When it makes sense to look for a speech therapist
Not every child who swaps sounds, starts speaking late, or has trouble swallowing needs speech therapy, but there are signs that make an assessment worthwhile. It can be helpful to seek support when a child is hard to understand, replaces many sounds after the expected age, stutters persistently, chokes or coughs frequently while eating, has a very hoarse voice for weeks, or shows difficulties with feeding and chewing.
It is also worth asking for an assessment if parents, nursery staff, or teachers notice that the child has difficulty following instructions, building sentences, learning rhymes, linking sounds to letters, or taking part in school activities because of language difficulties. The earlier the issue is clarified, the easier it may be to respond appropriately.
In Portugal, a speech therapist is the health professional who assesses and works in the areas of communication, language, speech, voice, fluency, reading, writing, and swallowing. The key point is that this is not just about “teaching a child to speak”, but about helping them communicate better in daily life.
What training should a speech therapist have?
When choosing a speech therapist, the first thing to confirm is their basic qualification. In Portugal, the professional should have a degree in Speech Therapy or an equivalent recognised qualification. This profession is part of the health therapy field and requires specific technical knowledge about child development, communication, and swallowing.
It is a good idea to ask whether the therapist is registered with the professional association in the field, whether they work in a clinic, school, or hospital setting, and whether they have experience with the child’s specific issue. A therapist can be highly competent while still having more practice in certain areas, such as language delay, speech sound disorders, stuttering, reading and writing difficulties, paediatric feeding, or complex developmental needs.
It is also fair to ask about additional training. Some therapists specialise further in areas such as orofacial motricity, early intervention, autism spectrum disorders, dysphagia, augmentative and alternative communication, or school-age intervention. Ongoing training is a good sign, as long as it is linked to real needs and not miracle promises.
What to check before booking sessions
Before moving forward, try to understand whether the therapist offers a structured first assessment. A good assessment usually includes a conversation with the family, observation of the child, a developmental history, and, if needed, contact with the school or other health professionals. The goal is not to label the child quickly, but to understand the problem and the context in which it appears.
Look for a few positive signs: the therapist explains clearly what they are observing, listens to the family’s concerns, does not promise immediate results, adapts their language to the child’s age, and is open to working together with parents and caregivers. Trust matters a great deal, because speech therapy depends on consistency and participation at home.
If the professional dismisses concerns, criticises the child or family, promises a quick “cure”, or recommends approaches without explaining the reasoning, caution is advised. Serious interventions are usually transparent, individualised, and focused on concrete goals.
Questions to ask in the first appointment
Bringing a few questions can help you choose a speech therapist more confidently. You may ask:
- What assessment will be done and how long will it take?
- What possible difficulties are you considering?
- What are the priority goals for my child?
- How many sessions do you recommend and how often?
- What can I do at home between sessions?
- How will we measure progress?
- When should we review the plan?
These questions show whether the professional works in a structured way and can turn the initial concern into a practical plan. A clear answer does not need to be overly technical, but it should be enough for the family to understand the path ahead.
How to set realistic goals
Goals should be specific, observable, and appropriate for the child’s age. Instead of saying only “I want them to speak better”, it is better to define goals such as increasing speech clarity in certain situations, expanding vocabulary, improving sentence structure, reducing choking episodes, or building confidence to speak in the classroom.
In a good therapy plan, goals are divided into stages. For example, with a young child, the initial focus may be shared attention, communicative intent, and understanding. For a school-age child, work may involve speech sounds, storytelling, phonological awareness, or reading. For a teenager, goals may relate to articulation, voice, fluency, or the social impact of communication.
It is important that the goals are explained to the family in simple language. When parents understand the “why”, they can collaborate more effectively and support the work at home without turning everything into pressure.
What good follow-up should look like
Follow-up is not limited to the weekly session. Ideally, there is a plan with regular progress review, exercise adjustment, and communication with the family. In many cases, progress depends as much on what happens in the clinic as on the opportunities for practice in everyday life.
A careful speech therapist will usually suggest short exercises, meal-time strategies, language games, shared reading, listening activities, or ways to support the child in daily routines. There is no need for lots of tasks; the goal is to build small practices into real life.
It is also useful to know whether the professional tracks progress over time. This may be done through clinical observation, recordings with permission, goal checklists, or periodic reports. The essential thing is to have clear information that shows whether the intervention is working.
