For Families / What to expect from speech-language therapy sessions
If your child has been referred for speech therapy, or you’ve booked a first appointment yourself, it helps to know what you’re walking into. This guide follows the order you’ll go through it: the first appointment, assessment, therapy sessions, your part at home, and how progress is tracked.
Every speech-language pathologist (SLP), called a speech and language therapist (SLT) in the UK, works a little differently, and every child’s plan is built around that child. So treat this as a general picture, and ask your child’s SLP about anything that isn’t clear.
Step 1
The first appointment is usually about getting to know your child and understanding your concerns. It may involve questions, conversation, play or assessment activities, depending on your child’s age and needs.
The SLP will usually start by asking about your child’s health, development and hearing, and what you’ve noticed at home. This is called a case history (ASHA, n.d.-f). They’ll also ask which languages your child hears and uses, with whom and how much. This tells them how to judge your child’s skills and which languages to look at (ASHA, n.d.-d). If your child hasn’t had a recent hearing test, they may screen hearing or suggest one (ASHA, n.d.-f).
Then they’ll watch how your child communicates, through play, talking, gestures or other activities, and may start some assessment activities. Young children often don’t show everything they can do in a new room with someone they’ve just met, so your description of what happens at home counts for a lot.
If your child is being seen for eating, drinking or swallowing, the appointment will look different. The SLP will usually want to watch your child eat or drink, so ask beforehand what to bring.
You don’t need to teach your child anything or practice particular words beforehand. If they’re old enough to understand, tell them they’re going to meet someone who helps children with talking. Explain that they might play games, look at pictures, answer some questions or just chat.
Keep it low-key, and avoid putting pressure on them to perform. Something familiar, like a favorite toy, can help them settle.
If the SLP doesn’t speak your home language, ask whether they work with an interpreter. Ideally this is a trained interpreter rather than a family member (ASHA, n.d.-a).
That’s common, and it’s fine. Many children need time to settle with someone new, and some won’t want to do every activity, or will talk much less than they do at home. A good SLP expects this. They’ll adapt the activities, follow your child’s lead, and learn a lot just from watching them play and from what you tell them. If the first session doesn’t show the full picture, they can see your child again or use a video from home.
Step 2
An assessment looks at what your child can do, what they find difficult, and whether they need support. It may include talking with you, watching your child play, samples of how they talk, and structured activities. It may also include standardized tests, which compare a child’s skills with a reference group of children, when they’re appropriate. Formal tests aren’t always needed.
Your SLP might also use dynamic assessment. This means teaching your child something new and seeing how they respond to help, rather than only checking what they can already do on their own (ASHA, n.d.-d; ASHA, n.d.-g). Depending on your child’s needs, assessment may take one appointment or several.
Therapy is regular sessions working towards goals you’ve agreed together. Assessment doesn’t stop once therapy starts: the SLP keeps checking your child’s progress as they go (ASHA, n.d.-g).
Many standardized tests were developed with children who speak one language. Their scores may not reflect a bilingual child’s abilities accurately, especially when the child doesn’t match the group the test was designed for (ASHA, n.d.-d). A good assessment considers all the languages your child uses, drawing on information from you, samples of their communication in each language, and approaches such as dynamic assessment that give information beyond test scores (ASHA, n.d.-d). If your child was only tested in English, it’s reasonable to ask how the SLP considered their Arabic.
Your SLP will explain what they noticed, whether your child needs support, and what they recommend next. That might mean starting therapy, more assessment, strategies to try at home or school, or keeping an eye on your child’s development for a while. Not every child who has an assessment needs ongoing therapy.
The SLP may give your child’s difficulty a name, or they may need more time or information first. Either way, you should have the chance to talk through the recommendations and ask questions before deciding what happens next.
Ask whether you’ll get a written summary or report. What’s provided varies between services, but having something in writing helps when you share the findings with your child’s doctor or school.
Step 3
Sessions change a lot with age. A toddler’s session can look like ordinary play, while a school-age child may sit at a table and work on something specific. The ages below are a rough guide, not fixed formats. Many school-age children still learn well through play.
With younger children, the adults around them do much of the work. Parent-implemented approaches, where the SLP coaches you to use strategies during daily routines, have good evidence for young children’s language (ASHA, n.d.-c; Roberts & Kaiser, 2011).
