New to this topic? Start with our companion article: My 6-Year-Old Is Hard to Understand: Speech Sound Delays Explained | Brisbane Speech Pathologist
Once you've recognised that your six-year-old's speech isn't where you'd expect it to be (something our companion article My 6-Year-Old Is Hard to Understand walks through in detail), the next question is always the same: what do we actually do about it?
This article is the practical follow-up. It's the one to read when you've decided something needs to happen and you want to know what an assessment actually looks like, which therapy approaches the evidence supports for delayed patterns specifically, and what you can do at home between sessions. If your child's errors are unusual rather than just lingering, you'll get more out of Therapy for Atypical Speech Sound Errors; if the errors are inconsistent, head to Therapy Approaches for Disordered Speech.
When to Seek an Assessment
There's no such thing as coming "too early" for a speech sound assessment. But if your child is approaching or past their sixth birthday and you're noticing any of the following, it's definitely time to book in:
- Unfamiliar people struggle to understand your child. By age 6, strangers should be able to follow most of what your child says.
- Your child is still using speech patterns typical of a much younger child — for example, saying "tat" for "cat" or "poon" for "spoon."
- Your child is getting frustrated because people can't understand them, or they're starting to avoid speaking in certain situations.
- Teachers have raised concerns about your child's speech clarity or its impact on literacy.
- Your child is having difficulty with reading or spelling, particularly sounding out words — speech sound difficulties and literacy challenges are closely connected.
You don't need a GP referral to see a speech pathologist in private practice. You can simply get in touch and book directly.
What Does a Speech Sound Assessment Involve?
A speech pathology assessment for speech sounds is structured but still child-friendly. Here's what you can expect:
Parent Interview
We'll start by chatting with you about your child's speech history, any concerns you've had along the way, and what communication looks like at home and school. We'll ask about things like ear infections, family history of speech or language difficulties, and what sounds or patterns you've noticed.
Speech Sound Sampling
We'll ask your child to name pictures, describe scenes, or tell us about something they're interested in. This gives us a sample of all the speech sounds they're producing in different positions — at the start, middle, and end of words. We listen carefully for which sounds are accurate, which are substituted, and what patterns are at play.
Standardised Assessment
We typically use a standardised speech sound assessment tool — such as the DEAP (Diagnostic Evaluation of Articulation and Phonology), developed by Barbara Dodd and colleagues. The DEAP is widely used in Australia and gives us a detailed picture of your child's speech sound profile, including whether the patterns are delayed, atypical, or inconsistent (Dodd, 2014).
Stimulability Testing
We'll check whether your child can produce the sounds they're having difficulty with when given a model. For example, "Can you say 'sss'?" This tells us how ready those sounds are to respond to therapy.
Intelligibility Rating
We'll also assess your child's overall intelligibility — how well they can be understood by familiar and unfamiliar listeners. An intelligibility rating scale gives us a clear baseline and helps us measure progress over time. It's one of the most meaningful indicators of how your child's speech is affecting their everyday communication.
Phonological Awareness Screening
Because speech sounds and literacy are closely linked, we'll often screen your child's phonological awareness as well — that is, their ability to hear, identify, and manipulate sounds in words. This helps us understand whether their speech difficulties might be affecting their reading and spelling.
Summary and Recommendations
After the assessment, we'll explain our findings clearly. We'll tell you which sounds and patterns your child is using, how they compare to what's expected for their age, and whether therapy is recommended. If it is, we'll outline what the therapy plan might look like.
Has your child had their hearing checked recently? It's one of the first questions we ask when planning therapy. The "s" and "f" sounds sit in a high-frequency range that's easy to miss if there's even a little bit of fluid behind the eardrum — and that changes how we approach the whole therapy plan.
What Therapy Actually Looks Like
Not all speech therapy is the same, and the approach a speech pathologist chooses depends on what's driving your child's speech difficulties. Picking the right approach — and tailoring it to your specific child — is where the clinical expertise lives, and it's why DIY speech sound work usually doesn't shift the underlying system. Here's a flavour of what therapy might look like for a child with delayed speech sound patterns.
