how to get speech therapy for my son

A Parent’s Guide to Speech Therapy for Children

As a parent, you know your child better than anyone. You are the expert of your child in knowing what they need and how they communicate their needs. You also may be the first one to notice if your child is having trouble expressing themselves. If you have concerns about your child’s speech, language or feeding development, it may be time to contact a speech-language pathologist (SLP).

There are many reasons why you may want to seek speech therapy for your child. Some common reasons include: articulation problems, stuttering, difficulty with pronunciation, poor grammar skills, difficulty eating, and difficulty understanding others or being understood.

If this is your first time working with a speech-language pathologist, it may be overwhelming. As a parent, and a speech-language pathologist (SLP), I’d like to help you in the journey and clarify some things for you.

First, we will discuss the different types of SLPs available. Just as with other medical providers, there are several specialties within the general speech-language pathology umbrella. It’s important to choose the right provider to match your needs.

I’ll also provide some tips on how to find a SLP in your area to meet the needs of your child.

Finally, we will give an overview of what you can expect during a typical speech therapy session.

Article Overview

• What is a speech-language pathologist (SLP)?
• What are the different types of speech-language pathologists?
• How do I find a speech therapist in my area for my child?
• Questions to ask speech-language pathologist before starting therapy.

What is an evaluation?

What can i expect during a typical speech therapy session with my child, what are some things i can do at home to help my child with speech therapy goals, why is early intervention so important when it comes to speech and language development.

• Resources for parents of children who need speech therapy services.

What is a Speech-Language Pathologist (SLP)?

A speech-language pathologist is a healthcare professional who evaluates and treats speech, language, cognitive-communication, and swallowing/feeding disorders. They may work with children or adults.

Speech-language pathology is a vast field that includes many different areas of specialty. Some of the most common areas of specialization include articulation, fluency, voice and resonance, language, cognition, hearing, swallowing, chewing, social communication, and using augmentative and alternative communication (AAC) modalities.

What are the different types of speech therapists?

Each of these areas is important in its own way, and speech-language pathologists who specialize in any one of them can provide vital help to children and adults who are struggling to communicate. For example, SLPs who specialize in articulation can help children to pronounce words correctly, while SLPs who specialize in language therapy will be more fit to address any expressive, receptive, or pragmatic (social) language delays or differences.

Because there are so many areas to focus on, many providers specialize in a specific area of focus. The list below (which is not exhaustive) highlights some of the most common areas of specialty. Most SLPs are familiar with treating multiple areas of concerns depending on the age of the clients they treat (i.e. pediatric vs geriatric).

• Articulation Therapy: This type of therapy helps children with the production of sounds.
• Language Therapy: This type of therapy helps children who have difficulty with receptive language, expressive language, and pragmatic language.
• Fluency Disorders: This type of therapy helps children who stutter.
• Voice Disorders: This type of therapy helps children with voice problems.
• Cognitive-Communication Disorders: This type of therapy helps children with specific language and higher level thinking skills.
• Augmentative and Alternative Communication (AAC): This type of therapy helps children who need alternative methods to communicate, such as picture exchanges, or electronic devices to communicate more effectively.
• Dysphagia Therapy: This type of therapy helps children with swallowing disorders.
• Early Intervention: This is an umbrella term used for children 0-3 or 0-5 depending on where you live.
• Pediatric Feeding Therapist: This type of therapy helps children with feeding difficulties. Some therapists specialize in the oral phase of feeding (chewing) while some specialize in the swallowing phase. They will see children who are having a hard time accepting or eating certain foods or if their diet is impacting their overall development and growth. Here is some more information on what feeding therapy can look like .
• Oral-Motor:  This type of therapy can help improve the movement and coordination of the lips, tongue, and jaw for speech production and feeding.

No matter what your child’s specific needs may be, there is sure to be a speech-language pathologist who can help. It’s important to do your research and find the therapist who is the right fit for you and your child. There are many different types of speech-language pathologists available, each with their own unique set of skills and areas of expertise.

How do I find a speech therapist for my child?

Before searching for a SLP, there are a few questions you need to ask yourself.

• Do you plan to use insurance, pay privately, or are you looking for services to be provided from your child’s school district?
• What type of therapy are you looking for?
• Do you prefer a male or female therapist?
• Where do you want to receive therapy? (In office, in the home, teletherapy?)

There are several ways to find a SLP in your area. Your ideal path may vary depending on the age of your child.

Here are a few ways you can find a speech therapist for your child in your area:

Ask your pediatrician for a referral.

Your pediatrician will know providers in your area and should be able to help you identify then type of provider you need to work with. 

Request an evaluation by your state’s early-intervention program.

If your child is between the ages of birth and five (birth to three in select states), you may qualify for speech-therapy services through your state’s early-intervention program. Your pediatrician can refer you to early-intervention or you can contact your state’s early intervention program to request an evaluation yourself. You can search “early intervention in my state ” and the state run helpline can guide you on next steps.

Request an evaluation from your child’s school.

If your child is older than the age of your early intervention program, ask for an evaluation from your in-school speech-language pathologist. Call the special education department in your school district and express your concerns. They should walk you through the next steps for what you need to do in order to see if your child is eligible to get support.

For example, in Connecticut where I live we have Birth-to-Three. Once the child turns three years old, they are eligible to be screened/evaluated by the school district, even if they are not in kindergarten yet.

Search the American Speech-Language-Hearing Association (ASHA) database.

The American Speech-Language-Hearing Association (ASHA) is a national organization that provides speech-language pathology certification. You can use their website to search for a speech-language pathologist in your area. This database includes information on each speech-language pathologist’s qualifications and areas of expertise.

Search Health Grades for a provider.

Health Grades is a website that allows you to search for health care providers by location and by specialty. You can also read reviews from other patients about their experiences with different SLPs.

Leverage local Facebook groups.

If you’re looking for a SLP in your area, leveraging your local Facebook groups can be a great way to get recommendations from other parents. Ask the group if anyone has had experience with a SLP in your area and what they thought of the provider. You may also be able to find online Facebook groups specifically for speech therapy recommendations.

Reach out to your insurance company.

Your insurance company should be able to provide you with a list of in-network speech therapists near you.

Research speech therapy providers online.

You can research SLPs in your area by visiting their websites, looking for customer reviews, and/or contacting the provider directly.

Once you have narrowed your list down to a few providers, you’ll want to reach out for a consultation. Many providers will offer a free 15-minute consultation, but this does vary by practice and provider type.

During your initial meeting or consult with the provider, here are a few questions to ask:

Questions to ask a Speech-language pathologist before starting therapy.

• What is your area of expertise?
• How long have you been practicing?
• Are you licensed and certified?
• Do you have experience working with children who have my child’s specific needs?
• How will speech therapy help my child?
• What do I need to do to help my child during speech therapy? 
• How often will my child need speech therapy?
• What should I expect from speech therapy sessions? 
• Is there anything my child can do at home to practice?
• Do I need to purchase anything for our sessions?
• How will we determine success?
• Will I be able to attend the speech therapy sessions with my child?
• What is your communication style (directive, collaborative, etc)?
• What are the fees for services?
• What is your cancellation policy?

Following your consult selection of your provider, you will schedule an evaluation.

A speech or feeding evaluation is a process by which a SLP determines the nature and extent of your child’s delays or differences in a specific area. Depending on your concerns, the speech therapist will assess your child’s speech, language, communication skills, or feeding skills. The SLP will ask you questions about your child’s medical history and development. They will observe your child’s speech/language/feeding directly using standardized or non-standardized testing. They will also observe indirectly usually through play or snack.

After the evaluation, the SLP will explain their findings and give recommendations for next steps. If there are delays or areas that need to be addressed, the SLP will develop a treatment plan for your child. This plan will include exercises and goals for your child to work on during sessions and at home.

Speech therapy sessions will involve working on specific goals dependent on the areas of need. During your initial evaluation, your SLP will identify the areas of delay or disorder.

Therapy sessions vary significantly depending on provider; your child’s area of focus, your child’s ability to attend and have demands be placed, and your child’s age. Regardless of the different styles and approaches to therapy, there will be a goal established and a way to work on that goal each session in an engaging manner.

Your SLP may target specific speech sounds, words, or sentences during therapy sessions. If your child is having difficulty with a particular sound, the SLP will work on exercises to help them produce that sound correctly in repetition (drill) or more of a play-based child-directed manner. This might involve saying the sound in different positions within words for “x” amount of trials throughout the session.

If your child is having difficulty with speech fluency, or stuttering, the SLP will work on exercises to help them increase their speech rate and improve their overall fluency.

If your child is in feeding therapy, your speech therapist may work on exposure to foods (in and out of the mouth), and specific oral motor skills that impact chewing and swallowing exercises during therapy sessions. 

Many speech therapy sessions also target social skills, such as turn-taking and conversation skills. The speech therapist will work on this through specific games and activities.

At the end of each speech therapy session, the speech therapist will typically provide you with some take home exercises to practice with your child in order to help them reach their speech, language or feeding goals.

Speech therapy sessions typically last 30-60 minutes, depending on your child’s age and attention span. Session frequency may vary. Once a week or bi-weekly is most common, although some speech therapists may recommend more frequent sessions depending on your child’s needs.

Speech therapy takes practice and patience! Your SLP should help you identify the specific actions you can take at home to help your child reach their speech and communication goals.

This might involve specific exercises or activities to do with your child, as well as tips on how to support your child’s speech and language development in general. It is important to practice speech and language skills in a variety of contexts and situations, not just during speech therapy sessions.

Here is a blog with a video on what speech-language therapy can look like at home.

The best time to seek speech therapy services is often when problems are first noticed. An abundance of research exists that shows how important early intervention is for children. Early intervention is crucial when it comes to speech and language development, so don’t wait if you think your child may need help. Sometimes children need a little bit of a push early on to help “catch up” to age appropriate developmental norms. Most early intervention evaluations are free through your state and insurance. I always tell parents if you have a concern, there is no harm in having your child evaluated and making a decision from there based on the findings.

You should have access to a screening or evaluation either through early intervention, or your school district (depending on the child’s age) at little to no cost. If you are not eligible for support through these agencies, you can seek further support through private therapies with insurance, or out of pocket pay.

I hope this helps!

