In Home vs. Clinic Speech Therapy: What Parents Should Know

If you are looking for speech therapy for your child, one of the first questions you may have is where therapy should actually take place.

Should you bring your child to a clinic? Is therapy at home an option? Does one setting work better than another?

At Little Sunflowers, we provide in home speech and language therapy because we love being able to work with young children in an environment where they already feel comfortable.

But every child and every family is different.

Here are a few things to consider when deciding what might work best for yours.

What is in home speech therapy?

It is pretty much exactly what it sounds like.

Instead of bringing your child to a clinic each week, the speech language pathologist comes to your home.

Therapy can happen in the living room, playroom or another familiar space using toys, books, activities and routines that are already part of your child's life.

For infants, toddlers and young children especially, I find there can be something really valuable about working on communication in the same environment where so much of their communication happens every day.

Your child is already comfortable

Walking into an unfamiliar office can take some getting used to, especially for a toddler or young child.

At home, we're meeting your child in a place they already know.

Their toys are there. Their favorite books are there. You are there.

That allows us to spend our time playing, interacting and working toward your child's communication goals in a way that can feel very natural.

We can work on communication during real life activities

One of my favorite things about in home therapy is that we can work with things your child actually encounters every day.

If we're working on requesting, maybe we're using a favorite toy.

If we're building vocabulary, we can use the toys, books and objects your child already loves.

If we're working on following directions, taking turns or expressing wants and needs, we can practice those skills through familiar play and routines.

The goal isn't just for your child to use a skill during a therapy session.

We want those communication skills to become useful throughout their everyday life.

Parents can be part of the process

Your child's speech therapy session is important.

But the rest of their week matters too.

In home therapy gives parents and caregivers an opportunity to see what we're doing, ask questions and learn simple strategies that can be incorporated into everyday interactions.

You don't need to turn your home into a therapy room or spend hours practicing.

Sometimes it's as simple as changing how we play with a favorite toy, read a book or respond when your child is trying to communicate.

Those little moments add up.

And yes, it's also more convenient

This part matters too.

Families are busy.

Between work, siblings, school, naps, activities and everything else that happens during the week, getting a young child to another appointment can be a lot.

With in home therapy, you don't have to pack everyone into the car, drive to an office, wait for the appointment and drive home again.

We come to you.

For many of the families we work with in Merrick and surrounding Nassau County communities, that can make speech therapy much easier to fit into family life.

When might a clinic make more sense?

In home therapy isn't necessarily the right choice for every child.

Some children may benefit from services or resources available in a clinic setting. A clinic may offer specialized equipment, group opportunities or other services that aren't available through an individual in home provider.

Some families may also simply prefer having therapy happen outside their home.

The important thing is finding an approach that makes sense for your child's needs and your family.

What does in home therapy with Little Sunflowers look like?

Our sessions are personalized around your child.

We don't arrive with the expectation that every child should sit at a table and complete the same activities.

For young children especially, therapy is often play based.

We may use toys, books, games and everyday interactions to work on your child's individual communication goals.

Depending on your child's needs, that might include building vocabulary, combining words, producing speech sounds more clearly, understanding language, expressing thoughts and needs, or developing social communication skills.

And because we're working in your home, we can help you understand how to continue supporting those skills between sessions.

What does in home speech therapy cost?

Little Sunflowers is a private pay practice.

A one hour speech and language evaluation is $200.

Individual therapy sessions are $100 for 30 minutes or $125 for 45 minutes.

We also offer a free phone consultation before you get started.

Is in home speech therapy right for my child?

You don't need to know the answer before contacting us.

If you're concerned about your child's speech or language development, we can start with a conversation.

Tell us what you're noticing.

Maybe your toddler isn't using as many words as you expected. Maybe your child is difficult for other people to understand. Maybe they're getting frustrated trying to communicate. Or maybe you've already had an evaluation and still aren't sure what to do next.

We'll listen to your concerns, answer your questions and help you determine whether an evaluation or additional support may be appropriate.

Looking for in home speech therapy in Merrick, NY?

Little Sunflowers Speech & Language provides personalized, play based pediatric speech and language therapy for infants, toddlers and children in Merrick and surrounding Nassau County communities.

