When to Take Your Child to the SLP

If you are concerned about your child’s speech, language, communication, feeding, or swallowing, it can be hard to know where to start. Maybe your child is hard to understand, has trouble following directions, struggles during meals, or just isn’t communicating in the ways you expected for their age. Speech-language pathologists, often called SLPs or speech therapists, evaluate and treat many of these needs.

SLP's may work with children who have speech or language delays, autism, ADHD-related communication challenges, childhood apraxia of speech, feeding and swallowing disorders, stuttering, brain injury, cerebral palsy, Down syndrome, selective mutism, learning-related language needs, and other conditions that affect communication or feeding.

This guide is designed to empower parents or caregivers with information and context to help them make better decisions about the next best steps for their child. This guide is not a substitute for medical or professional advice, but it can help you decide what questions to ask next.

Quick answer: Ask about a speech-language evaluation when your child’s speech, communication, feeding, swallowing, learning, or social participation is getting in the way of daily life. You do not need to know the diagnosis first. For choking, breathing trouble during meals, sudden changes in communication, or changes after a head injury, contact a medical provider promptly.

What Kinds of Concerns Can SLPs Help With?

You may be most familiar with speech language pathology, or speech therapy, in relation to speech - stuttering or pronunciation concerns, or in relation to support for autistic children. And while those are common areas SLPs treat clients, they can help across a wide range of communication difficulties. An SLP may help a child communicate more clearly, understand and use language, participate socially, manage stuttering, support learning-related language skills, or eat and swallow more safely. SLPs may also support augmentative and alternative communication, or AAC, which can include gestures, signs, picture boards, communication apps, speech-generating devices, or other ways to communicate besides speech.

Children may see an SLP because of a specific diagnosis, such as ADHD or a brain injury. Others come to speech therapy because a parent, pediatrician, teacher, or caregiver has noticed a concern before any diagnosis is made.

When Should You Ask About a Speech or Language Evaluation?

You do not need to know your child’s exact diagnosis before asking for help. Many parents start with a concern they can describe plainly: “My child is hard to understand,” “mealtimes are stressful,” “my child does not seem to follow directions,” or “they know what they want to say but cannot get the words out.”

A speech-language evaluation may be worth considering when communication, feeding, swallowing, learning, social interaction, or participation at home or at school is becoming difficult. Depending on your child’s age and needs, you might start with a pediatrician, an early intervention program, a school team, or a licensed speech-language pathologist.

Some concerns should be addressed promptly. If your child coughs or chokes during meals, has breathing difficulty while eating or drinking, loses communication skills, has a sudden change after a head injury, or is no longer meeting developmental milestones, contact a medical provider or your child’s care team as soon as possible.

ASHA also offers a parent-facing guide to early signs of speech, language, swallowing, and hearing concerns. If you are unsure whether what you are seeing is typical, reviewing common early signs can help you decide what to bring up with your child’s pediatrician, school team, early intervention program, or SLP.

And remember, an evaluation does not always mean your child will need ongoing therapy. It can help clarify what is happening, whether speech therapy may help, and what supports your child may need at home, in school, or in another care setting.

Where Should Parents Start by Age?

Where to start often depends on your child’s age and the type of concern. These options are not the only paths, but they can help families take the first step.

Can My Child Get a Free or Reduced-Cost Evaluation?

Many families have public evaluation options, but the right place to start often depends on the child’s age and needs.

• If your child is an infant or toddler, your state's early intervention program may be a good first step. These programs help families connect with evaluation and support services for young children who may have developmental delays.
• For preschool and school-age children, families can ask their local school district about evaluation options under IDEA. A school evaluation can help determine whether a child qualifies for special education or related services, which may include speech-language support.
• Families who are unsure where to begin can also contact a Parent Training and Information Center. These centers help parents understand disability services, school evaluation rights, and the questions to ask when seeking support.

What Happens During a Speech-Language Evaluation?

A speech-language evaluation usually starts with your concerns and your child’s history. The SLP may ask about development, hearing, medical history, school concerns, feeding, behavior during communication, and what your child can do at home or in other settings.

Because hearing can affect speech and language development, the SLP or your child’s pediatrician may also recommend a hearing screening or audiology evaluation. This may be especially important if your child has frequent ear infections, does not respond consistently to sound, has unclear speech, or seems delayed in understanding or using language. The National Institute on Deafness and Other Communication Disorders provides more information about the connection among speech, language, and hearing development.

