How to choose a speech therapist for your toddler: what I would tell a friend

By Yelena Letser, MS, CCC-SLP · Holistically Speaking Speech Therapy · Flower Mound, TX

This post is for informational and educational purposes only and does not constitute medical advice. I am a licensed speech-language pathologist, not a physician. Please consult your child's pediatrician or a qualified healthcare provider with any concerns about your child's development.

Parents ask me some version of this question a lot: how do I know if I'm choosing the right therapist? Sometimes they're just starting out and trying to figure out where to begin. Sometimes they've already been through therapy somewhere else and something didn't feel right, and they're trying to put their finger on what it was.

I want to answer this the way I would if a friend called me and asked. Not with a checklist, but with the things that actually matter.

Credentials first, but they're just the floor

Start here: a qualified speech-language pathologist holds a master's degree and the CCC-SLP certification from ASHA. In Texas, they also need an active state license. These are non-negotiable, and any good therapist will be transparent about them without you having to dig.

But credentials are really just the starting point. Two SLPs can have identical training and produce completely different experiences for a child and family. What happens after you verify the letters behind their name is what really matters.

Make sure they actually work with toddlers

Speech-language pathology covers an enormous range. Some SLPs spend their days working with adults after strokes. Others focus on teenagers with reading difficulties. Working with a two-year-old requires a completely different skillset, temperament, and clinical approach than any of those populations.

It sounds like a basic question, but ask: what age do you work with most? A therapist who lives and breathes toddler development will answer that question differently than one for whom young children are just one small part of a much broader caseload.

Watch how they play

For toddlers, play is not a warm-up activity or a reward at the end of a session. It is the therapy. The brain of a two or three-year-old is not built to sit at a table and repeat words on command. It is built to learn through exploration, through connection, through the back-and-forth of engaged interaction with someone who is genuinely present with them.

Research on naturalistic, play-based intervention models consistently shows faster language gains, better retention, and stronger generalization into real life compared to structured drill approaches with young children. A 2023 study using DIR/Floortime with toddlers under age four found statistically significant improvements in intentional communication and social engagement after just 24 sessions.

What this looks like in practice: a session might involve building a tower, chasing bubbles, or playing pretend. From the outside it can look like just playing. But a skilled therapist is making dozens of clinical decisions throughout that play, following the child's lead while carefully embedding language targets into every exchange. That is the work.

If a therapist describes sessions that involve a lot of table work, flashcards, or structured repetition with a toddler, that is worth asking more about.

"Play, joint attention, and imitation have been especially salient variables predicting language outcomes in young children. Interventions targeting these foundational skills show the strongest long-term results." — Wetherby and Prizant, The ASHA Leader

Ask about the nervous system

This one might sound unusual, but I think it is one of the most telling questions you can ask a therapist: how do you handle a child who comes in dysregulated?

A lot of toddlers who struggle with communication are also carrying some degree of nervous system stress, whether that shows up as sensory sensitivity, frequent meltdowns, shutting down, or just a general difficulty settling. These aren't behavior problems. They are signals from a nervous system that is working hard.

A child whose nervous system is in a stress state cannot fully access the parts of the brain responsible for language and learning. Dr. Stephen Porges' research on the autonomic nervous system shows that social engagement and communication are neurobiologically dependent on a felt sense of safety. Therapy that ignores this is working against itself.

A therapist who understands this will adjust their pacing, follow the child's lead, prioritize connection before correction, and think about regulation as part of the clinical picture. That orientation makes a real difference, especially for children with complex or overlapping challenges.

You should be in the room

Parent involvement in early speech therapy consistently leads to better outcomes than therapy delivered to the child alone. This is not a preference, it is well established in the research. The reason is simple: you are with your child far more hours each week than any therapist ever will be, and those hours are full of natural opportunities for language learning.

A good SLP will not just update you at the end of a session. They will teach you what they are doing and why, and show you how to carry the same strategies into your daily routines at home. Mealtimes, bath time, the car, the grocery store: all of it is language therapy when you know what to do.

If you find yourself sitting in a waiting room during every session with no idea what happened inside, that is worth addressing.

Trust what you feel in the room

Beyond all of this, pay attention to how you feel in a consultation. Do you feel listened to? Does the therapist ask good questions about your child specifically, or does it feel like a script? Does your child seem at ease?

You know your child better than anyone. A good therapist will treat that knowledge as an asset, not an afterthought. The therapeutic relationship matters, both the one between the therapist and your child and the one between the therapist and you as a family.

A note for families in Flower Mound and the DFW area

If you are searching for a pediatric speech therapist in Flower Mound, Lewisville, Highland Village, or the surrounding area and are specifically looking for someone who takes a holistic, play-based approach, I hope this gives you a useful framework for the search. Whether you end up working with me or someone else, these are the things I would look for.

I offer a free consultation for families who want to talk through their child's specific situation before committing to anything. I accept BCBS insurance and HSA/FSA payments.

Questions about your child?

Schedule a free consultation at holistically-speaking.com and we can talk through what you are seeing and whether speech therapy makes sense as a next step.

References

Wetherby, A.M., & Prizant, B.M. (2008). Language outcomes for young children with autism spectrum disorders. The ASHA Leader.

Rodrigues, M., et al. (2023). Early speech therapy intervention in children with autism spectrum disorder using DIR/Floortime. PubMed Central.

Girolametto, L., et al. (1996). Interactive focused stimulation for toddlers with expressive vocabulary delays. Journal of Speech and Hearing Research, 39, 1274–1283.

Porges, S.W. (2011). The early development of the autonomic nervous system provides a neural platform for social behavior. Infant and Child Development, 20(1), 106–118.

American Speech-Language-Hearing Association (ASHA). Early intervention services. Retrieved from