When Should You See a Speech Therapist? Signs You Shouldn't Ignore

Mar 22

It was during a family dinner when my sister first noticed something might be different about her son's speech. Three-year-old Ethan was chattering away about his day at preschool, but most of what he said was unintelligible to anyone outside our immediate family. My sister caught my eye across the table with that worried look parents get when they're wondering: "Is this normal?"

Maybe you've had a similar moment of concern about your child's communication. Or perhaps you've noticed changes in your aging parent's speech after a health event. Or you might even be wondering about your own speech patterns, voice, or communication skills.

The question "When should I see a speech therapist?" isn't always easy to answer. In this guide, we'll explore the signs that might indicate it's time to seek professional help, what speech therapy actually involves, and why timing matters more than many people realize.

Understanding What Speech Therapists Actually Do

Before diving into when to see a speech therapist (also called a speech-language pathologist or SLP), let's clarify what these professionals actually do. Many people think speech therapy is just about correcting a lisp or helping someone who stutters—but their scope of practice is actually much broader.

Speech-language pathologists are highly trained healthcare professionals who evaluate, diagnose, and treat a wide range of communication and swallowing disorders across the lifespan. They work with:

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Babies who have feeding difficulties
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Toddlers who aren't meeting speech and language milestones

School-age children with reading difficulties or social communication challenges

Adults recovering from stroke or brain injury

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People with voice disorders
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Individuals with cognitive-communication impairments

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Those with swallowing difficulties
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People who stutter or have other fluency disorders

Anyone needing to modify an accent for personal or professional reasons

Red Flags for Children: When to Seek Help Early

Children develop communication skills at varying rates, which can make it difficult to determine what's a temporary delay versus what might need intervention. Here are some age-specific guidelines that might indicate it's time for an assessment:

Babies (Birth to 12 months)

Limited babbling or vocal play by 6-7 months

No response to sounds or their name by 9 months

No gesturing (pointing, waving) by 12 months

Feeding difficulties, including trouble transitioning to solid foods

Persistent mouth breathing or open mouth posture

Limited eye contact or social engagement

I worked with a family whose 9-month-old rarely made any sounds at all. They'd been told by friends and family to "wait and see," but their instincts told them something wasn't right. Early intervention revealed a moderate hearing loss that, once addressed with hearing aids, allowed their daughter to catch up quickly with her communication milestones.

Toddlers (1-3 years)

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No clear words by 18 months
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Less than 50 words by 24 months
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Not combining words by 2½ years ("more milk," "daddy go")

Losing previously acquired speech skills

Extremely frustrated when trying to communicate

Speech that is difficult for familiar people to understand

Avoiding social interaction or preferring to play alone

Showing very limited interest in toys or play activities

Remember my nephew Ethan? By age 3, children should be understood by unfamiliar listeners about 75% of the time. Ethan was far below that benchmark, which prompted my sister to schedule an evaluation. The speech therapist identified a phonological disorder that responded very well to treatment once it was addressed.

Preschool and School-Age Children (4-12 years)

Speech that remains difficult to understand past age 4

Persistent sound errors beyond the typical age of acquisition

Difficulty following directions appropriate for their age

Struggling to express thoughts clearly or organize ideas

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Limited vocabulary compared to peers
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Difficulties with reading, spelling, or writing

Problems with social communication or making friends

Ongoing difficulties with stuttering or voice quality

Teacher concerns about communication skills

A third-grade teacher contacted me about a student who was bright and engaged but whose written work was filled with unusual spelling errors that seemed to match his speech pattern. An evaluation revealed a previously undiagnosed phonological processing disorder that was affecting both his speech and literacy skills.

Teenagers

Voice changes not related to puberty (hoarseness, vocal strain)

Social communication difficulties affecting relationships

Public speaking anxiety that interferes with school performance

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Ongoing articulation issues
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Academic challenges related to language processing

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Word-finding difficulties
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Executive functioning challenges (organizing thoughts, planning)

I worked with a high school junior who developed severe anxiety about class presentations. What she initially thought was just nervousness turned out to include some subtle language organization difficulties that made spontaneous speaking especially challenging. Targeted therapy helped her develop strategies that transformed her confidence.

