What to Expect During Your First Speech Therapy Session

Starting speech therapy, whether for yourself, your child, or another loved one, comes with a mix of emotions, including curiosity, hope, and maybe a little uncertainty. People often wonder what actually happens at the very first session. Do you jump right into exercises? Will you be evaluated? How much information do you need to share? 

At Great Speech, we understand that taking the first step towards speech therapy is often the hardest one. Because of this, the initial appointment is designed to be welcoming, informative, and surprisingly low-pressure. Instead of diving headfirst into therapy exercises, the goal of the first session is to build a strong foundation and plan for future sessions. We do this by getting to understand your individualised needs, getting to know each other, and mapping out a clear speech therapy plan that feels obtainable and customized. 

Below, we will outline what to expect during your first speech therapy appointment. 

1. Getting to Know Each Other

Your first session typically begins with a few minutes of getting to know each other. Comfort is essential for progress, especially in a virtual session. Because of this, we usually start with light conversation and ice-breaker activities. 

We offer speech therapy for people of all ages: toddlers, children, teens, and adults (including seniors). Our approach for getting to know each other is dependent on age and ability. For adult clients, this may include friendly conversation about your work, family, interests, or what prompted you to seek therapy. For toddlers and children, we often foster a connection through age-appropriate questions and play-based interactions. 

These early moments help set the tone, regardless of age. When clients feel safe and understood, speech therapy is more effective. 

2. Review of Your Concerns and Goals

After we get to know each other, the speech therapist will take time to understand why you are seeking speech therapy. Depending on age and ability, this will happen directly with the client, or with a parent or caregiver.

Discussion may include:

• Your communication challenges
• Any concerns raised by family members, caregivers, teachers, or doctors. 
• The specific goals that you hope to achieve. For example, improved language development, speech clarity, stronger public speaking confidence, or better social communication skills. 

The more open you are about these concerns and goals, the more individualized the speech therapy plan will be. Because of this, this part of the session is not rushed. The therapist wants to hear your perspective and understand what progress will look like for you, personally. 

3. Review of Developmental, Medical, and Other Relevant History

Next, your speech therapist will go over your developmental and medical history that may help understand the bigger picture and identify factors that might influence your speech, language, and communication skills. 

Depending on the client, this may include:

• Developmental history
• Medical history
• Past evaluations or diagnoses
• Previous therapy experiences
• School or workplace challenges
• Any environmental or family factors that might impact your communication

4. Assessment

The assessment is a core part of your first appointment. Speech-Language Pathologists (SLPs) at Great Speech use a structured assessment tool to establish a baseline and determine the best starting point for speech therapy. 

The initial assessment may include:

• Speech sound production (pronunciation, clarity, and articulation)
• Language comprehension (understanding directions and vocabulary)
• Expressive language abilities (word retrieval, sentence structure, and storytelling)
• Social communication skills (tone of voice, eye contact, pragmatic language)
• Speech fluency (rate of speech or stuttering)
• Voice quality (pitch, volume, and resonance)

Some people fear the word “assessment”. Don’t worry, there is no way to “fail”. The purpose of the assessment is simply to understand where you are today so that progress can be measured going forward. 

For children, assessments often feel like interactive games or tasks that we weave organically into natural conversation. For adults, they may feel like guided questions, structured tasks, or conversational prompts. 

The results from the assessment are invaluable. The SLP will use this information to develop a personalized treatment plan. 

5. Outlining Expectations and Self-Led Practice

Formal exercises do not typically begin in the first session; however, most speech therapists will take a few minutes to explain what you can work on between now and the next appointment. The goal is to provide helpful guidance to start building momentum right away, while not overwhelming you. The SLP will also explain how home practice fits into overall progress. At Great Speech, consistency matters. Little steps taken regularly often lead to the biggest breakthroughs. 

6. Question Time

Before wrapping up your first appointment, your speech therapist will invite you to share any final questions or concerns. There are no silly questions. Great Speech therapists want you to feel confident, informed, and supported from day one. Common questions that our clients ask are:

• How long will it take to see progress?
• How can I support my child or loved one between sessions? 
• What if I’m nervous about speaking on camera?
• How do I communicate with you outside of appointments? 

7. Scheduling and Communication Moving Forward

Your first appointment ends with a quick review of the next scheduled appointment time. Your therapist will also typically share the best ways to communicate with them outside of appointments. 

By the time the session is over, clients typically feel more at ease and excited than when they began. The unknown becomes clear, and the therapy plan feels doable. 

What You Won’t Need to Worry About During The First Appointment

Clients sometimes expect logistical or administrative discussions during our first appointment. That is not the case. For example, schedule preferences and billing details are handled completely by our onboarding and billing teams before you are matched with a speech therapist. Your first appointment time is dedicated to getting to know you and your challenges and goals, not paperwork. If you would like to read more about the topic of insurance, check out our Insurance Page. 

The First Step Matters

Your first visit with Great Speech is not about performance or perfection. It’s about making a connection, discussing your needs, and creating a plan that fits your personalized goals. With us, you’re matched with a speech therapist who understands your goals and meets you exactly where you are. 

Whether you are seeking clearer speech, improved confidence, smoother communication, or support for your child’s language development, the first session is the launch point for meaningful progress. 

Book an Appointment to get started. We will be there to help you every step of the way.