For more speech and language tips, follow Speech and Feeding Kids on YouTube.

About the Author

DRAKE HASTINGS M.S., CCC-SLP

Drake Hastings is a speech-language pathologist who specializes in speech, oral motor, and feeding therapy for kids. Drake has a passion for working with children and families while helping children achieve goals using a fun and motivating approach to learning.

Drake’s main areas of focus within the practice are feeding therapy, and speech (sound production) therapy. Drake has experience working with children who are diagnosed with Autism Spectrum Disorder, Apraxia of Speech, Dysarthria, Down Syndrome, and rare genetic disorders. Drake has experience working and collaborating with a wide variety of families and therapeutic team members while treating children of all ages.

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What Is Speech Therapy?

If your child needs speech therapy, you're not alone. Here's everything you need to know about speech therapy for kids and toddlers.

How Does Speech Therapy Work?

What does speech therapy treat, signs a child may need speech therapy.

• What is Early Intervention Speech Therapy?
• Speech Therapy for Toddlers

Speech Therapy for Elementary-Aged Kids

What about private speech therapy, what age is best to start speech therapy, how parents can refer their child for speech therapy, does insurance cover speech therapy, how long will my child be in speech therapy, how effective is speech therapy.

Prostock-Studio / Getty Images

If your child is currently in speech therapy or you're wondering if they might be a candidate for it, you're not alone. According to the American Speech-Language Hearing Association (ASHA), almost 8% of children in the United States have a communication or swallowing disorder. It doesn't mean you've done anything wrong, but it can be tough for families. The good news is speech therapy can make a difference.

So, what is speech therapy and how can it help? Here’s everything you need to know. 

Speech therapy is the treatment of communication, voice, and feeding/swallowing disorders by a trained professional.

Speech-language pathologists (SLPs) have a master's degree in speech-language pathology and specialize in evaluating, diagnosing, treating, and preventing these disorders. SLPs hold a license to practice in their state. 

You may also come across ASHA-certified SLPs. They have taken an additional step to pass a national exam and complete an ASHA-accredited supervised clinical fellowship.

There are various reasons a child may need speech therapy. Common ones include:  

1. Speech sound disorders. This means a child has difficulty with the production of speech sounds and how we combine them into words.

2. Language disorders. A child will have difficulty understanding and/or using language to communicate. Language disorders may impact vocabulary development, grammar, as well as the ability to tell a story, follow directions, answer questions, and more.

3. Social communication disorder/pragmatic language disorder . In this case, a child will have difficulty using language to socialize. This may include difficulty understanding social cues, taking turns during conversation, initiating or maintaining a conversation, and understanding personal space. A social communication disorder often leads to difficulty forming friendships. Children with these language barriers may have a concurrent diagnosis of autism spectrum disorder .

4. Cognitive - communication disorder . This includes difficulty with memory, reasoning, problem solving, and organization, impacting the ability to communicate.

5. Voice disorder . Children will have differences in voice quality (e.g., being too hoarse or too nasal).

6. Fluency disorder/stuttering . Kids will have difficulty maintaining a smooth flow of speech. A fluency disorder may include repetitions of sounds within words, prolongations of parts of words, and/or pauses in speech.

7. Feeding/swallowing disorder . This presents as a difficulty with sucking, chewing, and/or swallowing food or liquid.

Children may need speech therapy when they have not acquired speech/language milestones by an expected age. While milestones can vary from child to child, parents should refer their child for an evaluation if they have any concerns. Evaluation, which may include both standardized and non-standardized testing as well as observation, can help diagnose a speech/language disorder.

Some signs that may indicate a need for speech therapy include:

• A child isn't babbling by 6-7 months
• The child is having difficulty with feeding and/or swallowing
• A child beyond the age of 1 has no words
• A child beyond the age of 2 is not combining words into phrases
• The child's speech is difficult to understand
• The child is omitting syllables or sounds in words
• Speech errors are noticed during conversation
• The child has difficulty following directions or understanding spoken language
• The child has difficulty answering questions
• The child has a smaller vocabulary than what is expected for their age
• The child is stuttering
• The child's voice quality has changed or is noticeably hoarse or nasal
• The child has difficulty communicating with others socially
• The child has hearing loss
• The child has a cleft lip or palate

What is Early Intervention Speech Therapy? 

Early intervention refers to state-funded evaluations and interventions—including speech therapy—for children, ages birth to 3, and their families. In some states, early intervention continues until the age of 5. While professionals may refer a child to early intervention, parents can also refer their child on their own.

Speech Therapy for Toddlers 

Speech therapy for toddlers usually resembles play where toys are used to elicit target skills, says Dominica Lumb, M.S., CCC-SLP, who has over 30 years of experience conducting speech therapy with children in various settings. 

Children are given choices during play to encourage the need to communicate. While working on language skills, toddlers are encouraged to request objects, ask questions, answer questions, and use appropriate vocabulary.

Parents may be included in therapy sessions at this age. They may be taught to model speech sounds or how to label objects and actions during everyday routines to enhance vocabulary development.

Speech therapy can also work differently depending on a child’s needs. For example, one may require a mode of communication that differs from speaking. That’s referred to as augmentative and alternative communication (AAC) and may include picture boards or computers/iPads for communicating through text or voice synthesizer. This can begin in early intervention and beyond.

Speech therapy at this stage is typically more structured. Games are often used for motivation, but goals are targeted through practice and repetition. Children practice new skills throughout a continuum until they're able to use these skills naturally in all environments.

After early intervention, children may continue receiving services in elementary school through an individualized education plan (IEP). The IEP is written by all specialists who will be working with the child. It states the child's goals and documents any accommodations the child may need to meet them.

Therapy at this age may follow a “pull-out” model where a child receives support in a separate classroom or a “push-in” model where an SLP provides services within the regular classroom. This model can change throughout the duration of therapy. For example, a child working on the correct production of a sound will typically begin with pull-out therapy and, when ready, will be observed in their classroom to assess for carryover of this skill.

SLPs in the school setting also consult with teachers to provide the support children need to communicate effectively in the classroom.

While children must qualify for speech therapy through early intervention and in public schools, private practices can provide services beyond these standards.

Speech therapy in the private practice setting typically occurs one-on-one with the child receiving the SLP's undivided attention. But group therapy may occur when beneficial to the child.

"Therapy in the private practice setting is very child and family focused," explains Shanna Klump, M.S., CCC-SLP, CEO of Kid Connections Therapy in Severna Park, Maryland. "The family's goals for their child are often at the forefront of the work we do. In addition, parents and other family members often participate in the sessions to learn strategies that can be implemented at home to encourage generalization of skills."

Parents should refer their child for a speech/language evaluation when they first notice their child is falling behind in any area of speech/language or is no longer meeting speech/language milestones . It is never too late or too early to start therapy but, in general, earlier intervention leads to a better outcome. If you're unsure if your child requires speech therapy, a referral to an SLP is always recommended.

A parent can contact their local early intervention office to learn about speech therapy options. The Centers for Disease Control and Prevention (CDC) provides early intervention contacts by state. Parents can also reach out to their child's health care provider to determine where their local early intervention office is located.

A school-aged child can be referred for a speech/language evaluation by reaching out to the child's teacher or the school's SLP.

An evaluation by a private SLP is an option at any age, but evaluations through early intervention or a public school district are provided at no cost. ASHA ProFind connects parents to SLPs who have indicated they are accepting referrals.

While public school therapy is free, private outpatient speech/language therapy is often covered by health plans, but with limitations.

According to Klump, insurance coverage for speech therapy varies by state, insurance plan, and diagnosis. She explains that while some states require habilitative service coverage for children, others do not.

Often, private practices, including Klump's Kid Connections, complete a benefits verification before initiating speech evaluation or therapy. In her experience, therapy sessions without insurance coverage may cost between $100-150, depending on location.

As each health plan has its own coverage, it is important to reach out to your insurance company to determine your out-of-pocket costs.

Insurance and Speech Therapy Coverage

If you're looking to see what insurance covers, Shanna Klump, M.S., CCC-SLP, CEO of Kid Connections Therapy, suggests parents obtain the following information from their insurance carrier:

• Visit limit. This may be a hard or soft limit which refers to whether an extension of services could be granted if deemed medically necessary
• Whether the visit limit is combined with other services. For example, occupational therapy and physical therapy are sometimes grouped with speech therapy in the number of sessions covered
• Whether there are exclusions to coverage for different diagnoses
• If a deductible must be met
• The co-pay amount per session

Speech therapy can take anywhere from months to years. Each child makes progress at their own rate and has individualized goals based on their communication needs. Just as children develop and meet milestones individually, the time it takes them to master new skills will vary.

Speech therapy has been found to be effective for children. One study of more than 700 children with speech or language disorders up to 16 years old, found an average of six hours of speech therapy over six months significantly improved communication performance. Speech therapy was shown to be much more effective than no treatment over the same period.

Children of all ages typically find speech therapy engaging, fun, and rewarding. They're able to see their progress and use their newly learned skills proudly. Speech therapy is an effective way to enhance a child's ability to communicate and through these communication skills, a child will have better access to the world.

Is speech and language therapy effective for children with primary speech and language impairment? Report of a randomized control trial . International Journal of Language & Communication Disorders . 2011

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Parent's Academy › Speech Therapy › Speech Therapy for Kids › Speech Therapy for Kids: An All-in-One Guide

Speech Therapy for Kids: An All-in-One Guide

Robert mckenzie.

New York , New York

Jan 7, 2022 The decision to send your kid for pediatric speech therapy can be confusing, and is always difficult.

This blog attempts to: make that decision clearer and easier by first digging into the questions parents grapple with before they see a speech-language pathologist (SLP) , then it explores the practical issues of seeing a therapist, then how to practice at home in between therapy sessions, and finally, how to know when to stop seeing your SLP.

Welcome to our series of “All-in-One” guides connecting blog writers around an important topic that is explored in-depth on our blog page. The subject of this guide explores everything parents need to know about SLPs and speech therapy.

Fun Speech Therapist-approved Activities

Speech Blubs  is a language therapy app with more than 1,500 activities, face filters, voice-activated activities, and educational bonus videos. The more you practice, the more it carries over! Try the Speech Blubs app for fun and engaging therapy sessions with your little one.

Boost Your Child’s Speech Development!

