Speech and Language Therapy, How Much & How Long?

There is much debate about therapy frequency and intensity. How long should sessions be and how frequently should they occur? There is no easy answer as the information can be different based on age (e.g. child or adult), type of disorder (e.g. speech or language), type of therapy approach used (e.g. cycles or constraint induced), as well as the individual needs of each client.



When looking at treatment for children with language disorders, again, clinicians need to consider the child’s age and his or her ability to tolerate therapy sessions. That said, a number of research studies have been completed to assess the progress children make with therapy durations and frequencies. When determining the length of a therapy sessions, young children typically do well with 30 minute sessions due to their attention span. Similarly, Ukrainetz et al. (2009), found that 30 minute sessions one to three times a week were sufficient because their research found that 4 hours of treatment were as effective as 11 hours. Duration for therapy can vary. Law et al. (2004) obtained great gains with treatment sessions lasting for more than 8 weeks. However, greater language gains are reported in preschoolers with concentrated sessions (e.g. 24 sessions over 6 weeks) instead of distributed sessions (e.g. 24 sessions over 24 weeks) (Barratt et al., 1992). That said, McGinty et al. (2011) found that both frequent sessions (e.g. four times a week) and less frequent sessions (e.g. two times a week) yielded similar outcomes for children as long as the number of trials obtained in a session was high. Therefore, from the available, current studies, we can determine that frequent sessions with a high number of trials over a concentrated amount of time will achieve the greatest results.

Speech Sound Disorders (SSD)

Speech sound disorders (e.g. articulation disorders and phonological processing disorders) vary from approach to approach. However, when looking at the research it’s clear that treatment can last from 7 months to 30 months of therapy from referral to dismissal (Gillam et al., 2012) depending on severity, approach, and client needs. Similar to language sessions, speech and language treatment sessions targeting speech sounds are about 30 to 45 minutes two to three times a week with a high number of trials in order to achieve the most progress (Williams et al., 2010). That said, when a child’s severity increases, there needs to be an increase in the intensity in both the number of sessions a week and number of trials obtained in order to make the most progress for that child (Gillam et al., 2012)


Studies targeting adult speech and language treatment post stroke or traumatic brain injury have found a variety of results in terms of how frequent and how long therapy sessions should be. This is likely because a clinician must consider the client’s arousal level, prognosis, stage in recovery, as well as ability to tolerate therapy sessions when determining the appropriate frequency, intensity, and duration of services for an individual post stroke or traumatic brain injury (TBI) (Cherney, 2010). This means more therapy may be beneficial for one person, but not for another because maybe they don’t have the attention span for intensive therapy or such a model would be too tiring for them at this point in treatment. The same applies to session length, someone may benefit from an hour or two of therapy daily, but this may not be feasible due to their current condition. That said, research has found that clients demonstrate significant gains when they received intensive treatment over a short amount of time rather than distributed sessions over longer periods of time (Bhogal et al., 2003), but a clinician must always consider the individual needs of the client.


Overall, we can see that more therapy and more trials is typically the gold standard in order to make the most progress in a short amount of time. That said, individual characteristics need to be considered with every client in order to determine the right approach for them.


Barratt, J., Littlejohns, P., & Thompson, J. (1992). Trial of intensive compared with weekly speech therapy in preschool children. Archives of Diseases in Childhood, 67, 106-108.

Bhogal, S., Teasell, R., & Speechley, M. (2003). Intensity of aphasia therapy, impact on recovery. Stroke, 34(4), 987 – 993.

Brandel, J., & Loeb, D. F. (2011). Program intensity and service delivery models in the schools: SLP survey results. Language, Speech, and Hearing Services in Schools, 42, 461–490.

Cherney LR, Patterson J, Raymer A, Frymark T, Schooling T., (2010). Updated evidence-based systematic review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals with Stroke-Induced Aphasia. Rockville Pike, MD: American Speech-Language-Hearing Association.

Gillam, R., Baker, E., Williams, A. (2012). How Much is Enough? Dosage in Child Language Intervention. American Speech-Language-Hearing Association Convention. Georgia: Atlanta.

McGinty, A. S., Breit-Smith, A., Fan, X., Justice, L. M., & Kaderavek, J. N. (2011). Does intensity matter? Preschoolers’ print knowledge development within a classroom-based intervention. Early Childhood Research Quarterly, 26, 255–267.

Ukrainetz, T.A., Ross, C.L., & Harm, H.M. (2009). An investigation of treatment scheduling for phonemic awareness with kindergartners who are at risk for reading difficulties. Language, Speech, and Hearing Services in Schools, 40, 86-100.

Warren, S. F., Fey, M. E., & Yoder, P. J. (2007). Differential treatment intensity research: A missing link to creating optimally effective communication interventions. Mental Retardation and Developmental Disabilities Research Reviews, 13(1), 70–77.

Williams, A. L., McLeod, S., & McCauley, R. J. (Eds.). (2010). Interventions for speech sound disorders in children. Baltimore, MD: Brookes.