What Is Speech Therapy?
Speech therapy is a treatment for speech, language, and voice disorders. During speech therapy, you or your child works with a speech-language pathologist (SLP), who teaches you how to speak more clearly, use language better, and understand what other people are saying.
"Speech therapy helps people who experience challenges with speaking, understanding language, expressing thoughts, or using communication in social situations. These difficulties can affect learning, relationships, confidence, and overall quality of life if not addressed early," explains Marisha Speights, PhD, CCC-SLP, a speech scientist and director of the Pediatric Speech Technologies and Acoustics Research Lab (PedzSTAR Lab) at Northwestern University in Evanston, Illinois.
During speech therapy sessions, an SLP teaches you or your child how to:
- Speak and pronounce words more clearly
- Use words better to communicate
- Understand language better
- Interact socially by using language correctly in conversations
- Speak more clearly after a stroke or other medical condition, or if you have a disorder like stuttering or hoarseness
- Manage eating and swallowing problems after an injury, illness, or a medical condition like a cleft lip or tongue tie
Neuroplasticity is an important concept in speech therapy. It's the brain's ability to rewire, form new connections, and adapt after damage from a stroke or other brain injury. SLPs apply the principles of neuroplasticity to help their clients recover and learn to talk again.
Who gets speech therapy?
People of all ages can be referred to speech therapy. SLPs help infants and toddlers learn how to understand and use language. "Parents are often a part of sessions at this age and are coached in techniques to use at home to help children develop functional skills such as speaking and following directions," says Liesl Hartmann, a board-certified speech-language pathologist and clinical director for Positive Development in the Washington, D.C., area.
With school-age children, SLPs address speech fluency disorders like stuttering, difficulties speaking clearly, and social skills. Speech therapy is also a treatment for autism. "Many autistic children need support in finding their voice. Some are able to speak with their mouths, while others need assistive technology [like picture boards or apps] to communicate," Hartmann says.
For adults, SLPs can help regain skills lost from a stroke, brain injury, or other medical issue. Speech therapy is also used in assisted living facilities and nursing homes. It helps people work on skills they've lost with age, such as communication and swallowing, Hartmann says.
To learn whether you or your child needs speech therapy, see a primary care doctor or other health care provider. They may send you to a specialist to be evaluated for a speech, language, or other communication disorder.
It's important to get your child help if you suspect a speech or language problem. "Waiting too long can mean missing important periods in brain development when therapy is most effective," Speights says. The earlier your child starts this treatment, the more effective it will be.
Where Do You Get Speech Therapy?
Speech therapy is available at:
- Private medical practices
- Hospitals
- Schools
- Rehabilitation centers
- Day care centers
- Assisted living facilities
- Nursing homes
- Virtual platforms
Reasons for Getting Speech Therapy
If your doctor identifies trouble with communication, a referral will be placed to a speech and language pathologist. First they'll perform an evaluation to understand and diagnose the impairment noted and make a treatment plan based on the cause.
Speech therapy is a treatment for these conditions:
Speech disorders
People with speech disorders know what they want to say, but they have trouble making the sounds or speaking clearly. This makes it hard for other people to understand them.
These are some examples of speech disorders:
Dysarthria. This is slow or slurred speech caused by damage to the muscles that control speaking. Conditions that affect the brain and nervous system, like strokes, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS), cause dysarthria.
Fluency disorders. These conditions affect the flow or rhythm of speech. People who stutter repeat certain sounds, like "b-b-b-boy," or pause while they speak. Cluttering means that you speak very fast but skip certain words or parts of words, or don't pronounce words clearly.
Articulation disorders. This is when children can't make certain sounds, so they substitute others. For example, a child might say "fwont toof" instead of "front tooth."
Language disorders
These conditions can make you less able to get the right words out and form sentences. In children, language disorders usually happen because of a hearing problem or developmental disorder. In adults, the cause is often a brain injury or disease such as a stroke. Examples of language disorders are:
Aphasia. This means you have trouble speaking, understanding language, reading, or writing. It happens when an injury like a stroke damages parts of your brain that you need to speak and process language.
Receptive language disorders. Children with these disorders have trouble understanding language. They may look like they're not paying attention because they can't follow a conversation. It's hard for children with receptive language disorders to follow spoken directions.
Expressive language disorders. With these disorders, children can't find the right words to use. As a result, they may speak in short and simple sentences. Expressive language disorders happen because of hearing loss, developmental delays, and when children aren't exposed to spoken language.
