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Play-Based Speech Therapy Online: Teletherapy's Reach in Early Intervention

Updated: Mar 29

Speech therapist using puppet during therapy

What does teletherapy look like for early intervention?

Today, I'll invite you into my world and provide insight into what online, play-based speech therapy truly entails when working with babies, children, and adults with communication disorders. There's a prevalent misconception, especially regarding early intervention, that teletherapy is only suitable for older children and adults with higher levels of cognition who can sit still in front of a screen for at least 30 minutes. Research, however, indicates that online therapy is just as effective as in-person treatment. Teletherapy serves as an excellent platform for clients aged birth to 3, and I'll illustrate this with today's case history.

Please note that the following client described here is a real child; however, I will be using a different name to protect his privacy.

Teletherapy for Birth to Three Clients: A Case History

Client: Caleb

Age: 23 months old

Diagnosis: Language delay


Caleb jargons (basically, it sounds like he is speaking his own language that nobody else understands). He occasionally uses one-word utterances but usually points to things that he wants. He often becomes frustrated and cries when he wants or needs something, as he has difficulty expressing himself. At his age, he should be starting to use two-word phrases to make comments and requests.

What do we do in therapy?

1. Engaging Start: Incorporating Music into Teletherapy Session

I start the session off with a song as part of our routine. Children learn best when they are having fun, and there is an element of predictability in the activity. During our song, he practices following directions using simple gestures that accompany the music. As he learns the song, he also learns the vocabulary that we sing. 

2. Transitioning Activities: From Songs to Reading and Play

We then transition into a reading or play activity using his own books, toys, and other tangibles at home. During the session, I introduce therapy concepts to the parent, such as following the child’s lead, expanding the child’s phrases (from 1 to 2-word phrases), imitation during play, 3:1 comment to question ratio (asking fewer questions while making more comments when interacting with the child), etc. I also provide the parent with sample activities that they can do to practice these new concepts. For example, I might suggest we play a game using a shark hand-puppet that has an appetite for stinky, dirty clothes. During this activity, we teach Caleb clothing and body part vocabulary. 

3. Modeling Techniques and Observational Feedback

I model use of today’s coaching concept (balancing comments with fewer questions) to the parent during the activity. An effective strategy I often suggest to parents who notice themselves relying too heavily on questions during play is to transform questions into comments. Instead of constantly asking the child, 'What’s that?' try providing the answer yourself: 'That's a kitty.' By maintaining a balance between questions and answers, parents can seamlessly integrate modeling to introduce new vocabulary, while simultaneously fostering a more enjoyable interaction. This approach helps prevent children from feeling overwhelmed or shutting down due to excessive questioning, creating a more conducive environment for learning and engagement. I observe the caregiver and child interact and provide feedback on what worked to enhance language and areas needing improvement. 

4. Closure with Purpose: Wrapping Up Sessions and Providing Homework Suggestions

Finally, we wrap the session up with a song, and I offer some suggested activities they can do during the week to work on enhancing language (for example, working on prepositions/location words while playing hide and seek with toys).

Empowering Families Through Teletherapy: A Holistic Approach to Speech Therapy

As you can see, teletherapy for babies and toddlers is PLAY-BASED. I work closely with parents and caregivers to teach speech and language enhancing techniques that they can use with their children. I'm deeply passionate about online early intervention because it uniquely positions me within the home environment, enabling me to empower families in a collaborative journey toward enhancing language skills. Unlike the traditional in-person therapy model, where sessions often occur in clinics or homes with a clinician-led approach, online therapy fosters a more inclusive dynamic. Here, parents are not relegated to waiting rooms or passive observers; instead, they actively participate in sessions, gaining invaluable insights and hands-on experience in implementing therapeutic techniques within their daily routines. This shift from passive observation to active engagement is transformative, as it allows families to seamlessly integrate language-enhancing practices into their everyday interactions, ultimately fostering a more holistic and sustainable approach to speech therapy.

My goal during our online sessions is for the entire family to gain a sense of empowerment as all members become crucial components of the treatment. I teach parents and caregivers evidence-based techniques that they can use to help their child’s speech and language skills blossom. In contrast to traditional therapy, my clients are able to receive skilled treatment by their caregivers at home on a daily basis. I often see early intervention clients progressing through therapy at a much quicker pace than when I used to provide in-person based treatment. Teletherapy allows children to learn language where it counts - at home, with their families, and in their own community.

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