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Speech Therapy 101: How, Why, When, and Where to Get It

speech therapy for toddlersA little over a year ago, I made one of the hardest phone calls — I called the pediatrician and asked for an appointment because I had concerns over my toddler’s speech. The next day, I sat in the pediatrician’s office with Harrison quietly zooming cars at my feet and I explained that he had completely regressed in speech. He maybe had twelve words and about half of those were in his own language that only me and my husband understood. I told the doctor about the head banging Harrison did from frustration, the screaming and whining, and me nearly pulling my own hair out from frustration. The inability to communicate with my child was breaking down our relationship and creating horrible stress in our family.

He smiled and reassured me that this was normal, especially for a boy. But that there was absolutely something we could do about it. He jotted down the number of a private therapist who he liked and told me to start there. The private therapy group would do an evaluation (that would be covered by insurance) and we could go from there with a decision. “Won’t he talk eventually?” I asked. That was what everyone always said to me before when I expressed concern — he’ll talk eventually, boys always talk late, just you wait, he’ll open his mouth and be speaking sentences when he’s four — but somehow in my gut, I knew this was different.

“Yes,” the pediatrician smiled, “he will talk eventually without therapy. But the big issue here is that he’s almost two and not talking. What you run the risk of is the speech delay creating other delays and then him being labeled. For instance, the three-year-old that hates tags in clothes. He will scream and kick and be labeled with a sensory disorder when really, it’s just a tag that’s bothering him every day but he can’t say it.”

It made sense to me and it was all the kick-in-the-pants that I needed to make that phone call.

After three months of private therapy, our therapist recommended that we apply for the Wake County speech program, Early Intervention. We were in it for the long haul, she explained, and Early Intervention had the resources to help us with the cost. It meant another evaluation for Harrison, but it was free and soon 90% of our speech expenses were covered by a combination of the county and our private insurance policy. We were able to keep the same therapist we had in private therapy by asking for her specifically. (And she agreed to see him in our home!) A year later, Harrison exited the program as a three-year-old that was almost caught up to normal speech for his age. It was a hard year and hard work, but my little boy was a champion through it all. I’m so proud of him.

I get asked pretty often about the first steps to take, the options available, etc. So here is a “Speech Therapy 101 for Toddlers” as I learned it over the past year:

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  • So you have concerns 1 of 15
    So you have concerns
    Does your child verbalize less than her peers? Does she bang her head in frustration? Scream more than using words? Become easily frustrated or incredibly shy because she can't communicate her wants and needs? She may have a speech delay. But great news! There are tons of resources out there to help her!
  • Step 1: Go see the pediatrician 2 of 15
    Step 1: Go see the pediatrician
    Make a visit to talk to the pediatrician about your concerns. He or she can ask you basic questions and tell you whether or not your toddler seems to be on-track for speech. If it seems there might be a delay, the pediatrician can write a referral and point you in the right direction.
  • Make the call 3 of 15
    Make the call
    This is the hardest part, Momma. But it's so important. Pick up the phone & make that appointment for the therapy assessment. Remember, you can always change your mind if you feel it's not a good fit, but the assessment won't hurt your child at all.
  • The assessment 4 of 15
    The assessment
    This is either done in the home or at the therapist's. The therapist will ask you questions, talk to you about the child's first few years. She'll watch your child, play with him, even run some "tests" like asking him to point out a cow or what a cow says.
  • It can be pricey 5 of 15
    It can be pricey
    Therapy visits can be roughly $60/visit at a private center. Ask about county or state programs, usually called Early Intervention.
  • Call your insurance company 6 of 15
    Call your insurance company
    I know, I know. Awful. But most insurance policies will cover speech therapy in some way. Find out how much they cover, how many sessions, etc.
  • Private therapy 7 of 15
    Private therapy
    One option is therapy through a private center. They typically offer a wide range of therapies, are dedicated to children, and the therapists are licensed.
  • Therapy through the county or state 8 of 15
    Therapy through the county or state
    This is often times done in the home or the school, rather than a private center. The therapist is appointed by state, although if you've been attached to one through a private facility, you can ask if she will be considered and reimbursed by the state.
  • Get ready for paperwork 9 of 15
    Get ready for paperwork
    If you decide to go the county/state route, better get a file folder ready. Put in it a copy of your insurance cards (front and back) and the initial speech assessment, along with a referral from the pediatrician. Gather your last tax forms, your last W2's, your current bank statement, and several months of pay stubs. The state is going to want to see what you make so they can decide your sliding scale fee.
  • It’s all play 10 of 15
    It's all play
    Don't worry, your toddler isn't going to be doing flashcard drills. The therapist is trained to use play as a platform for therapy. I don't know how it works, but it just plain ol' does and it's really cool to watch.
  • Attend therapy with your child 11 of 15
    Attend therapy with your child
    This is the BEST thing you can do as a way to watch her progress, plus get tips from the therapist. It's really important for the moms and dads to stay in touch with the therapist about "homework" (I'll touch on that in a minute) and goals.
  • Warning: therapy is tough 12 of 15
    Warning: therapy is tough
    You may notice that your child is more tired the day of therapy. He may need a little extra grace on behavior or an earlier bedtime or a day to stay home and rest, rather than run errands. It's okay and it's normal - his little brain has been hard at work!
  • Practice, practice, practice 13 of 15
    Practice, practice, practice
    This is going to require a lot of work for both you and your child. Your therapist will give you "homework" each week, like enforcing that the child say "please" instead of "peas." Simple tasks to focus on, but you have to be consistant.
  • Preschool can also help 14 of 15
    Preschool can also help
    Interacting with other children is essential for growing speech - he'll be forced to use words, to stretch his wings, and he'll hear his peers interact. Even if daycare is out, a few hours per week at a preschool or playgroup can do wonders.
  • It’s not forever 15 of 15
    It's not forever
    I know it feels like forever, Momma. I know it's frustrating and you just want to hear sentences and talk to your child. Remember that this is temporary. Your child will talk. And you will LOVE it.

Disclaimer: This is based off my own personal experience. Remember that the first, and most important, step is to talk to your doctor!

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Beth Anne writes words & takes pictures at Okay, BA! You can also find her on the Twitters & Facebook.

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