Answers to Your Questions About Speech Therapy, Dyslexia, and Tutoring

Check in at the front desk, where our intake coordinator confirms your paperwork. Your child’s specialist then greets you in the waiting room. The evaluation combines standardized testing with clinical assessment, and the specialist chooses tests based on your concerns. Children often work best one on one, so if you’d like to observe, speak with the specialist first.

The specialist will talk with you after the session, though scores won’t be available yet. After scoring and interpreting the results, they write a report with your child’s scores and recommendations. About one to two weeks later, you’ll meet by Zoom or phone to review the results and set up a recurring session schedule. Most students start sessions the following week.

The foundation of reading is deeply language-based, and an underlying language skill often drives reading difficulty. We check those skills first, such as phonological awareness, vocabulary, and rapid automatic naming, so treatment targets the root cause. Students with reading or math concerns but no language concerns may be referred to a learning specialist. Learn more about language evaluations for reading.

Try a “one up” style: add just one word to what your child says, so “ball” becomes “red ball.” Use simple routines like “Ready, set...” and pause before the last word so your child can fill it in. Make three or four statements before asking a question, which gives your child language to borrow.

Not automatically. If your child isn’t hitting every skill exactly on time, that doesn’t mean there’s a delay. But a parent’s intuition is usually right, and it’s never too early to ask questions or get a screening. If you have a language concern, an evaluation from a speech-language pathologist is worth considering.

Early intervention sessions take place in person at our Johnston and North Liberty offices, and virtual services are also available. Speech-language pathologists and learning specialists guide each session, using individualized strategies, parent coaching, and play based activities.

An articulation disorder is trouble making a particular sound correctly, like the R or S. A phonological disorder is a pattern of sound errors across many words, such as leaving off word endings. Both can make a child harder to understand, and the approach to therapy differs.

Young children often swap sounds in predictable ways, such as “tat” for “cat” or “wabbit” for “rabbit.” Many of these patterns fade during the preschool years. If they continue longer than expected or make your child hard to understand, a speech evaluation can help.

The sounds L, R, S, CH, SH, and TH often aren’t fully mastered until ages 6, 7, or even 8. At age four, the most important thing is whether people outside the family can understand most of what your child says. If strangers understand most of it, minor sound errors are usually not a concern. If you still have worries, an evaluation is a good next step, because early support helps. Learn more about four-year-old speech milestones.

Repeat the word back correctly in a natural way, instead of asking your child to say it again. Read together, talk through daily routines, and praise effort. Short, playful practice works better than drills. Your therapist can give you specific sounds and activities for your child.

Yes. A tongue-tie limits how far the tongue can move, and a tongue thrust changes where the tongue rests and moves during swallowing. Both can contribute to speech sound errors and speech that’s hard to understand. A provider should look at how the mouth works, not only how it looks. Learn more about tongue-tie and myofunctional therapy.

Common signs include speech errors that change each time (the same word said differently), more errors in longer words and phrases, and groping for the right mouth position. Some children distort vowels, leave out sounds, or rely on simple consonant-and-vowel syllables, and speech is often hard to understand. Only a speech-language pathologist can confirm apraxia.

Apraxia is a specific type of speech sound disorder. Therapy for a phonological disorder often works on one sound pattern at a time, while apraxia therapy focuses on the motor movements of speech. That’s why an accurate evaluation matters.

In many children, the cause is not known. Risk factors for speech and language disorders include a family history of speech or language problems, frequent ear infections, and some diagnoses. Apraxia is not a sign of low intelligence. Apraxia Kids offers more resources for families.

As motor speech skills improve, therapy may shift from working on movement patterns to targeting specific sounds that still affect how well others understand your child. Your therapist adjusts the plan as your child progresses.

Apraxia therapy focuses on the motor movements of speech, not one sound at a time. Our therapists are trained in PROMPT, which uses touch cues to guide mouth movements. Sessions at ETLC are typically 30 minutes and adjusted to your child’s needs, and we review goals every four months.

No. Communication tools such as pictures, sign, or a speech device do not hold back speech, and they can reduce frustration. They give a child a way to share ideas while speech develops. Our therapists can help you decide whether a tool is right for your child.

Receptive language is understanding what others say, like following directions. Expressive language is using words and sentences to share thoughts. A child can struggle with one or both. Knowing which areas are affected helps a therapist plan support that fits your child.

Yes. Children who say few or no words can make real progress with therapy. A therapist builds communication step by step, using play, gestures, pictures, or a speech device while spoken words develop. Starting early gives your child more ways to share what they want and need.

In many cases, the cause is unknown. Risk factors include a family history of speech or language problems, repeated ear infections early in life, and conditions such as cleft palate, autism, premature birth, and Down syndrome. If you’re worried, an evaluation can help you understand what your child needs.

