10 Mistakes SLPs Make in Early Intervention (and What to Do Instead)

Early Intervention can look deceptively simple. You walk into a home, play with a child for 30 minutes, give the caregiver a few ideas, and move on to your next visit.

Except… that’s not really what good Early Intervention looks like. When I first started working in EI, nobody handed me a manual explaining how to walk into a family’s home, build rapport, support the caregiver, address communication, and somehow fit everything into one short session.

A lot of it I had to figure out along the way. Here are 10 common mistakes I see SLPs make in Early Intervention and what I recommend doing instead:

1. Walking in with a therapy agenda before talking to the caregiver

You planned bubbles, blocks, and a book.

Meanwhile, Mom tells you, “He screams every time I try to get him dressed,” or “He used to say a few words, but now he doesn’t.”

Suddenly, your planned activity may not be the priority.

Do this instead: Start with the caregiver. Ask what changed, what went well, what was difficult, and what they need help with today. Your session should respond to the child and family, not just your lesson plan.

2. Bringing too many toys

You arrive with an amazing therapy bag, the child loves everything, and the session goes perfectly.

Then you leave with all of it.

Do this instead: Use more of what is already in the home. Read the child’s books. Play with their toys. Use snack time, getting dressed, cleaning up, or other daily routines. If you bring printable materials, leave a copy for the family when possible.

The goal is for communication opportunities to continue after you leave.

3. Doing therapy while the caregiver is in another room

You spend 30 minutes working directly with the child while the caregiver cooks, cleans, works, or watches from across the room.

Sometimes that is unavoidable. But it should not become the structure of every session.

Do this instead: Bring the caregiver into the interaction, even periodically. Model a strategy, explain it, and then let the caregiver try it. Yes, actually let them try!

The goal is not to turn caregivers into therapists. It is to help strategies naturally fit into the family’s everyday routines.

4. Asking too many questions

“What color is that?”

“What does the cow say?”

“What is this?”

“Say ball.”

“Where is the dog?”

Sometimes toddler therapy starts sounding like a 30-minute quiz.

Do this instead: Comment more. Model language. Narrate. Pause. Wait. Create opportunities for the child to initiate.

Communication should feel like an interaction, not an exam.

5. Focusing only on spoken words

This can look like repeated imitation drills, labeling tasks, and lots of “Say ___.”

Meanwhile, the child may be pointing, reaching, vocalizing, gesturing, bringing you objects, or using AAC.

Do this instead: Look at the child’s entire communication system.

Ask yourself:

How can I make this child’s communication more effective, intentional, and understandable?

Speech can absolutely be part of the goal. It just does not have to be the only goal.

6. Waiting too long to introduce AAC

“He’s too young.”

“Let’s give speech more time.”

“His parents don’t want a device.”

“I’m not sure which AAC system to use.”

So AAC never gets introduced.

Do this instead: Think about AAC early when a child needs additional ways to communicate.

AAC can include gestures, signs, pictures, communication boards, and speech-generating devices. It can be simple or complex depending on the child.

You can also explore Kuzmin.Help, a simple EI AAC tool that can be added to a child’s communication supports.

Giving a child another way to communicate does not mean giving up on speech.

7. Saying, “I don’t do feeding”

A caregiver mentions coughing with liquids, difficulty chewing, gagging, a very limited diet, or stressful meals.

And the conversation ends with, “I don’t do feeding.”

Do this instead: You do not have to turn every session into feeding therapy, but SLPs should know basic feeding development, red flags, and when further assessment or referral may be needed.

Ask simple questions:

What does the child eat?

What textures?

Can they chew?

How long do meals take?

Any coughing, choking, gagging, pocketing, or vomiting?

Is the diet becoming more restricted?

Sometimes one feeding question opens a very important conversation.

8. Giving caregivers too much homework

“Work on requesting, two-word combinations, following directions, turn-taking, animal sounds, body parts, MORE, and ALL DONE.”

That may all be clinically appropriate.

But it is probably not happening every day.

Do this instead: Choose one or two realistic strategies and connect them to routines the family already has.

Instead of “Practice requesting,” try:

“At snack, pause before opening the container and give him an opportunity to ask for help.”

Simple. Functional. Realistic.

9. Trying to address every goal in every session

Language.

AAC.

Play.

Following directions.

Imitation.

Feeding.

Turn-taking.

Behavior.

All in 30 minutes.

You do not have to check every box every session.

Do this instead: Prioritize.

Ask:

What would make the biggest functional difference for this child and family today?

The answer may change from week to week, and that is okay.

10. Measuring progress only by what happens during your session

“He said MORE five times.”

“He identified 8 out of 10 animals.” Great.

But what happened during the rest of the week?

Do this instead: Ask about progress between sessions.

“He started pointing to the refrigerator when he wants milk.”

“She brings me a book when she wants me to read.”

“He used his picture with Grandma.”

“She showed me what she wanted instead of screaming.”

That is functional progress.

Early Intervention Requires a Different Mindset

Good EI therapy is not about arriving with the perfect toy or getting the highest number of trials in 30 minutes.

It is about observing, listening, coaching, problem-solving, following the child’s interests, understanding family priorities, and helping communication become easier during everyday life. I wish someone had explained more of this to me when I first started.

A lot of Early Intervention is learned through experience, but newer SLPs should not have to figure everything out the hard way.

Because walking into that first EI home should feel exciting, not like you're supposed to already know everything.