Top Ten Things Your SLP May Be Too Nice to Tell You…Tips for Parents for Maximizing Therapy Sessions at Home
TOP 10 THINGS YOUR THERAPIST WANTS YOU TO KNOW AND MAY BE TOO NICE TO TELL YOU -
1. Minimize the distractions from other people for your child, especially during initial sessions.
This means don’t have grandparents or your best friend or the neighbor’s children over until your child has established relationships with her therapists. It’s much easier to keep a new client’s attention if the stressors are limited in the beginning. Grandparents can come to watch AFTER your therapist has a good read on your child, and after she already loves her and wants to play.
2. Turn the TV off before she gets there!
It’s hard to start a fun session when your child is having a melt-down because Dora or Super Why has been abruptly turned off.
3. Put the pacy and cups away.
This is unless you’re working on feeding, oral motor with a straw cup, or your kid absolutely, positively has to have the pacifier to regulate. Your therapist may want you to keep the pacy available, but she should NOT have to be the one to have to pry it from your child’s mouth! It makes her the bad guy, and that’s really a mom’s job.
4. Do a “warm up” before she comes.
Act excited before she gets there telling your child, “________ is coming to play!” Do a movement activity like swinging or jumping on the bed or couch or running laps 5 minutes before she’s due (or in my case, 5 minutes after I’m due since I consistently run 10-15 minutes late!) This serves to pep up kids who need to kick it up a notch to talk. More often, it calms down really active kids who have a hard time engaging and attending.
5. Follow your therapist’s lead with participating in the session.
I LOVE for moms to sit and actually play with us, unless mom is so chatty that I can’t get a word in edge-wise or a mom that subconsciously sabotages techniques by answering for her child, is too quick to jump in to rescue her child (a little bit of frustration is sometimes good thing), a mom who is too mean, or a mom who justifies every little negative thing that he may do (He’s tired today because he went to bed late, so no wonder he can’t do what you’re asking…).
Do chime in and tell her why you think something may be going badly (i.e. “This is his 2nd day of antiobiotics for an ear infection.” or “He was up 7 times during the night.”), but don’t tie her hands or so lower the expectations that she ends up wondering why you didn’t call to reschedule if he’s truly having such a bad day.
If your child is clingy to you and won’t interact or play with your therapist, make yourself present, but not quite as available. For instance, casually check your e-mail from across the room or stand up and dust so he can’t sit in your lap. Be there so he’s not stressed, but don’t coddle him unless he really needs it. If in doubt, ask your therapist what she’d like you to do.
Read your child’s cues, BUT remember that challenging your child may be just what he needs. Don’t feel threatened if she’s not doing it exactly as you would. She’s there to teach you NEW stuff.
6. Cancel if you know you’re not going to get anything accomplished, and please cancel if anyone at home has an illness that’s contagious.
I can’t tell you how many times I’ve picked up a child and felt him burning up with a fever or sat while mom changed dirty diaper after dirty diaper and thought…. I hope I’m not going to catch this and take it on to my next 4 clients or home to my own children! Speech therapy is important, but it’s not an emergency! It’s okay to miss a session when your child is not going to benefit anyway. This might also include the day you’re leaving on vacation and the house is a disaster or when the water heater has broken and the repairman is going to be going in and out of the front door 50 times.
This is also true for when Dad is home with the flu. He’s touched doorknobs. He’s sneezed out his germs into the air. Cancel or at least call and warn her!
7. Handle your child’s major behavioral issues, but not the minor ones.
I’d rather ignore little infringements than get off on the wrong foot with a kid. I almost always use gentle redirection in sessions rather than “disciplinary” stuff like time out or even verbal corrections. However, if your child is truly being horrible (i.e., purposefully throwing toys at your therapist, hitting, biting, destroying her toys, or hurting your other children), step in and parent. If you’re not sure how to handle these behaviors and also need coaching in this area, ask her to model what she would do for discipline in that situation.
One other pet peeve I have is parents who are constantly chiming in, “Tell her thank you,” “Say please or you can’t have it, ” “Say MISS Laura,” or using other politeness or verbal cues that are irritating for a non-talker and for me when we’re just trying to get ANY word! Ditch the etiquette lessons until he can communicate!
8. Don’t save all of your questions for the last minute.
I routinely ask moms how the week is gone, if they have any questions, etc… at the beginning of the session. Answering questions is what your therapist is there for, so don’t save a bombshell bit of information or a long question until she’s about to walk out the door. It’s not fair to her other families who may be waiting 20 minutes for their appointment because she feels like she must answer your question before she leaves. If it’s a complicated issue she may need to think about, leave her a voice mail or shoot her an e-mail a day or two before she comes so she can be prepared with a credible answer.