The evaluation may include play-based observation, conversation, parent or caregiver questions, formal testing, speech-sound tasks, language activities, oral-motor or feeding observations, or a review of school and medical information. Afterward, the SLP should explain what they found, whether therapy or monitoring is recommended, and whether another provider should be involved.

For a closer look at the evaluation process, read our guide on what to expect during the initial SLP assessment.

Should Parents Talk With Their Pediatrician, Too?

A pediatrician can be a helpful starting point, especially when you are not sure whether the concern is related to speech, hearing, development, feeding, behavior, or another health issue. Developmental screening may be recommended when a parent or clinician has a concern, and it can look at several areas of development, including communication, problem-solving, social-emotional skills, and movement.

You can still ask about speech-language support even if you are waiting for a pediatric appointment, school evaluation, or specialist visit. For many families, the first step is simply to document the concern and ask which evaluation pathway best fits the child’s age and needs.

Common Reasons Children May See a Speech-Language Pathologist

As a parent, it can be hard to know which concerns are part of typical development and which ones are worth asking about. Maybe your child is not using as many words as other children their age, is hard to understand, has trouble following directions, avoids speaking in certain situations, or struggles during meals.

The concerns below are grouped so you can start with the one that best describes your child. Speech, language, learning, feeding, and social communication are closely connected, so one concern may touch several areas of a child’s life. Use these groupings as a starting point, not as a diagnosis.

Communication rarely fits into one neat box. Speech, language, learning, feeding, and social interaction often overlap, especially when a child has multiple concerns or an existing diagnosis. These groupings are here to help you find the most relevant starting point, not to sort your child into a category.

Speech Sounds, Stuttering, and Voice

Have you noticed that your child is hard to understand, even for people who know them well? Do they repeat sounds, get stuck on words, or seem frustrated when trying to talk? Does their voice sound hoarse, strained, very soft, unusually nasal, or different from how it used to?

These concerns can involve speech sounds, stuttering, voice, or the movement of the mouth, tongue, lips, and jaw during speech. Some children know what they want to say but have trouble making the words come out clearly or smoothly. An SLP can help identify what is affecting your child’s speech and whether therapy, home strategies, or another type of evaluation may be helpful.

Language, Learning, and Classroom Communication

Have you noticed that your child has trouble following directions, answering questions, or finding the words they want to use? Do they have a hard time telling you what happened at school, retelling a story, learning new words, or keeping up with reading and writing tasks?

Language skills affect more than talking. They shape how a child learns, participates, plays, and connects with others. An SLP can evaluate how your child understands and uses language, then recommend support that fits their age, needs, and school or home routines.

If your child uses more than one language, share that with the evaluator. Children may show different strengths across the languages they hear and use, and an evaluation should consider the child’s full language background. Families should not be told to stop using a home language without a clear clinical reason; the goal is to understand and support the child’s communication across daily life. You can also seek support from a bilingual or multilingual SLP, also known as a Multilingual Service Provider.

Social Communication and Speaking in Certain Settings

Have you noticed that your child has trouble joining play, taking turns in conversation, using gestures, or understanding how others are feeling? Do they speak freely at home but become very quiet at school, with unfamiliar people, or in certain social situations?

Social communication concerns can show up in different ways. Some children want to connect with others but have trouble knowing how to join in, ask questions, respond, or understand social cues. Others may speak comfortably in one setting but not another. These concerns may overlap with autism, ADHD, anxiety, selective mutism, language disorders, or other developmental and emotional needs.

If your child has an autism diagnosis or you are wondering whether autism may be part of the picture, see the section on Support Related to Medical or Developmental Conditions below. This section focuses on speaking and social communication patterns parents may notice across everyday situations.

Feeding and Swallowing Concerns

Have you noticed that meals are stressful for your child or your family? Does your child cough, choke, gag, refuse many foods, take a long time to eat, have trouble chewing, or seem uncomfortable while eating or drinking?

Feeding and swallowing concerns can occur on their own or alongside other medical, sensory, developmental, or neurological conditions. Because eating and drinking involve comfort, nutrition, hydration, and safety, this section focuses on feeding and swallowing as direct reasons to ask for help.

An SLP may help evaluate how your child eats, drinks, chews, and swallows, then recommend strategies or therapy to support safer, more comfortable feeding. If your child has breathing difficulty during meals, coughs or chokes often, loses weight, becomes dehydrated, or has a sudden change in eating or swallowing, contact a medical provider promptly.

