How Does Speech Therapy Work for 4-Year-Olds?

If you’re considering speech therapy for your 4-year-old, or you’ve been told they need speech therapy, you probably have some questions. What will sessions look like? How long will  therapy take? Here’s everything you need to know about speech therapy for 4-year-olds.

What do 4-year-olds receive speech therapy for?

Speech therapy treats a range of issues in people of all ages, from babies to older adults. But for preschoolers, there are a couple main reasons they may receive services.

1 Language disorders

Language disorders can affect two types of language. One is receptive language–the words a child is able to understand. The other is expressive language, which is the words, grammar, and even nonverbal communication a child is able to use to communicate what they need.

If a child isn’t understanding vocabulary and key concepts, like being able to follow multi-step directions easily or understand words in sentences spoken to them, they may have a receptive language delay and need speech therapy. Children can also have an expressive language delay. This means they have a hard time using words, phrases, and sentences to clearly express their wants and needs. If a 4-year-old isn’t speaking yet, or isn’t speaking in full sentences, they may need speech therapy to help grow their communication abilities.

2 Speech sound disorders

Articulation treatment for speech sound disorders is another reason 4-year-olds may receive speech therapy. It’s normal for children to have some errors as they try to produce all the sounds in their spoken language. However, as a child grows, they should be able to pronounce more and more sounds correctly. If they have too many speech errors, they may need speech therapy to help their speech sound clearer and easier to understand.

3 Stuttering

4-year-olds may also receive therapy for fluency problems, or stuttering. Fluency refers to the smoothness of a person’s speech. If you notice that your child repeats sounds or words often, or seems to pause as if they’re frozen and can’t get any sound out, this can be a sign of stuttering and speech treatment is likely needed.

How do you know if your 4-year-old needs speech therapy?

The best way to know if your preschooler should have a speech and language evaluation is to look at the milestones children should reach during their fourth year. If your child isn’t gaining these abilities at the age of 4, it may be a sign they need speech therapy.

Receptive and expressive language milestones for 4-year-olds:
  • Follows multi-step directions (3 to 4 steps) without needing them repeated (example: “Take your shoes off, leave them by the back door, and go wash your hands”)

  • Understands time-based concepts and words like yesterday, today, tomorrow

  • Describes their emotions and feelings

  • Is able to understand and answer questions completely

  • Participates in a back-and-forth conversation

  • Uses mostly correct grammar and vocabulary

Articulation milestones for 4-year-olds:
  • 4-year-olds should be able to produce all speech sounds in their words and conversations correctly, although you may still hear errors on these sounds: /l/, /s/, /r/, /v/, /z,/, “sh,” “ch,” and “th.”

  • A 4-year-old’s speech should be very easy to understand, even to people they don’t speak with often.

Speech fluency milestones for 4-year-olds:
  • 4-year-olds should not have frequent sound or word repetition, such as “I w-w-w-want that.”

  • They should not appear frozen or pause in conversation as if they can’t get their words out.

  • Their speech should have a natural fluency and smoothness.

How to find a speech therapist and get an evaluation

How can you find a speech therapist near you? Just like you’d research a new doctor before making an appointment, you should do the same for your child’s speech therapist. It’s always helpful to start by asking friends or acquaintances whose children have had speech therapy if they’d recommend their experience. 

If you have health insurance, contact your plan to better understand their policies and coverage regarding speech therapy. Your health plan may have a list of in-network speech therapy providers that you can research. 

You can also speak with your child’s pediatrician. They likely have a list of local speech therapy providers that they recommend. And you may need a pediatrician referral in order to be reimbursed for speech therapy by your health insurance. 

Finally, there are several online directories where you can search speech therapists by location and qualifications. One of these directories is compiled by the American Speech-Language-Hearing Association, which is the professional credentialing organization for speech-language pathologists.

No matter how you find a speech therapist for an evaluation, make sure to read any online reviews you find! And remember, you’re in control when it comes to the final choice. It should be someone who is licensed and experienced, and who connects well with your child.

What does speech therapy for a 4-year-old look like?

Speech therapy for a 4-year-old will look a lot like playing. But your speech therapist is choosing every activity for a specific reason.

Speech therapy for a 4-year-old will look a lot like playing.

Speech therapists use toys, games, and activities that motivate a child to participate in speech therapy tasks. For example, your speech therapist may encourage your child to use a grammatically correct sentence to request the game they want. Or they may have your child say a certain number of speech sounds before taking a turn in a game or completing a step in a craft.

Your child’s speech therapist will find out what your child really enjoys, and whether it’s cats, dinosaurs, trains, or board games, they’ll work that into their speech therapy sessions. 

How long does speech therapy last? 

Families often ask, “How long will my child’s speech therapy take?” It would be great if there was just one answer, but the length of therapy is different for each unique person. 

However, there are a few things that help determine how long therapy takes. One is the child’s age. The sooner a child begins speech therapy, the sooner they begin making progress. This also decreases the risk that they will fall further behind. So if your child is recommended for therapy at age 4, it’s best to go ahead and start at that time.

Your child’s diagnosis also affects the length of therapy. Sometimes children with a developmental delay catch up quickly with the right support and intervention. With more involved diagnoses that involve neurological complications or congenital disorders, therapy may take longer.

The more you help your child practice, the more quickly they’ll progress! 

As your child’s caregiver, you have a big role to play here. The more you help your child practice, the more quickly they’ll progress! While speech therapy sessions are an essential part of your child’s improvement, so is the practice that happens at home, between sessions. Continuing to work on your child’s goals throughout the week helps reinforce what was learned in therapy. It sets your kiddo up for more success at their next session.

Best of all, you don’t need any special training, materials, or expertise. When it comes to speech and language, the world is your classroom. You can easily help your child practice during everyday activities and the time you already spend together.

As a parent or caregiver, you’re doing the right thing in learning how to support your child’s communication needs. No matter where you are in the speech therapy journey, your speech therapist is there to walk alongside you and your child. Trust your instincts, and know that you are never alone in this process.

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