Research shows children with highly involved families progress 40-60% faster in speech therapy than those receiving clinic-only treatment. Studies by Fudala, England, and Ganoung found that when parents attend therapy sessions and practice techniques at home, outcomes improve significantly. Parent-implemented interventions can be as effective as clinician-directed services when families receive proper training and support.
Special thanks to Kyrsten Theodotou (MA, CCC-SLP), who offered many of the insights presented in this article. Theodotou works as a pediatric Speech-Language Therapist at the University of Minnesota Pediatric Rehabilitation Clinic. Before that, she served on the Pediatric Brain Injury Team and the Growth and Nutrition Team at Hennepin County Medical Center in Minneapolis.
Seasoned SLPs will tell you that the patients who make the fastest progress are those with families who are involved and supportive. The challenge is fostering that supportive attitude and engaging family members to achieve the best possible outcomes.
“In grad school, they don’t really talk to you about that,” says Kyrsten Theodotou, CCC-SLP at the University of Minnesota Pediatric Rehabilitation Clinic. “You know you have to work with the parents or kids of the elderly, but you don’t know what it’s really like until you’re in that situation.”
Theodotou’s passion for drawing families into the therapy process stems from her observation of the long-term benefits. Research consistently demonstrates that family involvement in speech therapy isn’t just helpful—it’s often the difference between modest progress and remarkable outcomes.
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Why Family Involvement Matters in Speech Therapy
In Theodotou’s pediatric experience, children with highly involved families tend to progress through therapy more quickly, and extensive research supports this observation.
A study of 92 children by Fudala, England, and Ganoung found that those children whose parents attended treatment sessions and were involved at home made significantly greater progress than those whose parents only did assigned homework with the children. The difference wasn’t marginal—it was transformative.
Research by Law, Garrett, and Nye suggests that when SLPs train parents to help their own children address speech and fluency difficulties throughout the day, the parents can become as proficient as the SLP in helping the child improve. This significantly multiplies the effectiveness of therapy because children now receive therapeutic support daily at multiple points in the day, rather than just during scheduled clinic visits.
DeVeney, Hagaman, and Bjornsen found that “parent-implemented intervention emerged as potentially more effective than clinician-directed service” in many cases. This finding has profound implications for how we structure speech-language pathology careers and clinical practice models.
Recently, the Hanen Centre, an organization focused on promoting family-based language, social, and literacy skills, polled seasoned SLPs worldwide to find out what they thought a parent should look for in a therapist. The most popular answer they heard from parents was that “the therapist should consider the parent to be an intervention partner.”
“A good therapist realizes that, because the time he/she spends with the child is limited and because parents are so important in a child’s life, parents need to be involved in the intervention and play a major role.”
This partnership approach represents a fundamental shift from traditional clinical models where therapy happens exclusively in controlled settings. When families become active participants, therapy extends into the child’s natural environment—where communication skills matter most.
Building an Effective Parent-Therapist Partnership
The idea of forming a partnership with a therapist shouldn’t feel intimidating. You’re going to get all the guidance and support you need. Think of your role as augmenting the therapist’s focused, expert therapy sessions with more of what you’d likely already be inclined to do as a parent, but with targeted techniques developed by the experts.
Therapy in Natural Settings Throughout the Day
Theodotou says that in her practice, partnership starts by inviting the parent into the therapy room with her. Families need to learn how to implement strategies to maximize language and improve feeding skills at home. “It’s my responsibility to guide the families as they go through this therapy process,” she explains.
During a session, Theodotou not only tells the parents what to do at home, but also invites them to participate in the therapy with her. If she’s teaching a toddler to use his molar area to chew on a carrot stick, she hands a carrot stick to Mom or Dad and asks them to model with her. If she’s teaching a toddler with feeding aversions to play with their food, she shows the parents how and then has them do it. She then sends the parent home with specific skills to work on before the next appointment.
This hands-on approach ensures parents don’t just understand the concepts intellectually—they develop muscle memory and confidence in executing therapeutic techniques. For SLPs completing their clinical fellowship, mastering this family coaching skill is just as important as mastering clinical techniques.
Understanding Home Dynamics and Habits
“If there’s not a lot of progress, then it’s a discussion with the parents: Why is that?” Theodotou says it’s her job to work with them to identify and address potential barriers to success.
It’s essential to tune into the whole family dynamic of meal times. Are the parents putting on cartoons so they can get more calories in their child? Are they taking extended periods of time to eat? Are the kids constantly snacking all day because they don’t want to sit at the table? All of these factors influence how you develop and execute your plan with the family.
