Questions to Ask a Speech-Language Pathologist

At the start of speech therapy, good questions for a speech-language pathologist cover their credentials, how they choose an approach, the goals, how progress is measured and your part at home. The American Speech-Language-Hearing Association suggests writing questions down before a visit, since they are easy to forget during it.

What you’ll learn

• What a speech therapist’s certificate and state license each tell you
• What evidence-based practice means, and where your family fits in it
• Questions about goals, progress and how often sessions happen
• How to ask about your part between sessions

What Should Parents Ask About a Speech Therapy Approach?

A useful place to start, before asking about any one therapy approach, is the definition of evidence-based practice. The American Speech-Language-Hearing Association (ASHA) describes it as bringing together the clinician’s expertise, the evidence, and the perspectives of the child and the child’s caregivers. Evidence covers both the best available scientific research and the data and observations the clinician gathers on your own child. The family’s part is its own circumstances, culture, values, priorities and expectations.

Because of how ASHA defines it, no single therapy approach is the evidence-based one, since evidence-based practice is a way of reaching decisions rather than a particular program. ASHA says weighing all three parts together lets clinicians provide services that reflect the interests, values, needs and choices of the people they serve. For toddlers who start talking late, ASHA adds that the therapist considers the family’s cultural background when choosing an approach. Approaches also vary in how natural they are.

If an approach is described to you as naturalistic, naturalistic language intervention explains what the term means. Three questions cover the three parts of evidence-based practice:

• “Which approach are you planning to use, and why does it suit my child?”
• “What does the research say about it, and what have you noticed in your own sessions with my child?”
• “How can our routines, languages and priorities shape the plan?”

From clinical practice

ASHA defines evidence-based practice by putting three things side by side: the evidence, the clinician’s expertise, and the family’s values, priorities and expectations. What a parent asks and explains is therefore one of the things a therapy plan is built from.

That holds even when asking how a plan was chosen, or why, feels like doubting the therapist.

Checking a Speech Therapist’s Credentials

Two credentials are worth asking about, and they do different jobs. The Certificate of Clinical Competence is ASHA’s nationally recognized professional credential, written CCC-SLP for speech-language pathologists. To hold it, a clinician has earned a master’s or doctoral degree from an accredited program, completed clinical experience supervised by an ASHA-certified professional and passed a national examination. ASHA says the certificate assures consumers that holders keep up with changes in the profession through continuing professional development.

A state license is the other credential. ASHA certification is voluntary, while state licensure is mandatory, so every practitioner in a state must meet that state’s licensure requirements. ASHA describes the license as basic consumer protection. ASHA also says the requirements for its certificate are equal to or higher than any state’s requirements for a first license.

Asking “Are you ASHA-certified, and which state license do you hold?” covers both credentials in one question. Certification can also be checked through ASHA’s online Certification Verification system, which is free to use.

Goals, and How Progress Gets Measured

For toddlers who start talking late, ASHA describes goals as chosen by the family and the speech-language pathologist together. They are picked because they are developmentally appropriate and have the potential to improve communication. In ASHA’s words, the broader aim is enhancing everyday communication, so it is fair to ask how each therapy goal connects to the moments in your child’s day when talking matters, and to your child’s wider speech and language development.

ASHA also describes intervention as including ongoing tracking of the child’s progress toward the goals, with the goals changed as needed. When therapy comes through a school, the child’s Individualized Education Program, or IEP, must include measurable annual goals, according to the Center for Parent Information and Resources. It must also describe how progress toward them will be measured, and when progress reports will be provided.

• “Which goals are we starting with, and why these first?”
• “How will you measure progress, and how often will I hear about it?”
• “If a goal is not moving, what would we change?”

If therapy is under way and the delay is still there, speech delay that continues during therapy looks at the questions worth raising next. If your child has yet to be evaluated, the route to an evaluation is covered in getting a speech evaluation.

