what is speech therapy?
Speech Language Pathologists (SLPs) evaluate, diagnose, and treat a variety of communication difficulties, feeding/swallowing difficulties, and voice disorders. SLPs provide speech therapy to individuals across the lifespan, who have a variety of diagnoses and communication difficulties such as: Expressive Language Delay, Receptive Language Delay, Articulation Disorders, Phonological Disorders, Stuttering, Apraxia, Autism, Dyslexia, Dysphagia, Dysarthria, Stroke, Parkinson’s Disease, Dementia, and more.
  • At CareFirst Rehab, we evaluate and treat individuals with speech, language, and feeding/swallowing disorders such as: 
  • Articulation Disorders
  • Apraxia of Speech
  • Aphasia
  • Cognitive Language Impairments secondary to: Traumatic Brain Injury, Brain Tumor, Dementia, and Stroke
  • Dysphagia 
  • Dyslexia/Literacy Challenges
  • Feeding Aversions
  • Lisps
  • Phonological Disorders
  • Social Communication Differences
  • Tethered Oral Tissues
  • Vocal Fold Paralysis/Injury 
  • Voice Disorders

When should a child see a speech therapist?

Hearing and Understanding


Birth–3 Months

  • Startles at loud sounds.
  • Quiets or smiles when you talk.
  • Seems to recognize your voice. Quiets if crying.

Birth–3 Months

  • Makes cooing sounds.
  • Cries change for different needs.
  • Smiles at people.

4–6 Months

  • Moves her eyes in the direction of sounds.
  • Responds to changes in your tone of voice.
  • Notices toys that make sounds.
  • Pays attention to music.

4–6 Months

  • Coos and babbles when playing alone or with you. 
  • Makes speech-like babbling sounds, like pa, ba, and mi.
  • Giggles and laughs.
  • Makes sounds when happy or upset.

7 Months–1 Year

  • Turns and looks in the direction of sounds.
  • Looks when you point.
  • Turns when you call her name.
  • Understands words for common items and people—words like cup, truck, juice, and daddy.
  • Starts to respond to simple words and phrases, like “No,” “Come here,” and “Want more?”
  • Plays games with you, like peek-a-boo and pat-a-cake.
  • Listens to songs and stories for a short time.

7 Months–1 Year

  • Babbles long strings of sounds, like mimi upup babababa.
  • Uses sounds and gestures to get and keep attention.
  • Points to objects and shows them to others.
  • Uses gestures like waving bye, reaching for “up,” and shaking his head no.
  • Imitates different speech sounds.
  • Says 1 or 2 words, like hi, dog, dada, mama, or uh-oh. This will happen around his first birthday, but sounds may not be clear.

Ages: 1-2 

Hearing and Understanding


  • Points to a few body parts when you ask.
  • Follows 1-part directions, like “Roll the ball” or “Kiss the baby.”
  • Responds to simple questions, like “Who’s that?” or “Where’s your shoe?”
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when you name them.

  • Uses a lot of new words.
  • Uses p, b, m, h, and w in words.
  • Starts to name pictures in books.
  • Asks questions, like “What’s that?”, “Who’s that?”, and “Where’s kitty?” 
  • Puts 2 words together, like “more apple,” “no bed,” and “mommy book.”

Ages 2-3

Hearing and Understanding


  • Understands opposites, like go–stop, big–little, and up–down.
  • Follows 2-part directions, like “Get the spoon and put it on the table.”
  • Understands new words quickly.

Has a word for almost everything.

  • Talks about things that are not in the room.
  • Uses k, g, f, t, d, and n in words.
  • Uses words like in, on, and under.
  • Uses two- or three- words to talk about and ask for things.
  • People who know your child can understand him.
  • Asks “Why?”
  • Puts 3 words together to talk about things. May repeat some words and sounds.

 Ages 3-4

Hearing and Understanding


  • Responds when you call from another room.
  • Understands words for some colors, like red, blue, and green.
  • Understands words for some shapes, like circle and square.
  • Understands words for family, like brother, grandmother, and aunt.

Answers simple who, what, and where questions.

  • Says rhyming words, like hatcat.
  • Uses pronouns, like I, you, me, we, and they.
  • Uses some plural words, like toys, birds, and buses.
  • Most people understand what your child says.
  • Asks when and how questions.
  • Puts 4 words together. May make some mistakes, like “I goed to school.”
  • Talks about what happened during the day. Uses about 4 sentences at a time.

 Ages 4-5 

Hearing and Understanding


Understands words for order, like first, next, and last.

  • Understands words for time, like yesterday, today, and tomorrow.
  • Follows longer directions, like “Put your pajamas on, brush your teeth, and then pick out a book.”
  • Follows classroom directions, like “Draw a circle on your paper around something you eat.”
  • Hears and understands most of what she hears at home and in school.

Says all speech sounds in words. May make mistakes on sounds that are harder to say, like l, s, r, v, z, ch, sh, and th.

  • Responds to “What did you say?”
  • Talks without repeating sounds or words most of the time.
  • Names letters and numbers.
  • Uses sentences that have more than 1 action word, like jump, play, and get. May make some mistakes, like “Zach gots 2 video games, but I got one.”
  • Tells a short story.
  • Keeps a conversation going.
  • Talks in different ways, depending on the listener and place. Your child may use short sentences with younger children. He may talk louder outside than inside.

If you notice any of the following: 

· Inability to communicate effectively in social settings

· Slow or stagnant speech development

· Sudden decrease of expressive speech skills

· Limited vocabulary when compared to others in same age group

· Speech that is not understood by family members and/or strangers

· Lacks interest in communicating and/or gets frustrated when attempting to communicate

· Stuttering that fosters a sense of embarrassment and/or difficulty with peers

· Difficulty with sucking, chewing, and/or swallowing

· Excessive drooling

· Consistently hoarse voice

· Not speaking clearly by age 3

What does feeding therapy help with?

Feeding therapy can help infants and children with:

Reduced or limited intake

Food refusal and food selectivity by type and/or texture

Oral motor deficits

Delayed feeding development

Food or swallowing phobias

why is feeding therapy important?

Feeding therapy can prevent and eliminate nutritional concerns, growth concerns (including failure to thrive), unsafe swallowing which may lead to aspiration, pneumonia, and future poor eating habits/attitudes.

Feeding therapy can help with:

Independently eating a wide array of textures

Demonstrating safe


Increasing intake

Decreasing negative mealtime behaviors

How long will my speech therapy visit last?

A speech therapy session usually lasts from 30 minutes. If you are receiving a formal evaluation or assessment, however, that particular session may take 60 minutes, depending on the extent of the testing that is being done.

Do I need a physician’s referral/prescription to attend speech therapy?

No, patients can generally access speech therapy services directly without a doctor’s referral. Medicare & Medicaid patients will need a doctor’s prescription. It is the responsibility of the patient/guardian to verify insurance coverage prior to scheduling their first speech therapy appointment or can pay out-of-pocket for the services.

Will my insurance cover speech therapy? How much does it cost?


Care First Rehab has provided high quality, professional speech and language therapy for children and adults for over 10 years. We provide speech therapy services at our clinic in Cary, NC, and in the natural environment (in-home and preschools) to patients living in Wake County and Durham County. Our trained therapists have the tools and expertise to build treatment plans that will meet your specific needs and address your areas of concern. We work to provide measurable results through use of research-based, evidence based patient-centered techniques.

Our Speech Language Pathologists at CareFirst Rehab have extensive experience and knowledge in a wide variety of communication disorders.

See below for milestones by age to help you assess your child and their needs



Call: 919-804-8654