And the best first step is an easy one.

Schedule a free phone consultation and tell us a little about your child.

Schedule a Free Consultation

(516) 668-1445

Your Child Didn't Qualify for Early Intervention. What Now? A guide for parents in Nassau County.

You had concerns about your child's speech or language development, so you did what you were supposed to do. You reached out, scheduled an evaluation and went through the Early Intervention or school based evaluation process.

Then you were told your child didn't qualify for services.

Now what?

This is something I hear from parents often. Their child may not meet the specific requirements for Early Intervention or school based services, but they still have concerns.

Maybe your child isn't talking as much as you expected. Maybe they're having trouble putting words together. Maybe other people have difficulty understanding them. Maybe they become frustrated when they can't communicate what they want. Or maybe you simply have that feeling as a parent that they could use some extra support.

Not qualifying for services doesn't mean you have to stop asking questions.

What does it mean if my child didn't qualify?

Early Intervention and school based programs have specific eligibility requirements that determine which children receive services.

If your child doesn't meet those requirements, it doesn't necessarily mean there is nothing to work on or that your concerns aren't valid.

It means they didn't meet the criteria required to receive services through that particular program.

That's an important distinction.

There are children who may not qualify for a public program but can still benefit from additional support with their speech, language or communication skills.

And that's where private speech therapy can be an option.

When should I consider private speech therapy?

There's no single answer because every child develops differently.

But if you went through an evaluation because you had concerns in the first place and those concerns haven't gone away, it's reasonable to continue asking questions.

You might be noticing that your child:

Isn't using as many words as you expected

Has difficulty putting words together

Is difficult for you or other people to understand

Gets frustrated when trying to communicate

Has difficulty expressing their wants, needs or ideas

Has trouble understanding questions or following directions

Has difficulty interacting or communicating with other children

Or you may not be able to identify one specific issue. You just know that something about your child's communication is concerning you.

You don't need to figure this out on your own.

A conversation with a speech language pathologist can help you better understand what you're seeing and whether an evaluation or additional support might be helpful.

How can Little Sunflowers help?

At Little Sunflowers Speech & Language, we work with infants, toddlers and children with a variety of speech and language needs.

We also work with families whose children may not qualify for Early Intervention or school based services, but whose parents still feel they could benefit from additional support.

We start by listening to you.

What are you noticing at home?

What prompted you to seek an evaluation in the first place?

What is easy for your child?

What seems difficult?

What would you like your child to be able to communicate more easily?

From there, we can help determine an appropriate next step.

What does private speech therapy look like?

Our approach is personalized because every child's communication needs are different.

Depending on your child's needs, therapy may focus on areas such as speech and language development, articulation and speech sounds, expressive language, receptive language or social communication.

For young children, therapy doesn't have to feel like sitting at a table doing work.

Our sessions are play based and engaging. We can use toys, activities and everyday interactions to work toward communication goals in a way that feels natural for your child.

Little Sunflowers also provides in home therapy, which allows us to work with children in a comfortable, familiar environment and incorporate communication strategies into activities and routines that are already part of their lives.

What happens if I contact Little Sunflowers?

Getting started doesn't have to mean immediately committing to therapy.

We offer a free phone consultation so you can tell us what's going on and ask questions.

We'll talk about what you're noticing, your child's history and any previous evaluations or services.

If an evaluation seems appropriate, that's usually the next step.

The goal of the evaluation is to better understand your child's communication skills, identify areas where they may benefit from additional support and help determine what comes next.

If therapy is recommended, we'll develop an individualized plan based on your child's specific needs and goals.

In other words, you don't need to know exactly what your child needs before you call us.

That's what we're here to help you figure out.

What if I'm worried about overreacting?

Parents sometimes wonder if they should simply wait and see.

And sometimes monitoring a child's development may be appropriate.

But having a concern doesn't mean you're overreacting, and scheduling a conversation doesn't commit you to therapy.

If something has been on your mind, asking a speech language pathologist about it can give you more information and help you decide what makes sense for your child.

Sometimes the next step is therapy.

Sometimes it's strategies you can work on at home.

Sometimes it's continuing to monitor development.

The first step is simply understanding what's going on.

