I take my child to speech and language therapy. My child goes twice a week for thirty minutes and we have been coming for a year and a half. I have gotten to know some of the other moms in the waiting room that are here at the same time. I have enjoyed talking to them while we wait for our children. Today, in conversation, one mom said that they started about four months ago and are almost done. That got me thinking. There has definitely been progress and my son is doing so much better now, but how do I know how long I will have my child in therapy?
As speech-language pathologists, we are often asked by parents how long their child will be in therapy. The reality is that it is very hard for us to know. There is no hard and fast answer to how long your child will be in therapy. Here are some of the factors that affect how long a child will need therapy.
What is your child’s challenge?
First, you should understand that children come to speech and language therapy for a variety of reasons. Some children have receptive language problems (comprehension difficulties) or expressive language (expressing themselves) challenges. Others are hard to understand and may have a speech articulation disorder, phonological disorder, or Childhood Apraxia of Speech. Children can have difficulty with stuttering, feeding, or even social communication. Many types challenges bring children to therapy. Additionally, children with the same diagnosis can have completely different challenges. One child’s expressive language problem can be completely different from another child’s expressive language problem.
How severe is the problem?
In general, you can expect that the more severely impacted your child is, the longer it will take to address it fully in therapy. If a child has more than one speech and language problem, it can take longer. For example, the child with a mixed receptive-expressive language disorder, articulation disorder who stutters will likely spend a great deal more time in therapy. A child with an expressive language disorder and social communication challenges will spend longer in therapy as well.
Is there another coexisting problem?
Any additional challenge would, in most cases, cause speech therapy to become a longer-term proposition. It is not unusual for children to have other neurodevelopmental disorders, such as specific learning disorder (literacy and numeracy), attention deficit disorder, autism spectrum disorder, and developmental coordination disorder. Reading concerns, such as dyslexia, are common in children with mixed receptive-expressive language issues. Research has shown a link between language disorders, ADHD (19 percent), anxiety disorders (10 percent), oppositional defiant disorder (ODD) and conduct disorder (7 percent combined).
Is your therapist competent?
The field of speech-language pathology is regulated. The State of Arizona licenses speech-language pathology professionals. In addition, the American Speech-Language-Hearing Association (ASHA) is a national organization that assures the clinical competence of all certified therapists via their Certificate of Clinical Competence (CCC). For the most part, the therapist working with your child is likely qualified to practice. It is important for you to have a therapist with a strong knowledge base and level of experience for the particular speech, language, or communication challenge your child is dealing with. Additionally, how well your child likes this person is important. Children work well for therapists they find engaging. These factors are likely to have an influence on how long your therapy program takes.
Is the frequency of therapy appropriate?
In general, the more often your child meets with the speech-language pathologist, the faster they will meet their goals. If we see a five-year-old child on Monday for a one-hour session and they have to wait a whole week to readdress the goal with their therapist, therapy moves slower. That same child could be seen on Monday and Wednesday for thirty minutes with more frequent stimulation and opportunity to be provided with feedback. This helps the child to move through therapy more quickly. The younger children, and even older children with memory challenges or articulation disorders, benefit from more frequent sessions. Research shows that children with Childhood Apraxia of Speech may need therapy four to five times weekly. We often analogize going to speech therapy to working out. Working out at the gym once a week does not have the same benefits as working out more frequently. When I work with a personal trainer at the gym, I benefit from the more frequent coaching.
How involved are you?
As therapists, we know that the more parents become involved in therapy, the quicker therapy progresses. You need to know what your child’s goals in therapy are and work with your child’s therapist to achieve these goals. Follow through on homework and try to apply the strategies that your child’s therapist shares with you. It is helpful if your child feels that therapy is important to you too. Support your child’s therapist by sharing important bits of information about things your child values, topics of interest, places you have been, and what might motivate your child. You are part of the treatment team.
Is your child learning to practice independently?
In general, we say that the more you practice, the faster you will meet your goals in therapy. That doesn’t mean practice to the point of having your child shut down. For example, if you are learning to play a guitar, and get guitar lessons once a week, but don’t practice at all, the chances of you making substantial progress is pretty slim. If you have a lesson once a week and spend the other six days a week practicing, your chances of being able to join a band significantly increase. Speech therapy is much the same.
The bottom line …
It is not possible to say how long your child will be in therapy. Each child is different. Each family’s ability to support their child in therapy is different. It is important for you to know that we want your child to finish therapy as quickly as they are able. We have to meet children where they are at and move them along, helping them progress and achieve their goals. For the most part, there is no quick fix and some issues can take a long time to remediate.
Know that we tend to terminate therapy when:
The student is performing at a predetermined level or is within normal range.
The child has reached all goals and objectives and is no longer considered to be at risk. The initial concerning behavior has been eliminated.
The child’s progress toward goals has plateaued and efforts made to modify the intervention plan have not led to notable gains. This means the efforts made to change the goals, procedures, activities, and strategies have made no difference.
Our goal as pediatric speech-language pathologists is to help children communicate better. We attempt to establish realistic long-term goals and short-term objectives. Talk to your child’s SLP and have them help you define progress by identifying discrete, measurable goals. Discuss therapy frequently and hold yourself accountable to daily practice.