Improve language & communication skills with fun learning!

The Questions to Ask if Your Child has Speech Issues

When should i take my child to a slp.

Knowing if/when to contact a therapist is half the battle in tackling speech issues. The general rule of thumb is if your child is more than one age group behind, then you should seek help. The following blog gives the basics about what a speech therapist does, and lists the milestones that children generally meet. Use this list as a comparison marker for deciding about your child. Check this blog: When is it Time to Go to a Speech Therapist?  

Recommended article

When is it time to go to a speech-language pathologist.

More briefly, check out this list: There are several reasons why a child should receive services:

What does a Pediatric SLP do? What will my first visit look like?

A speech pathologist, according to the American Speech-Language-Hearing Association (ASHA) says they are “experts in communication . . . (who) treat many types of communication and swallowing problems.” Our blog, Pediatric Speech Therapy Appointments describes in more detail what SLPs do, what will happen at a first appointment, and answers if it’s ok to go into the session with your child. Then, the blog gives practical suggestions for parents to be prepared before they arrive. These are key for maximizing parent’s time with the therapist.

Pediatric Speech Therapy Appointments

What will an SLP ask me?

Many parents aren’t great communicators with doctors. They absolutely know what’s wrong, but have trouble communicating their thoughts. It’s not surprising that most parents don’t understand the terminology that therapists use. This is no one’s fault, these can be complex issues. 

This next blog tries to remedy that situation by listing the issues that therapists will be interested in, and most likely ask you. The blog also lists common words used by therapists so you’ll know what the heck they’re talking about before you arrive for a session. Check out: 25 Speech and Language Terms Every Parent Should Know Before Talking to A Pediatrician . You’ll be much more relaxed going in. 

25 Speech and Language Terms Every Parent Should Know

Of course, there are many tests out there that a therapist may choose for your child, but parents should be aware of them to help guide the discussion. Check out this blog for an extensive list of tests, and also if your therapist believes that sight or hearing issues might be the cause.

Testing for Speech and Language Therapy

I know i need an slp, what now, rules and regs in one spot.

Well, there are rules and regulations for almost everything regarding SLPs, which can be found on ASHA’s website . A more general guide for getting started in this process is in this blog:

Parents Guide to Speech and Language Pathology

What to do about the “ dwl ” (dreaded waiting list).

Ok, let’s call it like we see it. There are just not enough speech therapists! The waiting time to see one can be months or more. Every speech professional will say that early intervention is the KEY to helping your child improve. The problem is, early intervention can become late intervention while you’re at home waiting for the only therapist in town to carve out some time for your little one. 

This blog explores what you can do to make the most of the time you’re waiting for your speech therapy appointment . Check it out, because there are tips to getting to a therapist sooner.

The Dreaded Waitlist for Speech Therapy

What to do if your insurance doesn’t cover it.

Insurance companies make money by collecting money, not by paying it out to their customers. It can be quite likely that basic insurance packages don’t cover “extras” like speech therapy. This is in quotes because anyone with a child who has trouble communicating doesn’t look at therapy as an “extra,” but as a “necessity.” So, we have a blog that talks about what parents can do if their insurance doesn’t cover speech therapy . Helping your child should be a social and governmental imperative, but don’t get me started.

What to Do When Insurance Won’t Cover Your Speech Therapy Costs

Setting goals and practice at-home for success, how to set goals for speech therapy.

“Speech therapy at home? How am I going to schedule that?” How do parents get started? “This isn’t my area of expertise, what do I know about speech therapy?” All valid points and questions. Speech Blubs’ SLP Natalie Barnes from Cape Town, South Africa has laid it all out on how to get started with speech therapy at home . She takes the stress and mystery out of figuring out this process. Make your life a little easier.

Setting Realistic Therapy Goals

Working on your slp’s goals at home.

Any SLP worth her/his salt will give you homework after a session, so if they don’t, be sure to ask for some! This homework works on specific targeted exercises that help your child achieve certain goals. Speech therapy for toddlers will include exercises to help toward those goals. Speech Blubs SLP Stacie Bennett gives great advice for working on speech therapy goals at home . This will really help.

Should Parents Work on Their Child’s Speech Goals at Home?

How to engage my child in home therapy practice.

Kids certainly have their own minds. Actually, once they start having opinions, speech issues or not, they may not want to use an app that is supposed to help them. They also may not want to just because you said they should/have to. This is just one reason that experts say it’s better to start them as young as possible. They are much more likely to be attracted by bright colors, face filters, or funny sounds. That said, there are some strategies that work for kids of all ages, and can be found in our article on Tips to Engage Kids in Learning . The cool thing about Speech Blubs is that once they start, they usually want to continue.

How to Engage Children In Speech Therapy

Get the whole family involved in home therapy.

As in all things, “it takes a village,” and that is certainly true of families. The more a child’s family is supportive, the more he/she will want to practice. Your child’s siblings, another parent, aunts and uncles, etc. can all help. The power of positivity is amazing, and works here. For more information on how to get the whole family involved (more or less), check out this blog on family involvement in speech development .

Involve Your Family in Your Child’s Speech Development

Other resources that can help my child.

There is some good news here. While you’re waiting for an appointment with a therapist, or if you’re in between appointments, we can point you to a LOT of help. Speech Blubs provides 1500+ games, activities, and exercises to get your child practicing targeted speech goals. 

In addition, we also have a great blog that teaches you how t o use music to help learn speech . In fact, ASHA (2012) reported that “music has improved a patient’s motivation, attitude, and performance in his or her speech-language therapy ( The ASHA Leader , 2012).” 

Kids Music and Speech Therapy

Congrats your child can talk what’s next.

Deciding when your child is ready to stop going to speech therapy is a somewhat subjective decision that depends on your goals, your speech therapist’s goals, and your child’s engagement level. Fortunately, we have a blog to help parents with that decision when to stop speech therapy . Our SLP Natalie Barnes discusses what the research shows, what the signs are for knowing when your child is ready, and talks about “maintenance therapy.” Of course, Speech Blubs is a great tool for a fun way to maintain what your child has learned. 

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The author’s views are entirely his or her own and may not necessarily reflect the views of Blub Blub Inc. All content provided on this website is for informational purposes only and is not intended to be a substitute for independent professional medical judgement, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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“The results indicate that parent-implemented language interventions have a significant, positive impact on receptive and expressive language skills.”

“Student progress reports indicated that the children made similar progress during the study whichever treatment method was used."

"The results suggest comparable treatment outcomes between traditional service delivery and telepractice"

“Following intervention, students in the telehealth group made significant improvement in speech sound production as measured by change in scores on the GFTA-2"

“Such a finding underscores the importance of comprehensive and ongoing training for successful parent-delivered interventions”

Any age is the right age to start Expressable.

Children learn best from the people they love most—you! During your toddler’s sessions, you’ll learn simple, effective strategies to incorporate at home.

Join your child for fun, interactive virtual sessions, where you’ll learn tips from your speech therapist to easily apply throughout daily life.

Children can start to interact with their speech therapist more independently, but you’ll always be kept in the loop with home activities and updates.

Track your child’s progress and watch their communication soar.

Your child’s custom care plan includes goals that are measured each week as they get closer to graduation.

More practice equals more progress.

That's why we give your child the tools and support to discover new learning moments wherever they go!

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Why thousands of kids and families love Expressable.

"She is a complete rockstar. Kind, funny, and really kept my toddler engaged. We couldn't wait for Tuesdays. Madelyn was professional and personal and we could see her genuine concern for our kiddo."

Madelyn worked with this client to improve her expressive language and intelligibility, helping her effectively communicate basic wants and needs.

"Inga gave me hope in a world of false diagnoses. She was beyond sweet and caring with my son. The screen did not make the session feel distant or dry, it felt very familiar and every week we looked forward to it."

Inga helped this client improve their language abilities and increase vocabulary so he could express his wants and needs with ease.

"Robin is amazing! She has made my daughter feel comfortable throughout the entire process! She was always open to try new techniques and adjust the process to find what clicked with my daughter."

Robin helped this client improve their sound production and overall conversational speech.

"Andrea is phenomenal in facilitating the speech sessions with my son. She gives great insight on how to use various methods to communicate with him. He enjoys the sessions. My husband and I are glad to have this opportunity as a key component of our son’s development."

Andrea helped this client with many language-building techniques like modeling words, using gestures, simple signs, and more to communicate his basic wants and needs.

"We had the most perfect therapist, Fabine. She was joyful, patient, encouraging and always enthusiastic. Our daughter quickly mastered the work and was discharged months earlier than we expected! We liked the twice a week format. It was clearly more beneficial than once a week, in person. Additionally, the homework helped us support her new sounds at home."

Fabine helped this client reach age-appropriate sound production to effectively communicate their thoughts and ideas.

"Arch is amazing with my son. She has really helped him with his speech and is so patient and caring. She has made speech fun for him, and he has made significant improvements since working with Arch. We are thankful for Arch and the excellent program Expressable offers."

Archana helped this client speak more clearly to reach communication milestones typical for his age.

Accessing care should be a breeze. See our coverage options.

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Communication is one of our most vital, life-long skills. Speech therapy can help children reach communication milestones appropriate for their age; clearly articulate their thoughts, feelings, and ideas; comprehend the language of others; and develop socially. It also contributes to their academic success and emotional well-being. Plus so much more!

The first step is to schedule an evaluation with a speech therapist. They’ll assess your child’s communication development and make a professional recommendation as to whether your child could benefit from speech therapy.

There is no minimum age. Communication skills begin developing in infancy. Building strong language skills in very young children can set the foundation for strong communication and literacy skills later on. Speech therapy is particularly important for children who aren’t reaching age-appropriate communication milestones, or who are experiencing difficulties such as stuttering or a lisp. Because speech and language patterns become more ingrained over time, the earlier speech errors can be corrected, the better the outcomes are likely to be.

The duration of speech therapy is different for everyone, and it depends on several factors. This includes the type of speech disorder or communication challenge, the frequency of speech therapy sessions, how often you and your child practice the skills taught in speech therapy at home, your child’s age, any underlying medical conditions, and more.

