How Therapy Decisions Are Made

Initiation, Review, and Discharge of Speech-Language Therapy

Speech-language therapy is most effective when it is purposeful, reviewed regularly, and responsive to the needs of the client and family. At our clinic, therapy decisions are guided by professional standards, evidence-based practice, and individualized clinical judgment.

When Therapy Is Recommended

Speech-language therapy is recommended following assessment when communication needs are identified within the speech-language pathology scope of practice and are impacting functional participation in daily activities. Recommendations may include therapy frequency, initial goals, and home practice strategies. These recommendations are reviewed and discussed with clients and caregivers to support shared understanding and informed decision-making.

How Therapy Continues

Ongoing therapy is guided by the client’s response to intervention and progress toward individualized goals. Therapy is not time-limited or automatic. Instead, progress and service appropriateness are reviewed periodically to ensure that intervention continues to be clinically meaningful and aligned with current needs. Therapy goals, frequency, and strategies may be adjusted over time based on clinical findings and functional outcomes.

Review and Discharge Considerations

Discharge or transition from therapy is considered as part of routine clinical review and may occur when one or more of the following apply:

• therapy goals have been achieved and communication skills are functional across relevant contexts

• skills are demonstrated consistently with reduced or no support

• continued progress no longer requires skilled speech-language pathology intervention

• progress plateaus despite appropriate goal adjustments and supports

• therapy can be effectively supported through monitoring, consultation, or caregiver-implemented strategies

• referral to another service or professional is recommended to better meet the client’s needs

• the client or caregiver requests to discontinue services following discussion and review of recommendations

Discharge does not reflect a lack of progress. It reflects a clinical decision that therapy has met its purpose or that another service pathway is more appropriate at that time.

Shared Decision-Making

Clients and caregivers are active partners in the therapy process. Therapy recommendations, progress, and service decisions are discussed openly, and clients and caregivers may choose to pause or discontinue services at any time. When therapy ends, recommendations and next steps are provided as appropriate.

Professional Standards

All services are provided in accordance with the professional and ethical standards of the College of Audiologists and Speech-Language Pathologists of Ontario. Therapy duration and frequency are determined by clinical need and functional relevance, not by fixed timelines or service availability.

Progress Monitoring and Re-Assessment

Progress is monitored on an ongoing basis through each therapy session, with session notes documenting performance, responsiveness to strategies, and short-term changes over time. This continuous monitoring informs day-to-day clinical decisions and adjustments to therapy activities and supports.

Formal re-assessment is a distinct process and is completed when clinically indicated, rather than at fixed intervals. Re-assessment may be recommended to support clinical decision-making when therapy goals are achieved or nearing completion, progress plateaus despite appropriate modifications, functional communication demands change, a transition in services is being considered (e.g., discharge, monitoring, referral), or when required for coordination with other services or programs. This approach aligns with professional standards and evidence-based practice, which emphasize data-driven review and clinical judgment rather than predetermined reassessment schedules.

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Please don't hesitate to reach out to your SLP if you have any further questions! 😊