Does My Child Need Speech Therapy?


“Does my child need speech therapy?”  As a speech-language pathologist, this is a common question I hear from parents.  Parents will describe their child’s communication and then say something along the lines of “I don’t know if he needs therapy or if he’s just lazy/young/confused”.  Here are my recommendations if you’re concerned about your child’s communication skills and are wondering if your child needs speech therapy.


Step One:

Look for Free Screenings

If you are concerned about your child’s speech and language development, you should never hesitate to contact a speech-language pathologist for more information.  I find that parents are usually the best judges of whether or not there is a problem.  I have had many parents come to me and say “I think there’s something wrong but no one else believes me” and then when I look into it I find that they are right.  So, if you are worried, call a speech-language pathologist.

I know that speech therapy services and evaluations can be very expensive, so I recommend starting with trying to find a free screening.   The public school system will provide free speech and language screenings to children aged 3 years on up, but you have to specifically request the screening.  Call your local school district or your child’s school if he is attending a public school building and ask for a speech and language screening to be conducted by a speech-language pathologist.  If your child is younger than 3 years, most states have their own early intervention program where you can have your child evaluated for free and if he qualifies, they will provide services for free as well.

You can also call around to different speech-language therapy clinics and see if anyone is offering free screenings.  In my private practice, I offer free screenings to anyone who comes in, but I know some clinics only offer free screenings at certain times.  If you can find one, sign up for one of these free screenings but follow the rest of the steps in this article while you’re waiting to get in.  They will give you good information to share with the speech-language pathologist.  If you can’t find a free screening, you can always pay for a full evaluation, or try the steps below first to either confirm or deny your suspicions.

Step Two

Compare Your Child to Other Children His Age

Typically, you don’t want to compare your child to other children but in terms of speech and language development, it can be helpful.  Just be careful, there is a very wide range of “normal” when it comes to speech and language skills so some children will be further ahead of behind others while still being considered “normal”.  That being said, if you can compare your child’s speech and language skills to several other children his age, you may get a feel for how his communication is developing.

Look out for big differences between how your child sounds or how he’s able to communicate and the other children.  For example, if you notice that some of the other children are using the pronouns “he” and “she” correctly but your child isn’t, I would consider that a small difference.  This is something you could help your child with at home but I wouldn’t recommend speech therapy for such a small problem.  However, if all of the children are speaking in full sentences and your child only says single words, then that is a big difference that would be a red flag.  Another big difference would be if you can understand most of the other children that are the same age as your child but people can rarely understand what your child says.  Write down any differences you notice.  Small differences can be addressed at home, big difference should be brought up to a speech-language pathologist.


Step Three

Ask Teachers and Doctors for Their Opinions

Your child’s teachers and doctors can also be great resources for finding out how your child’s speech and language development compares to other children.  Ask your teacher if he/she has any concerns with your child’s communication skills.  Ask specific questions about the things you are concerned about.  For example, if you’re worried about his social interactions, ask the teacher how your child uses language to interact with other children.  Asking specific questions like this may help the teacher remember specific deficits that he/she may not have brought up otherwise.  Keep in mind though, that your child’s teacher has many children in the classroom that he/she must keep track of.

Little things may go unnoticed by even the most experienced teachers.  You can also ask your child’s doctors what they think.  Doctors, especially pediatricians, have some training on what speech and language skills a child should have but they only see your child for a few minutes every several months or even every few years.  If you have a concern, specifically mention it to your child’s doctor and ask what he/she thinks.  For example, if your child is hard to understand, tell your child’s doctor “My child is only understood by strangers 25% of the time and I’m worried”.  If you just say “how does my child’s speech sound to you?”, the doctor may say it sounds fine because he/she hasn’t had enough time to listen to your child.

The amount of training that doctors have in his area is very minimal compared to a speech-language pathologist so if you are still concerned even after your child’s doctor says it’s fine, you are perfectly welcome to visit a speech-language pathologist anyway.  Most speech therapists do not need a doctor’s referral.


Step Four

Use Developmental Checklists

A developmental checklist is a list of skills that a child should have by a particular age.  These lists are based on research that shows when children typically master various skills.  There are many such checklists for speech and language skills that you can refer to.  Use these to see which skills your child has mastered and which ones he is still missing.  Again, keep in mind that there is a wide range of normal so your child can be missing a few items on a checklist and still be perfectly fine.  You can find speech and language developmental checklists on my website.  Simply click on this link to my archives and scroll down to the bottom of the page.  There you’ll find a section labeled “Developmental Milestones” which will have all of the information you need.


Step Five

Try Teaching Skills at Home

There are many ways that you can work on speech and language skills at home.  I recommend trying some speech therapy-type activities at home even if you are planning on having a speech screening or speech evaluation.  You can tell the speech therapist what strategies you’ve tried and how well they worked.  This will help the speech therapist know where to start and will help them make progress more quickly.  I also recommend doing speech and language activities at home if your child is already in speech therapy.  Working on the same things that your child’s speech-language pathologist is working on will help your child learn the skill better and generalize it more quickly to other settings.


Thank you so much for reading!   Check out my website for more information, activities, and resources regarding speech and language delays, disorders, and therapies.