No. Children learning two languages reach milestones on a similar timeline to other children, though their words are split between the two languages. If a child struggles in both languages, that is worth an evaluation. You don’t need to stop speaking your home language. Learn more about bilingual language development.

Children learn language through live, back and forth interaction with caregivers, and screens can’t replicate that, no matter how well designed. For very young children, video chatting with a responsive adult is the best screen use. For preschoolers, choose programs with real evidence behind them. If you think screen habits may be connected to a delay, talk with your pediatrician or a speech-language pathologist. Learn more about a digital diet for kids.

Talk about what you’re doing during daily routines, and give your child time to answer. Add a word or two to what they say, so “ball” becomes “big ball.” Read together every day and ask questions about the story. Your therapist can suggest activities that fit your child’s goals. Reach out to our team.

Many young children go through a “clumsy stage” with repeated syllables, like “mo-mo-mom,” and it often passes within five to six months. Signs that point to stuttering include more frequent stuttering, getting stuck on one sound, or facial tension such as grimacing, eye blinking, or head nodding. If you notice these, don’t wait. Early evaluation is better than waiting.

Speak slowly and in a relaxed way, because children mirror your pace. Pause before you respond, and make it clear you’re listening to what your child says, not how they say it. Avoid saying “slow down” or “take a breath,” and don’t finish their sentences. Ask fewer questions, one at a time, and set aside 5 to 10 minutes a day of distraction-free time together. Learn more about supporting a child who stutters and the Stuttering Foundation.

Avoidance tends to increase anxiety over time, not reduce it. Instead, show your child that you accept the way they talk, give them plenty of time to answer, and encourage them to join in. A speech-language pathologist can help with strategies and with building communication confidence.

No. Stuttering is not caused by anxiety, nervousness, or parenting. It is a neurological difference in how the brain coordinates the complex movements of speech. Parents play an important role in helping, and our therapists work with families so every child feels supported.

Talk with your child about what happened, and let them know stuttering isn’t their fault and doesn’t change how capable they are. Teach family, friends, and teachers what stuttering is, so they know how to respond. Our therapists also build communication confidence, which is an important part of support for any child who stutters.

No. Stuttering therapy is effective across the lifespan. For older children who feel upset or anxious about stuttering, a counseling integrated approach can help alongside fluency strategies. Our team works with children from 18 months through adulthood. Reach out to our team.

Dyslexia is neurological in origin, which means it comes from differences in how the brain processes written language. It is primarily a difficulty with phonological processing, which is the ability to hear and work with the sounds in words. It is not a sign of low intelligence.

No. Reversing letters is common in young children and is not a sign of dyslexia on its own. Dyslexia is mainly a difficulty with the sounds in language, not with vision. If reversals continue along with other reading struggles, ask for an evaluation.

It starts with a parent questionnaire, followed by a full assessment of phonemic awareness, phonics, reading fluency, spelling, comprehension, and written language. A speech-language pathologist or psychologist completes it, it takes about two to four hours, and it may lead to a diagnosis. We use the results to build a plan for your child.

Dyslexia doesn’t go away with a new teacher or more time. Children who get explicit, step by step instruction in phonemic awareness and phonics can learn to read, and getting that support in place early is the best thing you can do. It’s never too early to ask for an evaluation.

Strong reading instruction teaches phonemic awareness and phonics in a clear sequence. Children learn to blend sounds in unfamiliar words instead of guessing from pictures, and they practice with decodable text. At ETLC, we use a multisensory, research-proven approach in one-on-one sessions built around an individual plan.

No. A formal diagnosis isn’t required to begin working with a learning specialist or speech-language pathologist. School eligibility for services is a separate standard from a clinical diagnosis. If you’re seeing reading struggles, an evaluation with our team is a good place to start.

Use hands on tools like blocks, number lines, and hundreds charts so your child can see what numbers mean. Build number sense by counting real objects, estimating grocery totals, or doubling a recipe. Praise effort and treat mistakes as part of learning. If math stays hard, a full assessment can find the missing foundational skills. Learn more about math struggles and fun ways to build math skills at home.

Writing is one of the most demanding tasks we ask of children, because it uses planning, working memory, attention, and organization all at once. Break assignments into steps, let your child record an answer before writing it, and try speech to text. Keep journaling low stakes. If handwriting is hard to read, tiring, or letter reversals continue past second grade, ask about support. Learn more about how you can help making writing easy.

Try a visual method. Show the word, let your child picture it, then have them trace it in the air while saying each letter, spell it backward, and write it on paper. Games help too, such as Memory Match, Rainbow Writing, and Sight Word Hopscotch. If the same words keep slipping despite regular practice, it may be worth talking with a learning specialist. Learn more about how to help your child master sight words.