One feeding area she often troubleshoots is the family meal. Sometimes parents find it easier to feed a child separately from their own mealtime, but Theodotou says this can leave kids feeling isolated and unenthusiastic about the eating experience. She emphasizes a positive, pleasant meal experience in which family members eat with the child and, if possible, share food from their own plates with the child so the child feels part of the family.
| Challenge | Why It Happens | Solution Strategy |
|---|---|---|
| Separate meal times | Parents find it easier to manage their child’s feeding separately | Start with whoever is home—even one parent and child creates a connection |
| Extended feeding times | Pressure to get enough calories, distraction tactics | Set reasonable time limits, focus on pleasant experience over quantity |
| Constant snacking | Child won’t sit for meals, parents worried about nutrition | Establish snack schedule, make table time positive and engaging |
| Screen time during meals | The only way to get a child to eat or sit still | Gradually reduce, model family conversation, celebrate small wins |
Using “We” Language Sets the Right Mindset
Another important aspect of involving parents concerns the language used during a session. Using “we” language instead of “I” or “you” language draws the parent into the team framework and deepens the sense of relationship. It also helps the SLP to remember that the parent is part of the team.
As one experienced SLP explains: “I’m always amazed at the impact the simplest ideas can have. I had to force myself to say ‘we.’ At first, I had to keep repeating to myself the ‘say we’ mantra. Over time, I was thinking ‘we.'” This linguistic shift might seem small, but it fundamentally changes the power dynamic from expert-patient to collaborative partnership.
Creating an Emotional Connection with Families
“I think empathizing has probably been the biggest lesson that I’ve learned since graduation,” Theodotou says. For families, their child’s speech or feeding challenges are often out of their control. Parents have no idea where to go from here or what the future holds for their child—it’s very overwhelming for them.
Three key areas can help you build this emotional connection and create the trust necessary for effective family involvement in speech therapy.
Taking Things Slowly and Validating Fears
Theodotou shares that when her own daughter started eating solids, she experienced a shift in perspective. She tells parents all of the time to just let their children explore and to offer new foods as much as possible between sessions, not letting fear prevent exploration.
When she watched her own daughter gagging and struggling with new food, however, she came to a deeper understanding of the fear parents can experience. “I’ve learned to empathize more with the fears of your child choking or not being ready to try something.”
Her new understanding means that sometimes she chooses to wait a little longer before introducing food she believes the child is ready for, even though the parent does not. At times, parents bring a new food into the therapy room to discuss whether the size or firmness is appropriate, then try it together. This waiting can be necessary because children pick up on their parents’ emotions around various activities. If the parent appears anxious or unsettled about a particular food, the child may also feel that way, leading to negative associations from the start.
Engaging Parents Means Hearing Their Concerns
Theodotou and other SLPs emphasize the importance of determining the family’s priorities regarding feeding or speech with their loved ones. By validating those concerns and making sure to incorporate these concerns into your therapy—even if they aren’t top concerns for you—families will feel heard and understood and often become more engaged with the process.
This principle applies across all settings where SLPs work, from hospital-based clinical fellowships to school-based practices. Understanding what keeps a parent up at night about their child’s communication challenges helps you meet families where they are emotionally.
Regular Encouragement and Positive Communication
Take time to encourage the families along the way. When you connect with them, share what went well. Parents often report that they have never received a positive phone call before. This doesn’t need to be the norm. Positivity surely increases communication and engagement.
Celebrating small wins—a new sound attempted, a food texture tolerated, a communication breakthrough—helps families stay motivated through what can be a long therapeutic journey. For many families, these celebrations become anchors of hope during challenging periods.
Overcoming Barriers to Family Engagement
One frustrating reality all SLPs face is families that just aren’t tracking with your plans for their loved one. You send home articulation assignments or feeding parameters only to find out the following week that there was only minimal follow-through.
“You may have goals for the kid, and the family may not be at those goals yet. So it’s really being a team member with the family and letting them be a part of their child’s planning and getting families to the point where you want them to be,” Theodotou explains.
Meeting Families Where They Are
She refers back to the family dinner example. Maybe Mom gets home from work just as Dad is leaving the house, or siblings are being shuffled to various extracurricular activities during regular meal hours. The “ideal” therapeutic plan might not fit the family’s reality.
“Maybe say: Start with something small. Do this meal together with anybody who’s in the house at the same time. Come to the table for snacks,” she suggests. Ultimately, you work to modify the ideal to fit the family’s situation and start from there. Progress happens in increments, not overnight transformations.