Sound contrast approaches
Approaches like minimal pairs, multiple oppositions, and maximal oppositions all involve carefully chosen words that differ by a single sound, used in playful repetition. The core idea is to help your child notice that using different sounds changes the meaning of words — when they hear and see the difference it makes, the system starts to reorganise itself. A speech pathologist will choose the contrasts based on your child's specific patterns, and the choice matters more than the activity itself (Baker & McLeod, 2011). One of the lovely moments in therapy is when a parent notices their child suddenly using a sound correctly we haven't even targeted yet.
Phonological awareness work
Because speech sounds and literacy are so closely linked, therapy for delayed patterns often weaves in phonological awareness activities — rhyming, syllable games, and noticing sounds in words. This combination is particularly helpful for children at risk of literacy difficulties (Gillon, 2018). For the full picture, see How Speech Sound Errors Affect Reading and Learning.
Articulation work (when a specific sound is the issue)
Some children don't have a pattern-based delay at all — they have difficulty with one or two specific sounds (the classic lisp is a common example). That calls for a different kind of work, focused on how the tongue, lips and jaw are placed for that sound. We explain the difference in detail in Phonological Processing vs Articulation: What's the Difference?
How Families Support Therapy at Home
Your involvement makes a real difference — not by trying to run therapy at home, but by working alongside your speech pathologist between sessions. The home piece is specific to what your child is working on that week, which is why it's set up by the clinician rather than pieced together from the internet.
Practise what the speech pathologist sets for you
A speech pathologist will usually send home short, targeted practice tasks. Consistent, brief sessions at home — even 5 to 10 minutes a few times a week — help consolidate what's happening in therapy. Sugden and colleagues (2018) found that home practice makes a real difference to outcomes, which matches what we see every day.
Model, rather than correct
If your child says a sound incorrectly in everyday conversation, one thing that tends to help is simply modelling the correct version back. If your child says "Look at the tup!" you might respond with "Yes, I see the cup! That's a big cup." This gives them a natural model without creating pressure or interrupting the flow of conversation. Families who lean into gentle modelling rather than correction tend to see steadier progress — and a more willing practiser.
Keep it positive and be patient
Speech sound changes take time. Your child has been using these patterns for years, and it takes lots of repetition for new patterns to become automatic. Praising effort rather than accuracy, and keeping practice playful, is one of the most powerful things a parent can do.
How Long Does Therapy Typically Take?
This is one of the most common questions we get, and the honest answer is: it depends. Factors that influence the length of therapy include:
- How many sounds or patterns are affected. A child with one or two delayed patterns will likely need less time than a child with multiple patterns.
- The type of difficulty. Phonological delays (pattern-based difficulties) often respond well to therapy within a term or two. Individual articulation difficulties may take longer, depending on the sound.
- Consistency of home practice. Children whose families do regular home practice between sessions tend to progress more quickly. Sugden and colleagues (2018) found that home practice significantly enhanced outcomes in speech sound intervention, supporting what we see every day in clinical work.
- The child's overall language and learning profile. If there are additional language or learning factors at play, therapy may take longer.
As a rough guide, many children with delayed speech sounds make significant progress within one to two school terms of weekly therapy, combined with home practice. We review progress regularly and adjust the plan as needed.
Speech sound therapy works — and with the right approach matched to your child's profile, most children make steady, meaningful progress. If you'd like to understand what's going on with your child's speech and what would help, get in touch with our team. Any actual clinical work — assessment, diagnosis, or therapy — happens through a proper consultation tailored to your child. Speaking Speech Pathology offers mobile speech pathology in your home across Brisbane's south side and Logan.
Alexandra Bouwmeester is a Senior Speech Pathologist (MSPA, CPSP) with over 14 years' experience in speech sound assessment and intervention. She offers mobile speech pathology to families across Brisbane's south side and Logan.
References
- Baker, E., & McLeod, S. (2011). Evidence-based practice for children with speech sound disorders: Part 1 — Narrative review. Language, Speech, and Hearing Services in Schools, 42(2), 102–139.
- Gillon, G. T. (2018). Phonological Awareness: From Research to Practice (2nd ed.). Guilford Press.
- Sugden, E., Baker, E., Munro, N., & Williams, A. L. (2018). Home practice habits of children with speech sound disorder and their caregivers. Journal of Speech, Language, and Hearing Research, 61(12), 2910–2928.
