Common Speech-Language Therapy Questions

This page is designed to answer some frequently asked questions we have received over the years from contact with parents, individuals, and families inquiring about speech language services.

Preschool-aged children

Q: My two-year-old is not talking. My child seems to understand everything I say but mostly points or gestures to communicate. My child can say a few sounds but has a limited amount of words. Should I be concerned? What should my first step be? Is two years of age too young to be seen by a speech-language pathologist?
A: You should be concerned if your child is two years of age or older and has a very limited number of words or sounds or communicates mostly with gestures. The first step is to have your child seen by a Certified Speech-Language Pathologist (SLP) for an initial assessment. Two years of age is not too young if your child is not talking. An assessment will determine what skill level your child is presenting with and if there is a significant delay. It is the starting point for developing a plan of action to facilitate further language development.
Q: How does an SLP at your clinic assess language development in a very young child, especially if my child is talking very little or is shy with others?
A: A combination of measures is used to determine the language abilities of your child, for both understanding of words and language and verbal expression. These measures include parent reporting and questionnaires, observation in play with the parent/caregiver and with the clinician, and elicitation of speech sounds or words through selected age-appropriate activities. For children closer to three years of age or older, more formal measures involving pictures and books or language tests may be appropriate tools to obtain further information.
Q: How long is a speech-language assessment for a young child?
A: The length of the assessment is variable, depending on the child and the presenting concern. Typically, an initial language assessment session for a very young child would be an hour to an hour and a half to include time for discussion with the parent following data collection and assessment. Further follow-up visits may be required.
Q: What can I expect to gain from an initial assessment?
A: The SLP will be able to gather all the information and concerns you report about your child’s language development and also her assessment observations into a developmental profile. This will assist you in understanding the current skill level of your child relative to his/her age. Following this, an individualized plan of action or therapy can be developed for your child to assist with language growth.
Q: If my preschooler is showing signs of stuttering should I be concerned or is it just something that he/she will outgrow?
A: Signs of speech dysfluency, such as word or phrase repetitions can be normal developmental behaviours between the ages of three to six when a child is developing language skills. Other patterns of speech dysfluency, however, that show signs of blocking on sounds, multiple sound repetitions, a high frequency of repetitions or any overt struggle to get words out, may be symptomatic of beginning stuttering. If your child is showing any signs of consistent speech dysfluency for longer than three months, it is recommended that he/she be seen by a certified SLP for an assessment to determine if the dysfluency is not developmental. Early intervention for beginning stuttering is important in prevention of chronic stuttering in children. Your clinician will determine the best approach for your child based on the assessed risk of developing true stuttering.
Q: What does language therapy for a young child typically involve?
A: If your child has been assessed as having a significant language delay (either in understanding words or expressing words/sentences, or both), a plan of action will be determined between you and the clinician that best works for you and your child. For some children, this may involve parent coaching on age-appropriate activities and strategies to do at home in play with your child with periodic monitoring and follow-up at the clinic. For some families, more regular sessions for direct work with the child and the parent together may be recommended and considered best.
Q: What if my child is speaking in full sentences but his/her speech sounds are unclear and it is hard to understand what he/she is saying? Is this just part of normal development or should I be concerned?
A: The acquisition and mastery of speech sounds (articulation skills) typically follow a developmental sequence, which means that in a normally developing child, speech clarity and articulation skills spontaneously improve with maturation and may not become fully developed until seven or eight years of age. Given that, however, there can be a number of reasons why speech sound development is delayed or does not progress as expected with age, and results in speech that is hard to understand. These could include a history of frequent ear infections, motor speech difficulties (trouble forming certain speech sounds easily with tongue or lips), family history of speech delay, or other contributing factors such as general developmental delay or disorder. Sometimes there is no easily identifiable reason for articulation delay but a child’s speech clarity does not improve. This could be related to more subtle factors in the area of auditory processing, such as poor perception of speech sound differences, poor attention/listening abilities, and reduced auditory memory. A good rule of thumb is to seek an initial assessment by a certified SLP if you are at all concerned about the clarity of your child’s speech. Following an assessment, the clinician will be able to determine if your child would benefit from articulation therapy sessions at this time to improve his/her speech or if it would be better to wait.
Q: What does articulation therapy for a preschooler involve?
A: Sessions are half an hour in length and involve fun age-appropriate activities for sound practice of target speech sounds, as determined by the clinician. Follow-up home materials for daily practice are provided after the session. Weekly sessions are recommended as needed and individualized to meet the specific needs of your child. Progress is carefully monitored for recommended continuation of service. There is no requirement for a set number of sessions. Scheduling can be as flexible as needed for the family.

