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0-4 years with Communication Difficulties

Nurturing Your Child’s Voice

We warmly welcome you to CATTS online speech therapy, where we are passionate about supporting young children under 4 years old in reaching their full potential.

As a parent, you want nothing more than to see your child thrive and reach their full potential. When it comes to communication, it can be a challenge if your child is not speaking as expected.

With our expertise and evidence-based techniques, we will guide and encourage your child’s development, fostering their natural love of communication.


One of the most common questions we get asked by parents of children at this age is, “Is my child’s speech delayed?”

We have created a simple explainer on this page which outlines the ages and stages of language development.

Please take a look at it as it will help you understand what the current ‘norms’ are for each age 0-6 years.
(Opens in a new tab, so you won’t lose your place here)


What the parents of our Under 5 clients are saying about us.

If your child is facing communication challenges, we understand how difficult this can be for you as a parent.

That’s why we’re here to help.

Our online platform provides a convenient and comfortable environment for you and your child to receive high-quality speech therapy right in the comfort of your own home. No more scheduling conflicts, no more traveling – just a few clicks and you’re ready to start your child’s journey towards confident communication.

At CATTS, we believe that every child is unique and deserves personalised attention. Our therapists will work closely with you to tailor their approach to your child’s specific needs, ensuring that each session is enjoyable and impactful. Our goal is to empower your child with the skills they need to express themselves with confidence, and to support your family in this journey every step of the way.

Together, let’s nurture your child’s voice and give them the gift of effective communication.

Start now and watch your child’s confidence and abilities grow!


What brought you to us today?

Maybe you have a concern yourself about your child’s communication?
As a parent, once you get that nagging feeling that something may be up with your child, the first thing is that sinking feeling in the pit of your stomach. You may not want to believe it, or suspect that it is nothing. If you are like many parents, your first port of call possibly is using Google. With the wide range of free opinions on the internet, and the fact that algorythms are skewed towards the more extreme end of symptons, very rarely do you close the browser less worried than before you started.
You want the very best for your child, and it is ok to be worried. Unlike other professionals, Speech Therapists can take a direct referral from a concerned mom or dad directly if they are concerned in any way. The only thing that we as CATTS would like to reaffirm with you, is that you are the expert on your child. There are no wrong outcomes if you want a speech therapist to evaluate your child because you have a concern. With this age group, it is always best to seek help early – no questions.

Maybe a relative or friend has noticed something?
Like above, it is always best to get a young child checked out as soon as possible if there are concerns about their communication. However, sometimes, you, as the child’s parent may be too close to your child to notice. It can be the case especially if you find that you need to interpret for your child a lot with other people. This is where the value of external viewpoint can be very helpful in identifying a reason to refer to a speech and language therapist. Often the biggest concern if you are reading this page after coming through this path is always related to the tact – or lack of tact – used by the other person. This can be especially a problem if they have been less than sensitive when mentioning it. Only the child’s parent or legal guardian can refer them to SLT, which puts you in the driving seat. If you wish to get a more level set viewpoint based on data before deciding to refer your child, please see our checklist at the end of this page.

Preschool Teacher, PHN, Doctor or other medical professional has specifically mentioned to you to get your child checked out by a speech and language therapist?
The above professionals should know to refer when they spot something that raises a concern with them. In general, if it is suggested by a professional, it is always good to get child checked out. In CATTS experience over the past decade or so, if a preschool, Montessori, or primary school teacher has referred a child to us, there is usually a reason to investigate.


How therapy works with this age group (0-4years)

The component of successful therapy with this age group is you – the child’s parent. Young children are hardwired to learn from their primary caregiver, so the more you know and are empowered by your therapist, the better the outcomes for your child. Very often, you will be taught ways to follow your child’s direction, using what they are interested in at the time, to achieve communication goals. The speech therapist will often use materials that will engage your child, however their aim is to ensure that you are able to spot the hundreds (or thousands) of communication opportunities that you have with your child every day you are with them.
There are some standardised assessments that the speech therapist may choose to use if appropriate during the sessions. They may also ask you to complete forms beforehand, or between sessions.

Picture of mom and child playing with a jigsaw viewed through a Zoom meeting window.

The main thing to be aware of is that at this age range, you, as parent, are often the main participant in the therapy sessions.

The aim is to empower you, to be able to continue all the good work done over the 30 or 45 minute session, for the other 11,760 minutes until the next therapy session.


Our speech therapists will also take the time to explain why a specific technique or approach has been chosen for your child at that time. Very often they may be a variety of ways to achieve a specific goal, as it is customised therapy, our SLTs will work with you to chose one that suits your child, and your own circumstances. This can be very important if your child is being looked after while you are in work, or attends a preschool. You need to be able to confidently articulate why this approach is being used, and to ensure that it is continued while your child is in someone else’s care at that time.

This is how you set your child up for success, so that in therapy, at home, and at childminder/preschool, the best communication approach for them is always being used by those around them. That is where the progress is truly made.

What to Expect

Firstly, we would ask you to remove any expectations on what you may picture online therapy is! For this age range, it follows what the child wants, at that time. The device you are viewing the Zoom meeting on moves where they child wants to go – the child is never expected to sit in one place for the duration of the session. Movement is the name of the game at that age. What you can expect is to sit on the floor during therapy, or perhaps they prefer to be sitting at a play table? Maybe they get a kick out of sitting in a downstairs study at mom’s desk? Perhaps when they get something right on a game they need to run around the room to do a victory lap? It’s all good.

