Questions to Ask a Speech Therapist
Questions to bring to an appointment with a speech and language therapist, whether for a child or for yourself, covering what the assessment found, what is being worked on first, practice at home, how progress is measured, cost, and when therapy ends. These are questions for the appointment, not a substitute for one.
20 questions, each with the reason to ask it · includes a conversation guide
The questions
Open any question to see why it works.
- 1
What did the assessment show, in plain terms?
Reports are written in standard scores, percentiles and clinical terms because they have to serve other professionals as well. Ask for a version you could repeat accurately to a grandparent or a teacher, and if the answer stays technical, say so and ask again.
- 2
What is the name for what you are seeing, and is that a description or a diagnosis?
Terms such as speech delay, articulation disorder, developmental language disorder and childhood apraxia of speech carry different implications for services, for school paperwork and for what happens next. Knowing which category you are in tells you what to ask about afterwards.
- 3
Which parts of this are within the normal range for this age, and which are not?
A good deal of what gets referred turns out to be ordinary variation, and sounds arrive at different ages. Asking for the expected range separates what is being watched from what is being treated.
- 4
What are we working on first, and why that rather than something else?
Therapists sequence targets deliberately, usually by which sound or skill the person can already produce with help, which one affects being understood most, or the order things typically develop in. The reason they give tells you how they are thinking about the whole plan.
- 5
How will we know whether it is working, and by when?
Ask for the goal in a measurable form, the starting point it is measured from, and a date when it will be reviewed. A plan with no review date can continue indefinitely without anyone deciding it should.
- 6
How often would you like to see us, and what changes if we can only manage less?
Session frequency is often set by insurance limits or a school's allocation rather than by clinical judgement. Asking makes the trade-off explicit and lets you know whether fewer sessions with more home practice is a reasonable version of the plan.
- 7
What should we be doing at home between sessions, and how long should it take?
Home practice usually determines the pace more than the sessions do. Ask for minutes per day rather than a vague instruction, ask when in the day it works best, and ask what to do if it turns into a fight.
- 8
Can I watch a session, or record part of one?
Watching is how you learn to do the practice correctly rather than approximately. Some settings do not permit recording for privacy reasons, so ask rather than assume, and ask for a written or video demonstration instead if the answer is no.
- 9
Is there anything we should stop doing at home?
Parents often do things that work against the plan without knowing: correcting every attempt, finishing sentences, asking a child to say it again in front of other people. Ask specifically about those three, since they rarely come up unless raised.
- 10
Is anything else worth checking, such as hearing?
A hearing check is a standard part of the picture for speech and language concerns. Ask what has already been ruled out, who did it, and whether anything else, such as an ear, nose and throat review or a feeding assessment, would be usual at this point.
- 11
How does this connect with school, and does the school need to be involved?
School-based services and private therapy run on different criteria and different paperwork. Ask what the school would need to receive, who sends it, and whether the therapist can speak to the teacher directly with your consent.
- 12
If we are looking at school services, what qualifies and what does not?
Eligibility for school support usually turns on whether communication is affecting access to education, which is a narrower test than the clinical picture. A person can be eligible for one and not the other, and knowing that in advance prevents a confusing meeting later.
- 13
What is the likely course of this: months, years, or something to manage long term?
Ask for a range and for what would move it in either direction. An honest answer is sometimes that it is too early to say, in which case ask what they would expect to see by the review date.
- 14
Who will deliver the sessions, you or an assistant?
Therapy assistants deliver a lot of sessions under supervision, which is normal, but you should know who is doing the work and who owns the plan. Ask how often the supervising therapist reviews progress directly.
- 15
How much experience do you have with this particular difficulty?
Stuttering, apraxia, voice, adult stroke rehabilitation and communication support for autistic people are quite different areas of practice. Ask about volume and recency rather than interest, and ask who they would refer to if it is not their usual area.
- 16
Do you use a particular approach or programme, and what does it involve for us?
Named programmes differ in how many sessions a week they expect, how long the block runs and what the family has to do. Ask what the commitment looks like in practice before agreeing to it, including travel and cost.
- 17
What does this cost per session, what does insurance or funding cover, and what happens when it runs out?
Ask for the private rate, the number of sessions covered in a year, whether reassessment is billed separately, and what the option is if funding ends before the goals are met.
- 18
What happens if we miss sessions or need to take a break?
Ask about the cancellation policy, whether a place is held, and what the waiting list looks like if you have to stop and restart. It is also worth asking whether progress usually holds over a long break such as a school summer.
- 19
What does discharge look like, and what would need to be true for us to stop?
Ask for the criteria in advance so the end is a decision rather than a drift. Ask also whether discharge is final or whether they would review again after a period, and how you would get back in if things slip.
- 20
If we are not seeing change in a few months, what would you try differently?
This asks for the alternative plan before you need it. A clear answer might involve changing the target, changing the approach, adding an assessment, or referring on, and it tells you they are prepared to revise rather than continue by default.
Preparing for the appointment
Practical guidance for the conversation itself.
Before you go
Before you go
- Write down two or three specific examples of what worries you, with the words used and who was listening. Examples are more use than adjectives.
- Record a short clip of ordinary talking at home if you can. Speech in a clinic room is often not representative.
- Bring any previous reports, hearing test results and a list of anyone else already involved.
- Note when you first noticed it and whether it has changed since, in either direction.
- Write your questions down and take the top three to the front, since appointments are shorter than they sound.
During the appointment
During the appointment
- Ask for the spelling of any term you have not heard before, so you can look it up afterwards without guessing.
- Repeat the plan back in your own words before you leave and let them correct it.
- Ask what you should notice at home if things are going in the right direction.
- Ask who to contact between appointments and for what kind of question.
- Ask for the home practice in writing, or take a photo of the demonstration.
Terms you may hear
Terms you may hear
Speech and language are not the same thing
Speech generally refers to producing sounds, and language to understanding and putting words together. A person can have difficulty with one and not the other, and the practice at home looks different for each.
Receptive and expressive
Receptive refers to understanding what is said, expressive to producing it. Reports often give separate scores for the two, and the gap between them is usually part of what the therapist is explaining.
Standard scores and percentiles
Assessment results are usually reported by comparison with a group of the same age rather than as a mark out of a total. Ask what the numbers mean for this test in particular, since the scales are not the same across tests.
Titles vary by country
The same profession is called speech and language therapist in some countries and speech-language pathologist in others, and the regulator and funding routes differ. Swallowing difficulties often sit with the same profession, which surprises people.