A session might look like your child playing a fishing game, but the SLP may be using every turn to practice one speech sound. During a pretend tea party, they might be helping your child follow instructions, learn new words or use longer sentences. Even when therapy looks like play, there should be a reason behind each activity.
ASHA describes therapy as ranging from therapist-led to child-led, with many sessions mixing the two (ASHA, n.d.-g). In therapist-led activities, the SLP chooses the game and asks for specific responses, which gives your child lots of practice in a short time. In child-led play, your child takes the lead and the SLP joins in and models language, which is closer to real conversation. The SLP chooses the mix based on your child’s age, goal, attention and what they enjoy.
If a session looks like just play, ask what the target was. Your SLP should be able to tell you what they were working on and why.
It depends on your child’s age, their needs and the type of therapy. Parents are usually closely involved in sessions with young children. Older children may sometimes work with the SLP on their own. Even if you’re not in the room for every activity, your SLP should tell you what they’re working on and how you can help between sessions.
This varies between services. For example, two NHS services in England describe first appointments lasting about 45 minutes, and 45 to 60 minutes (Central and North West London NHS Foundation Trust, n.d.; Leicestershire Partnership NHS Trust, n.d.). Shorter or longer appointments are possible, so check with your service. An initial assessment may take longer than a regular session or be spread over several visits. Therapy might be weekly, more often or less often, depending on your child’s needs and the type of support.
How often a child practices may affect progress, depending on the therapy approach. One study of speech sound therapy found that how often sessions happened made a difference, but there isn’t one schedule that works for every child (Allen, 2013). Your SLP should explain why they’re recommending a particular schedule and check whether it’s working.
Step 4
A weekly session is a small part of your child’s week. What happens in between matters too.
You might be involved in the session itself, by watching, joining in, or being coached to use strategies. You might also help between sessions, for example by recording your child’s speech at home or keeping a list of new words (ASHA, n.d.-f).
Parents are often involved in speech therapy through home tasks, though research hasn’t yet shown the best way to do it (Sugden et al., 2016). Parents in one study described how hard it can be to fit practice into family life, and the researchers concluded that SLPs should plan home practice together with parents (Sugden et al., 2019).
Making home practice manageable
Ask for one or two tasks, not a long list.
Attach practice to something you already do, like bath time, the car ride or a bedtime story.
A few minutes on most days is often easier to keep up than one long session.
Tell your SLP if practice isn’t happening. They can change it to fit your family.
Keep talking to your child in the language you’re most comfortable with. You don’t need to switch to English at home (ASHA, n.d.-d).
Step 5
Goals come from two places: what the assessment found, and what matters to your family. Good practice combines research evidence, the SLP’s clinical expertise, and your family’s views and priorities (ASHA, n.d.-b). ASHA describes family-centered care as a collaboration between the SLP, the child and their family (ASHA, n.d.-g).
The best goals connect to everyday life, so your child can take part in the activities and roles that matter to them. Where possible, your child helps choose them too (ASHA, n.d.-e). For example:
A clear goal says what skill your child is working on, in what situation, and how you’ll both know it’s been reached.
Your SLP keeps track of progress towards each goal throughout therapy (ASHA, n.d.-g). Goals are reviewed and changed as your child moves on.
To do this, your SLP might note how often your child uses a particular word, says a sound correctly, or follows an instruction with less help. They may also ask what you’re noticing at home or school. Together, this shows whether a skill is improving in therapy and whether your child is using it in everyday life.
There isn’t a fixed timeline. Some children start using new skills fairly quickly, while others need longer-term support. It depends on what your child is working on, their needs, the therapy approach and how often they get to practice.
Early progress can look small: trying a new sound during a game, using a new gesture, or following an instruction with less help. Over time, the aim is for your child to use those skills in everyday life. Progress isn’t always steady, so ask your SLP how things are going rather than judging from one session.
If your child isn’t making the progress you expected, talk to your SLP. They can review the goals, rethink the approach, or look at whether something else is affecting progress.
Questions you can ask at any point
Keep reading
Want to know which areas an SLP can help with, from first words to stuttering and feeding? Read How SLPs Can Help.
Undated web pages were accessed on October 27, 2026.
