How We Found a Speech Therapist We Actually Liked

For littleWords speech app, the goal is not to turn parents into therapists. The goal is to make everyday moments easier to join, easier to repeat, and easier for a child to use in their own way.

We went through three speech therapists before we found one who was right for our son. Three. That’s about a year of intake forms, copays, half-hour drives, and gut feelings I ignored because I felt guilty about being picky. If I had to do it over, I’d be picky from day one. Here’s what we learned.

The first one was technically qualified and a complete mismatch

The first SLP we saw came highly recommended by our pediatrician. She had decades of experience. Her certifications were spotless. She also believed in withholding preferred items to “motivate communication.” So my son sat across from her at a tiny table while she held up his favorite truck and refused to give it to him until he said the word.

He didn’t say the word. He cried. She wrote in her notes that he was “non-compliant.”

We left that office and I sat in the car staring at the steering wheel. My gut was screaming that something was wrong. But she was the expert, right? So we went back twice more before I finally told my husband I couldn’t watch it anymore.

What I learned later is that research supports what my gut was telling me. A 2012 study published in the Journal of Positive Behavior Interventions found that therapy approaches perceived as aversive by young children were associated with increased avoidance behaviors and decreased session engagement over time. In other words, if the kid is crying and shutting down, the therapy is not working, no matter how many letters are after the clinician’s name.

If your gut is telling you the therapy is hurting your kid, your gut is right. You don’t owe the SLP an explanation. You don’t owe the practice a notice period. You just stop going.

The second one was sweet and never made eye contact with my son

The second SLP we tried was warm with me, took thorough notes, and barely looked at my child the entire session. She would describe what he was doing to me, in the third person, while he was in the room. “He’s avoiding the task. He’s stimming again. He’s not attending.” He understood every word.

I don’t think she was a bad person. I think she was trained in a model that treated kids as patients to be observed rather than humans to be in relationship with. My son felt that, and he started hiding under the chair whenever we pulled into the parking lot.

What struck me most was how quickly his body language changed between sessions. At home, he was silly and vocal, babbling strings of sounds and echoing lines from his favorite shows. In that office, he went silent. He folded in on himself. A 2020 paper in Language, Speech, and Hearing Services in Schools noted that therapeutic alliance, even in pediatric populations, is one of the strongest predictors of communication outcomes. The authors found that children who rated their therapists as warm and attentive (using child-friendly scales) made measurably faster progress in expressive language targets compared to children in clinician-directed sessions with limited rapport-building time. My son could not fill out a scale, but he could hide under a chair, and that was his scale.

The lesson: watch how the therapist talks to your child, not just about your child. If they don’t make eye contact with the kid in the first five minutes, they’re not going to build a bond. And without a bond, the therapy is just expensive vocabulary drills.

The third one was great with kids and terrible with me

The third SLP was wonderful with my son. He laughed during sessions. He started to say “uh oh” appropriately, which was a huge milestone. But every time I asked a question, she answered like I was an inconvenience. “Mom, we don’t worry about that yet.” “Mom, that’s outside my scope.” “Mom, we’re focused on session goals.”

I am not a complication. I am the person who spends 168 hours a week with this child, while you spend 30 minutes. I needed to be coached. I needed home practice ideas. I needed to understand the why behind the activities so I could replicate them on a Tuesday afternoon when my son was screaming about socks.

This wasn’t just my opinion. A landmark 2006 meta-analysis by Roberts and Kaiser in the American Journal of Speech-Language Pathology examined parent-implemented language interventions and found that when parents were trained as active participants in therapy, children showed significantly larger gains in expressive and receptive language than in clinician-only models. The effect sizes were not small. Parent coaching was not a nice bonus. It was a core ingredient.

There is a specific moment I keep coming back to. My son had started using “uh oh” consistently in session. I wanted to know how to set up situations at home where he would naturally want to say it. Not in a flashcard way. In a real-life way. Something like “accidentally” dropping a spoon at dinner or pretending the block tower fell. The SLP told me to “just let him generalize on his own.” But generalization does not happen by magic, especially for kids who process language in chunks. I needed strategies, and she wasn’t willing to give them. That gap between a strong session and an empty week at home is where so many kids stall.

The right SLP treats the parent as a teammate. If yours doesn’t, find someone else.

Dana, sitting on the floor

My friend Rebecca from our church playgroup in Overland Park gave me Dana’s name on a sticky note. “She’s not taking new clients, but call anyway,” she said. “Tell her Becca sent you.” I called on a Thursday morning. Dana answered the phone herself, which should have been my first clue that this practice was different. She had a 4:15 slot open the following Tuesday. I took it without asking my husband.

The first session, Dana sat on the floor with my son for ten solid minutes and didn’t try to “do speech” at all. She just played with him, with his toys, the way he played, while I watched from a chair that was, I realized later, deliberately placed so I could see both their faces. Then she turned to me and said, “Okay, here’s what I noticed. Tell me what you’ve noticed.”

That sentence changed our trajectory. She treated me like a co-investigator. She explained the difference between gestalt language processing and analytic processing in clear language (she compared it to learning a song by memorizing the whole chorus versus learning it word by word, which is the first analogy that ever made it click for me). She referenced the Natural Language Acquisition framework described by Marge Blanc, and she explained the stages so clearly that I could see exactly where my son was. He was in Stage 2, starting to mix and recombine chunks of language he had memorized. Knowing that reframed everything. His echolalia was not a problem to fix. It was a stage to build on.