Most children love online speech therapy! Many become more attentive with online learning, and they prefer the interactivity of online exercises and communication. Plus, there are many effective strategies that speech therapists use to engage children online. Expressable’s model of care also focuses on the most important component of improving children’s speech and language skills: the involvement of their parent or caregiver. When parents are actively involved in their child’s care, that leads to faster progress. Our therapists work directly with caregivers to teach them techniques and strategies they can use in their child’s everyday life.

Speech therapy sessions are focused on each client’s care plan, and the activities done during sessions always relate to those goals. So, if a person is in speech therapy to better pronounce the /s/ sound, they’ll begin by learning how to make the sound by itself and work up to practicing it in conversation. Or if someone wants to improve the quality of their voice, their speech therapist will teach them appropriate breathing and vocal exercises. The therapist will aim to do as many trials of each exercise as possible, in order to make the most of each session.

Your speech therapist will constantly be measuring and assessing your response to these exercises. When needed, they’ll make changes to your treatment plan to help you make progress as quickly as possible. Regardless of your goals, your speech therapist will always provide practice activities to complete at home between sessions.

Expressable currently accepts many of the largest insurance companies, and we’re actively working on contracting with new plans across the country. We also offer affordable private pay options and accept HSAs/FSAs for those who do not have insurance coverage or prefer to pay out-of-pocket.

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What to Expect At Your Child’s Speech Therapy Evaluation

A common question we often hear as speech therapists both in and out of the clinic setting is, “Does my child need speech therapy?” The most common concerns prompting this question can range from “I can’t understand my child,” to “My child is not talking as much as their peers,” to “My child just doesn’t seem to understand what I am saying,” and even “My child has difficulty eating.” If you have found that you have similar concerns about your child’s speech and language development it may be time to consider a comprehensive speech and language evaluation. Oftentimes having your child evaluated can seem daunting and overwhelming. And that’s ok! Read on to learn what to expect from your child’s evaluation and how a speech therapist can help. 

What Does a Speech Therapist Do?

Speech Therapists or Speech-Language Pathologists (SLP’s) can help with so much more than just producing sounds correctly. While that can be a big part of a speech therapist’s job, SLP’s can work with your child in many other areas including:

Expressive Language : how your child uses words to express himself/herself Receptive Language : your child’s ability to hear and comprehend spoken language Articulation : the production of speech sounds Fluency : refers to the continuity, rate, smoothness in speech (ex. stuttering) Voice : this can include voice quality, vocal hygiene, pitch, loudness, or vocal effort Auditory Processing : your child may have difficulty processing what they hear AAC (Augmentative Alternative Communication) : AAC refers to various communication methods used to help one communicate without talking (ex. Picture communication, communication devices) Feeding/Oral Motor Skills : if your child has difficulty chewing, swallowing, or advancing their diet an SLP may be able to help

How To Schedule a Speech Therapy Evaluation for your Child:

If you are ready to take the next steps in having your child seen for a speech therapy evaluation, contact your child’s primary care doctor for a speech therapy referral. You may also call our office and one of our patient coordinators can assist you with next steps and help get your child scheduled for an evaluation. 

What To Expect From Your Child’s Evaluation: 

Believe or not, speech therapy evaluations are actually FUN! Prior to your evaluation date, your child’s therapist may contact you in order to find out any additional information they might need in order to complete a thorough and comprehensive evaluation which addresses all of your concerns. 

At your evaluation appointment, your therapist will talk further with you about your concerns, what goals you and your child have for therapy, and review pertinent medical history. The therapist will interact with your child through play or movement activities in order to understand their communication skills in a more natural context. If your child is able, the therapist will administer a speech assessment to formally evaluate their skills in your area of concern. 

Don’t be alarmed if your child’s evaluation looks a lot like they’re “just playing”. This is sometimes how an SLP can learn the most about your child! You can be assured that your therapist is constantly evaluating and assessing your child’s skills. Our goal is to make the evaluation fun and comfortable for your child. Finally, the therapist may take a look inside your child’s mouth to simply ensure that all of the structures needed for speech and communication are intact and functioning properly. 

Once the assessments and evaluation are complete the therapist will review their findings and make recommendations as to whether further treatment is necessary and answer any questions you may have about the evaluation process.  

What Happens After the Evaluation:

At your evaluation, your therapist will let you know if weekly therapy appointments are recommended. If ongoing treatment is recommended and you have not already scheduled a weekly appointment time, your therapist and patient coordinator will help you through that process. Your therapist may also provide you with activities and strategies to implement at home to target any areas of concern outside of the clinic environment. 

If after the evaluation, your therapist does not recommend treatment, they may ask you to continue to monitor your child’s development and check back in six months to a year, for example, if concerns persist. 

As a parent or caregiver, you know your child best. If you have any concerns about their speech and language development do not hesitate to pursue an evaluation. SLP’s are here to guide you, answer any questions, and make sure that your child receives the best care possible! We can’t wait to see you! 

Elizabeth Vincent, M.S., CCC-SLP

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How to Do Speech Therapy at Home

iStockphoto / Mordolff

Like any other skill acquired in childhood, learning how to communicate clearly—both in terms of how you speak and the words you choose—is one that develops over the course of many months and years. Some kids begin babbling away early in toddlerhood while others remain the strong and silent type until they’re more comfortable with speech patterns.

According to the American Academy of Pediatrics (AAP), most children begin talking between 1 and 2 years of age. By age 2, most kids have a vast foundation of words to work with (think “ball,” “dog,” “Mama” or “Dada,” “cup,” “eat”) and are often putting words together into two-word questions and sentences.

If your child doesn’t seem to be falling within the range of normal for speech, it may not be a sign of a speech or language delay , but it also may be appropriate to begin engaging in some simple speech exercises with your child at home.

At-home speech therapy can be especially helpful for kids who aren’t easily frustrated and who have only mild delays or articulation errors, said Massachusetts-based pediatric speech therapist Alyssa Gusenoff. More serious problems, like speech regressions, should be brought up with a licensed speech therapist.

Here is a guide to performing basic speech therapy at home with your child, from first steps all the way through seeking outside help.

Assess Your Options 

There’s no reason to go it alone when it comes to speech therapy if there are resources in your community that can assist you. First, you should consult with your child’s pediatrician if you feel that your child has a speech delay or articulation issue. A pediatrician can share developmental milestones for speech and let you know if your child is actually struggling.

“It’s important to know what’s developmentally appropriate for speech and what’s simply parent-preferred,” Gusenoff said. “Parents without a pediatric background may not realize that 4 year olds don’t need the 'r' sound yet.”

Gusenoff said that many communities offer early intervention services for children who aren’t yet school-aged. If your child is already enrolled in school, your district may employ a speech therapist who can help you, too. Don’t be shy—ask around to see what’s available. Many services are provided free of charge for town residents.

Assess Your Child

If you’ve decided to try at-home speech therapy (either in lieu of professional services or, perhaps, while you wait for a therapist to become available), what works for your child will depend on several things.

Younger children will have a hard time focusing and concentrating on anything you call “therapy.” You can try to keep things fun and light, but a child too little to understand he’s making speech errors may not be receptive to correcting them. An older child can be more motivated to improve their speech because it means they will be better understood by peers and caregivers.

Temperament

Again, kids who are not easily frustrated are more likely to work on speech with a parent. Kids with a low frustration tolerance may view therapy as a negative experience.

Type of Speech Involvement Needed

There will be different approaches to therapy if your child has a speech delay (they have far fewer words than they should at their age) versus an articulation problem (they make a “t” sound instead of a hard “c” sound). 

Co-Existing Conditions

If your child is simply behind in this one area, it may be easier for you to slowly catch them up over time at home. If a speech issue occurs along with another developmental condition, like autism, you may want to seek professional help.

Experiment with At-Home Methods

Once you’re ready to forge ahead, you can try a variety of approaches to helping your child improve their speech. Here are some of Gusenoff’s favorite strategies.

Stop Anticipating Your Child’s Needs

It’s tempting, we know, to jump for what your child wants whenever they simply point at it—but doing so doesn’t encourage them to use their words. Give them a chance to ask for the pretzels, Gusenoff said, rather than grabbing them as soon as your child points to the cabinet.

Minimize Pacifier Usage

If your older toddler or preschooler is still using a pacifier, it can be very hard to break the habit , but it’s also very hard to talk with a pacifier in your mouth, so continuing to use one when speech is developing can interrupt the process.

Offer Choices

Instead of saying, “What would you like to drink?” ask your child “Would you like milk or juice?” A child struggling to build vocabulary will benefit from hearing the options and being able to choose one, rather than being expected to pull the correct word out of thin air. 

Increase Visibility

“When you say the name of an object, hold the object up towards your mouth so your child sees your mouth move,” Gusenoff recommended. This creates an immediate visual connection between the object and the way the word for that object is formed in the mouth.

Take turns repeating words to each other (example: “I’ll say ‘apple’ and then you say ‘apple.’ Ready? ‘Apple.’ Your turn!”). Peek-a-boo games also encourage speech by keeping a child’s attention, as do hiding games. Gusenoff said hiding objects around the house, like hiding small objects inside playdough, and keeping objects reserved inside containers can all encourage kids to ask questions, make exclamations, and request assistance.

Prompt and Withhold (Within Reason)

If your child is struggling because they simply haven’t had a lot of opportunities to practice various types of speech, you’ll have to learn to get comfortable making them feel mildly un comfortable sometimes. Don’t push your child to the brink of tears, but it’s okay to pause or hang back to see if your child can eventually solve their own problem when they need something.

For example, Gusenoff said you can help your child put on one shoe—then get up and walk away. Does your child call after you to get your attention? If so, ask him what he needs (you know the answer, but pretend like you don’t!). The goal here is to encourage your child to communicate for himself, rather than always relying on you to do all the talking.

Most children learn best when things are repeated over and over (and over!) again, and that’s often true for speech as well. When your child says a word correctly, repeat it back to him in a positive tone. If your child makes an articulation error, Gusenoff said, repeat it back to them incorrectly so they can hear what they actually said versus what they think they said. Some kids may not realize they’re making an error until mom or dad repeats it back to them!

Make Lots of Observations

Now that you’re spending dedicated time at home on speech therapy, it’s important to start tracking your child’s progress. Gusenoff said it’s easy to forget or overlook where your child is starting out when learning a new skill, meaning you can underestimate the amount of progress they’ve made. Keep a record or log so you can visually track your efforts.

