Question 1: Early Signs a Child Might Need Speech Therapy
When a parent suspects their child might need speech therapy, Stephen advises against relying on a quick checklist. Instead, he recommends comparing a child's development to typical milestones. "What should actually be considered is how a child develops typically," he explains. He points to the American Speech-Language-Hearing Association (ASHA) as a reliable resource for age-appropriate skills. If a child hasn't reached certain abilities, Stephen suggests parents "discuss this with the child's physician to see if speech therapy would be a good option."
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Question 2: In-Person vs. Virtual Speech Therapy
Stephen believes most children can potentially succeed in either setting. The deciding factors are often practical: internet quality, scheduling, and cost. "In some cases, in-person therapy may be more expensive than virtual," he notes. However, he acknowledges exceptions. Children with significant behavioral issues may not participate well virtually. For those using Augmentative and Alternative Communication (AAC) devices, a caregiver must be present to assist. "If this would not be possible, in-person therapy may be better," he says, but adds that "at least initially, both methods of service delivery can be considered for any child."
Question 3: The Biggest Misconception About Speech Therapy
Stephen identifies a narrow public perception as the most common misconception. "Many people think that speech therapy is only related to speaking - sound errors, lisps, and stuttering," he says. In reality, speech-language pathologists work on language skills like grammar, reading comprehension, and vocabulary—areas often assumed to belong to English teachers. They also address voice quality, such as hoarseness or a raspy voice. Most surprisingly, Stephen explains, "speech therapists help with swallowing difficulties in adults and children. We can assess and provide treatment for individuals who are having trouble chewing and swallowing food." This breadth of practice is often overlooked.
Question 4: School-Based vs. Private Practice Therapy
Stephen's clinical approach remains consistent across settings, but the level of parent interaction differs significantly. In private practice, he has "more of an opportunity to check in with parents after sessions to provide them with ideas of what to do at home." In schools, therapists are required to meet parents at IEP meetings and provide periodic progress reports, but treatment typically happens at school in collaboration with teachers. Still, Stephen makes an effort: "At my schools, I do like to reach out to parents and, if a parent is open to it, I am always happy to send materials home for them to work on." He emphasizes that the manner of therapy differs, not the underlying approach.
Question 5: One Thing Parents Can Do at Home
Stephen's top recommendation is simple but powerful: ask the speech therapist. "All speech therapists are happy to include parents in the speech therapy - after all, we only see the kids for around an hour a week, but parents are there the rest of the time," he points out. He acknowledges that therapists' caseloads can be high, and sending materials home may slip their minds. "But if a parent asks, we will be sure to send some over," he assures. This proactive step can significantly reinforce progress between sessions. For more information on Stephen's practice, visit Domino Therapy.