are recommended. Individual sessions provide more direct intervention, more hands-on time with the SLP, and fewer distractions. However, some children have a hard time transferring what they learn in this more “unnatural” setting to their everyday lives. For other kids, small groups may be used so that they can learn from their peers, yet still benefit from a semi-structured setting. One downside to individualized and small-group settings is that parents and caregivers may not always be as knowledgeable about what to do to practice with their children outside of therapy. If individual or small-group services are recommended – where parents or teachers are not present for the sessions – it is very important that a method of contact be established so that everyone can be on the same page about how to help your child practice.
In other cases, speech therapists may want to work with a child in their most natural environment, and that may differ depending on the child’s age. Services may be provided in the child’s home – or the home of a family member or care provider – depending on where they spend most of the hours in their day. Home services are very common for infants and toddlers because younger kids often have a harder time transferring their learning to their home environment. For older kids, a speech therapist may also “push-in” to a classroom – or daycare room, vocational program, or after-school setting – in order to help a child use their skills in a more natural setting where they do not have to worry about transferring their learning to their everyday lives. One downside is that some children have a hard time focusing in a busier environment. However, this format often provides lots of time for the SLP to work not only with the child, but to also train parents, caregivers, and teachers how to do the same things with them throughout the day that the therapist is doing in their shorter session.
5. When will we reexamine my child’s progress?
Depending on the program or on your insurance, your child’s progress may be re-evaluated at different intervals. If your insurance will only cover a certain number of visits, this will determine when your child’s progress is re-examined. With early intervention programs for infants and toddlers, your child’s speech services will be part of an Individualized Family Service Plan (IFSP), which is often reviewed every six months. With school-age children, services are part of an Individualized Education Program (IEP), in which goals are usually reviewed every four months. Of course, as a parent, it will be your prerogative, to ask to review your child’s progress any time you see fit. Down the line, if you feel your child struggling, speak up sooner than later. If you feel your child is doing a great job and it’s time to look again at goals, or the frequency and intensity of services, let your SLP know about that as well.
All in all, these questions – combined with establishing goals for your child – will help you get off to the right start in establishing a working relationship with your child’s speech therapist.
What other questions are you considering asking during the first visit?