Adults: It's Never Too Late

Many adults mistakenly believe that speech therapy is just for children, but SLPs work with people of all ages. Here are signs that might indicate an adult could benefit from speech therapy:

Communication Changes Following Medical Events

Slurred speech, reduced clarity, or changes in voice quality after a stroke

Word-finding difficulties or comprehension problems

Cognitive changes affecting communication after a concussion or TBI

Swallowing difficulties following illness, injury, or surgery

Voice changes during or after treatment for head and neck cancer

After his stroke at 58, my uncle's speech became slightly slurred and he struggled to find the right words. Just six sessions with a speech therapist gave him strategies that significantly improved his communication and confidence.

Voice Concerns

Chronic hoarseness lasting more than 2-3 weeks

Vocal fatigue, especially for professional voice users

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Voice changes (pitch, quality, volume)
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Pain or strain when speaking
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Frequent throat clearing or coughing while talking

A colleague who teaches elementary school found herself consistently hoarse by Wednesday each week. Rather than accepting this as an occupational hazard, she consulted a speech therapist who helped her develop better vocal hygiene practices and techniques for projecting her voice without strain.

Swallowing or Eating Issues

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Coughing or choking during meals
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Food getting stuck in the throat
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Pain when swallowing
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Taking much longer to eat than previously

Avoiding certain foods due to swallowing difficulties

Unexplained weight loss associated with eating difficulties

"I thought difficulty swallowing was just part of getting older," my friend's father told me after his first swallowing therapy session. "I had no idea there were exercises and techniques that could make such a difference."

Cognitive-Communication Changes

Difficulties with attention, memory, or problem-solving affecting communication

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Changes in social communication skills
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Challenges organizing thoughts or following complex conversations

Problems understanding implied meanings or humor

Professional Communication Enhancement

Desire to modify an accent for clearer communication

Public speaking or presentation skills development

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Professional voice training
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Executive communication coaching
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An engineering colleague sought speech therapy not for a disorder but to enhance his presentation skills for leadership roles. The targeted therapy he received transformed not just his public speaking but his overall professional presence.

Older Adults: Addressing Age-Related Changes

As we age, various changes in speech, language, voice, and cognition may occur. While some changes are a normal part of aging, others may signal conditions that would benefit from intervention:

Progressive difficulty finding words or naming objects

Increasing problems following conversation in noisy environments

Voice becoming significantly weaker, breathier, or rough

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Noticeable changes in speech clarity
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Swallowing difficulties or frequent coughing with meals

Memory issues affecting daily communication

Changes in social communication patterns

My mother noticed her 79-year-old friend had started avoiding their weekly bridge game. A gentle conversation revealed she was having increasing difficulty following the fast-paced table talk. A hearing evaluation and subsequent communication strategies from a speech therapist helped her reengage with an activity she had always loved.

Breaking Down Barriers: Why People Delay Getting Help

Despite the clear benefits of early intervention, many people delay seeking speech therapy services. Understanding these barriers might help you overcome them:

The "Wait and See" Approach

One of the most common reasons people delay seeking help is the hope that the problem will resolve itself. While this is sometimes the case, particularly with young children, communication disorders often don't disappear without intervention.

The 'wait and see' approach costs precious time during critical developmental windows when intervention is most effective. It's often better to evaluate a child and find they don't need services than miss an opportunity for early intervention.

Misconceptions About Speech Therapy

Many people don't understand the full scope of speech therapy services or harbor misconceptions about what it involves.

"I thought speech therapy was just about helping kids talk clearer," admitted Robert, dad of a 6 year old boy who was struggling with his expressive language. "I had no idea SLPs were able to help with vocabulary, grammar and helping my son narrate events more clearly."

Access and Insurance Concerns

Concerns about cost, insurance coverage, and finding qualified providers can create significant barriers.