At the 0-4 years range, your device is placed where it will be close to your child, based on what your child is doing!

You can expect to be interactive with your child a lot in sessions. Our speech therapists will work directly with your child at times, as well as directly with you during the session. Young children can’t be expected to attend to a single task for more than short bursts at a time, so the therapy sessions can often follow the pattern of directly interacting with your child, review, and debrief with you (which gives the young child a nice little break), work with your child again, and repeat. The only thing you need to focus on is your child, and don’t be afraid to practice in session what the SLT is recommending you do. Be prepared to ‘get silly’ especially at this age. Mom or dad is one of their favourite toys.

Our speech therapists will create a tailored treatment plan to meet your child’s unique needs and goals. They are the experts in the room on which methods to use to achieve these unique needs and goals but you are the expert on your child, your family and your work circumstances. There needs to be a discussion to balance what is achieveable in your own circumstances. You may feel torn, and want to commit to doing numerous activities over the days between sessions, but better progress can be made if you commit to maybe one or two key techniques or goals, and nail them each time, every time. Committing to home activities that you feel will be difficult to squeeze in when you are discussing in the session, and then not achieve, only tend to enhance feelings of parental guilt. Our team are absoloutely aware that everyone needs to juggle multiple committments in their life. Don’t worry about having an honest conversation with our therapist about what you can realistically commit to. Slow and steady often wins the race.


Watch how we make online therapy fun for young (and older) children!

How you can prepare for your child’s online therapy.

Online Therapy takes much less time for you
when compared to traditional, in the same room therapy.

There are a few simple steps which you can take to ensure that it goes even easier.


We have created a series of short video explainers at the link below to help answer all of the most commonly asked questions.


There are a lot of things you can do at home that is within your control to ensure a successful session, but we can break them down into three areas (which you are probably already doing anyway).

The device used. This is the tablet, laptop or phone you are taking the Zoom call on. It is always good to check that your broadband is working, that the device you intend to use isn’t choosing that percise moment to have an urgent ‘system update’. As a portable device is necessary for young kids as it needs to move with them, just check that the battery in the device has enough charge.

Distractions. We want you to get the most out of your child’s therapy session. Adults at times can find it hard to filter out distractions, especially noise. With under 5s, every distraction is a must see! If possible, make sure any other siblings are out of the room (or if not, that they are safely in your view, with a quiet activity). Yes, this may mean that an older sibling needs to watch Cocomelon videos for half an hour on headset. Visual distractions such as toys, or other enticing items should be put away, or hidden from the child’s view. If, as part of your child’s session, you and the therapist have agreed to use a toy or game as the focus for that session, make sure to check with the therapist whether your child should see it before the call or not.

Personal comfort. Make sure that you have given your child a snack, and have used the toilet, or had a change nappy shortly before your session. It can be hard for a kid to focus if they are hungry or thirsty. Same goes for you of course!


How to prepare for under 5s Online Speech and Language Therapy

Helping you, help your child

If you want to learn more about how children learn language through play, and how you can encourage your 0-4 year old, take a look at our free talk on Using Toys to Support Your Child’s Language Development.


Explaining what to expect to your child.

We have a separate page here, which is written to allow you explain to your child what to expect when they start speech therapy with CATTS. You can show it to them on the site as it is on your phone, tablet or computer, or you can click on the ‘PRINT ME’ button on the page to print out a copy which you can use instead to discuss with your child. The printed version is condensed to fit on a single A4 page, so that you can stick it on your fridge or other prominent place beforehand so that your child sees it and can refer to it whenever they wish if they have questions beforehand.

All kids of any age are appropriate for online Speech and Language Therapy.
The only difference is the approach that the speech therapist will take.
In some cases it is direct intervention, in other cases it is parent coaching.
JENNIFER GRUNDULIS, CATTS SENIOR SLT.


Below are some of the more common communication difficulties at this age range.

Please select whichever one best describes your child’s difficulty. If you are not sure, please scroll to the end of this page and complete our referral form below and we will get back to you to discuss how we can assist you.


Is my Child’s Speech is delayed?

Hearing your child saying his first word is magical. Each child is different and develops this skill at different stages. Girls usually learn to speak earlier than boys, and first-born children often pick up speech quicker than their younger siblings.

The question is: when should you be concerned about your child’s speech?

Generally, children reach their speech and language developmental milestones at approximate ages. You can compare your child’s development to other children her age to know when your child will need help to develop speech.


My child’s speech cannot be understood

If, after reading this, you suspect your child has a speech sound disorder, complete our checklist and contact us for a consultation as soon as possible.

Research backs up the fact early recognition and diagnosis of speech sound disorders can help children overcome speech problems.

Don’t delay and hope they will ‘grow out of it’ – get an expert SLT/SLP’s opinion in the first instance.


My child has a stutter

There is no known cause for stuttering, and there is no one thing a parent can do that would cause their child to stutter.

Children learn language at a very fast pace. In just a few short years, they go from crying to have their needs met, to speaking in complete sentences! With this, parents may hear their child start to stutter or stammer, which is a repetition or prolongation of a sound, word or phrase.

Many children go through a typical, developmentally appropriate stage of stuttering (stammering) between the ages of 2-5 years. This often coincides with a burst of language development, especially when children are learning to put words into sentences.


Next Step.

The very first step is to complete our online checklist below, which will be sent to our practice manager Joe, who in turn will get in touch with you to further explore your needs and how CATTS can help. We have a short explainer on what to expect once you submit this form here.

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