Support Related to Medical or Developmental Conditions

Does your child have a medical, developmental, genetic, or neurological condition that affects how they communicate, eat, learn, or participate at home or school? Are you trying to understand whether speech therapy could help with clearer speech, language development, feeding, swallowing, AAC, social communication, executive-function support, or classroom participation?

Some diagnoses touch several areas at once. For example, a child with autism may need support with social communication, language, AAC, feeding, or school participation. A child with ADHD may need support with listening, organization, storytelling, social communication, or classroom language demands. A child with cerebral palsy may need help with speech clarity, swallowing, or communication tools. A child with Down syndrome may need support with hearing-related communication, early language, feeding, and speech clarity.

This section is organized by condition because parents may already have a diagnosis or may be looking for resources related to one. The speech, language, feeding, swallowing, and social communication sections above may still be useful, since SLP-related needs often overlap.

Who Can Evaluate or Diagnose My Child?

Depending on the concern, assessment and diagnosis may involve SLPs, physicians, psychologists, and other qualified professionals. The first step is often not a final diagnosis; it is getting the right evaluation started.

• Brain injury-related conditions (e.g., aphasia, dysarthria) are typically diagnosed in coordination with a physician and other specialists; SLPs assess communication and swallowing and provide treatment.
• ADHD is typically diagnosed by a qualified health professional, such as a pediatrician, psychiatrist, or psychologist. An SLP may evaluate communication, language, executive-function-related communication, or school participation needs.
• Orofacial myofunctional disorders may be identified by an SLP and/or dental professionals; evaluation and treatment often involve collaboration.
• Selective mutism is often diagnosed by a behavioral health professional; an SLP may assess communication and collaborate on treatment.
• Autism diagnoses are typically made by qualified professionals such as developmental pediatricians, psychologists, psychiatrists, or neurologists; SLPs often contribute to the assessment of communication and social interaction.

If you need to find an SLP, the ASHA ProFind directory can help you locate certified professionals.

Where Can Speech Therapy Take Place?

If your child has communication, feeding, swallowing, or learning-related needs, there are many therapy options available. You will receive recommendations for next steps after an evaluation, but here are some common settings where speech therapy takes place:

• Early intervention or home-based services: Some infants and toddlers receive services through a state early intervention program, which may occur in the home or another natural environment.
• School: Most schools have one or several speech-language pathologists on staff who can work with your child one-on-one or in small groups. They may also collaborate with teachers to support access to the curriculum.
• Private practice: Many SLPs work in private practices or clinics. These SLPs can work with your child outside of school hours, and some have specialties that closely fit your child’s needs.
• Hospital or rehabilitation setting: Children with medical, neurological, feeding, swallowing, or injury-related needs may receive speech therapy as part of a larger medical or rehabilitation plan.
• Telepractice: Some children may receive speech therapy online when clinically appropriate and allowed by the provider’s license, state rules, school policies, or payer requirements.

No matter where speech sessions take place, your participation matters. Work with your child’s SLP to determine how to support practice at home between sessions.

What Can Parents Do While Waiting for an Evaluation?

While you wait, keep the pressure low and the opportunities for communication frequent. Talk during everyday routines, read together, describe what your child is doing, offer choices, model short phrases, and give your child time to respond. For feeding or swallowing concerns, follow medical guidance and avoid trying new strategies that could affect safety unless a qualified provider recommends them.

If you are waiting for an appointment or services to begin, CDC has a family resource with steps you can take while you wait. You can also keep notes about what you notice, gather school or medical information, and write down the questions you want to ask during the evaluation.

It can also help to write down what you notice: when the concern happens, what makes it better or harder, what your child can do comfortably, and what you want the evaluator to understand. These notes can make the first appointment more useful.

Helpful Speech Therapy and Communication Resources for Parents

If you are trying to figure out what to do next, it can help to have the most useful resources in one place. The links below include milestone guides, evaluation options, school and early intervention resources, condition-specific information, and tools for finding an SLP.

If You Are Wondering Whether to Ask for Help

• ASHA early signs of speech, language, swallowing, and hearing concerns — Helps parents recognize possible signs of speech, language, feeding, swallowing, voice, fluency, and hearing concerns.
• ASHA developmental milestones and handouts — Offers age-based milestone handouts for communication and feeding/swallowing, including family-friendly materials.
• NIDCD speech and language developmental milestones — Explains how speech, language, and hearing are connected and why hearing may be considered during evaluation.
• CDC: Concerned About Your Child’s Development? — Explains what families can do if they are worried about development and where to ask for evaluation help.

