Frequently Asked Questions
Answers To Questions I Hear Most Often From Parents
Have questions about your child’s speech development or about getting started? You’re in the right place. If you don’t see your question here, I’d love to help — just reach out.
Speech & Language Development
Speech refers to the physical production of sounds — how clearly your child pronounces words. Language is the broader system of communication — understanding words, following directions, and expressing thoughts and ideas. A child can have a speech delay, a language delay, or both, which is why a thorough evaluation always looks at each area separately.
By 9 months most babies are babbling, pointing, and responding to their name. By 18 months most toddlers are using at least 10-20 words. By age 2 most children are combining two words together. By age 3 most preschoolers are speaking in sentences and understood by familiar adults most of the time. If your child isn’t meeting these general markers, it’s worth talking to a speech-language pathologist.
Speech and language delays can have many causes — and in many cases no single cause is identified. Common contributing factors include hearing loss, developmental differences, limited language exposure,and neurological differences. An evaluation is the best way to understand what’s driving your child’s delay and what kind of support will be most effective.
Yes — hearing loss is a common and often overlooked cause of speech and language delays in young children. If a child can’t hear clearly, he can’t learn to replicate sounds and words accurately. While pediatricians routinely screen hearing at well visits, those screenings don’t always catch every type of hearing loss. If your child has a speech or language delay, a formal hearing evaluation by a licensed audiologist is always recommended as an important first step before or alongside a speech evaluation.
Prelinguistic skills are the foundational communication abilities that develop before a child says their first words — things like eye contact, joint attention, pointing and turn-taking. These are the building blocks of language and children need to develop them before meaningful speech is possible. Addressing these skills early is often the most critical first step in therapy.
Sometimes delayed speech can be one of the early signs of autism spectrum disorder, alongside other differences like limited eye contact or reduced social engagement. However most children with speech delays do not have autism — delays have many possible causes. A thorough evaluation can help clarify what’s going on and whether a referral for further assessment makes sense.
A late talker is a child whose language development is delayed but who is otherwise developing typically — play skills, social engagement and understanding of language are relatively on track. Some late talkers catch up with support while others benefit from early intervention. Early evaluation is the best way to determine which path your child is on.
Play and language development are deeply connected. Children move through predictable stages — from cause-and-effect play in infancy, to functional play with objects, to symbolic and pretend play in the toddler years. A child’s readiness to use words is directly tied to where they are in play development — which is why play skills are always part of how I evaluate and treat speech and language delays.
Getting Help & What To Expect
Trust your instincts — parents are often the first to notice when something is off. Consider reaching out if your child isn’t meeting age-appropriate milestones, is significantly harder to understand than peers, gets frequently frustrated trying to communicate, or shows limited interest in interacting with others. A free consultation is a low-stakes way to get a professional perspective.
While some children do catch up on their own, research consistently shows that early intervention leads to better outcomes for children with speech and language delays. Waiting can mean losing valuable time during a critical window of development. A free consultation costs you nothing and gives you real, personalized information rather than simply wondering.
Speech therapy along with parent coaching can begin at age 6 months when early communication concerns are present, and sometimes earlier depending on your child’s history and needs. Early intervention is especially powerful in the first three years of life when the brain is developing most rapidly. If you have concerns about your infant or very young toddler, it is never too early to seek an evaluation.
A screening is a brief check to determine whether a child may be at risk for a delay — it gives a broad yes or no answer about whether further assessment is needed. A full evaluation is a comprehensive assessment of your child’s communication, language, speech, and play skills, resulting in detailed findings and specific recommendations. At Play Say Learn evaluations are play-based and designed to feel comfortable and natural for your child.
This varies depending on the child, the nature of their delay, and how consistently strategies are practiced at home between sessions. Some children make meaningful progress in a few months while others benefit from longer support. After an evaluation I’ll give you a clearer picture of what to expect for your specific child.
Sessions are play-based, child-led, and built around your child’s interests and developmental level. Young toddlers learn best through natural, meaningful play — not drills at a table — so every session is designed to feel engaging and enjoyable for your child. I work directly with your child during sessions while also coaching you with simple strategies to use at home
Children spend a small fraction of their week in therapy and the vast majority of their time at home with you. When parents know how to support communication during everyday routines — mealtimes, bath time, play, and reading — progress accelerates significantly. Parent coaching isn’t about adding more to your plate. It’s about making small, natural adjustments to interactions you’re already having every day.
About Play Say Learn
I specialize in speech and language therapy for infants 6 months and older, late-talking toddlers and preschoolers with speech or language delays or disorders. I also work with children who are hard to understand and children with limited play or social interaction skills. In addition I offer stuttering evaluation and therapy for children, teens and adults.
I currently provide in-home speech therapy to families in Franklin, Brentwood, Westhaven, Green Hills, Belle Meade, 12 South and surrounding areas in the greater Nashville, Tennessee area. In-home sessions bring therapy directly to your family and offer a convenient option for busy parents of young children. A private office location is also coming soon — contact us to learn about current availability.
Yes — virtual sessions are available for families throughout Tennessee and New Jersey living outside of the local in-person service area. Teletherapy works best for parent coaching and consultations rather than direct therapy with very young children, so virtual sessions are typically focused on guiding and coaching parents with strategies they can use at home. If you’re unsure whether virtual or in-person sessions are the right fit for your child, we can discuss that during your free consultation call.
Play Say Learn is an intentionally small, boutique practice. Your child works directly with me in every session — there are no rotating therapists and no high-volume scheduling. Every therapy plan is individually designed around your child’s specific strengths, interests, and developmental needs, with parent coaching built into the approach from the start.
Fees & Insurance
My practice is private-pay, which means insurance is not billed directly. Sessions can be paid with all major credit cards as well as HSA and FSA cards. It’s worth calling your insurance provider to ask about out-of-network speech therapy benefits — many families find they have partial coverage. I’m happy to provide detailed invoices and superbills after sessions that you can submit for possible reimbursement. For information about current session fees please reach out during your free consultation call.
Getting Started
It’s a relaxed, 20-minute phone call — no pressure and no commitment required. We’ll talk about what you’re noticing, what milestones your child has and hasn’t reached, and whether an evaluation or therapy might be a helpful next step. You’ll leave the call with clarity and a clear sense of what I’d recommend.
Simply book your free 20-minute consultation call below. No paperwork, no commitment, no pressure — just a conversation about your child and a clear path forward.