Does my child need speech therapy?

April 21, 2022 Stephanie Keffer

Speech therapy services are given to children of all ages for a variety of reasons. Your young child may need speech therapy if:

They are having a hard time learning to talk
They have difficulties pronouncing some or all sounds
They are frustrated because they can’t yet say what they want to
They have a hard time playing with or talking to other children
They have trouble with one or more steps of feeding
They are stuttering

Since I don’t know your family, I can’t say for sure if your child needs speech therapy or not. But I can give you the ultimate explanation of pediatric speech therapy so you can see when to start speech therapy to support your child’s individual needs.

What is pediatric speech therapy?

Pediatric speech therapy includes all services provided to children from birth to 18 years old to support their communication skills. Speech therapy is provided by licensed speech language pathologists (also known as speech therapists or SLPs).

Speech therapists work to support every area of communication you can think of, including: language expression (talking skills), language comprehension (understanding skills), social skills, pronunciation skills, and vocal skills. In addition to supporting children’s communication skills, pediatric speech therapists also support swallowing skills.

Pediatric speech therapy may be provided in individual sessions or group classes. Children under the age of 3 may access speech therapy through their insurance or their state’s early intervention program. And children 3 years and older can get speech therapy through their insurance company or the public school system.

What does pediatric speech therapy treat?

A pediatric speech therapist treats a variety of speech and/or language delays and disorders.

If you’ve read our blog before you’ve probably heard our spiel about the word “disorder.” Disorder and impairment are medical words; and they are used by medical providers to ask insurance companies to pay for supports and classes for your child. It’s important to know that these technical terms in no way summarize who your child is or how well they are doing!

What are pediatric speech disorders?

A speech disorder refers to a difficulty pronouncing or making sounds and words.

Here’s a list of the most common pediatric speech disorders:

Articulation disorders: An articulation disorder happens when children do not clearly pronounce a set of specific sounds. One of the most commonly treated articulation disorders is difficulty pronouncing the “R” sound. Another example is when a child who can’t pronounce the “K” or “G” sound, so they say “T” and “D” in their place (so cookie becomes tootie, and go becomes doe). Articulation disorders are most common in preschool age and elementary school children.

Childhood apraxia of speech: Apraxia of speech is a medical reason for a person to have difficulty talking. A speech therapist will say that it is a motor impairment because it has to do with how your brain sends messages to tell your mouth to move for talking. You will often see children with apraxia understand everything and they are frustrated because they have so many ideas they want to share but aren’t able to because it’s hard for them to coordinate the movements for talking (This has nothing to do with intelligence!).
Childhood apraxia of speech is not formally diagnosed until children are 3 years or older because their speech systems are still developing significantly before the age of 3. There may be signs of suspected apraxia before the age of 3 and speech therapists can begin to support a child’s developing speech system using strategies known to help children with apraxia learn to coordinate the movements for speech.

Fluency disorders: The most common fluency disorder people know about is stuttering. Stuttering is characterized by “getting stuck on” sounds or words. Children who stutter may repeat sounds or words many times, or their mouth can “get stuck” and nothing comes out.
There is a difference between developmental stuttering (which resolves on its own in a short period of time) and a diagnosis of stuttering. Pediatric speech therapists often treat stuttering in children who are in preschool, elementary, middle, and high school age because children must be able to identify their own stuttering and learn to use compensatory strategies.
Stuttering isn’t something to be cured, rather children learn strategies to help them have smoother speech.

Voice disorders: Voice disorders refers to a broad range of disorders that have to do with your voice box. One voice disorder you may have heard of before is vocal nodules; and these are not uncommon in toddlers who use a very loud voice.
Voice disorders are identified because of differences in the pitch, volume, or quality of voice.
This category also includes supporting children who are learning to talk after again being on a ventilator (which is something we’ve all heard of since the onset of COVID-19).
Cleft lip and palate: Children who are born with cleft lip and palate benefit from the support of a speech therapist and the other members of the craino-facial team to help them learn to pronounce all their speech sounds.
Hearing Impairment: Children who have hearing loss and children with cochlear implants are supported by speech therapist when learning to use verbal communication.

What are pediatric language disorders?

There are two categories of language disorders in kids (and adults):

Expressive language disorders have to do with the way we use language to express our wants, needs, and ideas. An example of an expressive language disorder would be a child whose vocabulary is smaller than their peers or a preschooler who has a hard time telling you about things that happened in their day.
Receptive language disorders refer to difficulties with understanding language. It could be that a child has a hard time learning the meaning of new words, following directions, and/or understanding questions.

A child may have either an expressive language disorder or a receptive language disorder, or both.

It is uncommon however for a child to have a receptive language disorder but not have an expressive language disorder because you must understand words before you are able to use them. For example, if you didn’t know the meaning of the word, “banana” then you wouldn’t know to say it when you see a banana and want to eat it. If a child’s talking skills seem to be more advanced than their understanding it is likely that something else is going on and a developmental evaluation is recommended.

One more type of language disorders seen in children

The last type of language disorder is in its own category because it is something that is acquired; all the types of speech and language disorders mentioned so far are (usually) something that a child is born with and is seen as they develop.

But it is also possible that a child may acquire a language disorder as a result of a serious accident; you may have heard the medical term traumatic brain injury. When children hurt their head during a serious accident and end up in the hospital, pediatric speech therapists will work with them to help them be able to return home and/or go back to school. They work on skills like attention, memory, concentration, staying on topic in conversation, impulsivity, and safety awareness. Children who have serious head injuries often are treated for cognitive communication disorders to help them build back up their skills.

Speech therapists are also trained to treat feeding disorders

While every state and center has their own regulations around who can treat feeding disorders, speech therapists are trained in school to help children who have trouble with feeding. Feeding disorders include problems with breastfeeding, chewing, swallowing, gagging, and picky eating.