The family’s role in progress
Parents and caregivers play a central role, not as “teachers at home” but as partners in the process. Children learn more when language is encouraged in natural situations: playing, chatting in the car, packing the school bag, cooking, reading stories, or going shopping. The therapist can guide the family on how to repeat, expand phrases, allow response time, or reinforce communication behaviours.
It is important to keep expectations realistic. Some difficulties improve quickly; others require months of follow-up. There are also situations where progress is slower because of other associated conditions, such as learning difficulties, hearing changes, global developmental delay, or neurodevelopmental disorders.
The family should feel able to ask questions, express doubts, and request adjustments. If something is not working, it should be discussed. Speech therapy is a collaborative process, not a closed solution.
When to ask for a second opinion
Asking for a second opinion does not mean you lack trust. It can be a sensible decision when the initial explanation is unclear, when the goals seem unsuitable, when the child does not seem well supported, or when progress does not match expectations after some time in therapy.
A second opinion can be especially useful in more complex cases, such as uncertainty between several possible causes, feeding with aspiration risk, major voice changes, marked language delay, or suspected learning difficulties linked to communication issues. In these situations, it may be necessary to coordinate with a paediatrician, ENT specialist, neurodevelopmental paediatrician, psychologist, nursery educator, or teacher.
Private care, school support, or public services
In Portugal, speech therapy may be available in private practice, in schools, in clinics, in hospitals, or through referral to public services, depending on the situation. The important thing is to understand how follow-up will continue and who is coordinating the plan.
In the public system, access may depend on medical assessment, referral, and local availability. In private care, appointments are usually quicker to arrange, but it is essential to confirm credentials and plan for costs and frequency. In a school setting, support may be coordinated with the educational team, especially when difficulties affect learning.
Whatever the setting, the focus should be the same: a proper assessment, clear goals, consistent follow-up, and open communication with the family.
How to tell if it is working
Signs of progress vary from case to case. The child may become easier to understand, use more words, speak with more confidence, improve eating, reduce choking episodes, organise sentences better, take part more in school, or show less frustration when communicating.
Progress is not always linear. There may be weeks when it seems nothing has changed and then sudden visible gains. The most important thing is to look at trends over time rather than a single day.
If, after a reasonable period, there is no explanation of how things are going, if the goals are never reviewed, or if the family leaves every session without understanding what is being done, that deserves a conversation. Transparency is part of good follow-up.
Common mistakes to avoid
There are a few common mistakes when choosing a speech therapist. The first is deciding based only on price or proximity without confirming training and experience. Another mistake is waiting too long, especially when the difficulty is already affecting communication, school, or feeding.
It also does not help to compare a child rigidly with siblings, classmates, or “the right age”. Every child develops at their own pace, but that does not mean persistent signs should be ignored. The balance is between observing calmly and acting when needed.
Finally, do not expect magic solutions. Serious intervention requires assessment, patience, practice, and review. This is especially true for young children, complex difficulties, and contexts with other developmental needs.
Conclusion
Choosing a speech therapist is about more than finding someone who offers sessions. It is about choosing a professional with the right training, experience in the right area, the ability to communicate clearly, and the willingness to work as a team with the family. When goals are well defined and follow-up is consistent, the child has a better chance of developing communication with confidence.
If you have doubts, ask for an assessment and request simple, concrete explanations. A good speech therapist should help the family understand the problem, the plan, and the next steps. That brings reassurance, reduces anxiety, and improves the chances of progress.
Note: this article is for informational purposes only and does not replace an individual clinical assessment.
FAQ
At what age can a child see a speech therapist?
There is no fixed minimum age. In some cases, an assessment can be useful very early, especially when there is language delay, feeding difficulties, or questions about communication development.
How many sessions are needed?
It depends on the difficulty, the child’s age, the recommended frequency, and how the child responds. Some situations need short-term follow-up; others require longer-term intervention.
Does the speech therapist give exercises for home?
Often yes. Exercises are usually simple and built into the daily routine, to help generalise what is practised in sessions.
If the child does not want to cooperate, does therapy not work?
Not necessarily. The therapist should adapt the approach to the child’s age and profile. In many cases, working through play, relationship, and meaningful activities increases participation.
Useful sources
For institutional information and guidance in Portugal, you can consult the Directorate-General of Health, the National Health Service, and the professional association in the field.
