Parents often ask, how long will my child need speech therapy?
Truth is, there is no easy answer. This is because the dosage and frequency of therapy can vary significantly depending on the communication difficulty.
When thinking about dosage, we are often more familiar with the link between dosage and antibiotics. For example, when the doctor says, “Take these antibiotics three times a day,” that dosage reflects the clinical trials that have taken place to determine what is the most efficacious amount and timing the patient needs for optimum recovery. Because of this, we follow the instructions and we do take the tablets three times a day, so that we get better and get better faster.
The same concept applies to your child’s therapy. The dosage refers to how many times a communication target needs to be modelled or elicited and the frequency refers to the time. Your speech pathologist will typically recommend the dosage and frequency which is reflective of the research.
While there is still a lot more research to be done around dosage, frequency and speech pathology, there are certain things that we do know.
For example, we know that children with speech sound disorders using the multiple oppositions approach require a dosage of at least 50 trials and a frequency of 30 sessions.
Similarly, children who have a diagnosis of Childhood Apraxia of Speech (CAS) who have ReST therapy need a frequency of 4 times a week for 3 weeks OR twice a week for 6 weeks.
There are many therapy approaches that show that weekly therapy is the commonly recommended frequency for language therapy. We also have research that improvements are even more pronounced when there is the random practice within a natural setting for example, when parents can expose the targets randomly throughout the day at home (but more on that in our follow-up blog).
Therapy approaches targeting early language, stuttering, reading and spelling therapy (such as Sounds Write), vocabulary therapy, grammar therapy all require at least 45 minutes to 1 hour every week with the speech pathologist and then incidental practice at home or at school in between therapy sessions.
For different reasons, there are only specific times when fortnightly therapy is effective. This is typically when the clients are in the maintenance stages of stuttering therapy or phasing out of therapy. While spacing between therapy sessions is shown in the research, I am yet to find a paper that recommends fortnightly therapy as a standard frequency.
A recent informal survey of speech pathologists revealed that many practices do offer fortnightly sessions however many clinicians admitted that they had observed progress to be slower in most cases.
While some clinicians found there were a small percentage of parents who were consistently able to do therapy every day during the fortnightly sessions, they reported that most parents were not consistent with homework.
Similarly, we used to offer fortnightly appointments but we found anecdotally that parents struggled to get the required dosage of incidental practice between sessions and therapy ended up taking so much longer, and thus, ended up costing parents more money anyway.
And that’s why we don’t do that anymore.
At TalkHQ, we will discuss with you the recommended dosage and help work with you to implement this therapy schedule. This is because we want to help you and your child achieve outcomes faster.
When financial or time commitments make this service delivery difficult for families, we have our TalkHQ Bootcamp option. The Bootcamp model likens therapy to the exercise bootcamps that we often participate in.
Clients are given weekly appointments for 10 consecutive weeks where families commit to attending and focussing on homework and then these children have a 10 week consolidation period. During the consolidation period, that parent can review the activities that were given during the Bootcamp period at their own pace without the time and financial commitment of weekly visits to the speech pathologist.
Feedback from families who have decided to avail of the Bootcamp model have indicated that this has made accessing therapy much more manageable for their families and they have seen the progress from their weekly sessions.