Online Speech Therapy For Kids
What to expect in virtual speech therapy for toddlers…
If you're reading this, you're probably wondering, "Should I do online speech therapy with my toddler?" We are going to explain online speech therapy for kids, and the pros/cons of an online therapy session to help you make your decision.
What is virtual speech therapy for toddlers?
Speech therapy is traditionally done in person (in a family’s home or in a clinic, see B8 - What to Expect in Speech Therapy). However, across the globe, the use of online speech therapy for kids, where the therapist and child/family are working remotely from different locations using video calling apps, has significantly increased. Though speech therapy at home may not be as effective as in-person, it is still highly advantageous.
You may hear this method called by various names including:
Online Speech Therapy
Telehealth
Telemedicine
Telepractice
Teletherapy
Telespeech
Speech teletherapy
You may also hear it referred to with the name of the video calling app, such as “speech therapy via Zoom.”
All of these names are the same therapy model and are still language therapy, but now done via remote screen time.
How does online speech therapy for kids work?
In most situations, getting online speech therapy works within the same parameters as an in-person evaluation/therapy through insurance, clinic, community center etc. Learn more about speech therapy for children here.
For telehealth sessions (online speech therapy), you and your child will log onto a designated video app/program at the appointment time, and the speech-language pathologist (SLP) will do the same. The SLP will want to get to know your child a bit and make them feel comfortable--she may show them some fun toys or things on the screen (pictures, games, videos etc). Your child may also be encouraged to show the SLP something they like to play with or do.
Many SLPs doing remote teletherapy use some level of a coaching model, asking you to facilitate the activity or action, and providing guidance and suggestions as you go. (With young children, many in-person SLPs are using these same strategies too!) So it may look something like this:
Example Online Speech Therapy Session
Speech Language Pathologist (SLP): Ok Mom, we are going to practice using repetition of a word today. Do you have something we can play with together that Ricardo loves lately and is motivating? Something like bubbles or a ball or a racing car tower?
Mom: Ummm he has some new Elmo bubbles that he likes, will that work?
Speech Language Pathologist (SLP): Perfect! Why don’t you guys go get those bubbles and we’ll play them together.
...
Speech Language Pathologist (SLP): Is Ricardo saying the words bubbles or pop or blow or go yet?
Mom: He only says go.
Speech Language Pathologist (SLP): Ok then we’re going to practice Pop today over and over and over. Every time we blow the bubbles and then reach to pop them, we’re going to use the word pop. Ricardo, see your bubbles? Mama, are you ready to play bubbles? Ok, Mom blow some bubbles!
Mom: Get ‘em Ricardo!
Speech Language Pathologist (SLP): Nice Mom, he loves this! Next time, do the same thing but use the word pop. Like “pop pop pop Ricardo!” instead of just “get ‘em”. Let’s try it again, using that word pop.
See how the SLP guided the activity based on what the family had in their home, and then guided mom on the day’s lesson. She offered feedback and encouragement to have a successful and fun playtime with the child, while also teaching a language skill (in this case repetition) that the child needed to work on. The SLP could have also grabbed her own bubbles and blown them from her office, practicing the same activity alongside Ricardo and his Mom.
But my child won’t sit or look at the screen, so I can’t do this kind of therapy right?
Not at all! Many young children may look at the screen briefly, see that it’s not their favorite show, or Grandpa calling on Facetime and wander off, and that’s fine! In the example above, Ricardo was never expected to sit at the table and look at the SLP during their bubble activity. The SLP was able to provide coaching ideas and support to the caregiver, and they worked together in the session.
There are some screen-based activities that the SLP may try--and depending on the child and activity, it may go smoothly, or not. And if not, the SLP has lots of tricks up her sleeve to still get the information she needs from the child, even if not using screen-based tasks. I have successfully done teletherapy sessions while a family was in their backyard, at the park, in the Target parking lot, and with a child playing in a tent!
I don’t want someone watching me in my own home, it’s weird right?
It can certainly be unnerving at first but it gets easier with familiarity. I’ll be honest, when my daughter had her first remote therapy sessions, we played in her room and I certainly spent 5 minutes picking up her room beforehand. I didn’t need to, but it made me feel more comfortable.
The SLP really isn’t judging the pile of laundry on the couch or the dishes by the sink (let’s be real, she probably has them too!!). But to make yourself more comfortable, you could set up the camera in a room/angle you’re more comfortable with or set up a boundary that you’re only going to play in your child’s room or in the backyard. This is also true if you have others at home doing remote schooling or working from home, it may be easier to have designated spaces for each person during these sessions.