Gusenoff also recommends paying attention to what words you can understand from your child compared with what a grandparent, for example, and a total stranger can understand. There will be differences between those three metrics (i.e. you can understand 75 percent, your mother-in-law can understand 50 percent, and a stranger can understand 25 percent), but there shouldn’t be enormous gaps between each tier. According to Nemours, most people—regardless of how well they know your child—should be able to understand the majority of your child's speech by the time they turn 4.

Know Your Limitations

It’s important to understand that you may be able to guide and assist your child at home, helping to develop much-needed skills, but you may not be able to correct more significant problems without a professional. It’s one thing to help your child say his “d” and “b” sounds more clearly, but it’s another thing to teach him how to form more complex sounds involving the tongue or back of the throat.

Gusenoff added that kids who are very frustrated by their speech problems, who regress or don’t make any progress, who grope for sounds but are unable to move their mouths, and kids who experience quality of life issues because of communication errors or delays are not the best candidates for at-home speech therapy and would benefit from professional help.

If you’ve reached the limit of what you can provide for your child yourself, try not to take it as a personal offense. Instead, do what you can and then reach out for more help. Your child’s pediatrician is a great place to start—they often know all of the local resources and can point you in the right direction.

American Academy of Pediatrics. Language Delays in Toddlers: Information for Parents .

Nemours Foundation. Delayed Speech or Language Development .

By Sarah Bradley Sarah Bradley has been writing parenting content since 2017, after her third son was born. Since then, she has expanded her expertise to write about pregnancy and postpartum, childhood ages and stages, and general health conditions, including commerce articles for health products. Because she has been homeschooling her sons for seven years, she is also frequently asked to share homeschooling tips, tricks, and advice for parenting sites.

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Delayed Speech or Language Development

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As with other skills and milestones, the age at which kids learn language and start talking can vary. Knowing a bit about speech and language development can help parents figure out if there's cause for concern.

How Do Speech and Language Differ?

• Speech is the verbal expression of language and includes articulation (the way we form sounds and words).
• Language is giving and getting information. It's understanding and being understood through communication — verbal, nonverbal, and written.

What Are Speech or Language Delays?

Speech and language problems differ, but often overlap. For example:

• A child with a language delay might say words well but only be able to put two words together.
• A child with a speech delay might use words and phrases to express ideas but be hard to understand.

What Are the Signs of a Speech or Language Delay?

A baby who doesn't respond to sound or vocalize should be checked by a doctor right away. But often, it's hard for parents to know if their child is taking a bit longer to reach a speech or language milestone, or if there's a problem.

Here are some things to watch for. Call your doctor if your child:

• by 12 months : isn't using gestures, such as pointing or waving bye-bye
• by 18 months : prefers gestures over vocalizations to communicate
• by 18 months: has trouble imitating sounds
• has trouble understanding simple verbal requests
• by 2 years : can only imitate speech or actions and doesn't produce words or phrases spontaneously
• by 2 years: says only some sounds or words repeatedly and can't use oral language to communicate more than their immediate needs
• by 2 years: can't follow simple directions
• by 2 years: has an unusual tone of voice (such as raspy or nasal sounding)

Also call the doctor if your child’s speech is harder to understand than expected for their age:

• Parents and regular caregivers should understand about 50% of a child's speech at 2 years and 75% of it at 3 years.
• By 4 years old , a child should be mostly understood, even by people who don't know the child.

What Causes Speech or Language Delays?

A speech delay might be due to:

• an oral impairment, like problems with the tongue or palate (the roof of the mouth)
• a short frenulum (the fold beneath the tongue), which can limit tongue movement

Many kids with speech delays have oral–motor problems. These happen when there's a problem in the areas of the brain responsible for speech. This makes it hard to coordinate the lips, tongue, and jaw to make speech sounds. These kids also might have other oral-motor problems, such as feeding problems.

Hearing problems also can affect speech. So an audiologist should test a child's hearing whenever there's a speech concern. Kids who have trouble hearing may have trouble saying, understanding, imitating, and using language.

Ear infections , especially chronic infections, can affect hearing. But as long as there is normal hearing in one ear, speech and language will develop normally.

How Are Speech or Language Delays Diagnosed?

If your child might have a problem, it's important to see a speech-language pathologist (SLP) right away. You can find a speech-language pathologist on your own, or ask your health care provider to refer you to one.

The SLP (or speech therapist) will check your child's speech and language skills. The pathologist will do standardized tests and look for milestones in speech and language development.

The SLP also will check:

• what your child understands (called receptive language)
• what your child can say (called expressive language)
• sound development and clarity of speech
• your child's oral–motor status (how the mouth, tongue, palate, etc., work together for speech as well as eating and swallowing)

Based on the test results, the speech-language pathologist might recommend speech therapy for your child.

How Does Speech Therapy Help?

The speech therapist will work with your child to improve speech and language skills, and show you what to do at home to help your child.

How Can Parents Help?

Parents are an important part of helping kids who have a speech or language problem.

Here are a few ways to encourage speech development at home:

• Focus on communication. Talk with your baby, sing, and encourage imitation of sounds and gestures.
• Read to your child. Start reading when your child is a baby. Look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures.
• Use everyday situations. To build on your child's speech and language, talk your way through the day. Name foods at the grocery store, explain what you're doing as you cook a meal or clean a room, and point out objects around the house. Keep things simple, but avoid "baby talk."

Recognizing and treating speech and language delays early on is the best approach. Call your doctor if you have any concerns about your child’s speech or language development.

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5 Ways To Get Free Or Affordable Speech Therapy

May 31, 2016 by Lisa Geng

1. Early Intervention

In the US you don’t have to wait for your pediatrician to refer you for an evaluation for services through Early Intervention  if you have a concern about your child’s development in the following areas -call.

• Cognitive development
• Social-Emotional development
• Self-help skills

If your child is 3 years old and qualified they’ll get something called an IEP to attend your town school’s special needs preschool program.  For speech therapy and related services check this speech therapy matrix which goes by severity to see approximately how much therapy your child should be entitled to.  Even though securing appropriate therapy through the school is your child’s federal right, it may not be easy and you may want to use outside the school professional evaluations to help you advocate.  Which brings us to:

2. Insurance

While your child is legally only entitled to appropriate therapy through the school IEP, privately you can seek the best.  And why not seek the best?  Don’t choose your child’s professionals as you do your sports teams and only go to those within a certain radius of your home.  If you have to drive a bit further to find someone amazing for at least a definitive diagnosis, and to help oversee therapy, help in setting short as well as long term goals for the IEP, and help monitor progress, it’s highly recommended.

Main thing to remember is don’t just take “no” for an answer when looking to secure insurance for speech and occupational therapy, as well and other related services for your child.   For insurance it’s all about the coding used.  Make sure you don’t have a diagnosis with the word “developmental” or “childhood” in it as that implies the condition is one that the child will outgrow on their own without therapy and will be denied.  For example apraxia is a motor planning disorder, and there are various neurological codes to help secure coverage for that.

If autism or apraxia is suspected or diagnosed by an SLP you’ll want to confirm or rule out global soft signs of hypotonia, motor deficits, and/or sensory processing disorder with either a pediatric neurologist or developmental pediatrician.

Some codes are red flags for denials. A great code to use if you have a child with apraxia is 781.3 which is “lack of muscle coordination /coordination disorder.” This shows a physical diagnosis, which is typically covered, versus a developmental diagnosis, which is typically not covered.

-If there is an associated expressive language disorder with the apraxia, which is commonly the case, use #784.6 which is “other symbolic dysfunction.”

If #315.3, 315.31, 315.39, or 315.9 are used, these are developmental codes and may not be reimbursed  (Some codes have been updated since this page was created.   If you need a conversion for a code that has been updated you can find it here .)

Note: In the ICD 9 medical code book, #315.4 is Dyspraxia Syndrome. The confusion is that is that many of the #315 codes are developmental, but not this one.

The code for apraxia is under ICD-9 Codes. Insurance Code Website

-Oral/verbal apraxia is a neurologic disorder so never use the word developmental (admin note: or childhood/CAS) or a code that is “developmental” in the report or on the bill. -Useful ICD codes for Apraxia of Speech are #315.40, #784.69, #781.3. The latter code is also one used for Hypotonia, Sensorimotor Integraton Disorder, and Coordinaton disorder, which may be associated with apraxia of speech.

“apraxia, acalculia, agnosia, agraphia” is 784.69. Generally, codes in the 700 series are used for organic disorders. You should have neurological information supporting use of this code/diagnosis and should be able to answer the following questions:

• Is there a statement from a neurologist or pediatrician supporting a neurological component?
• How is this child’s verbal apraxia different from an articulation disorder?

For more insurance tips and sample letters for your child’s professionals as well as for the insurance company visit this page .  To find a private SLP ask other parents who they are happy with, or you can search TherapistsRatings or Wrightslaw Yellow Pages For Kids With Special Needs

3. University Speech and Hearing Clinics

Check Google to see if there are any universities near you that have a speech and hearing department.  Through them you can typically get free or very low cost therapy provided by a graduate student overseen by the PhD that runs the department.  A Cherab Foundation affiliate Speechville has this page of University Speech and Language Clinics which has not yet been updated, but can perhaps get you started.  You can also search for a graduate program here.

4. Sponsorship

Scottish Rite will provide free or low cost therapy for eligible families.  You can search for a location near you here .

There also  may be an ELKs or similar organization near you that sponsors special needs children.  My son for example was sponsored by the ELKs in NJ for both speech and occupational therapy.  According to the Elks “Nationally and locally, the Elks have worked diligently to better the lives of handicapped youngsters. The Order has a long history of supporting Special Olympics events, donating special equipment and supplies to the families of disabled children, sponsoring the treatment and research of many illnesses that affect children, and arranging for medical personnel to provide free in-home therapy services.”  Check to see if there are any sponsorship opportunities for your child, for example  Small Steps in Speech : The mission of Small Steps in Speech is to help children with speech and/or language disorders take the steps needed to be better communicators. They offer grants to purchase communication devices (including iPads).  Additional  grant or sponsorship opportunities

5. Placing An Ad

This one may seem risky, however it was shared at one of the Cherab support groups as a highly successful way of securing inexpensive appropriate therapy.  The mom placed an ad looking for an SLP for her child and asked for references and resumes and was shocked at both the amount and the quality of the SLPs that responded to her local ad.  Of course not all areas of the country or world may have the same response level, but may be worth a shot.

