New to this topic? Start with our companion article: Play and Speech Therapy: Why Playing Is Serious Business | Brisbane Speech Pathologist
In our companion article on why play matters, we made the case that play is the evidence-based approach for young children — not a soft option. Now let's get concrete. What does a play-based session actually look like, minute by minute? What's the therapist tracking while your child builds a tower or feeds a pretend cow? This article pulls back the curtain.
Play-based therapy looks like... play. But underneath, the speech pathologist is making constant decisions about what to model, when to wait, what to introduce, and what to leave alone. The principles that often surface — getting low, following the child's lead, commenting more than questioning — are also genuinely good things for parents to do anyway, and they cost nothing to try.
What a Play-Based Therapy Session Actually Looks Like
Let's walk through a typical session for a three-year-old working on building their vocabulary and putting two words together.
Setting Up
Before your child arrives, the speech pathologist has already planned the session. They've chosen two or three activities that are likely to bring out the specific words and sentence types your child is working on. They've thought about which toys to use, what language to model, and how to create opportunities for your child to communicate.
The room might have a few carefully chosen toys set out — not everything at once, because too many choices can be overwhelming and make it harder to keep the interaction focused.
Warm-Up
The session usually starts with a few minutes of free play. This helps your child settle in, feel comfortable, and show the therapist what they're interested in today. The speech pathologist watches, listens, and follows the child's lead — this is already assessment. How is the child communicating? What words are they using? How are they playing?
The Core Activity
This is where the targeted work happens — though it still looks and feels like play. Here's an example:
Activity: Farm animals and a toy barn
The speech pathologist has chosen this activity because they want to target:
- Animal names (vocabulary)
- Action words like "jump," "eat," "sleep" (verbs)
- Two-word combinations ("cow eat," "pig jump," "horse sleep")
During the play, the therapist is doing several things at once — modelling short, clear language at the child's target level ("The cow is eating! Munch munch munch. Cow eat."), expanding what the child says (if the child says "pig," the therapist says "pig jump!" while making the pig jump into the barn), and pausing expectantly in predictable routines so the child has a moment to fill in. Underneath, they're making constant calls about what to model, when to wait, what to introduce, and what to leave alone.
The child thinks they're playing farms. The therapist knows they've just had dozens of opportunities to hear and practise two-word combinations in a meaningful, motivating context. In my own sessions, the moment I know a plan is working is when a child stops noticing me — they're just deep in the play, and the language is tumbling out alongside it.
Wrapping Up
The last few minutes of the session often involve a brief chat with the parent — sharing what was targeted, how the child responded, and what to try at home during the week. The therapist might demonstrate a quick strategy for the parent to use with a similar activity at home.
What Play Looks Like Across Different Goals
Play-based therapy looks different depending on what the child is working on. A few examples to give you a flavour:
Language Goals
For a child building vocabulary, that might be a pretend kitchen with toy food (naming foods, colours, actions like cut, stir, pour) or water play with cups and funnels (pour, squeeze, full, empty). For a child starting to put words together, a car ramp invites simple two-word phrases like "car go!" and "more car!" repeated naturally across many turns. For a child working on understanding, hiding games and sorting activities slip in position words and concepts without ever feeling like a test.
Speech Sound Goals
A speech pathologist working on specific sounds might use a posting game (the child says a target word and posts it in a letterbox), a magnetic fishing game, or a barrier game where each turn calls for a target word. The playful context means the child is doing lots of practice without it feeling like a drill — and they're more willing to try the tricky sounds.
Social Communication Goals
For turn-taking and joint attention, simple board games and collaborative building come up a lot. For conversation skills, pretend play scenarios — shops, restaurants, vet surgeries — bring out greetings, questions, and topic maintenance. Puppet play is useful for talking about how characters might be feeling.
A Note on Repetition
One thing you'll notice watching a session is how often the therapist says the same word, the same phrase, the same model. That isn't the therapist running out of ideas — it's deliberate. Children need to hear and practise new words and sounds many, many times before they stick. Don't be afraid of the same game or the same book over and over at home either. That repetition is a feature, not a bug.
Taking These Ideas Home
You don't need to replicate a therapy session at home — and please don't try. But you can absolutely borrow the underlying moves: join in with what your child is already doing, model language just slightly above their current level, and leave small gaps for them to fill. For a fuller run-through of what to practise at home and how to keep it low-pressure, see Parent-Delivered Speech Therapy: What to Practise at Home. For the bigger question of when to follow versus when to lead, see Finding the Right Balance.
Every bubble blown, every block stacked, and every pretend cup of tea served is a carefully planned opportunity for your child to learn and grow. Research has consistently shown a strong relationship between pretend play skills and language development (Stagnitti & Lewis, 2015), reinforcing the idea that play is doing real cognitive and linguistic work.
If you'd like to see play-based therapy in action, get in touch — we'd love to show you what play can do, right in your own home. Any actual clinical work — assessment, diagnosis, or therapy — happens through a proper consultation tailored to your child.
Alexandra Bouwmeester is a Hanen-certified Senior Speech Pathologist (MSPA, CPSP) and mum of two young boys. She offers mobile speech pathology to families across Brisbane's south side and Logan.
References
- Stagnitti, K., & Lewis, F. M. (2015). Quality of pre-school children's pretend play and subsequent development of semantic organisation and narrative re-telling skills. International Journal of Speech-Language Pathology, 17(2), 148–158.
- Westby, C. E. (2000). A scale for assessing development of children's play. In K. Gitlin-Weiner, A. Sandgrund, & C. Schaefer (Eds.), Play Diagnosis and Assessment (2nd ed., pp. 15–57). John Wiley & Sons.