Your Part in Sessions and at Home

ASHA describes family-centered care as a collaboration between the clinician, the child and the family. In early intervention, families work with professionals to shape services around the family’s preferences, resources, concerns and priorities. Part C of the Individuals with Disabilities Education Act, which governs early intervention, also requires providers to involve families in all aspects of their child’s services, as far as each family chooses.

Coaching is one way that collaboration works in practice. ASHA describes it as an approach that builds the ability of families and other caregivers to use communication strategies in a child’s everyday settings. In early intervention, speech-language pathologists often coach families in language-building strategies during daily activities, with familiar routines and places used as chances to learn throughout the day.

Practice between therapy sessions belongs in the same conversation. ASHA says speech-language pathologists can train family members and caregivers to carry out specific parts of the intervention, and to help what a child learns carry over beyond the therapy setting. When a clinician works with a toddler through the parents, the clinician usually provides ideas and sample activities to do with the child. Talking through routines and everyday activities, ASHA notes, helps find learning opportunities.

• “What would you like us to practice at home, and can you show me how?”
• “Which parts of our day are good moments to use these strategies?”
• “How would you like me to take part in sessions?”

How Often Sessions Happen, and Where

ASHA uses the word dosage for how often, how intensively and for how long a child receives services. It lists dosage with format, provider and timing among the choices a speech-language pathologist weighs, and the provider can be the caregiver as well as the clinician. ASHA says dosage depends a great deal on the needs of the child and of the family and caregivers. That makes the schedule a decision made for your child and family, and a fair thing to ask about when therapy begins.

In early intervention, ASHA notes that some families want more frequent contact and more concrete support, while others prefer more freedom to learn on their own. That difference is part of deciding dosage, so it helps to say which suits your family. When services come through a school, the IEP states the anticipated frequency, location and duration of each service.

Services can take place in the family’s home, a child’s day care or school, or a private office, according to ASHA. The same ASHA advice about writing questions down suggests asking about the diagnosis, the course of treatment and its expected length, and where services happen. It also suggests asking how success will be judged, what expectations are realistic and what your own role will be, which together make a good list to bring to the first session.

Common Questions From Parents

What Does CCC-SLP Mean?

CCC-SLP stands for the Certificate of Clinical Competence in Speech-Language Pathology, ASHA’s national professional credential. Holders have finished an accredited master’s or doctoral program and supervised clinical experience, and passed a national exam. Certification is voluntary, while a state license is required.

How Do I Check a Speech Therapist’s Credentials?

A state license is mandatory for every practitioner in the state, so ask which state license the therapist holds. ASHA certification is a separate, voluntary credential, and ASHA’s free online Certification Verification system lets you search its list of certificate holders.

What Does Evidence-Based Mean in Speech Therapy?

In ASHA’s definition, evidence-based practice combines the therapist’s clinical expertise, evidence from research and from the therapist’s own data on your child, and your family’s values, priorities and circumstances. It describes a way of making decisions, so no one method owns the label.

How Will I Know If Therapy Is Helping?

Ask early how progress will be measured. ASHA describes therapy as including ongoing checks on progress toward each goal, with goals adjusted when needed. Through a school, the IEP has to spell out how progress is measured and when reports arrive.

How Often Should My Child Have Speech Therapy?

There is no single answer, because ASHA says the amount of therapy, which it calls dosage, depends largely on what the child and family need. Through a school, the IEP lists how often and how long each service is expected to run.

Can I Sit in on Sessions?

Asking to sit in is a fair request. In early intervention, federal law lets each family decide how involved to be in every aspect of the child’s services. Coaching, as ASHA describes it, centers on caregivers learning to use the strategies themselves.

What Should We Practice at Home?

Ask for specific activities. ASHA says therapists can train family members to carry out parts of the intervention. When working with a toddler through the parents, they usually suggest ideas and sample activities, and talking through your routines helps find the learning opportunities already in your day.

Reviewed by Monica d’Errico-Franklin, M.S., CCC-SLP

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