The mom wrote

“THERAPY idea for all of you parents!!! I know a lot of you are stuck without ANY help from social security, Medicaid, etc and are paying out of pocket, or HUGE copays for therapy … WELL… I posted a job offer on indeed.com asking for a private therapist, and I offered 30$ for 30 mins or 60$ an hour for therapy sessions a few days a week (right now, I am paying 100$ a week for TWO sessions that are 30 mins long… ugh) Anyway, within a week, 2 people responded. I have hired one of them. She is AWESOME and the GREAT thing is, she is going to come TO my home… So feeding therapy with vomiting doesn’t have to happen at an office! WOOOOOOT! A lot of these therapists are really wanting to be private contractors… they just don’t have enough people to start. Just wanted to share this info. (By the way, my daughter is too old for Early Intervention and she is already in a pre-k class, special education at school. just FYI) “

If you have any other suggestions please share below!

Reader Interactions

June 1, 2016 at 4:20 am

From Amber from the Cherab support group some more tips “We have a local non-profit group for children who have aged out of EI, and transition to the school district on an IEP called Developmental Pathway, . Anyway, these children are then eligible for a small grant, as well as a modest amount of month-month funding. There is a bit more to it, of course. But it has been a significant blessing to our family.

Also, our Apraxia dx qualified my daughter for a specific Medicaid program in our state. (We are slightly over the income threshold, and didn’t qualify for a medical waiver. But our state has Buy-In program specifically for families like ours.) I had to dig for this information”

May 9, 2017 at 2:22 pm

Very informative and innovative post.

July 12, 2017 at 8:44 pm

As a school speech therapist, just post your need on Facebook. I am always looking for after school, summer, and weekend fun! I have done EI, peds, and adults. I specialize in autism school-age, but I am qualified for much more. Any good therapist will let you know if she cannot handle your case and help you find someone who will.

July 29, 2021 at 7:29 am

Hi! Would you happen to have a recommendation for a speech and OT therapist in NYC, Manhattan by chance? One that could go on-site to my son’s daycare and provide the service?

Hope to hear back soon if possible. Just giving this a shot.

Law Office of Michelle Ball

Legal Requirements To Get Free School Speech Services

Last Updated on February 12, 2024 by Michelle Ball

By Michelle Ball, Sacramento California Expulsion, Special Education, sports/CIF, College, Education and School Attorney/Lawyer for Students since 1995

Students can receive free school speech services (also know as “related services”), but it isn’t as easy as just asking the school secretary. First, the student has to qualify for special education.

A Student Can Qualify for Special Education if They Have a Speech and Language Impairment

Special education qualification can be based solely on communication issues, called speech and language impairments. These issues may appear when a student is very young or later in life. Student speech impairments can manifest in many ways, such as being unable to understand the student, dropping letters or sounds, or even in social communication with peers (aka pragmatic language ).

To remedy these issues, students may be entitled to speech services from their public school at no expense. To understand how to qualify for school speech services, a parent needs to be familiar with the relevant laws .

What is the definition of a speech and language impairment (aka language disorder) under federal law?

Per Code of Federal Regulations, volume 34, section 300.8(c)(11) :

Speech or language impairment  means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.

What if the student has minor issues which don’t impact their education?

Per California Education Code 56333 the student’s speech and language disorder must negatively impact their education to be qualified for special education:

“A pupil shall be assessed as having a language or speech disorder which makes him or her eligible for special education and related services when he or she demonstrates difficulty understanding or using spoken language to such an extent that it adversely affects his or her educational performance and cannot be corrected without special education and related services .”

Who assesses a speech and language disorder?

Per 56333, a “ language, speech, and hearing specialist, ” which is a specially trained individual, qualified to test the student and evaluate the results, and recommend school speech services or other related services within their specialty.

What types of issues must a speech and language specialist find to qualify a student under California law?  

Per California law, Education Code 56333 :

(a)  Articulation disorders , such that the pupil’s production of speech significantly interferes with communication and attracts adverse attention.

(b)  Abnormal voice , characterized by persistent, defective voice quality, pitch, or loudness…  

(c)  Fluency difficulties which result in an abnormal flow of verbal expression to such a degree that these difficulties adversely affect communication between the pupil and listener.

(d)  Inappropriate or inadequate acquisition, comprehension, or expression of spoken language such that the pupil’s language performance level is found to be significantly below the language performance level of his or her peers.

(e)  Hearing loss which results in a language or speech disorder and significantly affects educational performance.

Are there other requirements to receive speech services in school?

California Code of Regulations, Title 5, section 3030(b)(11) specifies that students must also “meet one or more of the following criteria:”

“ (A) Articulation disorder .1. The pupil displays reduced intelligibility or an inability to use the speech mechanism which significantly interferes with communication and attracts adverse attention… and which adversely affects educational performance…

(B) Abnormal Voice. ..characterized by persistent, defective voice quality, pitch, or loudness.

(C) Fluency Disorders. ..when the flow of verbal expression including rate and rhythm adversely affects communication between the pupil and listener.

(D) Language Disorder. The pupil has an expressive or receptive language disorder when he or she meets one of the following criteria:

1. The pupil scores at least 1.5 standard deviations below the mean, or below the 7th percentile … in… the areas of language development: morphology, syntax, semantics, or pragmatics… or

2. The pupil scores at least 1.5 standard deviations below the mean or the score is below the 7th percentile … and displays inappropriate or inadequate usage of expressive or receptive language …”

What if a speech assessment says a student does not have a speech or language impairment?

A parent can request an outside independent assessment (aka IEE, or Independent Education Evaluation ) at school district expense, or pay for an outside assessment on their own. The IEE can evaluate the speech and language impairment, and make recommendations for school speech or related services for the student.

What related services may be available if a student qualifies?

Usually a student can receive one-on-one or group speech and language services, and school accommodations, which would be implemented via the student’s special education plan (IEP document) .

There may also be times when a speech and language therapist provides speech support during lunchtime or other times throughout the school day.

Special education lawyer Michelle Ball helps families obtain speech, occupational therapy, adaptive physical education, aide, and other supportive services and develop proper placements via the IEP process. As a Sacramento California student special needs attorney, Michelle Ball can assist parents across the state in places such as Redding, Sonora, Vallejo, Auburn, Antelope, Anaheim, Mission Viejo and many other locations.

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A Parent's Guide to R Sound Speech Therapy and How It Can Help Your Child

If your child has difficulty with the r-sound, they may need some help to learn how to pronounce it. This article covers the basics of R sound speech therapy and how it can help your child learn to speak more accurately.

It isn't too concerning if your child can't pronounce R as a preschooler. Rs are the most difficult letter to pronounce, and often kids won't fully develop the ability until the age of seven. However, if you are finding your attempts to teach your child to pronounce their Rs properly is causing conflict, it could interfere with family dynamics and your child's confidence.

The inability to pronounce Rs is a speech impediment called rhoticism. It is so common there is speech therapy specifically designed to help children pronounce their Rs. This is a complete guide to R speech therapy and how it can help your child learn to make the R sound stress-free.

Master 'R' Sounds with Ease!

What is Rhoticism?

Rhoticism is the most common speech disorder children experience. Inability to pronounce the R sound usually leads to a child pronouncing their Rs as Ws. This is because there are more variations of the letter R pronouncement than any other letter. Adding to the difficulty, it isn't easy to show a child how to position their mouth and tongue to make the sound correctly. For example, when showing a child to make the letter B, they can see the movement of your lips, making it easier for them to mimic you and make the sound.

When Should a Child Be Able to Say Their R's?

R is usually the last letter children learn to make. In most cases, a child begins to say forms of their Rs by about two and a half and has it perfected by the age of six. For some, however, development might not be perfected until as late as age seven . In most cases, rhoticism isn't addressed until a child approaches age seven or eight, but R sound speech therapy and coaching can start sooner.

Why Are There So Many Variations of R?

The R sound occurs most frequently when speaking English. It is challenging to master because it has so many variations in pronunciation. Where the R occurs in the word influences how the R should sound. Variations include:

• R as in run
• RL as in pearl
• IRE as in fire
• AR as in far
• EAR as in dear
• OR as in door
• ER as in sister
• AIR as in dare

With so many variations, you can see why it might be more challenging for a child to learn to master each sound with the rest of their letters.

How Can I Help My Child Say Rs?

Parents can also learn to assist their child with some fun exercises such as:

Connect Rs to Vowels

Many children find it easier to say their Rs with a vowel. R blends speech therapy such as making your way through the vowels, making it easier to understand how to pronounce R in different variations. First, pronouncing the vowel, either long or short, holding the sound, and then adding an R at the end helps your child hear how the letters sound together. For long A, you would begin with them saying aaaaaa and then adding the R to say aaaaaarrrrrr as in air. Then for the short, they would start saying ahhhhhhh and then add the R to say ahhhhrrrrr as in car.

Tongue Movement

As mentioned, one of the challenges with R's is the difficulty providing visual cues to show them how to pronounce the letter. Since you can't show them your tongue, you can try using your arm to show them by extending your arm out to the front and then pulling it up towards your body as you pronounce the R.

R Sound Activities

Always approach the exercises as something fun you can do together, so your child isn't self-conscious or nervous. For example, Rs are very much like growls. Have your child act out being certain animals like a cranky dog growling or a mighty lion roaring. Have them roll the R out as they mimic each animal. Pirates also make an R sound when they say "argh." You can dress up as pirates to practice the sounds. You can also watch their favorite cartoon and whenever a character makes an R sound have them shout it out or repeat it.

Use Rs Every Day

Find opportunities to pronounce Rs with your child, whether pointing out foods in the grocery store with Rs, items in a park, or even when your child hears you say an R.

Practicing R words speech therapy at home can be very helpful, but success is more likely with the help of a speech therapist.

What Causes Rhoticism?

Speech disorders like rhoticism are related to difficulty making sounds when speaking. In the case of rhoticism, it is related to not tensing their tongue enough or failing to move it correctly. Trying to master the up and backward movement when pronouncing R's can be tricky, which is why children often start by making a W sound instead. The child sees most letters pronounced with the lips, while Rs are pronounced with the tongue.

