More and more, researchers in speech-language intervention are confirming what practitioners have suspected for years: that intensity matters. Research has suggested early, intensified intervention is most effective in rapid, long-lasting improvement. It would be wonderful if we, as clinicians could accommodate every child or adult 5x weekly for hours at a time. Unfortunately, conventions of time, insurance, and practicality render that infeasible for ourselves as well as our clients. In particular for young children, where such a great impact can be made with early, intense, intervention, scheduling 1-2 sessions per week is difficult enough.

The natural solution is to foster carryover and development of skills through parent and caregiver training, but often conveying importance of home practice is difficult. And, caregivers have such busy schedules, even 10 minutes a day feels like asking a lot. Beyond that, it’s a difficult, fragile line to tread when training parents on new strategies. Particularly for young clinicians without children of their own, such suggestions feel almost intrusive to make, presumptive. Of course, it’s vital to establish some sort of rapport with clients and families prior to this, to find out their daily schedules, values, practices, and work with them to figure out a valid solution.

Even so, it’s a very real fear to cross some line you didn’t know was there before. In New York City specifically, as a school-based SLP, I find it difficult to coordinate with parents, to establish carryover practices. Parents are overloaded and have other responsibilities. Children, too. But in schools—and realistically, in most clinics—they’re only receiving services twice, maximum three times weekly, usually at 30 minutes per session. That’s not nearly enough to make the sort of rapid impacts we know can be made. How can we stress the importance of daily language development practice at home when these families have so much else to worry about?

A question from a new clinician: How can we as clinicians stress the importance of intensity and establish carryover routines?