If You Need Evaluation or Service Options

• CDC early intervention contacts by state — Helps families find state early intervention contacts for infants and toddlers who may have developmental delays or disabilities.
• PACER guide to the special education evaluation process — Parent-friendly guidance on how school evaluations work, how parents can request one, and what may happen after a child is evaluated.
• Find your Parent Training and Information Center — Connects families with state parent centers that help explain disability services, school evaluations, and family rights.
• ASHA ProFind — Lets families search for ASHA-certified speech-language pathologists and audiologists.
• What to expect during the initial SLP assessment — Explains what families may experience during a first speech-language evaluation.
• CDC: What to do while you wait to see a developmental specialist — Gives practical steps families can take while waiting for an appointment, evaluation, or services.

If Your Child Needs Help Communicating

• ASHA AAC guidance — Explains augmentative and alternative communication, including low-tech and high-tech options for children who need another way to communicate.
• ASHA multilingual service delivery guidance — Explains why speech-language evaluations and services should consider the child’s full language background.

If You Want to Learn About Speech, Fluency, or Oral-Motor Concerns

• ASHA childhood apraxia of speech — Explains childhood apraxia of speech, possible signs, and how SLPs may help.
• Apraxia Kids — Offers education, community resources, and support for families learning about childhood apraxia of speech.
• ASHA stuttering resources — Explains stuttering, possible signs, and ways SLPs may support children who stutter.
• The Stuttering Foundation — Offers parent-friendly information, videos, and resources about stuttering.
• ASHA orofacial myofunctional disorders — Explains tongue, lip, jaw, and facial movement patterns that may affect speech, swallowing, or dental development.
• International Association of Orofacial Myology — Provides information about orofacial myofunctional disorders and related professional support.

If You Want to Learn About Language, Learning, or Classroom Communication

• ASHA childhood spoken language disorders — Explains receptive and expressive language difficulties and how they may affect communication and learning.
• ASHA: What Is Speech? What Is Language? — Gives parents a simple explanation of the difference between speech and language.
• ASHA learning disabilities — Explains how learning disabilities may affect listening, speaking, reading, writing, spelling, reasoning, and math.
• Learning Disabilities Association of America — Offers education and support for families navigating learning disabilities.

If Your Child Has Social Communication or Speaking Concerns

• ASHA social communication resources — Explains how children use language socially, including taking turns, staying on topic, using gestures, adjusting communication for different settings, and understanding social cues.
• ASHA selective mutism resources — Explains selective mutism and how SLPs may collaborate with families, schools, and behavioral health providers.
• Selective Mutism Association — Offers family education and resources for children who speak in some settings but not others.

If Your Child Has Feeding or Swallowing Concerns

• ASHA feeding and swallowing disorders in children — Explains possible signs of pediatric feeding and swallowing disorders and when families should seek help.
• Children’s Health pediatric swallowing and feeding disorders — Provides parent-facing information about pediatric swallowing and feeding disorders, symptoms, diagnosis, possible causes, and treatment.

If Your Child Has a Medical or Developmental Condition

• ASHA ADHD resources — Explains how ADHD may affect communication, attention, executive function, learning, and social interaction.
• NIMH ADHD information — Provides federal health information about ADHD symptoms, diagnosis, treatment, and related concerns.
• CDC ADHD in the classroom — Explains how families, educators, and healthcare providers can support children with ADHD in school.
• ASHA autism resources — Explains how autism may affect communication, social interaction, behavior, feeding, and learning.
• Down Syndrome Resource Foundation speech resources — Explains speech development, intelligibility, AAC, and communication support for children and students with Down syndrome.
• Down Syndrome Education International parent guide to speech, language, and communication — Offers parent-focused guidance to support speech, language, and communication in children with Down syndrome.
• ASHA AAC for a child with cerebral palsy — Shows how AAC goals for a child with cerebral palsy can support participation, family priorities, and everyday communication.
• CerebralPalsy.org communication and AAC resources — Explains communication support and AAC options for people with cerebral palsy.
• ASHA aphasia resources — Explains how aphasia can affect understanding, speaking, reading, and writing.
• ASHA dysarthria resources — Explains how muscle weakness or movement difficulty can affect speech clarity.
• Brain Injury Association of America — Offers information and community resources for families affected by brain injury.
• National Aphasia Association — Offers education, support, and resources for people with aphasia and their families.