Talk before, during, and after reading. Before, look at the cover and make predictions. While reading, point out characters, setting, and feelings, and retell what has happened so far. After, model a short summary, have your child retell the main details, and check the prediction. Choose books that aren’t too hard or too easy, because engagement drops either way. Learn more about encouraging reading comprehension.

The summer slide is the academic regression many children experience over summer break, and students can lose up to two months of reading progress. Aim for 15 to 20 minutes of reading a day, and add audiobooks, cooking, one new vocabulary word each week, and board games. Short daily practice beats occasional long sessions. Learn more about preventing the summer slide.

Common signs include trouble with morning or bedtime routines, chores, and homework, and losing or misplacing items often. Children may also have messy work, lose their place while reading, act on impulses, or struggle with multistep problems. At school, a child may finish homework but forget to turn it in. Learn more about the signs of executive functioning difficulties.

No. Executive functioning is the set of brain skills that manage what to do, how to do it, and how long to do it. Diagnoses like ADD, ADHD, and autism can affect those skills. If attention is a concern, our speech-language pathologists may recommend further psychological testing.

Build predictable routines and talk through each step out loud. Break big tasks into smaller pieces, write the steps down, and let your child cross them off. Practice planning with everyday activities, like making a snack or getting ready for a sports game. Older children can list what a task needs and spot missing steps. Learn more about practicing planning at home.

Yes. Board and card games teach following rules, impulse control, turn-taking, and patience. For babies, peek-a-boo builds selective attention, and reading books together supports both selective and divided attention. Learn more about games for executive functioning.

Choose a quiet workspace away from play areas, and hold homework at the same time each day after a short snack and movement break. Have your child write down every assignment before leaving school, and add 3 to 5 minute brain breaks between tasks. The National PTA suggests about 10 minutes of homework per grade level each night. Learn more about homework, study skills, and test prep tips.

Consider extra help if homework takes much longer than is reasonable for your child’s grade, causes ongoing stress, or assignments keep getting lost. If your child knows the material at home but struggles on tests, it may be worth exploring whether a learning difference is involved. Start by talking with the teacher, then reach out to our team.

Help your child name what they’re feeling, then guide them back to calm with a simple strategy. Options include deep breaths, music, counting to ten, a walk, or squeezing a ball. You can also name your own feelings out loud so your child sees how it’s done. Learn more about helping your child regulate their emotions.

Practice simple steps: stand facing the person, make eye contact, start with a greeting or question, speak slowly and clearly, listen, respond to what the other person said, and end with a friendly closing line. Role-play common situations at home, and work on one or two steps at a time instead of all eight.

Some nervousness meeting new people is completely normal. If your child consistently avoids conversation, struggles much more than other children their age, or the challenges are affecting friendships and school, it may be time to talk with a speech-language pathologist about a social communication evaluation.

Orofacial myofunctional therapy teaches children to use their tongue and facial muscles correctly through strengthening and retraining. It can improve tongue posture at rest, tongue thrust, mouth breathing, snoring, speech sounds, dental development, and sleep quality. The process is individualized and looks different for each child.

A tongue-tie is a condition present at birth in which the frenulum, the band of tissue under the tongue, is abnormally tight or short. Function matters more than appearance. It can be addressed at any age, often early for infants to support breastfeeding. An evaluation is worth pursuing for feeding problems, poor weight gain, or a latch issue, however the frenulum looks.

No. A release, called a frenectomy, is a medical procedure performed by a dentist, oral surgeon, or ENT. A speech-language pathologist with myofunctional training evaluates how the tongue functions, helps decide whether a release is appropriate, and provides therapy before and after.

Signs can include snoring or mouth breathing, unusual sleep positions, teeth grinding, bedwetting, and dental changes like crowding or a narrow palate. Some children also seem irritable, unfocused, or hyperactive from poor sleep. If you notice these signs, it’s worth having your child’s breathing and oral function evaluated.

Yes. Pressure from the thumb can change facial growth and cause a narrow palate, overjet, or underbite. Sucking habits that continue past 15 months may point to an underlying issue, and it’s important to look for a cause if they continue at age three. A myofunctional evaluation can help.

Our team updates families on progress weekly. On a quarterly basis, your provider reviews your child’s goals with you, so you can see progress on specific skills together.

An evaluation report compares your child’s performance with other students their age, may list a diagnosis, and includes goals and session recommendations. It’s reviewed at least once a year. A progress report compares your child with where they started and is reviewed quarterly. Learn more about the difference.

Families are at the forefront of the evaluation, goal writing, and treatment process. Our therapists weigh your priorities when choosing goals, such as a child saying a sibling’s name clearly, even if typical development points to other sounds first. If your schedule changes, we can move sessions between in person and online and adjust the plan. Learn more about family-centered care at ETLC.