10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-11

Why the first appointment sets the tone for everything

The first meeting with a speech-language pathologist (SLP) is more than intake paperwork. It's your best chance to figure out whether this person's approach actually fits your child, before you've driven to a dozen sessions and spent a lot of money.

Speech-language pathologists are licensed in every state and hold at minimum a master's degree plus a Certificate of Clinical Competence from the American Speech-Language-Hearing Association (ASHA) ^[1]. That credential matters, but it doesn't tell you whether they specialize in late talkers, whether they work well with anxious or sensory-sensitive kids, or whether they'll be honest with you when progress stalls.

Parents often leave first appointments feeling like they got talked at. You can change that dynamic completely by coming in with real questions. Not polite questions. Honest ones.

This guide gives you 14 of them, in roughly the order they'd come up in a real conversation.

What's your experience specifically with late talkers?

Speech therapy covers an enormous range, from toddlers with no words to stroke survivors relearning language to adults with voice disorders. A generalist SLP might be excellent. But for a late talker you want someone who treats kids at the younger end regularly, not occasionally.

The research distinction here is real. "Late talker" usually means a child between 18 and 30 months whose expressive vocabulary sits below the 10th percentile for their age, with no known cause like hearing loss ^[2]. Some of these kids catch up on their own (the research calls them "late bloomers"), and some don't. An SLP who sees a lot of late talkers will have an opinion about which trajectory your child looks like, and they should be willing to share it.

Ask directly: Have they worked with kids at your child's age and profile before? Do they follow a particular treatment model (parent-implemented naturalistic therapy, DIR/Floortime, PROMPT, etc.)? How many late talkers do they see in a typical month? You're not quizzing them. You're gathering information to make a decision.

If they get vague, or pivot to credentials instead of clinical experience with your child's age group, that's worth noting.

How do you evaluate a child who isn't talking yet?

A good evaluation looks at more than the number of words a child says. It should include receptive language (what they understand), play skills, social attention, oral-motor function, and hearing status ^[3].

ASHA recommends that a full speech-language evaluation include standardized testing where appropriate, but also observation and parent report, because a stressed 22-month-old in an unfamiliar clinic often performs nothing like they do at home ^[1]. Ask the SLP how they account for that gap.

Here's what you want to know: Will they use standardized assessments, and if so, which ones? Are those tools normed on children who look like your child (if your child is multilingual or speaks a non-mainstream dialect, this matters a great deal)? Will they ask you to bring videos of your child playing at home? How long does the evaluation take before they feel ready to set goals?

A thorough evaluation usually takes more than one session. If an SLP hands you a treatment plan after 45 minutes of watching a toddler stack blocks, ask them to explain how that's possible. Some can. Some can't.

Raise hearing testing directly here too. The American Academy of Pediatrics recommends that every child with a speech or language delay get a full audiological evaluation, more than a pass/fail screening ^[4]. If your child hasn't had one, ask whether the SLP can refer you.

What specific goals will we be working on, and how were they chosen?

Goals should be measurable, time-bound, and tied to your child's current skills, not a generic list copied from a template. Vague goals like "improve expressive language" are hard to track and even harder to celebrate.

A well-written goal sounds more like this: "By [date], the child will spontaneously request preferred objects using a single word or approximation in 4 out of 5 opportunities across two settings." That gives you a baseline, a target, a timeline, and conditions. If the SLP's goals don't look something like that, ask them to be more specific.

Ask why those particular goals came first. Clinicians disagree about what to prioritize early. Some focus on building vocabulary breadth (many words at the one-word level). Others push for word combinations. Some target social communication and joint attention first, especially if there's any concern about autism spectrum differences ^[5]. None of these is obviously wrong, but you should understand the reasoning so you can tell if the approach is working.

If your child gets services through early intervention, goals are written into an Individualized Family Service Plan (IFSP), and you have the legal right to help write them under IDEA Part C ^[6].

How will you measure progress, and how will I know if things are or aren't working?

