Your Child’s First Telehealth Speech Therapy Session: A Parent’s Guide

Your Child Has a Telehealth Session Coming Up? Here’s How to Make It Great

So your child is starting speech therapy over video. Maybe you feel relieved to have taken the first step. Maybe you’re a little nervous. And maybe there’s a voice in the back of your head asking, “Is this really going to work through a screen?”

It’s a fair question, and for many children the answer is yes. Research suggests that telehealth speech therapy can produce outcomes comparable to in-person therapy for children. But I understand that knowing the research and experiencing it firsthand are two different things.

This guide will walk you through everything you need to know to set your child up for a great first session, and to feel confident about the process yourself.

Will This Really Work Over Video?

Let’s address this head-on, because it’s the most common concern parents have. The short answer: for many children, yes, and there’s a solid body of research behind it.

The American Speech-Language-Hearing Association (ASHA) recognizes telepractice as an appropriate service delivery model. Multiple peer-reviewed studies have found that many children make comparable progress in telehealth speech therapy and in-person sessions across articulation, language, fluency, and more, though individual results vary.

In some ways, telehealth actually has advantages. Your child works in their own comfortable environment. You’re right there observing and learning strategies in real time. There’s no commute, no waiting room, and no transition time eating into the session. And children who are used to learning and playing on screens often engage with telehealth naturally.

Give it a few sessions. It can take a little time for both of you to settle into the routine, and that’s normal.

What to Expect During the First Session

The first session is a little different from the rest. It’s partly about getting to know your child and partly about establishing the routine. Here’s what typically happens:

• A warm-up conversation. The therapist will spend a few minutes chatting with your child to build rapport. This might include talking about their favorite things, playing a quick game, or just getting comfortable on camera.
• A brief look at your child’s skills. Depending on where your child is in the process, the therapist may do some informal activities to observe their speech and language skills up close.
• Interactive activities. Even in the first session, there will be engaging, play-based activities. Think screen-shared games, picture cards, storytelling prompts, and other materials designed to feel like fun, not homework.
• Time to talk with you. The therapist will check in with you about your concerns, your child’s history, and what you’ve been noticing. Your input is essential.

The first session might feel a little different from what you imagined, and that’s okay. The goal is connection, not perfection.

How to Set Up the Space

You don’t need a special room or fancy equipment. A few small adjustments make a big difference:

• Choose a quiet spot. Pick a room or area with minimal background noise. Turn off the TV, close the door if possible, and let other family members know the session is happening.
• Use a table and chair. Having your child seated at a table helps with focus and keeps them in frame. Avoid the couch or bed, since those signal “relaxation,” not “work time.”
• Position the screen at eye level. Stack some books under the laptop or tablet if needed. When the camera is at eye level, the therapist can clearly see your child’s face and mouth, and your child stays more engaged.
• Clear the workspace. Put away toys, tablets, and anything else that might compete for attention. A clutter-free space helps your child focus on the session.
• Good lighting helps. Face a window or lamp so your child’s face is well-lit. Avoid having a bright window behind them, which creates a silhouette on camera.

What Tech Do You Need?

Getting set up is simpler than most people expect:

• A device with a camera and microphone. A laptop or tablet works best. Phones work too, but a larger screen is easier for children to interact with.
• Stable internet. If you can stream a video without buffering, your internet is fast enough. Wi-Fi is fine.
• A web browser. Sessions use a secure, HIPAA-compliant video platform. You’ll receive a link before the session. Just click it to join. No special software to download.

Pro tip: Test the link 5 minutes before the first session to make sure everything connects smoothly. That way you’re not troubleshooting while your child waits.

How to Keep Your Child Engaged

One of the biggest worries parents have is, “My child won’t sit still for a video call.” Here’s the thing: a speech therapy session is nothing like a Zoom meeting. It’s fast-paced, interactive, and designed to hold a child’s attention. That said, here are a few things you can do to help:

• Frame it positively. Tell your child they’re going to play some fun games with someone new on the computer. Avoid words like “test” or “work” before the first session.
• Schedule strategically. Choose a time when your child is typically alert and cooperative, not right before nap time or after a long day at school if you can help it.
• Don’t worry about perfection. If your child gets wiggly, looks away, or needs a moment, that’s completely normal. Therapists are trained to work with it, redirect, and keep things moving.
• Let the therapist lead. Resist the urge to prompt your child or answer for them. The therapist needs to see how your child communicates naturally. You’ll get your turn to participate, too.

Your Role During the Session

I believe parents are essential to the therapy process. You’re always welcome in sessions, and you can be as involved as you want to be. Here’s what participation can look like:

• Be present in the room. You don’t need to sit right next to your child the entire time, but being nearby allows you to observe techniques and step in when invited.
• Watch and learn. Pay attention to how the therapist models correct sounds, asks questions, or prompts your child. These are strategies you’ll use at home between sessions.
• Follow the therapist’s lead. Sometimes you’ll be asked to participate in an activity. Other times, the therapist may ask you to step back so they can work with your child one-on-one. Both are part of the plan.
• Ask questions. At the end of each session, there’s time to discuss what happened, what your child did well, and what to focus on during the week. Don’t hesitate to ask anything.

Your involvement is one of the biggest advantages of telehealth therapy. Instead of sitting in a waiting room while a therapist works behind closed doors, you’re right there, learning the same techniques so therapy continues all week long.

What Happens After the Session

After each session, your therapist will share a quick summary of what was worked on and any specific activities or strategies to practice at home. It isn’t a long list of homework, usually just one or two simple things you can work into everyday routines.

For example, your therapist might ask you to practice a specific sound during dinner conversation, play a quick word game in the car, or read a book together while focusing on a particular skill. These small, consistent efforts between sessions can make a real difference in how your child progresses.

Tips for Practicing Between Sessions

Short, regular practice tends to help more than occasional long sessions. Not a lot, just a little bit most days. Here’s how to make that realistic:

• Keep it short. Just 5 to 10 minutes a day is plenty. Longer isn’t necessarily better, especially with younger children.
• Build it into routines. Practice during meals, car rides, bath time, or before bed. It shouldn’t feel like a separate “therapy time.”
• Make it fun. Turn practice into a game. If your child is working on a specific sound, see how many words with that sound you can spot during a walk. Use silly sentences. Keep it light.
• Praise the effort, not just the result. “I love how hard you tried on that R sound!” is more motivating than “That’s wrong, try again.” Children respond to encouragement.
• Don’t stress if you miss a day. Consistency matters more than perfection. A few minutes most days is better than a 30-minute session once a week.

You’ve Got This

Starting speech therapy in any format is a big step, and the fact that you’re reading this means you’re already doing right by your child. Telehealth can make high-quality speech therapy more accessible and convenient. Your child gets to work in their own space, with you right there as part of the team.

It may feel new at first, and that’s okay. Give yourself and your child a few sessions to settle in, and don’t hesitate to ask questions along the way.

Ready to schedule your child’s first session? I provide telehealth speech therapy for children across New York and New Jersey, with flexible scheduling (including evenings) and no waitlist.