9. Be respectful of her schedule.
Schedule all of your other appointments around your therapy time. You wouldn’t call your pediatrician’s office and say, “I’d like to come in on Tuesday at 10.” You take what they give you. While it’s important for therapists to be flexible and respectful of your schedule, you may not be able to dictate exactly when you want her to come. If a therapist has a good reputation, she is going to be busy. If she’s busy, you’re going to need to take what appointment you can get, within reason of course. I am very careful to tell parents that I don’t want to come at the worst possible time of the day, but if you have to push lunch back a little and put your child down 30 minutes earlier for a nap so that your great therapist can come for an afternoon appointment, so be it. Not every client can be seen at 10:00 am on Wednesday. Be flexible.
10. Help your child love therapy.
Sometimes parents subconsciously sabotage their child’s good relationship with a therapist out of well, jealousy, or mistrust, or any other number of unproductive emotions. You need your child to love, or at least like, okay at least tolerate, his therapist. Stay positive, even when it may be off to a rocky start. Don’t characterize the session as “work.” Don’t say dumb things like, “Do you want _____ to go home?” Don’t ask him, “Do you want to play with her today” when the answer may be no. Expect that he and you are going to benefit tremendously from each session, and do everything you can to make it happen.
If your child hates therapy, consider switching approaches, times of the day, settings, or as a last resort, therapists. Unfortunately, there are good and bad SLPs just like there are good and bad hairdressers, car mechanics, preachers, cashiers, and math teachers. Find a good match for your child so he can get the help he needs.










Comment by Nel on 28 May 2008:
Thank you for this…nice to see that I’m doing most of these suggestions already….I am however, an admitted “last minute questioner” and you’re right I can leave e-mails and voice mails. Probably will get a more thought out answers to my questions too!
Comment by angeltish on 2 June 2008:
Hi Laura! Thank you so much for all the time and effort you put into your articles. This site has a goldmine of information! I have been a developmental therapist for just over a year and usually the kiddos that I work with have speech delays. I’ve read all of your articles, sometimes several times, to gain as much knowledge as possible because I have a degree in Elementary Education, not speech therapy. I’m feeling stuck and think you’ll be able to help. Most of the kiddos I work with are at least imitating sounds and actions when I start with them. One little guy is 2 years old and a couple months and rarely imitates me or his parents. I’ve been with him for about a month so I’m not sure if I’m not doing everything I should be or just not giving him enough time. Any advice or suggestions would be greatly appreciated!!!
Comment by Laura on 2 June 2008:
Angeltish - I’m so glad you’re finding this site helpful! It’s written for parents AND therapists, especially new ones. If you haven’t read this in one of my articles, one of my very best friends is a developmental therapist, and we have discussed and re-hashed all of this stuff on our cell phones between appointments with kids for almost 10 years now. I also owned a center-based developmental playgroup and employed several great DTs, so developmental interventionists are near and dear to me!
As far as imitating skills for your little client, read the article “Help! My Child Can’t Imitate Words.” It’s in the apraxia category. I always start with imitating actions in play if a child can’t imitate sounds. Also - make sure you’ve got him engaged. A distracted or isolated child is NOT going to imitate you until he is interacting with you. Try using a really playful, really fun approach to get him going. He may also need lots of movement activities before he’s regulated and ready too. If you need more ideas, send me back a few more details, and I’ll be glad to let you know what I think. Laura
Comment by Kendra on 7 October 2010:
LOVE this article. I think I may print it out and nicely give it to EVERY family I work with!
Comment by Linda on 30 April 2011:
Hi, My grandson, Aidrik will be four in a month. He has had two sessions with his speech therapist, and I am not sure what to think. First of all, I should preface this with the fact that Aidrik and his mom live with my husband and I and we are as much, sometimes more his parents than his mother. His father is not in the picture at all. My question is, Is his therapist going to ever show us things to be doing at home? As it is, she takes him off into a room and we know nothing about what they are doing. We,before starting therapy had already begun teaching him ASL, and he has done well with it, and tries hard to say what he is signing. He mainly leaves out consonants from words ie. cup is up, cookie is ooie, car is ar. I would like to find someone that will come to our home, but not sure how to go about it. Any advice or insight will be greatly appreciated.
Comment by Kara on 2 June 2011:
Please add, “Don’t bribe your child.” and/or “Don’t tell your child to make sure they do good in speech.” It irritates me when parents tell their child that they will go get ice cream, a toy or some other “treat” if they do good in speech and then put the therapist on the spot by asking if the child did well. I almost always use verbal praise & very rarely reward children with ‘treats’ and tell the parents upfront that I will always tell them their child did well. Imagine the damage that can be done to the child/therapist relationship if I told the parent the child did not do well. I once had a child who would not talk during sessions because the parents pressured her to make sure she did well in speech. She was so worried that she wouldn’t do well that she would hardly say a word. We finally had to switch therapists.
Comment by Anonymous on 6 June 2011:
Great handout for parent! thank you
Comment by amanda j on 18 January 2012:
Just wanted to say thanks for this article. I’m an EI and parents need to know how important these things are in the success of their child’s session!