You still have options

Being told that your child doesn't qualify for Early Intervention or school based speech services can be confusing, especially when you still have concerns.

But that decision doesn't have to be the end of the conversation.

Private speech therapy gives families another option.

If you're in Merrick or a surrounding Nassau County community and you're still concerned about your child's speech, language or communication development, we'd be happy to talk with you.

Little Sunflowers Speech & Language provides personalized, play based pediatric speech and language therapy for infants, toddlers and children in Merrick and surrounding Nassau County communities.

Still have questions about your child?

Start with a free phone consultation. Tell me what you're noticing and we'll help you determine what the next step might be.

Schedule a Free Consultation: (516) 668-1445

Clinician Modeling to Expand Language: How You Can Use This at Home

One of my favorite strategies for helping children grow their language skills is clinician modeling—a simple yet powerful way to expand a child’s vocabulary, sentence structure, and overall communication abilities. But here’s the best part: parents and caregivers can use this strategy too!

What is Clinician Modeling?

Clinician modeling is when an adult provides clear, intentional language examples for a child to hear and absorb. Instead of directly correcting errors, we model the correct way to say something in a natural, encouraging way.

For example, if a child says, "Dog run," you might model: "Yes! The dog is running!" This keeps communication positive and engaging while exposing the child to richer language.

Why is Modeling Important?

Modeling helps children:

• Hear correct grammar and sentence structure in a natural way

• Learn new vocabulary in context

• Feel confident in their communication without fear of being corrected

• Develop stronger expressive language skills over time

How Can You Use Modeling at Home?

Here are some simple ways to incorporate modeling into everyday interactions:

1. Expand What Your Child Says

• If your child says, "Big truck!" you can respond with, "Yes! That’s a big, red truck! It’s driving so fast!"

• Adding just a few extra words helps your child learn new concepts naturally.

2. Repeat and Rephrase

• If your child says something with an error, instead of correcting them directly, repeat it the correct way.

• Example:

  • Child: "Him want cookie."

  • You: "Oh, he wants a cookie! Let's get him one."

3. Narrate Daily Activities

• Talk about what you’re doing as you do it.

• Example: "I’m cutting up an apple. First, I’ll wash it, then I’ll slice it into little pieces. Here’s a crunchy piece for you!"

• This gives your child repeated exposure to words and sentence structures they can later use themselves.

4. Use Parallel Talk

• Describe what your child is doing as they do it.

• Example: "You’re building a tall tower with your blocks. Look at that blue block on top! Wow, it’s getting so high!"

5. Be Playful and Engaging

• Use silly voices, fun expressions, and lots of enthusiasm when modeling language.

• This keeps communication fun and interactive, making children more likely to engage and learn.

The Takeaway

Language learning happens best in a natural, supportive environment. By using modeling at home, you’re giving your child countless opportunities to hear and absorb new words and structures—without any pressure. Keep it fun, keep it engaging, and know that every conversation is helping your child’s language skills grow!

Want to learn more about how to support your child’s speech and language development? Feel free to reach out—I’d love to help!

Helping Children with Autism Build Conversation Skills: Turn-Taking Made Easy

At Little Sunflowers Speech and Language, we know that conversation is more than just words—it’s about connection. For many children with autism, turn-taking in conversations can be a challenge. Whether it’s knowing when to speak, when to listen, or how to stay engaged, these skills take time and support to develop.

The good news? With the right strategies, children can learn to take turns in conversations, strengthening their communication and social skills along the way.

Simple Strategies to Encourage Turn-Taking

💡 Use Visual Supports – Turn-taking cards, visual schedules, or conversation scripts can provide clear, structured guidance.

🎲 Make It a Game – Board games, rolling a ball back and forth, or storytelling games naturally encourage turn-taking in a fun, low-pressure way.

📖 Social Stories Work Wonders – Short, personalized stories help children understand conversation flow and expectations.

👀 Build Joint Attention – Engaging in shared activities (like pointing out interesting things or playing “I Spy”) helps children learn to tune in and take turns.

👏 Reinforce and Celebrate Progress – Praise and positive reinforcement, such as “Great job waiting for your turn!” can make a big difference in motivation and confidence.