This is the question most parents forget to ask, and it might be the most important one.

Progress in speech therapy is rarely a straight line. Some kids plateau for weeks, then jump. Others make early gains that taper off. You need a clear picture of what "working" looks like, and what the SLP's threshold is for changing course.

Ask: How often will you formally reassess? What data do you collect during sessions? Will you share session notes or data sheets with me? If we hit the 3-month mark without meaningful progress, what would you do differently?

Ethical clinicians welcome these questions. An SLP who gets defensive when you ask how they track outcomes is showing you something.

For toddlers, the MacArthur-Bates Communicative Development Inventories (CDIs) are a widely used parent-report measure of vocabulary and early communication milestones ^[11]. Ask if the SLP uses them or something similar, so you have a normed comparison point instead of just gut impressions.

What should I be doing at home between sessions?

The research here is clear: parent involvement in early speech therapy improves outcomes a lot. A 2018 meta-analysis in the Journal of Speech, Language, and Hearing Research found that parent-implemented naturalistic communication interventions produced meaningful gains in expressive language for children with primary language delays ^[7]. Weekly 45-minute sessions alone, with no home carry-over, are a much weaker intervention.

You should leave every appointment knowing at least one specific thing to do at home that week. Not "talk to your child more." Something concrete, like "during bath time, label the objects and pause for 5 seconds before you respond, to give him a chance to start."

Ask the SLP to show you, more than describe, any technique they want you to use at home. Watch them do it with your child, then try it yourself while they watch and correct you. That transfer of skill is part of what you're paying for.

If they never send you home with strategies, name the gap directly. "I want to be doing something specific at home between sessions. Can we make that a regular part of our time together?"

For parents who want structured daily practice between sessions, Little Words is an AI companion app built for exactly this kind of home carry-over for late talkers and neurodivergent kids, with activities matched to your child's current communication level.

Do you use any AAC, and how do you decide if my child needs it?

Augmentative and alternative communication (AAC) covers everything from picture exchange systems to speech-generating devices. A lot of parents worry that introducing AAC will kill their child's motivation to speak. The evidence doesn't support that fear ^[8].

ASHA's position is that AAC does not suppress speech development and may actually support it, by cutting communication frustration and giving children a successful communication experience while spoken words are still coming online ^[8]. Ask the SLP where they land on this. If they tell you to avoid AAC "so he'll be more motivated to talk," that's not consistent with current evidence.

Ask directly: What's your threshold for recommending AAC? What would make you suggest a system? If you do recommend one, will you help us set it up at home and at daycare or school?

If your child shows signs of significant motor speech involvement, ask whether they've considered a referral for a full AAC evaluation with an SLP who specializes in it.

For kids where apraxia of speech might be a factor, the PROMPT approach and other motor-based methods are worth discussing specifically.

What's your view on the cause of my child's speech delay, and does it change the approach?

Speech delays have many possible drivers: hearing loss, oral-motor differences, childhood apraxia of speech, language processing differences, autism spectrum differences, environmental factors, or no identifiable cause at all. The approach that works best varies by cause.

A child who is a late talker mainly for environmental or input-based reasons responds differently to treatment than a child with a motor speech disorder or one with autism-related communication differences ^[5]. Ask the SLP whether they have a working hypothesis about what's driving your child's delay, and how that shapes the plan.

You're not asking them to diagnose your child. You're asking whether their intervention is informed by a theory of the case. "We're working on vocabulary because his receptive language looks strong and I think expressive vocabulary is the main bottleneck" is a real answer. "We're just building language" is less useful.

If autism spectrum differences are on your radar, ask directly whether the SLP has training in autism-specific communication approaches, and what their experience is with kids who show features like echolalia. (If you're not sure what echolalia means or whether your child is doing it, that's worth understanding separately.)

How often should we be coming, and for how long?

Session frequency isn't standardized, and it varies more than most people expect. Recommendations run from one 30-minute session a week for mild delays to several sessions a week for complex profiles. There's no universal clinical guideline that names a magic number.