While navigating insurance can indeed be challenging, many people don't realize that speech therapy:

Is often covered by health insurance for medically necessary services

Is mandated for eligible children through school systems

May be available through early intervention programs at little to no cost for young children

Could be accessed through university clinics at reduced rates

Might be covered by workplace benefits or flexible spending accounts

Stigma and Misunderstanding

Unfortunately, communication disorders still carry some stigma, leading people to avoid seeking help.

A teenage client once told me he had endured three years of teasing about his /r/ sound before his parents sought therapy. "I just thought it was something I had to live with," he explained. Six months of therapy transformed not just his speech but his social confidence.

The Evaluation Process: What to Expect

Many people delay seeking help because they're unsure what the evaluation process involves. While procedures vary depending on the setting and specific concerns, here's a general outline:

Initial Contact and Intake

The process typically begins with gathering background information through forms and discussion. The SLP will want to know:

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The nature of your concerns
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When you first noticed them
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Any relevant medical history
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How the communication difficulties affect daily life

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What you've tried so far
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Your goals for improvement
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Formal Assessment

Depending on the concerns, the evaluation might include:

Standardized tests to assess various aspects of speech, language, voice, or cognition

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Informal observation and conversation
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Oral-motor examination
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Voice assessment
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Swallowing evaluation
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Language sample analysis
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Functional communication assessment
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Discussion and Planning

Following the assessment, the SLP will:

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Explain their findings
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Discuss whether therapy is recommended
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Outline treatment options and approaches

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Develop goals based on your priorities
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Create a treatment plan
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Address any questions or concerns
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Most people find the evaluation process far less intimidating than they anticipated. As Sophia, a speech therapist colleague, often tells new clients: "This isn't a test you can pass or fail. It's simply a structured way for us to understand your unique communication profile and how we might be able to help."

The Impact of Timing: Why "Early" Often Matters

While it's never too late to benefit from speech therapy, there are compelling reasons why earlier intervention often yields better results:

Neuroplasticity Advantages

The brain's ability to form new neural connections and reorganize itself—its neuroplasticity—is greatest in childhood but continues throughout life. Intervening earlier takes advantage of this natural capacity for change.

Prevention of Secondary Issues

Untreated communication disorders can lead to cascading effects:

Speech sound disorders may impact literacy development

Language delays can affect academic performance

Communication difficulties might lead to social isolation or behavioral problems

Subtle voice issues can progress to more significant pathology if vocal strain continues

Emotional and Psychological Benefits

The longer communication difficulties persist, the greater the potential impact on self-esteem, confidence, and identity. Early intervention can prevent these secondary emotional challenges.

Educational and Social Advantages

For children, addressing communication challenges early can remove barriers to educational success and social development, potentially changing their entire trajectory.

That said, I've seen remarkable progress in people of all ages. The 78-year-old who regained confident communication after a stroke. The middle-aged executive who finally addressed a lifelong stutter. The teenager who overcame reading difficulties despite years of struggle.

As one of my mentors liked to say: "The best time for speech therapy was when the problem first appeared. The second best time is now."

Finding the Right Speech Therapist

If you've decided to seek speech therapy services, finding the right provider is important. Here are some tips:

Consider Specialization

While all SLPs have broad training, many develop expertise in specific areas. Look for someone with experience addressing your particular concerns.

Check Credentials

In the United States, qualified SLPs should:

Hold a master's or doctoral degree in speech-language pathology

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Be licensed by their state
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Hold the Certificate of Clinical Competence (CCC-SLP) from the American Speech-Language-Hearing Association (ASHA)

Ask About Approach

Speech therapists may use different treatment approaches. Don't hesitate to ask:

What specific approach they recommend for your situation

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The evidence supporting that approach
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Typical timeline and frequency of sessions

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How progress will be measured
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What home practice might involve
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Consider Practical Factors

Logistics matter for consistent participation:

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Location and availability
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Insurance acceptance
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Telehealth options
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Session length and frequency
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Cancellation policies
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Trust Your Instincts

The therapeutic relationship is important. The best SLP for you or your family member will be someone who:

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Listens carefully to your concerns
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Explains things clearly
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Makes you feel comfortable
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Involves you in the goal-setting process

Seems genuinely invested in your success

The Therapy Journey: Setting Realistic Expectations

Understanding what to expect from speech therapy can help you approach it with appropriate expectations:

Progress Takes Time

While some issues show rapid improvement, many communication disorders require consistent work over time. Progress is often nonlinear, with periods of significant gains followed by plateaus.