Integrating Therapy Into Daily Routines
Another key is helping parents see how they can make therapy part of the daily routine, rather than something separate they do at set times. As Dr. Ruth Stoeckel, Ph.D., CCC-SLP, explains:
“As a young clinician who had no children, I was eager to assign parents ‘homework’ sheets for speech practice at home with their children. Many times the sheets were taken home and forgotten. As an older and (hopefully) wiser clinician, I have learned to request feedback rather than wait for it to be offered. And I have learned the value of teaching parents ways to insert speech practice into daily interactions.”
This can be as simple as weaving vocabulary practice into trips to the grocery store or emphasizing essential words in a sentence (“you’re playing with BLOCKS!”). When therapy becomes woven into the fabric of daily life rather than an additional task on an already overwhelming to-do list, compliance improves dramatically.
The Reward of Family Partnership
Theodotou says that even though actively engaging families isn’t always easy, it’s ultimately one of the most gratifying parts of her job, especially when they see a significant breakthrough. Sometimes that comes in the form of saying more words, using their nonverbal cues, or actually starting to enjoy eating.
“The parents see, ‘oh, they can do this.’ It’s those little moments that make it the most rewarding.” These breakthrough moments don’t just represent clinical progress—they represent families reclaiming hope and confidence in their child’s future.
For those considering graduate programs in speech-language pathology, understanding the critical role of family involvement should inform your clinical training choices. Programs that emphasize family-centered care and coaching models prepare you for the realities of modern SLP practice.
Frequently Asked Questions
How does family involvement improve speech therapy outcomes?
Research by Fudala, England, and Ganoung found that children whose parents attended treatment sessions and practiced at home made significantly greater progress than those who only did homework. When SLPs train parents to integrate therapy techniques throughout the day, children essentially receive therapy multiple times daily rather than once a week, multiplying treatment effectiveness. Studies show progress can be 40-60% faster with highly involved families.
What role should parents play during therapy sessions?
Parents should be active participants, not just observers. Effective SLPs invite parents into the therapy room to model techniques alongside them. For example, if teaching a child to chew, the therapist might hand a carrot stick to the parent to demonstrate together. Parents should practice techniques during sessions, ask questions, and learn specific strategies to use at home between appointments.
How can SLPs encourage reluctant families to participate?
Start by understanding the family’s priorities and barriers. Meet them where they are rather than imposing ideal scenarios. Use “we” language to create a partnership mindset. Start with small, achievable steps like practicing during one meal or integrating therapy into existing routines like grocery shopping. Regular, positive communication about progress—not just problems—significantly increases engagement.
What if a family’s schedule doesn’t allow for ideal practice routines?
Modify the therapeutic plan to fit the family’s reality. If family dinners aren’t possible, suggest practicing during snack time or with whoever is home. Help parents integrate therapy into activities they’re already doing—car rides, bedtime routines, playtime—rather than adding separate practice sessions. Small, consistent integration beats perfect execution of an unrealistic plan.
How do parent-implemented interventions compare to clinician-directed services?
Research by DeVeney, Hagaman, and Bjornsen found that “parent-implemented intervention emerged as potentially more effective than clinician-directed service” in many cases. When properly trained, parents can become as proficient as SLPs in helping their children with speech and fluency techniques. The key is that parents provide intervention multiple times daily in natural settings where communication skills are actually used.
What are common barriers to family involvement, and how can they be addressed?
Common barriers include conflicting work schedules, multiple children with different activities, parental anxiety about doing techniques “wrong,” and feeling overwhelmed. Address these by starting small, validating fears, demonstrating techniques in session together, using “we” language, and helping families integrate therapy into existing routines rather than adding separate tasks—regular encouragement and celebration of small victories motivated families.
Why is empathy important when working with families in speech therapy?
Parents often feel overwhelmed and uncertain about their child’s future when facing speech or feeding challenges. Empathy helps SLPs understand parental fears—such as choking concerns during feeding therapy—and adjust their pacing accordingly. When therapists validate family concerns and incorporate their priorities into treatment plans, families feel heard and become more engaged partners in the therapeutic process.
Key Takeaways
- Children with highly involved families progress 40-60% faster in speech therapy, and research shows that parent-implemented interventions can be as effective as clinician-directed services.
- Effective family involvement means inviting parents into therapy sessions to practice techniques alongside the therapist, not just assigning homework.
- Use “we” language consistently to foster a partnership mindset rather than an expert-patient dynamic, thereby increasing family engagement. nt
- Integrate therapy into daily routines like meals, grocery trips, and playtime rather than creating separate practice sessions that feel like additional tasks.sks
- Meet families where they are by understanding their barriers, validating their concerns, and modifying ideal plans to fit their real-life schedules and dynamics.
- Regular positive communication and celebrating small wins keep families motivated through what can be a long therapeutic journey.
Ready to Make Family-Centered Care Part of Your SLP Practice?
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