How Does R Speech Therapy Help?

R sound speech therapy can make a world of difference for your child. Your child's therapist provides a safe learning environment where they won't feel judged or pressured. Speech therapists take time to build a rapport with their patients to feel more comfortable during the process. Parents can often inadvertently cause a child to feel they are under attack or doing something wrong. Speech therapists alleviate that family stress providing neutral ground where a child can feel less vulnerable. Their goal is to assist your child in learning how to move their tongue to achieve the correct positions to pronounce their Rs correctly.

Each child is treated as an individual with an assessment to understand their challenges and then use different methods to find the approach that they respond to best. Therapists make articulation therapy fun using games and activities that children respond to well. Your child will improve over time, enjoying small successes each session until the Rs roll naturally off their tongue. Through practice, they learn how to make R sounds, add Rs to syllables, then words, phrases, and complete sentences with confidence !

We invite you to learn more about how Articulation Speech Therapy at Nobles Speech Therapy can help your child pronounce the R sound better and overcome other speech difficulties.

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School Year Hours

Nobles Speech Therapy LLC

8101 Sandy Spring Rd, Ste 300 [W-28]   Laurel ,  MD 20707

(301) 615-2529

[email protected]

Mayday alert as ship drifted towards Baltimore bridge ‘saved many lives’

Joe Biden and Maryland governor praise ‘heroes in the night’, whose actions meant motorists heading for crossing were spared from disaster

The 22-strong crew of the Dali container ship first realised something was horribly wrong at 1.24am on Monday night, when they lost power while sailing along the Patapsco River.

The vessel was 30 minutes into a 27-day journey from Baltimore to Sri Lanka, carrying cargo for the shipping giant Maersk and sailing under the Singaporean flag.

But as it approached the Francis Scott Key Bridge , Baltimore’s gateway to the Chesapeake Bay, the lights went out. The crew, helmed by two local “pilots” trained to traverse the bay, immediately contacted the Maryland Department of Transportation and issued a mayday call.

Officials on land watched in horror as they realised it was too late to stop the ship drifting, and frantically closed both the road across the bridge and shipping lane beneath it.

The ship’s power returned briefly, then turned off again, and smoke began to billow across the river.

Shortly before 1.29am, the Dali collided with a pillar almost halfway across the bridge , collapsing three of its main spans and trapping the vessel underneath steel trusses.

Vehicles on the bridge were sent hurtling into the freezing water, and a group of young people relaxing in a park on the south side of the bridge watched in horror as the bridge collapsed almost entirely in less than 30 seconds.

At 1.30am, the Baltimore fire department was alerted to an emergency, beginning a search and rescue operation that would involve dozens of local, state and federal agencies.

As initial reports suggested that eight construction workers had been repairing potholes on the 1.6-mile bridge when the ship struck, the task facing rescue workers became clear.

A person can survive in 8C water for around an hour before losing consciousness, and around three hours before dying, according to estimates by the National Centre for Cold Water Safety.

But the situation was complicated by the fact that sonar identified cars that had fallen to the bottom of the 50ft shipping channel. The strong tides of the Chesapeake Bay made the rescue job even harder.

As the minutes ticked by, a fire department spokesman said responders were dealing with a “developing mass casualty event”. Two people were pulled from the water, one unharmed and another in a serious condition.

Jen Woof, who lives on the south side of the river, was woken on Tuesday morning by her son, Jayden, who had crossed the bridge three times – the last time just three minutes before it collapsed.

Jayden had expected to spend the night with his girlfriend on the north side of the river, but travelled back home after the pair had an argument. Feeling guilty about the incident, he drove back to apologise, but his girlfriend sent him away. The third time he crossed, he was one of the last people to do so.

“He got over the bridge just three minutes before the bridge collapsed,” Ms Woof told The Telegraph.

“He was actually almost to our house when his girlfriend started texting him to ask if he was OK. He thought she was texting because they were arguing, and she said the bridge had collapsed.

“He came into my house, frantically panicking and yelling for me and showing me a video.”

Kayte O’Neill said she first heard about the disaster in a text from a friend on Tuesday morning.

“My literal response back was, ‘BRB [be right back], I’m going to throw up.’ And I did in fact throw up,” she said.

“I just feel bad for the people who are watching their screens because they had people who were on that bridge. I can’t even put myself in their shoes. I can’t.”

As the sun rose, search and rescue teams ran a complex operation involving helicopters, dive teams and drones searching the river for possible survivors.

A senior source involved in the operation told The Telegraph at 7.45am that the “odds are not looking good”.

By afternoon, the authorities had identified six missing people who were thought to have spent almost 12 hours in the water.

An underwater investigation found a concrete lorry that had fallen from the bridge and debris from the bridge scattered across the riverbed. Officials established a no-fly zone across the bay to prevent drone hobbyists from interfering with the search.

Concerns were also raised of a fuel spill, after the local authorities reported a smell of diesel around the wreck of the Dali. The ship’s crew remained on board, waiting to be rescued.

Speaking from the White House, Joe Biden said that the actions of the sailors who contacted the authorities before the bridge collapsed “undoubtedly saved lives” of motorists who would otherwise have driven across it.

He described the collapse as a “terrible accident” and said the bridge would be fully rebuilt using federal funds, while his administration would work to reopen the Port of Baltimore.

“We’re going to get it up and running again as soon as possible,” he said. “Fifteen thousand jobs depend on that port, and we’re going to do everything we can to protect those jobs and help those workers.”

He also claimed he had travelled over the collapsed Baltimore bridge “many many times” by both car and train, despite the structure not having any railway lines.

The ports of New York and Virginia said they would handle Baltimore’s freight traffic until Baltimore was reopened.

Wes Moore, the governor of Maryland, said the quick action of “heroes” in the middle of the night before the disaster had averted much of the possible loss of life.

“I’m thankful for the folks who, once the warning came up that there was a mayday, [were] able to stop cars from coming over the bridge… These people are heroes,” he said.

For locals, the loss of Baltimore’s iconic bridge is both an emotional and economic strain.

“We were on that bridge on Wednesday,” said Erin Miller, who lives nearby. “It’s going to cause a lot of traffic.

“A lot of people are going to be late to work, irritated, and it’s probably going to devastate Baltimore for a good few weeks. Probably a good few months.”

The Department of Homeland Security, which deals with the threat of terrorism, said there was “no indications that this was an intentional act”, although the FBI has begun an investigation into the cause of the ship’s power loss. One possible avenue of inquiry is why the ship could not divert its course after it became clear there was a problem.

“I am assuming the first line of investigation will be to understand why the vessel could not avoid the pier when there were no other vessels around,” said Dr Marina Bock, of Aston University.

The crash ended the life of the bridge, which began construction in 1972 and opened to road traffic in 1977.

Its namesake, Francis Scott Key, was an American lawyer and amateur poet best known for writing the lyrics to the US national anthem, The Star-Spangled Banner.

He lived in Frederick, Maryland, 50 miles west of Baltimore, and wrote the poem after witnessing the bombardment of Fort McHenry by the Royal Navy during the Battle of Baltimore in 1814.

David Simon paid tribute to the impact the collapse would have on the city he immortalised as the creator of the HBO series The Wire.

“Thinking first of the people on the bridge, but the mind wanders to a port city strangling,” he said on X.

“All the people who rely on ships in and out. The auto-ship imports, Domino Sugar, coal exports, dockwork, whatever container traffic we didn’t lose to Norfolk. Industries. Jobs. Families.”

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Trump Says Some Migrants Are ‘Not People’ and Predicts a ‘Blood Bath’ if He Loses

In a caustic and discursive speech in Ohio, former President Donald J. Trump once again doubled down on a doomsday vision of the United States.

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By Anjali Huynh and Michael Gold

Anjali Huynh reported from Vandalia, Ohio, and Michael Gold from New York.

• Published March 16, 2024 Updated March 18, 2024

Former President Donald J. Trump , at an event on Saturday ostensibly meant to boost his preferred candidate in Ohio’s Republican Senate primary race, gave a freewheeling speech in which he used dehumanizing language to describe immigrants, maintained a steady stream of insults and vulgarities and predicted that the United States would never have another election if he did not win in November.

With his general-election matchup against President Biden in clear view, Mr. Trump once more doubled down on the doomsday vision of the country that has animated his third presidential campaign and energized his base during the Republican primary.

The dark view resurfaced throughout his speech. While discussing the U.S. economy and its auto industry, Mr. Trump promised to place tariffs on cars manufactured abroad if he won in November. He added: “Now, if I don’t get elected, it’s going to be a blood bath for the whole — that’s going to be the least of it. It’s going to be a blood bath for the country.”

For nearly 90 minutes outside the Dayton International Airport in Vandalia, Ohio, Mr. Trump delivered a discursive speech, replete with attacks and caustic rhetoric. He noted several times that he was having difficulty reading the teleprompter.

The former president opened his speech by praising the people serving sentences in connection with the Jan. 6, 2021, riot at the Capitol. Mr. Trump, who faces criminal charges tied to his efforts to overturn his election loss, called them “hostages” and “unbelievable patriots,” commended their spirit and vowed to help them if elected in November. He also repeated his false claims that the 2020 election was stolen, which have been discredited by a mountain of evidence .

If he did not win this year’s presidential election, Mr. Trump said, “I don’t think you’re going to have another election, or certainly not an election that’s meaningful.”

Mr. Trump also stoked fears about the influx of migrants coming into the United States at the southern border. As he did during his successful campaign in 2016, Mr. Trump used incendiary and dehumanizing language to cast many migrants as threats to American citizens.

He asserted, without evidence, that other countries were emptying their prisons of “young people” and sending them across the border. “I don’t know if you call them ‘people,’ in some cases,” he said. “They’re not people, in my opinion.” He later referred to them as “animals.”

Border officials, including some who worked in the Trump administration, have said that most migrants who cross the border are members of vulnerable families fleeing violence and poverty, and available data does not support the idea that migrants are spurring increases in crime.

Mr. Trump mentioned Bernie Moreno, his preferred Senate candidate in Ohio and a former car dealer from Cleveland, only sparingly. Though he has Mr. Trump’s endorsement, Mr. Moreno, whose super PAC hosted Saturday’s event, has struggled to separate himself in a heated Republican primary contest to face Senator Sherrod Brown, Democrat of Ohio, this fall. Mr. Trump was redirected from a planned trip to Arizona to appear with Mr. Moreno as a last-minute push.