What you want from the SLP is a recommendation with a rationale. Ask: Why this frequency? What does the evidence say about intensity for a child with my child's profile? How long do you expect we'll be in therapy before we reassess?

Also ask what happens if your schedule or insurance can't support the recommended frequency. A good SLP will help you prioritize and will tell you honestly whether less frequent sessions are still worth doing, or whether the gap makes them largely useless.

For toddlers getting early intervention services (birth to age 3) under IDEA Part C, services happen in the "natural environment" and are designed to be at no cost to families in most states, though the exact rules vary ^[6]. Ask whether your child still qualifies for early intervention before you pay out of pocket.

For school-age children, services under IDEA Part B run through the school district and must be provided at no cost to families if the child qualifies ^[6].

How do you communicate with me between sessions?

Some SLPs send a brief note after every session. Some use a communication app. Some expect you to email if you have questions. Some are almost impossible to reach between appointments.

This isn't a minor preference. If your child has a rough week, if you notice something new, if you're confused about a home strategy, you need a response in a reasonable timeframe. Ask directly: What's the best way to reach you? What's your typical response time? Do you share session notes with parents?

Also ask whether they coordinate with other providers your child sees, like an occupational therapist, developmental pediatrician, or school team. Communication across providers matters, and someone has to start it. Find out whether the SLP will write reports for schools or join IEP or IFSP meetings.

What would make you refer me to another specialist?

This question shows you're thinking long-term, and it tells you a lot about the SLP's self-awareness.

A confident, ethical SLP knows the limits of their scope. They should be able to say: If I see signs of X, I'd refer you to an audiologist, developmental pediatrician, feeding specialist, or an SLP who specializes in AAC or motor speech. If progress stalls for more than Y months, I'd want a second opinion from a colleague.

If they say they'd never need to refer you, that's a warning sign. No single clinician handles every presentation equally well. The SLP who knows when to bring in another set of eyes is usually the better one.

It's also fine to ask whether they'd be open to you getting a second opinion at any point. The answer should be yes.

What does the research say about kids with my child's profile, and what can I realistically expect?

This is a hard question to ask, and a hard one to answer. Ask it anyway.

The honest truth is that outcomes for late talkers vary a lot. Research suggests roughly 50 to 70 percent of late talkers who get no intervention reach age-level language by school age, but the estimates spread wide depending on how each study defined "late talker" and which outcomes it tracked ^[2][9]. Children with both expressive and receptive delays, or with additional developmental differences, catch up on their own at lower rates.

Ask the SLP: Based on what you've seen, what range of outcomes do kids who look like my child typically have? What would make you more or less optimistic? What's your honest read at this early stage?

You're not asking for a guarantee. You're asking for an informed perspective from someone who has seen a lot of these kids. If they're too cautious to offer any prognosis at all, ask what additional information would help them give you a clearer picture.

The American Academy of Pediatrics recommends surveillance at every well-child visit plus formal developmental screening at 9, 18, and 30 months with validated tools ^[4]. If your pediatrician hasn't done this consistently, ask the SLP how their findings compare to those screening benchmarks.

Should I think about online speech therapy as an option?

Telehealth speech therapy is a real alternative now, not a fallback. A 2021 systematic review in the International Journal of Language & Communication Disorders found that teletherapy for speech-language services matched in-person outcomes for many pediatric populations, though the evidence base for very young toddlers is still building ^[10].

For families in rural areas, families with limited transportation, or kids who regulate better at home than in a clinic, online speech therapy is worth a real conversation. Ask the SLP whether they offer it and, if they don't, what their thinking is. A good one gives you an honest comparison based on your child's needs.

For very young children (under 2), the hands-on part of an in-person eval can be harder to replicate on video. For older late talkers, or for parent coaching sessions where the SLP is mostly teaching you techniques, telehealth often works extremely well.