Children who are treated for feeding disorders are often seen by a team of professionals which may include a nutritionist, gastrointestinal doctor, occupational therapist, and a pediatrician in addition to the speech therapist. A team approach is best to support feeding disorders because it is important to make sure your child is getting the nutrients they need to grow while also staying safe, making mealtime enjoyable, and avoiding choking.

Who gives pediatric speech therapy?

A licensed speech language pathologist (also known by the less formal name of speech therapist or the abbreviation SLP) is the person who leads pediatric speech therapy evaluations and therapy sessions.

You might not know that we are called pathologists because we are licensed to diagnose children with speech and language disorders.

In order to be a licensed speech pathologist, the following is required

At least a master’s degree in speech and language pathology
A state license in speech and language pathology
- If you are practicing telemedicine you must have a license in both the state where your patient is and the state where you physically are.
A Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association (ASHA). In order to earn your C’s (as we call them), you must pass a national accreditation exam and complete an ASHA-certified supervised 9-12 month clinical fellowship.

A speech language pathologist will sign their name on medical documents and then write “MS CCC-SLP” or “MA CCC-SLP” to reflect their credentials. MS stands for a Masters of Science and MA stands Masters of Art (they are the same thing, depending on which university you attend you will have one or the other). And the CCC-SLP signifies that they have their Certificate of Clinical Competence in Speech Language Pathology from ASHA.

A speech therapy assistant may also provide speech therapy to children while under the supervision of a licensed speech therapist. Speech therapy assistants often have an undergraduate degree in a related field of study.

How does pediatric speech therapy work?

Pediatric speech therapy is designed to meet the needs of an individual child, so speech therapy will look different depending on the specific child’s needs, their interests, and their age.

For young children, pediatric speech therapists disguise speech therapy in play; they use activities that children enjoy to teach them new communication skills. They may also use daily activities like snack time and washing your hands so children can learn words that they can use on a daily basis.

As children’s attention skills develop, speech therapy may begin to look more like elementary school activities. Reading books, working in groups, playing board games, and arts and crafts are a few of the activities used in speech therapy for elementary school children.

For all ages, but especially for children who are in middle school and high school, speech therapy is designed to help them in their day to day lives. Supporting their independence and social skills are two common overarching goals of speech therapy for teenagers.

Parents also play an important role in pediatric speech therapy. Speech therapists will help parents learn specific strategies and techniques that they can use at home. Home practice is arguably the most important part of pediatric speech therapy because so little time is actually spent in speech therapy each week. Children who practice consistently at home make faster progress and generally need less speech therapy as a result.

How do I know when to start speech therapy?

A speech and language evaluation is scheduled to investigate if a child needs speech therapy. The speech therapist will talk to you so they can take all your observations and concerns into account when deciding if your child needs speech therapy. At your speech therapy evaluation, your child will also get a chance to show off their skills and play with the speech therapist as well. At the end of your evaluation the speech therapist will share their observations and their recommendations for speech therapy.

How do I find a pediatric speech therapist near me?

There are 2 easy ways to find a speech therapist who can work with your child. You can either find a speech therapist through your insurance company or you can find a speech therapist through your state’s program (early intervention if your child is younger than 3 years and through the public school district if your child is 3 years or older).

I wrote an entire “How to” post about finding a speech therapist near you with helpful links and instructions. Follow this link to read about finding a pediatric speech therapist near you.

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Parents Also Asked:

What is the best speech therapy for a child?

The best speech therapists will incorporate things that a child already enjoys to help them learn new skills. Speech therapy is best when children are motivated to participate and this happens when they are having fun!

What age should a child have speech therapy?

The best age for speech therapy is at the first sign that they might be delayed in either their speech skills (pronunciation), receptive language (understanding), or expressive language (talking). While I always recommend getting started as soon as possible to support children while the gap is small, it’s never too late to start speech therapy either.

What are signs that a child needs speech therapy?

Some common signs that a child needs speech therapy include:

A child has not said their first word by 15 months
A child isn’t putting words together by the time they turn 2 years old
A child doesn’t seem to understand the meaning of words easily
A child has a hard time playing with other kids

How do I know if my 2 year old needs speech therapy?

A speech and language evaluation will help you know if your 2 year old needs speech therapy. At an age where there is so much variability in development, speech therapists are experts at identifying speech delays.

To learn more about what to expect in a speech and language evaluation for toddlers, keep reading here: What to expect at a toddler speech therapy evaluation

How do I know if my child needs speech therapy?

A speech and language evaluation is designed to help you know if your child needs speech therapy. There are two ways to schedule a speech and language evaluation for your child.

You can consult your child’s pediatrician and access speech therapy through your insurance company.
If your child is younger than 3 years old you can contact your state’s early intervention department and request a speech and language evaluation without a doctor’s referral. And if your child is 3 years or older you may request a speech and language evaluation through your neighborhood elementary school.

To learn more about the two ways to find out if your child needs speech therapy, keep reading here: How to find a pediatric speech therapist

Is speech therapy effective in toddlers?

Speech therapy is effective in teaching toddlers new communication skills most of the time because speech therapists use research and experience backed techniques to help teach toddlers new communication skills.

Speech therapy is not effective when children aren’t quite ready to participate in the play based activities of speech therapy. Because learning requires attention, it’s important that a toddler be able to have fun playing alongside someone else and pay attention to a game or activity they really like. Children who are developing play and attention skills often benefit from the support of other developmental specialists to help them get the most out of speech therapy.

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Written By: Stephanie Keffer, MS CCC-SLP

© 2020-2023. Stephanie Keffer, MS CCC-SLP. All Rights Reserved.

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