Every child’s journey with language is unique, but with patience and the right tools, they can develop stronger communication skills and meaningful connections.

#SpeechTherapy #AutismSupport #TurnTaking #ChildCommunication #MerrickNY #SpeechPathologist #LanguageDevelopment #LittleSunflowersSpeech

Vocabulary Milestones Reference

12 months - 2 to 6 words

15 months - 10 words

18 months - 50 words

24 months - 300 words

30 months - 500 words

36 months - 1,000 words

42 months - 1,200 words

48 months - 1,600 words

54 months - 1,900 words

60 months - 2,500 words

6 years - 7,000 words

12 years - 50,000 words

Pragmatics aka Social Language Skills

A few examples below of each time frame…

Birth-6 months:

•Startles to loud sounds

•Varies responses to different family members

•Stops crying when spoken to

6-12 months:

•Responds to “no”

•Tries to “talk” to listener

•Copies simple actions of others

1-2 years:

•Engages in parallel play

•Exhibits verbal turn-taking

•Talks to self during play

2-3 years:

•Watches other children and briefly joins in their play

•Requests permission for items or activities

•Makes conversational repairs when listener does not understand

FAQs

One of the most common questions I am asked as a private practitioner is if I take insurance?

I am private pay and do not take insurance at this time but I can provide a superbill for the initial evaluation and following treatment sessions, if requested. You then would submit the superbill to your insurance provider as an out-of-network claim. I try my best to help families get reimbursed whenever possible.

Phoneme Development

According to research there poses some variability in overall criteria based on studies completed yet general agreement yields a few overall conclusions about the acquisition of individual sounds (phonemes):

•Nasals “m, n, ng,” Stops “p, b, t, d, k, g,” and Glides “w, y” are typically acquired earliest.
•Up next include Fricatives “f, v, s, z, sh, zh,” Affricate “ch” and Liquids “l, r.”

•Previous studies also note voiced/voiceless “th” and “zh” were generally the latest phonemes to be acquired.

Acquisition of Pronouns

An approximation for the acquisition of pronouns - Research indicates that children use most subjective/objective pronouns by age 3 and possessive pronouns by age 5.

Approximate Age Pronouns

12 – 26 months I & it

27 – 30 months my, me, mine, you

31 – 34 months your, she, he, yours, we

35 – 40 months they, us, hers, his, them, her, him

41 – 46 months its, our, myself, ours, their, theirs

47+ months herself, himself, ourselves, yourselves

Expanding Toddler Vocabulary

Here are some tips to boost your toddlers vocabulary:

1. Read together.

2. Talk with versus at your child.

3. Sing songs.

4. Encourage them to use their “words” in lieu of frequent pointing/gesturing.

5. Model language for them.

6. Expand on their language, i.e., “ball” to “yes, that’s a small red ball.”

7. Explore new items and environments together.

PROMPT Training

What is PROMPT?

•PROMPT stands for Prompts for Restructuring Oral Muscular Phonetic Target. PROMPT is “a tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, lips, tongue, vocal folds) to manually guide them through a targeted word, phrase or sentence.” 

•PROMPT was developed to treat children with motor speech disorders including apraxia, speech/language language disorders. It can be used for children ages 6 months and older. 

•At Little Sunflowers Speech and Language we are committed to and prioritize continuing education and plan to be PROMPT trained by the end of this year.

Speech Intelligibility Expectations

Did you know that children’s speech intelligibility can be classified into the following age groups? Is your child speaking unclearly to familiar and unfamiliar listeners? Quite frankly, it could be developmentally appropriate depending on their chronological age. Check out my chart below for corresponding age to intelligibility levels.

19 – 24 months 25-50% intelligibility

2 – 3 years 50-75% intelligibility

4 – 5 years 75-90% intelligibility

5+ years 90-100% intelligibility

If you’re interested in discussing your child’s speech please fill out the contact form and we’ll set up a free consultation.

We’re Open!

We are happy to announce that Little Sunflowers Speech & Language is available to begin seeing clients! We are a private practice specializing in speech/language delays, social skills development, expressive/receptive language disorders, and articulation disorders. If you think your child may benefit from speech and language therapy please fill out our contact form for a free phone consultation. Referrals are welcome!