The speech therapy landscape has shifted enough that you should factor telehealth into your search, especially if local wait times are long. Wait times for pediatric SLPs can run 3 to 6 months or more in many regions, and starting online while you wait for an in-person slot is a reasonable move.

What's the single most important thing I can do right now as a parent?

Ask this one last. It resets the conversation to what's actionable today, and the answer tells you a lot about how the SLP thinks.

A therapist who says "keep coming to sessions" isn't treating you as a partner. One who gives you a specific, doable thing, whether that's using more comments and fewer questions during play, following your child's lead for 10 minutes a day with no agenda, or learning the basics of responsive interaction, is treating you as part of the treatment team.

You are the most consistent presence in your child's communication environment. You're there at dinner, bath time, bedtime, the car ride to grandma's. The SLP sees your child maybe once or twice a week for 45 minutes. Home matters enormously, and an SLP who doesn't find a way to plug you in is leaving a lot of the intervention on the table.

Before you leave the first appointment, you should know three things: what you're going to do this week, how it connects to the goals they set, and when you'll next hear from them. If you leave without that, it's okay to ask for it before you walk out. "Can we take five minutes to make sure I know what to do at home this week?" is always a reasonable request.

If you want a way to keep those home strategies organized and consistent day to day, the Little Words app is built for exactly that gap between sessions.

Frequently asked questions

What credentials should a speech therapist have to treat a late talker?

Look for the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) from ASHA, plus state licensure. Both are required for independent practice in most states. Beyond credentials, ask specifically about their experience with toddlers and late talkers, since SLPs can practice across a huge age and condition range and not all have deep pediatric experience.

How soon after a late talker diagnosis should we start speech therapy?

As soon as possible. Research consistently shows earlier intervention produces better outcomes for language delays. If your child is under 3, contact your state's early intervention program right away, since services under IDEA Part C are available at no cost and don't require a diagnosis to begin the evaluation process. Waiting to see if your child catches up on their own has real costs if they don't.

What's the difference between a speech delay and a language delay?

Speech delay is difficulty with the motor production of sounds and words. Language delay is difficulty with understanding or using language, including vocabulary, grammar, and social communication. A child can have one without the other. A late talker who understands everything but says few words has primarily an expressive language delay. Your SLP should clarify which type applies to your child.

Is it okay to ask an SLP for a second opinion?

Absolutely. Any ethical clinician will tell you that getting a second opinion is your right and sometimes genuinely helpful. If you're unsure about a diagnosis, a treatment approach, or whether progress is on track, a consultation with another SLP costs a session fee and can be clarifying. A good SLP won't be offended by the request.

What should I bring to the first speech therapy appointment?

Bring any previous evaluation reports, hearing test results, pediatrician notes, and IEP or IFSP documents if they exist. A short video of your child playing and communicating at home is often more useful than a clinic observation alone. Also bring a list of the words or sounds your child currently produces, and any concerns you have about feeding, play, or social attention.

How long does it typically take to see progress in speech therapy for a toddler?

Nobody has good universal data on this. Individual variation is enormous. Some toddlers show measurable gains in 6 to 8 weeks of consistent therapy plus home practice. Others plateau for months before jumping. Ask your SLP what progress they'd expect in the first 3 months with your child, and what would prompt them to reassess the approach if it isn't happening.

Can I sit in on my child's speech therapy sessions?

Yes, and in most cases you should. For parent-implemented naturalistic approaches, parent presence is the point. Even in more structured clinic-based models, observing sessions helps you understand your child's goals and carry strategies home. Ask explicitly whether you'll be in the room. Some therapists prefer to build rapport with the child alone first, but they should have a clear plan for involving you.

What if my child cries or refuses to cooperate during speech therapy sessions?

This is common, especially early. Ask the SLP how they handle dysregulation and refusal, and whether the session structure can adapt. A skilled pediatric SLP has many ways to engage a resistant child. If every session ends in a meltdown and the SLP doesn't adjust, that's worth discussing. Some children do better in shorter, more frequent sessions or in a different environment.

Does insurance cover speech therapy for a late talker?

