Does My Child Need Speech Therapy? A Parent-friendly Guide to Next Steps (Plus a Quick Quiz)

If you're wondering whether your child may need speech therapy, you’re in good company. Most parents don’t start with certainty. They start with a gut feeling. 

Maybe your toddler gets frustrated when you don’t understand what they want. Maybe your preschooler talks a lot, but people outside the family struggle to follow them. Maybe a teacher mentioned something and now you can’t un-hear it.

“My goal is to help children become better communicators,” says speech language pathologist Heidi Webster, CCC-SLP, who sees patients at Zarminali Pediatric - Sartell. “When kids can more effectively communicate, they feel more confident in initiating communication and have higher self-esteem. This leads to better relationships with their peers and family members.”

This guide will help you understand what an evaluation can tell you, what speech therapy looks like, and how to decide what next step makes sense for your family.

Why a speech evaluation is a great place to start

A speech and language evaluation is an information-gathering visit. It’s designed to answer questions like

• How is your child communicating right now?
• What are their strengths?
• What feels hard for them?
• Is what you’re seeing likely to improve with time and support, or would therapy help?

An evaluation can lead to several outcomes. You might learn that your child’s development is within expectations, and get a few targeted tips to support progress at home. If things are borderline or improving, the therapist may recommend watching for specific changes and checking back after a set period.

If speech or language differences are making it hard for your child to be understood, participate, or feel confident, therapy can offer a clear plan and measurable goals.

The everyday signs that it might be time for an evaluation

Signs often show up in daily routines and patterns. Here are a few categories to think through.

Communication breakdowns and frustration

• Your child seems to know what they want to say, but can’t get it out.
• They use fragmented language: single words when other kids use multiple.
• Your child struggles to understand or follow directions.
• They melt down when you don’t understand them.
• You find yourself guessing, anticipating, or “translating” constantly.

Being understood

• Family members can understand most of what your child says, but others struggle.
• Your child has difficulty answering or asking questions.
• Strangers often ask you, “What did they say?”
• Your child avoids talking with unfamiliar adults or kids because it doesn’t go well.

Participation and connection

• Speech challenges are affecting play, friendships, or school participation.
• Your child withdraws, gets silly, or acts out in group settings.
• You notice dips in confidence: they stop trying, or they let others speak for them.

Outside concerns

• A teacher, caregiver, or coach has flagged communication differences.
• You’re noticing a gap between what your child can do at home and what they do elsewhere.

None of these automatically mean your child needs therapy. They do mean it’s reasonable to gather more information.

Speech therapy is a ladder, not a light switch

One of the most helpful ways to understand speech therapy is to picture progress as a ladder.

Parents sometimes hear a child pronounce a sound once and think, “They can do it. Why aren’t they using it?” Or a child might say a word clearly during practice, then lose it completely in conversation. That doesn’t mean they’re being stubborn or not trying. It often means they’re on an earlier rung of the ladder.

Therapy helps children climb from “I can do it sometimes” to “I can do it naturally, with anyone, anywhere.”

What speech therapy sessions are actually like

Parents sometimes imagine speech therapy as sitting at a table repeating sounds on flashcards. In pediatric therapy, the vibe is usually very different.

Most therapists use a play- and interest-based approach. That means they follow what motivates your child (cars, animals, crafts) and build skill practice into activities your child wants to do.

“We first talk about the child’s interests,” says Heidi. “If a child likes dinosaurs, then our treatment materials and sessions include dinos.”

Motivation matters because repetition is how the brain learns, and kids repeat more when it feels fun and successful.

Therapy may include

• Visual supports (pictures, gestures, simple cues)
• Choices to reduce power struggles (“Do you want to practice with bubbles or blocks?”)
• Structured routines that help kids feel secure
• Frequent, tiny practice opportunities that don’t feel like “work”
• A parent debrief, especially early on, so you know what to reinforce at home

Playful and engaging

A good session often looks like your child is simply playing. Under the surface, the therapist is carefully shaping the play to create repeated, meaningful communication opportunities.

Communication is more than words

Gestures, pointing, signs, and shared attention are meaningful communication. A therapist will pay attention to how your child gets their message across, not only how many words they say.

Stuttering and fluency

Many young children go through phases of disfluency. If your child seems distressed by stuttering, avoids talking, or it’s increasing over time, an evaluation can help you learn how to respond in a way that protects confidence.

AAC is a bridge, not a barrier

AAC stands for augmentative and alternative communication. It can include picture boards, simple communication books, or speech-generating devices. Some parents worry that AAC will stop a child from talking. In reality, giving a child reliable ways to communicate can reduce frustration and support communication development. The goal is connection and expression now, not waiting until speech is “perfect.”

Sometimes OT support helps speech progress

If a child has sensory or regulation needs that make it hard to sit, attend, or tolerate frustration, occupational therapy can help build the foundation for communication work. Some children benefit from coordinated care so they can participate fully in speech therapy.

How to decide your next step

Evaluations aren’t about proving something is wrong. They’re about giving you clarity.

Reassurance and home strategies may be enough if

• Your child is steadily improving
• Communication breakdowns are occasional and manageable
• They’re generally confident and engaged
• You mostly want guidance on how to support them

An evaluation is worth it if

• You’re noticing persistent patterns over time
• Your child gets frequently frustrated by communication
• You’re unsure whether something is “typical” or needs support
• Teachers/caregivers are noticing concerns
• You’d feel better with a clear plan

Scheduling sooner makes sense if

• Your child is often hard to understand outside your family
• Communication challenges are affecting school, friendships, or participation
• You notice your child withdrawing, avoiding talking, or losing confidence
• You feel like you’re constantly translating or guessing

Quiz: Does my child need speech therapy?

This quiz isn’t a diagnosis. Think of it as a decision tool that helps you organize what you’re seeing.

For each question, answer: Not really / Sometimes / Often

1. People outside our family struggle to understand my child.
2. My child gets frustrated (crying, yelling, hitting, shutting down) when they can’t communicate what they want.
3. I often act as my child’s translator because others can’t understand them.
4. My child talks less around unfamiliar people or in groups.
5. My child can say a sound or word when practicing, but it disappears in conversation.
6. Speech is clearer in single words than in sentences.
7. Teachers or caregivers have mentioned concerns about speech, language, or communication.
8. My child has trouble following simple directions for their age, or seems to misunderstand language often.
9. My child struggles to express needs, feelings, or ideas in a way that matches what they seem to understand.
10. Communication challenges are affecting friendships, play, or participation at school.
11. My child relies heavily on pointing/pulling/gestures because words aren’t working (and they seem frustrated about it).
12. I’ve had the same concern for a while, and it hasn’t resolved with time.

Scoring and what it means

• Mostly “Not really”: If you have a concern, consider bringing it up at your next well visit and ask for a few targeted home strategies. If you still feel uneasy, an evaluation can provide peace of mind.
• A mix of “Sometimes,” with 1–3 “Often”: An evaluation is a reasonable next step. This pattern often means your child has skills but needs support with consistency, clarity, or carryover. Many children benefit from short-term therapy or a focused home plan.
• Several “Often” answers: It’s a good idea to schedule an evaluation soon. When communication is impacting daily life, therapy can reduce frustration, build confidence, and support connection with others.

Talk to your pediatrician

You won’t regret getting clarity. Bring up any speech concerns with your child’s clinician. Even if therapy isn’t needed, you’ll walk away with a plan. And when therapy is recommended, it’s because there’s a clear path to making communication easier for your child and your family.