Voice disorders
These disorders can happen after an injury or illness that damages your larynx (voice box) or the tissues around it, or from overusing your voice. A voice disorder can make your voice sound:
- Breathy
- Raspy
- Creaky
- Shaky
- Strained
- High- or low-pitched
- Louder or quieter than usual
- Nasal
- Weak
- Wet
Swallowing problems
The cause of swallowing problems is usually damage to the nervous system, such as from a stroke, MS, dementia, or Parkinson's disease. An injury or growth like a tumor in the mouth or throat can also cause these problems.
Dysphagia is the medical term for swallowing problems. It can be dangerous if food becomes stuck in the throat or gets into the lungs. Swallowing issues can also make your voice hoarse and affect your ability to speak clearly.
Hearing problems
Hearing loss makes it difficult to both hear and speak clearly. Some children are born with hearing loss. Many adults develop hearing problems as they get older.
What Happens During Speech Therapy
Every speech therapy session is different. The speech therapist personalizes the treatment based on their client's diagnosis, age, abilities, and communication needs. Goals and approaches are different for each developmental stage.
"For young children, therapy often uses play-based activities to keep learning fun and engaging," says Speights. The SLP may show the child pictures or flashcards, read books with them, or use other games to help them learn how to communicate better.
"As children grow, therapy may shift focus toward supporting academic skills and preparation for adulthood. Adults working with speech-language pathologists typically focus on daily life goals, such as returning to work or improving social communication," she says.
A speech therapy session might include activities to:
- Strengthen the mouth and tongue
- Improve coordination between the brain and mouth
- Practice different speech sounds
- Build vocabulary, grammar, and word recall
- Improve swallowing and breathing
- Strengthen conversation skills
- Improve communication using sign language, communication boards, and computer-aided speech, when needed – for example, to help autistic children
Benefits of Speech Therapy
The main goal of speech therapy is to help you or your child use language better and communicate more clearly and confidently. "Speech and language skills are necessary for being able to learn in school, have positive social relationships, succeed in the workforce, live independently, and have a good quality of life," says Hartmann.
Other benefits of this treatment include:
- Higher self-esteem
- Increased independence
- Improved relationships
- Better performance in school and at work
- Being able to hear or swallow better
Takeaways
Speech therapy is a type of rehabilitation for people who need help speaking, understanding language, and improving other communication skills. It's also a treatment for hearing disorders, voice disorders, and trouble swallowing. Children, teens, and adults can benefit from speech therapy. A speech-language pathologist (SLP) will evaluate you or your child and tailor a speech therapy program that fits your abilities, needs, and goals.
Speech Therapy FAQs
How long do you need speech therapy? The length of treatment depends on your age, the type of speech disorder you have and how severe it is, and your goals. "Some people may see improvements within a few months, while others, especially those with more complex needs, may benefit from longer-term therapy," says Speights. "Starting therapy early – when concerns first arise – can often lead to faster, more lasting improvements."
Does speech therapy work? Studies have shown that speech therapy can improve language and communication skills in children and adults. How well this therapy works depends on the specific condition being treated, the type and length of treatment, and the treatment goals.
How much does speech therapy cost? The average cost of speech therapy in the United States ranges from $100 to $600 per hour. Because it can take several sessions to see an improvement, the costs can add up. For example, people with vocal cord problems in one study needed an average of four to six sessions to see positive changes.
Does insurance cover speech therapy? Medicare, Medicaid, and most private health insurance plans will pay for speech therapy if a doctor considers it medically necessary, but you may be responsible for copays. While private insurance will cover treatment for communication disorders caused by an illness or injury, getting coverage for a developmental or inherited disorder can be more difficult. Call your insurance company before starting treatment to find out what your plan covers, if there are preferred locations, and how much you'll have to pay out of pocket for speech therapy.
Can you do speech therapy at home? You can do speech therapy at home, both with an SLP and on your own. Many SLPs visit their clients at home or in a residential facility such as an assisted living center to provide treatment. The SLP may also give you exercises to practice on your own or with your child at home. Children may also receive therapy in a school setting.
What indicates a need for speech therapy? You might need speech therapy if you have a disorder that makes it hard for you to communicate. A doctor will run tests to find the cause of the problem. Based on the results of those tests, the doctor may refer you to an SLP for speech therapy.