COVID, Waiting Lists and Getting the Best Therapy

As recently as July this year, there has been discussion in the media about the shortage of Speech Pathologists and lengthening waiting lists (Allison, 2021). It was suggested that many children are waiting up to 18 months to see a Speech Pathologist, and even when they are seen, therapy services are expensive or limited. These waits are placing children at risk of longer-term difficulties with social interaction and academic progression. Difficulties accessing services have been the source of frequent experiences of frustration and anxiety for parents seeking to help their children, with Capable Kids’ administration staff often fielding calls from parents who want to help with children. Add in the complications of lockdown and social distancing caused by COVID. We are in a situation where the risk of our children missing out on early intervention is even greater.

Is Telehealth right for my child?

However, in this time of frustration and uncertainty, there have been some positives. For the team at Capable Kids, the situation that COVID has presented has forced us to innovate to ensure that our Capable Kids’ families are receiving services that are as effective as if they were free to come into the clinic. Telehealth is the provision of therapy services over a secure video link. In the early intervention sector, telehealth has exploded in the past 12-18 months. For school-aged children, the initial evidence suggests that telehealth services were effective (Wales et al., 2017). While it is possible to engage a preschool or school-aged child over a video call using interactive games, pictures and videos, this was more difficult with our under three population, which required a less structured, more naturalistic intervention style.

So, what about our under 3s?

Luckily for Australian’s who were somewhat distanced from the rest of the world, we were slightly behind the rest of the world when it came to exposure to COVID and all of the risks associated with it. Canada, home of The Hanen Centre, a charitable organisation dedicated to providing evidence-based interventions for children with delays in their language development, had been innovating to adapt their well-established parent training programs to the telehealth world. Hanen Certified Speech-Language Pathologists had been implementing these online, parent training-coaching interventions around the world, with great success.

It takes how many to talk?

The It Takes Two To Talk (ITTTT) program consists of eight small-group parent sessions and three individual parent-child coaching sessions for children who are delayed in their language. This program aims to teach parents to provide intervention strategies to support their children’s language development.  The research to support parent-led interventions such as ITTTT is positive, with children who completed the program showing significant improvements in communication, engagement, language and social communication outcomes (Roberts et al., 2019), as well as social-emotional functioning and behaviour (Rose et al., 2020). In some instances, parent-implemented intervention such as ITTTT was more effective than traditional, clinician-directed interventions for late talking toddlers (DeVeney et al., 2017). One of the reasons that this program has been so effective for improving toddlers’ language skills is the heavy involvement of parents, who know their child the best and can implement the strategies throughout the day. The coaching aspect of the program allows parents and Speech Pathologists to work together to find the best strategies to meet the needs of the child and parent in practical, real-life situations.


How do I get involved?

Capable Kids has decided to offer this program to all children on the waiting list for our Engadine and South Coast services to ensure that they receive a timely, evidence-based intervention. The group format means that costs are lower than individual therapy costs. The telehealth format means more flexibility for families, as after-hours times are available and can be accessed from anywhere in the country with internet access. We are very excited to start the first ITTTT telehealth group this month and regularly offer it from now on.

If you are unsure whether your toddler’s language development is delayed,  Speech Pathology Australia has published a comprehensive list of communication milestones by age. By 18 months, children should understand up to 50 words and some short phrases, follow simple instructions, use between 6-20 words, name a few body parts, and copy many words and noises. By two years, they should follow two-part instructions, answer simple questions, and say more than 50 single words. If your child is not doing this, a language intervention such as ITTTT will benefit your child. If you would like to know more, please contact the team to find out about the next group.


Allison, C. (2021). Children’s speech problems could turn chronic with lengthy waits for speech therapy. Retrieved 03/08/2021 from


DeVeney, S. L., Hagaman, J. L., & Bjornsen, A. L. (2017). Parent-Implemented Versus Clinician-Directed Interventions for Late-Talking Toddlers: A Systematic Review of the Literature. Communication disorders quarterly, 39(1), 293-302.


Roberts, M. Y., Curtis, P. R., Sone, B. J., & Hampton, L. H. (2019). Association of Parent Training With Child Language Development: A Systematic Review and Meta-analysis. JAMA pediatrics, 173(7), 671-680.


Rose, T., Scarinci, N., Meyer, C., Harris, S., Forsingdal, S., Anger, N., & Webb, K. (2020). The It Takes Two to Talk® – The Hanen Program® for Parents: impacts on child behaviour and social-emotional functioning. Speech, language and hearing, 23(3), 180-188.


Wales, D., Skinner, L., & Hayman, M. (2017). The Efficacy of Telehealth-Delivered Speech and Language Intervention for Primary School-Age Children: A Systematic Review. International journal of telerehabilitation, 9(1), 55-70.