Often partially, but it varies by plan and state. Most private insurance plans cover speech therapy when there's a diagnosis code, and medical necessity documentation from your SLP helps the claim. Under IDEA, school-based and early intervention services are at no cost when a child qualifies. Always verify your plan's limits on session frequency, annual caps, and whether prior authorization is required.

What's the difference between early intervention and private speech therapy?

Early intervention (birth to 36 months) operates under IDEA Part C and is government-funded. It usually happens in the home or daycare and involves parent coaching as a core part. Private speech therapy can start at any age and happens in a clinic or via telehealth. The two aren't mutually exclusive. Some families do both, especially when early intervention frequency isn't enough.

Should I mention concerns about autism at the first speech therapy appointment?

Yes. If you have any concerns about social communication, eye contact, play patterns, restricted interests, or sensory sensitivities, say so directly. This information shapes the evaluation and the approach. An SLP can't diagnose autism, but they can screen for communication patterns associated with it and refer you to a developmental pediatrician or psychologist if a fuller evaluation is warranted.

How do I find a speech therapist who specializes in late talkers?

ASHA's ProFind directory at asha.org lets you filter by age group served and specialty area. Search for SLPs who list early childhood and language delays as focus areas. Ask your pediatrician for referrals. Early intervention programs also keep lists of qualified providers. If local wait times are long, telehealth SLPs who specialize in toddlers are a genuine option worth considering.

Sources

1. American Speech-Language-Hearing Association (ASHA), Scope of Practice in Speech-Language Pathology: ASHA credentialing (CCC-SLP) and scope of practice for speech-language pathologists
2. Rescorla, L. (2011). Late Talkers: Do Good Predictors of Outcome Exist? Developmental Disabilities Research Reviews, 17(2), 141-150.: Definition of late talker as child 18-30 months below 10th percentile in expressive vocabulary; 50-70% catch-up rate statistics
3. American Speech-Language-Hearing Association (ASHA), Late Blooming or Language Problem?: Full evaluation for late talkers includes receptive language, play skills, social attention, and oral-motor function
4. American Academy of Pediatrics, Developmental Surveillance and Screening Policy: AAP recommends formal developmental screening at 9, 18, and 30 months and audiological evaluation for any child with speech/language delay
5. Paul, R. & Norbury, C. (2012). Language Disorders from Infancy Through Adolescence. Elsevier.: Different underlying causes of speech delay (autism, apraxia, environmental) require different treatment approaches
6. U.S. Department of Education, Individuals with Disabilities Education Act (IDEA): IDEA Part C provides early intervention at no cost for birth to 36 months; Part B provides free services for ages 3-21 when eligible; parents have the right to participate in IFSP goal-writing
7. Roberts, M.Y. & Kaiser, A.P. (2018). Parent-implemented language interventions for children with language impairments: A meta-analysis. Journal of Speech, Language, and Hearing Research.: Parent-implemented naturalistic communication interventions produced meaningful gains in expressive language for children with primary language delays
8. American Speech-Language-Hearing Association (ASHA), Augmentative and Alternative Communication (AAC) Evidence Maps: AAC does not suppress speech development and may support it; ASHA position that AAC is appropriate for children who are not yet talking
9. Teverovsky, E.G., Bickel, J.O., & Feldman, H.M. (2009). Functional characteristics of children diagnosed with childhood apraxia of speech. Disability and Rehabilitation.: Children with both expressive and receptive language delays have lower rates of spontaneous catch-up than those with expressive-only delays
10. Sutherland, R. et al. (2021). A systematic review of telehealth for speech-language services. International Journal of Language & Communication Disorders.: Teletherapy for speech-language services was comparable in outcomes to in-person therapy for many pediatric populations
11. Fenson, L. et al., MacArthur-Bates Communicative Development Inventories (CDIs), Brookes Publishing: MacArthur-Bates CDIs are a widely used parent-report measure of vocabulary and early communication milestones used in clinical and research settings