Preparing for Speech-Language Therapy: The SLP and The Client

Author: Kendra Wormald, Reg. CASLPO Speech Language Pathologist
Date: Wednesday, February 26, 2025

Table of Contents

• The Client

  • How to Prepare for the Online Session 

  • After reserving an appointment, you should receive

  • What to Bring to your Session

  • Understand Your Insurance Coverage

  • Meeting the SLP

• The SLP

  • The Voice

    • Vocal Hygiene 

    • Vocal Warm-up / Cool Down:

    • Breath Support

  • The Plan

• Conclusion

The Client

Meeting with a healthcare professional or just someone new and sharing your struggles and challenges can feel daunting and nerve wracking. Feeling these often means what you’re doing is valuable and will offer an opportunity for growth. In order to feel more confident in meeting with the SLP for the first time, consider the following suggestions.

How To Prepare for the Online Session

• Ensure you are in a quiet and private location with good lighting and reduced environmental noise

• Ensure your internet is reliable  

• Use technology that is up to date and functioning. At this clinic we use the Zoom platform which is PHIPA compliant.

• Bookmark your zoom link, it will always be the same meeting room each session, for your specific SLP 

• Opt for a laptop or tablet over a smartphone

• Use technology that supports video conferencing. You always have the choice of turning on/off your camera however it is recommended to keep it on especially when targeting articulation, accent, voice, speech and oral-motor skills 

• Put aside all other work and distractions. You will not get the most effective results if you aren’t fully attended to the session. This is not a time to answer emails, or finish your work project. Even though the session is offered online, it does not make it less important or valuable as an in-person session. Respect yours and your SLP’s time and conversation.

 After reserving an appointment, you should receive:

• Confirmation Email (immediately):

  • Check to ensure the information is correct

• Intake Forms (between 30 minutes to 1 hour later):

  • These forms offer an opportunity to share your medical history, challenges and goals, support systems and sign off on policies and procedures. It is very important to complete these prior to meeting with your SLP so they can come to the session with a better idea of your background and purpose for booking the session. 

  • Why Does my SLP Need to Know Where I Live? 
    Your SLP is a regulated healthcare professional, meaning we have conduct we must follow and a certain way to maintain client records. Knowing your address ensures we can direct medical attention as necessary in the case a medical event occurred during the session. Additionally, since your SLP is regulated, they can only practice within certain provinces. For example, I am only able to practice within Ontario as an SLP, so if you resided outside of this province, you could not receive SLP services. Alternatively your SLP also offers communication consultation services for in and outside Ontario however the client will not be able to claim this through insurance.

• Reminder Email (48 hours before your appointment):

  • Mark the Wellsaid Cliniko emails as ‘safe’ to ensure these don’t go to your junk mail. I also recommend scheduling the meeting in your calendar and set a reminder

What to Bring to your Session 

1. A list of questions: It’s important to feel fully informed about the service you’re receiving. You are welcome to ask questions and clarify at any point in time. 

2. Insurance information if you want us to directly bill 

3. A list of goals and challenges. Bring several examples of the challenges you face in different contexts such as professionally, socially, and in high riskSituational examples are also a great idea to come ready with. Such as how a work conversation brokedown

4. Prior evaluations, assessments and referrals for related concerns

5. Feedback from others. This could be from a coworker or boss, your partner, friends and or family. Try to get various perspectives from important people in your life who may see you on a weekly or daily basis 

Understand Your Insurance Coverage

• Several insurance companies cover SLP services, which may be written as ‘speech therapy’.

• Take a look to see if you have coverage, the amount and percentage covered and the timing of the insurance term.

• You can only claim insurance for SLP services, as your SLP is a regulated healthcare professional. You cannot claim these sessions under areas such as psychotherapy or social work. 
  
  

Meeting the SLP

• Don’t try to impress your SLP upon meeting them. I like to remind my clients that showing your challenges during the screen and assessment will actually help your SLP better be able to support you. 

• You can ask as many questions as you want, as many times as you want. If information seems too complex or you feel you’d be supported in a different way - express that. 

• Your SLP is there to support YOU and your goals, not for themselves.  

• Share your learning style with your SLP. If you prefer images, research or videos or don’t like analogies - this is important information for your SLP to best support you 

The SLP

You may have heard the phrase “practice what you preach”, which remains true for what your SLP advises and how they should support their own voice and communication. It is vital that your SLP is able to effectively teach, provide feedback and share information in a clear and direct way to ensure the client is fully informed and supported throughout the session. You may wonder how your SLP prepares for sessions in order to ensure effective and clear knowledge translation. 

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The Voice 

Your SLP is likely facilitating 4-6, hour-long sessions each day. In order for this to be possible, the SLP should be intentional about voice care.

Vocal Hygiene: A daily practice of supportive habits to maintain the health of your vocal folds.

