Teletherapy – Empowering the Parents

     I am no exception to the age-old rule that for human beings, change is difficult. In 2000, I adamantly rejected installing a computer jack into my home office because I never thought I would use a computer in my practice. My office, home to my private practice, had been filled with toys, workbooks, puzzles and puppets used in my speech therapy lessons. The integration of technology in treatment was, at the time, a foreign concept and stubbornly contested. Now, unable to interact with my clients in-person, teletherapy is my only option to ensure the continuity of services. Today, we are all being challenged to embrace the unfamiliar. While daunting at first, I must admit that teletherapy has proved an invaluable tool in enhancing speech and language treatment.

I have known for many years that parent involvement is crucial especially for my youngest clients to progress in therapy. Research has shown the importance of training parents to practice therapeutic tools in their daily interactions with their children. Consistent practice throughout their day is critical to the child’s progress and is underscored by the unique bond a parent shares with their child. Parent-therapist collaboration has been a cornerstone of my treatment plans for years. Little did I know that with my discomfort of technology, teletherapy would enhance this practice and partnership.

As therapists, we keep a child engaged by being physically present offering cues, engaging their sensory motor skills to explore toys and interact with people. With toddlers, and especially those with communication disorders, it is nearly impossible to keep them engaged for a full session through the screen. The real challenge is how best to engage both parent and child. Therapists are trained to evaluate and treat a variety of communication disorders both for children and adults. Parents, however, only need to learn how to facilitate the goals necessary for improving their child’s individualized plan. Many parents have embraced working with their child on the other side of the screen. They are trying new things and loving the impact they can have on their child’s growth and development. Of course, on my end, there is endless planning. Before the session, I advise parents on what they’ll need for the activities so that we can do the same thing on each end of the screen. I’ve played ‘Ring Around the Rosy’ with a puppet and made “play clay” from scratch. Resourcefulness is key. Parents, look around your home and you will find treasures waiting to be played with by your toddler or preschooler. A ball and laundry hamper becomes basketball, or empty water bottles are transformed into bowling. A small pot and wooden spoon can be a drum or used for pretend play while you are preparing dinner.

While times are still uncertain, I hope that we can learn to see the benefit that teletherapy offers. Teletherapy has been a godsend to the children I work with and their successes are made possible by the parents’ unwavering commitment and involvement. Once therapists can safely work in-person with the children, I hope that parents continue their partnership with their therapist and take an active role in their child’s therapy. Empowerment is key, and whether physically together or apart, I am certain we can overcome these challenges together.

Toby Reich, M.A., CCC- SLP is a speech and language pathologist with a private practice in Kew Gardens Hills and is an adjunct lecturer at Queens College. She treats communication disorders in toddlers, preschoolers, and school age children from 5-18 years of age. For more information, visit her website at or contact her directly at

Educational Consultant

Toddler and Preschool Classroom Supervision – An observational visit to one classroom for a 1.5 hour visit. The fee includes a written report with suggestions, an in-person feedback session with the teacher and an in-person feedback session with the director.

Parent Training Lectures

A Parent Training Session – A one hour parent training session. Topics are based on the needs and interests of your parents. One example of a topic which has been highly successful in the past, “Providing a Language Rich Environment for your Toddler and Preschooler”.

Carryover of a Skill

Regardless of the disorder, the carrying over of a skill or concept learned in therapy to all contexts, is the ultimate goal. Parents and caregivers need to be informed how best to facilitate carryover once a child has achieved a goal in the therapy environment.

I play games for a living.

Yesterday, I was speaking with a young adult friend of my daughter’s and stated, I do not like video games and this is strange since I play games for a living. I explained that I am a speech and language pathologist and engage in play with the children I treat in order to achieve my treatment goals. I enjoy playing board games, pretending, and being silly. I do not enjoy swiping a cell phone or using a remote control to move objects on a screen. Although there is a place for video games in the lives of children, good old toys and board games are classic and important to a child’s development. Toys and games are social, three dimensional and hands-on which help develop an immense number of necessary skills. Just to name a few, these include building of dexterity, balance, coordination, turn taking skills, patience, sharing and fairness, symbolic play skills, spatial concepts, and good character including how to be a good sport.
As parents we need to remember to include a variety of toys and games in our children’s play room. Rotating the toys keep the toys fresh and interesting.

Providing a language rich environment for your toddler and preschooler

As parents, we are often in a hurry to complete the never ending list of daily chores and tasks. When accompanied by your toddler or preschooler, these errands are valuable learning experiences. When visiting the supermarket, for example, be sure to include your little one in the activity. Offer her the bag and count the apples as you place them in the bag. Talk about their attributes including the color, shape, size, texture and taste. Ask your child to help you decide which fruits and vegetables are most tasty and should be purchased. Be sure to look around and point out the interesting store displays. Often, adults gloss over displays (think balloons) that have become common place for us, but are thrilling for our youngsters.

Bath time is an excellent opportunity to teach our toddlers and preschoolers the names of our body parts. Using a wash cloth helps to pin-point the exact location of the body part for the child. Talk about the action of washing. Speak about the attributes of clean/dirty and wet/ dry. Add some cups to help the children learn the concept of containerism, the actions of scooping and pouring, and concepts of size and measurement. Bubbles and suds are thrilling to children and you will see how excited they are to splash. Give adequate time for the bath activity and remember to enjoy and have fun!

As the weather continues to improve, take your toddler and preschooler for a community walk. There is so much to see and talk about. The most trivial encounter to an adult is a world of amazement for our children. Listen for birds in the trees, describe the dog walking by, notice the bumps in the sidewalk.
The world is new and exciting for our children. As you begin to heighten your awareness to these daily opportunities for learning, you will easily come up with your own ideas and experiences. Please share them with me. I look forward to hearing from you.

Articulation Therapy

If an articulation disorder is identified at the time of the evaluation, the plan of treatment is dependent on the type and severity of the disorder. Articulation is generally described as the pronunciation of the speech sounds. Speech sounds may be described as a distortion, substitution or omission. Even if Toby did not perform the evaluation and it came from an outside source, she will provide baseline testing and/or diagnostic therapy to determine the most appropriate course of treatment.

Language delay or disorder

A language delay or disorder is generally described as a significant lag or deviation in the acquisition of language. Language can be impaired in any modality; speaking and understanding and mirrored in writing and reading. Therefore, language can be delayed at any age. Toby has experience working with students with language difficulties ages 18 months through 18 years.


Stuttering is generally described as a disruption in the fluency of speech. Toby has experience working with preschoolers and school age children who stutter. Dysfluent speech can be described as speech that contains sound, word or phrase repetition, sound or syllable prolongation, or silent blocks, or disruptions in the flow of the speech. Early identification and intervention is key, so the stutter does not worsen; struggle behavior may be a sign of an increase of severity, i.e. facial grimace, foot tapping, or avoidance of verbal communication.

Study strategies

Sometimes a student is not performing to his/her potential as a result of poor organization skills and/or difficulty retaining the information needed to perform well on exams. Toby has had success working with students grades 3 and older, teaching them strategies that directly affect school performance. If there is no language (including reading) disorder identified, often this therapy is short term, yet can yield huge gains by reducing student frustration and increasing motivation and classroom performance.

Early Intervention

Early Intervention services are provided for free by the NYS Department of Health’s Early Intervention Program. These in-home services are for infants and toddlers, ages 0-3, if they qualify. Toby prefers speaking with concerned parents before they begin the process of attaining these services, but can begin treating the child at any point in time.