She gave me homework that fit into our actual life, not idealized therapy-time. One of the first things she told me to do was narrate less and pause more. She said most parents of late talkers (herself included, with her own daughter, which she shared openly) over-narrate because they are trying so hard to fill the silence. But the silence is where the child’s language lives. She told me to say something, then count to ten in my head before saying anything else. Ten seconds feels like an eternity when you are staring at your kid across a plate of chicken nuggets, but by the third day, he started filling those gaps. Not with words at first. With sounds, gestures, a pointed finger, a look. Those are communication. Dana taught me to treat them that way.

She also walked me through something she called “communication temptations,” which were small, engineered moments in daily routines that created a reason for my son to communicate. Put his juice in a closed container he can’t open himself. Offer him a choice between two snacks by holding them up silently. Start a familiar song and stop right before the last word. These were not complicated. But nobody had explained them to me before, and they turned our kitchen table into the most productive therapy room in his week.

She told me, on day one, that my son was going to be fine and that fine wasn’t going to look like neurotypical and that was okay.

She also told me, without me asking, about a few tools she liked for between-session practice. One of them was the LittleWords speech app, which she described as a way for kids to practice expressive language in short, low-pressure conversations with an AI character. She made it clear it wasn’t a replacement for therapy. It was a way for my son to keep practicing without me hovering over him with a flashcard. What I liked about it was that my son could use it on his own terms. He would sit on the couch with the iPad and talk to the character, and sometimes he would say things to it that he wouldn’t say to me yet. That felt significant, even if I couldn’t quantify it. It gave him a space where there was no pressure to perform and no adult face to read for approval or disappointment.

That’s the energy you want from an SLP. Confident enough to recommend tools she didn’t create. Honest about what her own sessions can and can’t do. Treating the home environment as the most important therapy room there is.

We’re eighteen months in now. My son says “uh oh” and “more please” and, on a good day, a wobbly “love you mom” that makes me cry in the Aldi parking lot. Dana made that possible. But so did every minute of practice between sessions. The Tuesday sessions are the spark. The other six days are the fire.

A rubric I wish someone had handed me three SLPs ago

Here’s what I’d evaluate in the first session if I were starting over.

Do they greet your child by name and at eye level? This is basic. If they don’t, leave.

Do they let your child warm up before starting tasks? Five minutes of free play is not wasted time. It’s the foundation. A child who feels safe in the room will produce more language in that room. Research on child-directed therapy consistently shows that rapport-building in the first minutes of a session is correlated with higher rates of spontaneous communication later in the same session.

Do they explain their philosophy when you ask? Some SLPs are play-based, some are ABA-influenced, some are gestalt-aware, some are old-school articulation drillers. None of these is automatically wrong, but you need to know which one you’re paying for. If the answer is vague, ask again. If they can’t articulate why they do what they do, they may be following a protocol by rote rather than thinking critically about your specific child.

*Do they teach you something during the session?* Even one tiny thing. A way to wait longer before jumping in. A way to expand on what your kid said. A way to set up the snack table so it becomes a communication opportunity. If the parent walks out without a new tool, the session was incomplete.

Do they talk about your child like a whole person? Not as a set of deficits. Not as a checklist of missing milestones. As a kid with a personality, preferences, and a sense of humor. Dana once spent five minutes telling me how funny my son was, how his timing with “uh oh” was genuinely comedic, and how that sense of timing was a cognitive strength she could build on. That is what it looks like when a clinician sees your child.

Do they have an opinion about home practice? A good SLP knows that 30 minutes a week is a tiny fraction of your child’s life. They should care, deeply, about what happens the other 167 hours and 30 minutes. If they shrug at the question, they’re either undertrained or burnt out, and either way you should keep looking.

Do they adjust when something isn’t working mid-session? Watch what happens when your child loses interest, melts down, or refuses a task. Does the SLP push through? Redirect with the same task in a different wrapper? Or does she follow your child’s lead and find the language opportunity in whatever he gravitates toward next? Flexibility in the moment is a skill, and it separates good therapists from great ones. Dana once abandoned her entire session plan because my son found a ladybug on the windowsill. They spent fifteen minutes on that ladybug, and he produced more spontaneous language about it than he had in any structured activity that month.

You are allowed to switch

The biggest thing I want any parent reading this to take away is permission. You are allowed to switch SLPs. You are allowed to do it after one session. You are allowed to do it without giving a reason. You are not obligated to be polite about something this important.

I want to say something specific to the parents who feel stuck because of insurance. I know that switching is harder when your plan only covers one in-network provider, or when the waitlist for the next clinic is four months long. I know the guilt of thinking “at least we’re getting something” while watching your child shut down. If switching is not possible right now, you can still advocate within the relationship. Write down your questions before the session. Ask for a parent coaching component to be added to the treatment plan. Request a written home program with at least three activities you can do between visits. You have the right to ask for these things, and a good SLP will welcome the request. If they resist, that tells you something too.

I also want to address the parents who are told their child is “too young” for therapy or that they should “wait and see.” The American Speech-Language-Hearing Association recommends referral for evaluation if a child is not using single words by 16 months or two-word combinations by 24 months. Early intervention research, including a widely cited 2017 study in Pediatrics, shows that children who receive speech-language services before age three have significantly better language outcomes at school entry than children who begin services later. Waiting is not neutral. Waiting is a choice with consequences. If your pediatrician tells you to wait, you can self-refer to your state’s early intervention program. You do not need a doctor’s referral in most states.

Here’s the thing: your child’s relationship with their therapist will shape their relationship with their own voice for years. That is worth being impossibly picky about. We found Dana on try number four, and I wish we’d found her first. You can find your Dana too.