Mr. Trump issued vulgar and derogatory remarks about a number of Democrats, including ones he often targets, like Mr. Biden and Fani Willis, the Atlanta prosecutor overseeing his criminal case in Georgia, as well as those widely viewed as prospective future presidential candidates, such as Gov. Gavin Newsom of California and Gov. J.B. Pritzker of Illinois.

Mr. Trump called Mr. Biden a “stupid president” several times and at one point referred to him as a “dumb son of a — ” before trailing off. He also compared Ms. Willis’s first name to a vulgarity, called Mr. Newsom “Gavin New-scum” and took jabs at Mr. Pritzker’s physical appearance.

The Biden campaign issued a statement after the event claiming that Mr. Trump’s comments doubled “down on threats of political violence.”

“He wants another January 6, but the American people are going to give him another electoral defeat this November because they continue to reject his extremism, his affection for violence, and his thirst for revenge,” said James Singer, a spokesman for the Biden campaign.

Steven Cheung, a spokesman for Mr. Trump, clarified that Mr. Trump was talking about the auto industry and the economy, not political violence, and wrote in a statement that “Crooked Joe Biden and his campaign are engaging in deceptively, out-of-context editing.”

Mr. Trump’s sharp words were not reserved for national politicians: He briefly took aim at one of Mr. Moreno’s primary opponents, Matt Dolan, a wealthy Ohio state senator who has been surging in recent polls. Returning to his prepared remarks, Mr. Trump said he did not know Mr. Dolan but depicted him as “trying to become the next Mitt Romney.”

“My attitude is anybody who changes the name from the Cleveland Indians to the Cleveland Guardians should not be a senator,” Mr. Trump said, referring to the professional baseball team that Mr. Dolan’s family holds a majority stake in.

When Mr. Moreno was briefly called back onstage toward the end of Mr. Trump’s remarks, he praised the former president as a “good man.” But Mr. Moreno did not explicitly remind the crowd to support him in his Senate bid on Tuesday. Mr. Trump, for his part, said Mr. Moreno was a “fantastic guy.”

Mr. Trump’s campaign speeches generally swing between scripted remarks and seemingly off-the-cuff digressions. On Saturday, he acknowledged struggling to read the teleprompter as he tried to quote statistics on inflation.

“Everything is up: Chicken’s up, bread is up and I can’t read this damn teleprompter,” Mr. Trump said. “This sucker is moving around. It’s like reading a moving flag in a 35-mile-an-hour wind.”

Then, Mr. Trump, who before his presidency was known in New York for refusing to pay his bills to a wide range of service providers, joked about not paying the teleprompter company.

“Then they say Trump’s a bad guy, because I’ll say this: Don’t pay the teleprompter company,” he said as the crowd laughed. “Don’t pay.”

Anjali Huynh , a member of the 2023-24 Times Fellowship class based in New York, covers national politics, the 2024 presidential campaign and other elections. More about Anjali Huynh

Michael Gold is a political correspondent for The Times covering the campaigns of Donald J. Trump and other candidates in the 2024 presidential elections. More about Michael Gold

Our Coverage of the 2024 Elections

Presidential Race

Barack Obama and Bill Clinton will campaign alongside President Biden at a fund-raiser in New York , in an effort to amplify a message of Biden’s legislative achievements .

Trump Media, now publicly traded, could present new conflicts of interest  in a second Trump term.

Donald Trump cast Robert F. Kennedy Jr.  as a liberal democrat  in disguise  while also seeming to back the independent presidential candidate as a spoiler for the Biden campaign.

Other Key Races

Tammy Murphy, New Jersey’s first lady, abruptly ended her bid for U.S. Senate, a campaign flop that reflected intense national frustration with politics as usual .

Kari Lake, a Trump acolyte running for Senate in Arizona, is struggling to walk away from the controversial positions  that have turned off independents and alienated establishment Republicans.

Ohio will almost certainly go for Trump this November. Senator Sherrod Brown, the last Democrat holding statewide office, will need to defy the gravity of the presidential contest  to win a fourth term.

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Ask Amy: My grown sons don’t get along and it affects my grandchildren

• Published: Mar. 28, 2024, 3:09 a.m.

Amy Dickinson writes the syndicated Ask Amy column. Tribune Content Agency

• Amy Dickinson

Dear Amy: My two sons are not speaking to one another, after a fight that occurred during Christmas two years ago.

The result is that my granddaughters don’t like their uncle and aunt. The three girls are 11, 9, and 6.

While sleeping overnight at my house last weekend, I told my granddaughters that I love both of my sons equally. They started to cry.

The next day I met with their parents in a coffee shop and apologized.

I explained that I didn’t mean to offend anyone and asked for forgiveness.

I thought that they had forgiven me until recently when my son said that the oldest daughter (in fifth grade) is scarred. He claims that I screamed at her and that she now needs therapy.

He asked me to go to therapy, as well.

I asked my sons to forgive one another and to move forward so that our family can be back to normal. They declined.

Is there anything we can do to solve this?

– Unforgiven Grandmother

Dear Unforgiven: The old phrase, “This will end in tears” perfectly describes the lasting impact of this long-ago fight.

I’m going to assume that you are likely leaving out many details in your narrative, including important context. This forces me to speculate.

You told your three young granddaughters that you love both of your sons equally.

This is an innocuous and laudable statement. But I wonder if this statement came at the tail end of a larger discussion, and if so, why you were discussing this issue with these girls in the first place.

Children are extremely curious about relationships, and they will sometimes ask leading questions, but will then feel overwhelmed – or cornered – by the response. (This might explain why all three started to cry.)

Perhaps your granddaughters asked you to talk about their dad and their uncle’s relationship, expressing curiosity about the fight that led to the estrangement.

The eldest daughter might have disturbing memories of this Christmastime fight, and the conversation brought up some unresolved trauma.

An alternative explanation is that their dad is trying to box you into a corner by attempting to control the narrative.

And while you are minimizing this girl’s reaction by inference (as well as the suggestion that she now needs therapy), a skilled therapist could help the entire family to confront the larger challenge.

I hope you will find a way to cooperate, without letting your son completely control you. You should express your willingness to see a therapist, especially if he will join you.

You can email Amy Dickinson at [email protected] or send a letter to Ask Amy, P.O. Box 194, Freeville, NY 13068. You can also follow her on Twitter @askingamy or Facebook .

©2024 Amy Dickinson. Distributed by Tribune Content Agency, LLC.

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Book of Donald: Trump hawks special ‘God Bless the USA’ Bibles for $60

Former president sells Trump-endorsed Bible in concert with Lee Greenwood, country singer whose music is played at his rallies

Patriotic, prayerful and rightwing Americans are being offered the chance to purchase – for a mere $59.99 – a Bible endorsed by Donald Trump , in the latest example of the former US president touting wares to the American public.

In a post to his Truth Social platform on Tuesday, the current presumptive Republican nominee and 88-times charged criminal defendant said : “Happy Holy Week! Let’s Make America Pray Again. As we lead into Good Friday and Easter, I encourage you to get a copy of the God Bless the USA Bible.”

In an accompanying video message, Trump said : “I’m proud to be partnering with my very good friend Lee Greenwood – who doesn’t love his song God Bless the USA? – in connection with promoting the God Bless the USA Bible.”

Greenwood, a country singer whose signature tune is played at Trump rallies, is offering the Bibles for sale through a website, GodBlessTheUSABible.com.

The site features a picture of Trump smiling broadly and holding a Bible in front of his red-and-white-striped club tie. The cover of the Bible is embossed with the words “Holy Bible” and “God Bless the USA” and a design based on the US flag.

Greenwood’s website says the Bible is the only one endorsed by Trump, counsels buyers on what to do if their Bible has “sticky pages”, and answers the important question on many peoples’ minds: “Is any of the money from this Bible going to the Donald J Trump campaign for president?”

“No,” the site says. “GodBlessTheUSABible.com is not political and has nothing to do with any political campaign. GodBlessTheUSABible.com is not owned, managed or controlled by Donald J Trump, the Trump Organization, CIC Ventures LLC or any of their respective principals or affiliates.

“GodBlessTheUSABible.com uses Donald J Trump’s name, likeness and image under paid license from CIC Ventures LLC, which license may be terminated or revoked according to its terms.”

CIC Ventures was established in 2021 by a former Trump aide and a Trump-linked lawyer in Palm Beach, Florida, where Trump has lived since leaving power. Its principal address is that of Trump International Golf Club. The company has also been involved in Trump-themed money making schemes including digital training cards and gold sneakers.

Given Trump’s status as a thrice-married legally adjudicated rapist and billionaire New York property magnate nonetheless dependent on evangelical Christian support , his true relationship with and knowledge of the Bible has long been a subject of speculation.

In June 2020, towards the end of his presidency, he memorably marched out of the White House, across a square violently cleared of protesters for racial justice, and posed outside the historic St John’s church while holding a Bible in the air.

A reporter asked: “Is that your Bible?”

Trump said: “It’s a Bible.”

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In his video on Tuesday, Trump said: “Religion and Christianity are the biggest things missing from this country and I truly believe that we need to bring them back and we have to bring them back fast. I think it’s one of the biggest problems we have. That’s why our country is going haywire. We’ve lost religion in our country. All Americans need a Bible in their home, and I have many.”

In response, Gregory Minchak, of the anti-Trump Lincoln Project, commented : “There’s not a cross nor a picture of Jesus on the page, but plenty of photos of Trump. Who do you think this $60 Bible is for? It sure isn’t for Jesus.”

Sarafina Chitika, a senior Biden campaign spokesperson, issued a stinging statement.

“The last time the American people saw Donald Trump hold up a Bible,” she said, “it was for a photo op after he teargassed American citizens demonstrating against white supremacy.

“He can’t be bothered to leave Mar-a-Lago to meet with actual voters, but found the time to hawk bootleg sneakers, sell cheap perfume and promote his ‘new’ product to line his own pockets.

“It’s classic Donald Trump – a fraud who has spent his life scamming people and his presidency screwing over the middle class and cutting taxes for his rich friends.”

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