Participation Matters

The most successful outcomes typically involve:

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Regular attendance at sessions
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Consistent home practice
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Carryover of strategies into everyday situations

Active involvement of family members (especially for children)

Goals Evolve

As therapy progresses, goals often evolve based on progress and changing priorities. What begins as work on specific speech sounds might expand to include reading skills or social communication.

Discharge is a Process

The end of formal therapy doesn't mean the end of progress. Most SLPs will:

Gradually reduce session frequency as goals are met

Provide strategies for continued practice and maintenance

Remain available for periodic check-ins or "tune-ups"

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Offer resources for ongoing support
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Beyond the Therapy Room: Creating Supporting Environments

Effective communication support extends beyond formal therapy sessions. Here are ways to create supportive environments:

For Children

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Read together daily
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Engage in conversation without digital distractions

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Provide language-rich play experiences
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Follow through with home practice activities

Coordinate with teachers and other caregivers

Celebrate efforts, not just perfect results

For Adults with Acquired Disorders

Reduce environmental distractions during communication

Allow extra time for processing and response

Focus on communication success, not perfection

Create opportunities for practice in real-world settings

Join support groups to connect with others facing similar challenges

For Those with Chronic Conditions

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Develop self-advocacy skills
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Educate others about communication needs

Utilize appropriate accommodations or technology

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Balance challenge with support
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Recognize that communication needs may change over time

The Future of Speech Therapy: Innovations and Access

The field of speech-language pathology continues to evolve, with several exciting developments expanding access and effectiveness:

Telehealth Expansion

The rapid growth of telehealth services—accelerated by the COVID-19 pandemic—has dramatically improved access to speech therapy, particularly for those in rural areas or with mobility challenges.

Research increasingly shows that teletherapy can be as effective as in-person services for many communication disorders, while offering greater convenience and consistency.

Technology Integration

New technologies are enhancing traditional therapy approaches:

Apps that provide engaging practice between sessions

Biofeedback systems that visualize speech patterns

Augmentative and alternative communication (AAC) devices that become more sophisticated each year

Virtual reality environments for practicing communication in simulated real-world settings

Cultural and Linguistic Responsiveness

The field is increasingly focusing on providing culturally responsive services that honor linguistic diversity rather than viewing difference as disorder.

As multilingualism becomes more common, SLPs are developing better approaches for distinguishing between language difference and language disorder, and for supporting communication development across multiple languages.

Conclusion: The Power of Being Heard

Communication lies at the heart of human connection. When that ability is compromised—whether through developmental challenges, injury, illness, or other factors—the impact extends far beyond the mechanics of speech.

I've seen the frustration in a child's eyes when they cannot make themselves understood. I've witnessed the isolation that can develop when an adult gradually withdraws from social situations due to communication difficulties. And I've observed the profound relief and joy that comes with reconnecting through effective communication.

If you're wondering whether you or someone you love might benefit from speech therapy, consider this: seeking help is not an admission of failure or weakness. It's a powerful step toward addressing challenges that might otherwise create unnecessary barriers.

The question isn't really "When should you see a speech therapist?" but rather "Why would you wait to address something so fundamental to your quality of life and connection with others?"

Whether you're concerned about a toddler's language development, a teen's social communication skills, your own voice health, or an aging parent's cognitive-communication changes, reaching out to a speech-language pathologist can provide clarity, direction, and hope.

Because everyone deserves to be heard.

This blog post was created by the team at Speech By Madison. We specialize in pediatric speech and language development, with particular expertise in articulation disorders. If you have questions about speech therapy services, don't hesitate to reach out. Our experienced speech-language pathologists serve families throughout Fairfield County with personalized therapy that fits your child's unique needs. Visit our website to schedule a free phone consultation or call us directly at 203-442-4136. Early intervention makes a difference—contact us today to start your child's communication journey.

Speech By Madison