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Communication skills grow out of relationships between people, and sharing control is at the core of a healthy relationship. For children who have communication delays, it’s important for the professional to have a balanced relationship with the child and also with the parents.


Speech, language and communication are all about social relationships. Children need to learn ALL the social reasons for communication. Sometimes they need to answer questions, but they also need to ask questions. Children need to follow directions, but they also need to give directions. They need to make comments, make jokes, protest something they don’t like, reject something they don’t want, and ask for something they want.

Children know best what they want to communicate during an activity. That means we need to use therapy methods that help them understand and use communication for all their reasons. Naturalistic therapy uses regular, daily activities as the setting for practicing communication. During this example activity, Mom and Gigi share control of their interaction in a way that makes sense and is memorable for the little girl.

  • Mom: holds up shirt, “Shirt”

  • Gigi: holds up arms

  • Mom: “Shirt on,” puts shirt on Gigi’s arms and head

  • Gigi: pulls shirt down past face, looks at mom and laughs

  • Mom: “Peek!” laughs

  • Gigi: pulls shirt up to cover face, pulls down and laughs

  • Mom: “Peek!” laughs

  • Gigi: pulls shirt up and down, “Pe!”

Mom started a social interaction as part of getting dressed. She then shared turns, giving Gigi a chance to do or say something each time Mom did something. Mom modeled words about dressing, but Gigi was more interested in a social game they could play while dressing. By sharing control with Gigi, Mom was able to model a word that matched Gigi’s interest. After two examples (and more on other days), Gigi imitated the word peek. Gigi learned to say a word that she will want to use more in the future.

Sharing control allowed both Gigi and Mom to enjoy their time together. At the same time, Gigi initiated an interaction, got Mom to do something, and said a new word.


Professionals have clinical knowledge and skills that took years to develop. That does not mean, however, that they should make all the decisions about therapy. Parents and other adult caregivers spend more time with their child than anyone else. They know their child’s preferences, quirks and needs. More than anyone else, they want what’s best for their child. This means parents are the best informed and most motivated teacher their child could have.

Your child’s therapist or SLP should include you as a partner, sharing information and asking for your guidance in what you want for your child. The professional should be able to explain the guiding principles of the intervention approach and why the methods work. You should get some type of roadmap or outline of what steps you will take together and how you will measure progress toward your shared goals. The professional should invite your questions often and ask for your input regularly.

Your SLP should demonstrate methods that support your child’s communication development, then observe while you try out the methods for yourself. The SLP should be able to give you feedback on how you are using the methods, and show you how to measure progress your child makes when you are using the methods.

If methods don’t make sense to you, ask questions until you understand. If the professional is using long words or technical terms, ask for an explanation in layman’s terms. If you are told “because research says so” or “that won’t work,” it might be true but keep asking questions until you understand why. If you or your child are uncomfortable with a method, say so. Your professional should have the skills to make adjustments based on your input.


Speech-language pathologists who provide online therapy, known as telepractice, have more than the typical opportunities to include parents in therapy. The parent is always present during therapy at home, so every session provides opportunities for the SLP and parent to give input and address questions. Coaching parents to use naturalistic methods can be done easily with two-way video. For older children, the therapist can do direct therapy with the child while the parent observes, and the therapist can demonstrate activities for parent and child to do together.

Many speech-language pathologists who provide telepractice offer a short, online consultation session to answer your questions about their therapy methods and what they can offer you and your child. To find out more about what telepractioners have to offer, contact us for a directory of SLPs who meet your needs.




Joyce is very knowledgeable. Not only as a speech therapist but also on how the school system works. Which is very helpful going through the IEP process. She was able to engage with my daughter and was never hesitant to help in any way. I would definitely recommend Joyce to anyone that is looking for a trustworthy, caring and informed speech therapist.

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