What Should a Speech Session Look Like?

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A woman in our Facebook community shared that her 2 year old son was referred for behavioral therapy because he wouldn’t sit in a chair through his speech sessions.

Now I’ll be open about my bias here… I’m not a fan of behavioral therapy even for kids who have true behavioral problems.

So I’m definitely not a fan of it for kids whose “behaviors” are completely age-appropriate.

(Let’s be clear, a 2 year old not sitting in a chair through a therapy session is normal. I’d be more concerned if they did sit still for that long.)

But this brings up a question I see a lot, which is…

What should a speech therapy session look like?

If your child hasn’t started therapy yet and you’re not sure what to expect…

Or you’re not having a great experience with therapy and you’re wondering if what’s happening is normal…

This is for you.

All therapy is going to look a little different. 

And that’s a good thing.

Different therapists have different styles and strategies that they like and that they’ve found work well for them.

Plus all therapy should be customized for the individual child they’re working with.

But as a general rule, here are 3 things you should look for in a good therapy session:

1. Activities, Strategies, & Expectations Should Be Age Appropriate

Let’s start with that last piece, since that was the inspiration for this post. 

The expectations for a child’s participation and behavior should be age appropriate. 

Which means if the therapy is for a 2 year old, they should not be expected to sit a chair for more than a few minutes, if at all. 

This means the therapist shouldn’t have a full 30 minutes of table-based drill work planned. 

That can be an effective strategy in some situations. But it’s not appropriate for a child that age. 

It also means if a 2 year old bounces back and forth between 5 different activities throughout the session… that shouldn’t be a problem because that’s typical behavior for that age.

Therapy should involve strategies that can be easily incorporated into activities that are fun and appropriate for the individual child. They should also be flexible enough to change as the session does, especially for littles. 

This means taking into account not only their goals, but their age and interests as well.

2. Therapy Should Be Fun

This is easier if you do a good job with #1. 

Kids should want to go to their therapy sessions each week. 

I’m a huge believer in play-based therapy. Play is how kids learn best. 

And this doesn’t just apply to the little 2 year olds. I’ve done therapy with adults who preferred to play games during sessions. 

Regardless of the child’s age, therapy should be structured in a way that makes it fun and keeps them engaged throughout the process. 

3. Sessions Should Be Collaborative

Ideally, the therapist will collaborate with you, the parent, as part of the session. 

This may not happen if your child is getting therapy through their school…

But if you’re taking them in somewhere specifically for speech sessions this should absolutely be part of the process.

The collaboration can look a couple different ways…

In some instances, you might sit in on your child’s sessions and either observe what they’re doing or participate in the activities. 

The goal would be for you to learn how the therapist is working on goals so you can do something similar at home.

If you don’t sit in on your child’s sessions, the therapist should leave a few minutes at the end to talk to you about what they worked on and how you can continue to support those goals throughout the week. 

A quick note on “playing”…

One concern I’ve seen a number of times from parents is that the therapist is “just playing” with their child and isn’t actually doing anything special to support their speech skills. 

If the therapist is collaborating with you well throughout the sessions, this shouldn’t be a concern, because you’ll know what they’re doing, how to do it yourself, and why it’s helpful. 

But if that’s not the case, it’s very easy to just see play when you look at what’s happening during a session (in fact, it probably will look like that if they’re doing a good job with numbers 1 & 2). 

If you have a good therapist though, there’s much more than just play going on.

But don’t take my word for it or assume that’s what’s happening. 

Ask your child’s therapist…

What strategies are you using?

Why did you pick that activity?

What goal were you working on?

How did the activity support that goal?

Plus any other questions you have!

At the end of the day, the therapist is be there to support you and your child. So go ahead and ask all the questions until you’re confident that your child is receiving the best care available.