School-aged Children

Q: What services does this clinic offer for school-aged children?
A: This clinic offers assessment and treatment for school-age children who are experiencing difficulty developing clear pronunciation of speech sounds in words (articulation), for comprehension and verbal expression of oral language, for stuttering and voice disorders, and for reading and spelling/writing difficulties.
Q: What would an assessment involve?
A: An initial assessment can range from one to two hours, depending on the referring concern. Formal test measures are typically given in addition to observation and informal language sampling and data collection. Discussion of the findings and recommendations for follow-up are included as part of the assessment fee.
Q: How long are the therapy sessions and how often are they?
A: The frequency of therapy is recommended by the clinician who assessed the child and progress is carefully monitored to determine the need of continued service. Sessions for articulation, mild language difficulties, voice and stuttering therapy are typically thirty-minutes. Sessions for reading and writing therapy are generally one-hour.
Q: As a parent, am I expected to attend all the sessions?
A: Follow-up practice materials after a session are typically provided to parents who are interested in supporting the target skills worked on in the session by helping their child at home. This is not mandatory, although parent support at home is encouraged. Extensive home programming however is not provided in lieu of attending regular therapy sessions. Parents/caregivers do not typically sit-in on the sessions with a school-aged child as this is often found to be a distraction to the child during the lesson. Rather, time is spent at the end of the session to review important information/observations with the parent. If needed, an additional consultation or phone discussion to discuss the child’s progress can be arranged at no extra charge. If the parent specifically wishes to sit in on the session at any time, this is of course available.
Q: Can I receive a written report to take to my child’s school?
A: Yes, a written professional report on an assessment or therapy progress can be completed for an additional fee. The report becomes the personal property of the parent/caregiver and they can decide to whom they wish to provide a copy. Our clinic will provide an original report and one copy upon request. Telephone communication to other professionals involved with the child can be provided as needed upon written permission of the parent to release confidential information about the child. There is no additional fee for brief telephone consultations to other professionals (i.e., teachers, physicians, psychologists).


Q: What services does this clinic offer for adult clients?
A: This clinic offers assessment, consultation, and therapy services to adults with speech impairments, such as stuttering, and articulation disorders (unclear speech), as well as language impairments, secondary to stroke and accent modification for individuals who wish to speak Canadian English with less of an accent from their primary language.

General Information

Q: How do I arrange for an initial assessment? Do I need a Doctor’s referral?
A: Adult clients and parents can call the office directly or send an email to our clinicians to request an initial appointment. A doctor’s referral is not required for services to this clinic but may be required for reimbursement to extended private health care coverage plans under speech-language therapy services. If so, it must be dated on or before the day of the scheduled appointment date at this clinic.
Q: How do you accept payment for a session?
A: Halifax Speech & Language Services is a private speech pathology clinic and payment is accepted after each session by cash or personal cheque. Our clinicians are nationally certified with Speech-Language and Audiology Canada (SAC) and this qualifies us for reimbursement with private health insurance companies under speech-language therapy. An official receipt is provided following payment to submit for reimbursement to private health plans. We do not direct bill. Our fees are in keeping with the recommended guidelines of the Canadian and provincial associations for speech-language pathologists. Please call the clinic to inquire about our current rates.
Q: Where is your office located and is there free parking available?
A: The clinic is currently located in the Bedford Place Mall, on the Bedford Highway, with easy access off the 102 Highway. There is ample free parking. Our office is on the mezzanine level with elevators or stairs to the 2nd floor, making it easily accessible.