1. Liquid consumption: Drink a minimum of 64oz of water a day, ensuring consumption during conversations to support consistent hydration. If alcohol or caffeine is being consumed, double the amount of water intake. These substances will dry out the larynx (voice box) and may increase production of mucous, which will likely negatively impact the breath It is also important to consider if any medication you’re on are diuretics, i.e will dry you out

2. Avoid Triggering Foods: Some foods such as dairy, spicy and acidic foods (especially for those with GERD) can increase mucus production, sensation of something in the throat, tightness and burning 

3. Avoid throat clearing: Frequent throat clearing can increase fluid within the larynx which may increase susceptibility of vocal fold bruising, swelling and irritation which may affect the voice. To avoid this, switch to a controlled cough or swallow

4. Avoid irritants: smoking whether directly or second-hand can lead to inflammation and possible cancer of the vocal folds and other areas. Also, consider your environment. For example, I wouldn’t put my cat’s litter box in my home office and intentionally clean with scent-less products, or close my window when the pollen count is high. Using a humidifier to reduce air contaminants can also significantly help

5. Maintain loudness: Don’t speak over background noise. Closing a window if there’s construction noise, using a microphone, adjust proximity to the microphone

6. Posture, ergonomics, and tension: The way you sit can either support or negatively impact your breath support and function of muscles that support voicing. Having a chair and computer set-up that supports posture. I have my laptop positioned on a raised platform and have both of my screens within close proximity to reduce having teh swivel my head too far or often. I also set a reminder to stand and walk every hour following each session, to support blood and oxygen flow and reduce any build up tension 

7. Massages and stretches: Specific self-massages for the voice can look like circular motion on your larynx, mild pressure on the temporomandibular joint (TMJ) and surrounding areas such as the throat, tongue base, back of the neck, shoulders and chest. These are effective to do prior to, during and after speaking engagements

8. Plan for Voice Breaks: Speaking for an extended period of time can cause tension, misuse of vocal mechanisms and hoarseness. I try to ensure I don’t have more than 3-4 meetings in a row and when not in session, I intentionally am in vocal rest. On days where I know I have a surplus of meetings, I ensure my mornings and evenings outside of work are reduced-speaking activities. Your voice will often give you signals of being fatigued, it’s vital to attend to these and address them. Ignoring these will likely negatively impact the voice, if at the very lease increase the uncomfortableness and tightness within the throat, chest or mouth

Vocal Warm-up / Cool Down: We should look at using our voice the same way we use our muscles during a workout. You’ve likely heard that you should do some form of warmup and cooldown surrounding a workout, which remains true for voice support as well. In order to create voicing, there are several muscles engaged which benefit from easing into voicing

1. Tongue Trill: Relaxes the tongue and coordinates breathing and voice. You can do this by placing your tongue tip slightly behind the teeth as you exhale, leading to the tongue vibrating or ‘trilling’ 

2. Lip Trill: Reduced tension in the lips and coordinated breathing and voice. You can do this by placing your lips loosely together as you exhale. Try this on sounds such as ‘h’ and ‘b’. You can also progress through a pitch glide 

3. Pitch Glides: Shift throughout your pitch range from high to low, low to high 

4. Sirens:  Improves resonance focus and supports strength of vocal folds. Say wee-woo one high, one low, then the opposite way - low then high 

5. Yawn - sigh: Yawn then let out a long sigh on the exhale.  Use this especially when you feel tightness and fatigue in your throat 

6. Humming: Hum an ‘m’ sound as a cool down as you feel a tickle sensation in your lips and nose

7. Tongue Twisters and diadochokinetic (DDK): Say the sounds PahTahKah at different rates and with overdoing your mouth movement

Breath Support: Once you meet with your SLP, you will likely learn about the significance of breath in voice and communication. Ensuring the breath is being supported through posture, diaphragmatic and abdominal engagement, ensuring movement primarily comes from the diaphragm, then the lungs and chest wall. Put your hand on your belly, as you inhale, your belly should expand, pushing your hand away from your spine. As you exhale, the belly (diaphragm) passively recoils towards the spine. Speech breathing should be through the mouth for both inhaling and exhaling. Breathing around every 8-10 words, ensuring you sit in the breath for at least 1.5 seconds.

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The Plan

Much like many things in life, a session seldom goes as planned. Therefore, it is likely your SLP has some back pocket activities to support your challenges, will offer different approaches and explanations and possess the ability to be flexible.

Your SLP will review your intake form and any additional files, prior to your initial meeting. Taking into consideration your language, ethnicity and cultural backgrounds, education, career, and support systems available. These pieces of information are imperative to ensure the client is uniquely and specifically supported with equity, equality and respect. Your SLP will also reflect on your reported goals and challenges. Although the SLP will support you in shaping specific goals and identifying areas for opportunity for growth, it’s imperative that the SLP understands the intentions and aspirations of the client, to ensure they are appropriately supported. 

Following a formal and/or informal assessment, I and the client will review the areas of suggested targets and the evidence observed across different communication contexts such as reading, describing picture scenes, answering basic and complex questions, conflict scenarios and conversational speech. Together the client and SLP finalize the goals. These goals don’t have to be set in stone either. You can always add or take away goals or shift what ‘goal achievement’ means to you. Following sessions, your SLP will send you a home plan for the week, based on what you did within the previous session. 

The gold standard for frequency and length of practice in general, is supported by research to be 15 minutes of intentional practice each day while meeting with your SLP once a week. However it is imperative to discuss the time, cognitive capacity and financial availability the client has, when deciding frequency of sessions and practice. This process shouldn’t be stress inducing - be sure to work with your SLP on a plan that fits your goals and resources available.  

Conclusion

If you have more questions about the initial process of booking a session and meeting with an SLP, please feel welcome to reach out via phone or email.

To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.