One cool thing about remote teletherapy is that the therapist can give you pointers on ways to play with toys your child already has! It’s less about the “cool new toys” she has in her office and more about making what you already have more functional or giving ideas on new ways to play with it.
Any tips to succeed with virtual speech therapy for toddlers?
If your child is nervous or anxious, start the session in a comfortable place surrounded by comforting things. This may mean together on the couch, or in your child’s bedroom, with favorite loveys or toys nearby. Your child may not want to talk or play at all at first, but that’s totally fine.
Take the Speech Language Pathologist (SLP) along for the ride--give your child a chance to show off favorite or fun things. For example, my daughter showed her SLP all the Halloween decorations that we had at home, including walking us outside to see the front yard pumpkins, one of which was rotting. That certainly wasn’t in my plan for the session, but it made for some good language opportunities! And my daughter was very happy!
Don’t stress about your child not “performing” during the sessions. It is quite common in young children (with in-person therapy too!!) and SLPs have lots of ways to still make it a successful session. If you are stressed, your child may pick up on that emotion and become more upset as well.
Ask the Speech Language Pathologist if there’s a certain toy or activity she wants to try at the next session so that you can have it accessible and ready. Or vice versa, if you think your child will do great using X toy or in X location, you can tell the therapist that ahead of the next session
If possible, try to help your child be in a good mood before the sessions-- so a few minutes before the session, if possible, check that your child has:
A clean, dry diaper/just went potty and has comfortable clothes on
Had a snack before the session, or be just finishing it up as therapy starts
Woken up a bit before therapy starts, to give them some wake-up/warm-up time before jumping right into therapy
Comfortable items/loveys available if that is helpful to your child
Keep in mind it’s ok if this doesn’t all happen! Do they need a diaper change during a session, or are they all of a sudden starving? Go with the flow, and let the SLP know what your child needs! The session will still be successful!
Are there benefits to teletherapy?
Absolutely!
Many children are more comfortable in their natural home environment than in a clinic/office setting
In current pandemic safety measures, most clinic locations require in-person therapy to include wearing masks, and may also include additional things such as face shields, goggles or gloves--none of these are innately conducive to fun playful naturalistic learning for young children. By utilizing remote teletherapy, these safety measures are not required. Your child may feel more comfortable
Saves time not having to get ready and get out the door, drive and park at the therapy clinic/office setting
Saves money on gas and parking fees
Learn strategies of speech, language and play using your family’s own environment and toys
What do I do if this online speech therapy for kids really isn’t working?
At-home speech therapy doesn’t work perfectly for every child/family. Just as every therapist isn’t the perfect match for every child/family. But just because you have concerns, doesn’t automatically mean that the remote model is where the difficulty really lies. This is a good opportunity to really examine and break down what the specific problem is.
Is it a disconnect between the expectations of yourself and the SLP speech therapist? Discuss with her what you think your child might respond better to. Does your child need more warm-up time, more play-based activities, less screen-based activities, etc.
Is your child shy/anxious/nervous/scared and needs a different communication style? Discuss with the SLP that you think your child needs… more energy from her, less energy from her, less pressure to talk etc.
Or maybe this was only the second session and you need to give it more time. I typically recommend at least 3-4 visits before making a change, to give the child time to warm up to this new activity/experience.
If you’ve given it a few sessions and talked with the SLP about what’s not working, and still aren’t seeing improvement, then you can certainly discuss with the SLP the potential of switching to in-person therapy or changing another parameter. But remember, therapy is a new experience, and just switching to in-person from remote therapy may not be the magic fix.
That’s why it’s so important to communicate honestly and openly with the therapist about what you think could help and be open to trying new things with them.
Everyone’s goal is for your child to progress in their speech and language skills and have meaningful therapy sessions, so it’s a good skill for you to be able to calmly advocate for your child.
Main Takeaways: Online speech therapy...
Is still speech therapy, just offered in a different way
Is a great way to allow your child to feel comfortable in their own home, with their own toys and activities. And a great way to get pointers of how to use what items/toys/activities you already have in new ways
Does not require your child to engage with/at the screen to be successful
Beneficial for children of all ages
Written By:
Melissa Sartori, MS CCC-SLP
© 2020-2023. Stephanie Keffer, MS CCC-SLP. All Rights Reserved.
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