Let’s Talk Speech Therapy: What Caregivers Need to Know

Caregivers are key partners in supporting speech therapy, reinforcing activities that help their loved ones develop stronger speech and language skills

Paul Wynn,

AARP

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Published September 10, 2025

two people sitting at a desk working on speech therapy

Liam Eisenberg

After George “Buddy” Scott suffered a stroke while vacationing in the Caribbean in December 2021, his ability to communicate has never been the same. At just 52, George, a former marathon runner and managing director in international investments, was suddenly struck by paralysis on his right side and severe aphasia, a language disorder that stole his ability to speak.

Since then, his wife Karen has become her husband’s caregiver and his partner in speech therapy, learning techniques from speech therapists, researching treatments and pushing for new ways to help her husband communicate better. From their home base in San Diego, where they moved from New Jersey to access advanced therapy, Karen has taken on the role of daily speech coach, advocate and motivator to help George find new words.“ George has the vocabulary inside him; it’s just hard for the words to come out,” says Karen. “When he’s able to put together even a short sentence, it reminds us that his voice is still there, and that gives us hope and keeps us going.”

What is speech therapy?

A speech therapist, also known as a speech-language pathologist, is a specialist who helps people improve their ability to communicate and swallow. They work with individuals with speech, language, voice, cognitive-communication caused by several chronic conditions or brain injuries. Therapists also work with individuals who have swallowing issues, such as dysphagia, using various techniques, including modified diets, to strengthen swallowing muscles and adjust posture to make swallowing and eating safer. Speech therapists assess each person’s needs, create a personalized treatment plan and teach strategies and exercises to enhance communication and quality of life.

“The goal of speech therapy is to help individuals improve their communication, thinking and swallowing skills so that they can participate more fully in daily life. It addresses challenges with speaking, understanding language, voice, fluency, cognitive-communication and feeding or swallowing,” says Monica Sampson, chief staff officer at the American Speech-Language-Hearing Association in Rockville, Maryland.

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Your doctor may prescribe speech therapy for conditions such as:

Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease
Aphasia
Cognitive decline or dementia
Head and neck cancers
Parkinson’s disease
Stroke recovery
Swallowing disorders (dysphagia)
Traumatic brain injury

Despite the medical necessity of speech therapy, commercial health insurance plans offer variable coverage, often with significant visit limits, prior authorization requirements and coverage exclusions. Plans usually group speech therapy with physical and occupational therapy that compete for the number of available visits, which may range between 20 to 30 annual sessions. Occasionally, plans will approve additional visits beyond their predetermined limit or exclusions. Medicare Part B covers evaluation and treatment to improve speech and language skills under the care of a Medicare-approved speech therapist. There are no caps on the number of visits as long as speech therapy is deemed medically necessary.

Dementia

Speech therapy can be an important source of support for individuals living with dementia, helping them preserve their ability to communicate, stay socially engaged and manage daily tasks. As everyday interactions become more challenging for both the person and their caregivers, speech therapists offer strategies and tools to strengthen communication.

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“Especially in the early stages of dementia, we help the person communicate, like using synonyms if they can’t find a word or deciding whether they want others to fill in words for them,” says Becky Khayum, president of Memory and Aphasia Care, a rehabilitation company in Aurora, Illinois. “This ‘supported conversation’ helps care partners understand how much assistance is needed, and as the condition progresses, the care partner gradually provides more support to help them get their message across.”

Parkinson’s disease

Speech and communication are often affected by Parkinson’s disease because the muscles used for talking and controlling the voice become weaker or less coordinated. People may speak more softly, mumble or slur words. They might also have slower speech, pauses or difficulty starting words, making it harder for others to understand them.

Therapists focus on strengthening the muscles used for speech, improving voice volume and clarity and addressing issues like slurred speech or monotone voice. They also teach strategies to slow down speech, improve breathing for talking and use alternative communication tools if needed. “Speech therapy can help with swallowing difficulties, which are common in Parkinson’s, making eating safer and more comfortable,” says Khayum.

Caregiver’s role in speech therapy

Caregivers support loved ones by reinforcing the strategies and exercises recommended by speech therapists. By providing consistent support and guidance, they can make therapy more effective and help patients get the most out of their sessions.

Karen became an active partner in George’s speech therapy, working side by side with therapists to extend his progress beyond formal sessions. Early on, she realized that therapy twice a week would not be enough, so she sought out private programs, research studies and digital tools to keep his rehabilitation moving forward. Speech therapists introduced her to apps like Tactus, which provides structured speech exercises to practice at home, and Speechify, which converts written text into spoken words, highlighting each word as it is read aloud.

“Speech recovery doesn’t happen in therapy sessions alone. Every day I work with George, whether it’s practicing words, using apps or just reinforcing what he’s learned to make lasting gains,” says Karen.

Stuart Hopper works closely with speech therapists to support his husband, Carlos Contreras, who is living with Huntington’s disease. Contreras faces significant speech challenges, including difficulty finding words, forming coherent sentences and controlling the muscles needed for clear articulation.

Over the six years since his diagnosis, speech therapists have introduced specialized tools, including the EMST75 device to strengthen throat muscles and the Lingraphica tablet that helps people with communication challenges express themselves through touch-based icons, text and voice tools. “These speech therapy tools have helped Carlos articulate words more clearly and allowed us to stay better connected,” says Hopper.

Practical ways to reinforce speech and language

Caregivers are key partners, working closely with speech therapists to help patients get the most from therapy. “A vital first step is educating themselves, learning about the specific communication disorder, understanding therapy goals, and becoming comfortable with strategies like gesture cues, visual supports, and pacing techniques,” says Sampson.

Here are several practical tips that Sampson recommends to reinforce speech therapy at home.

Practice a little every day. Short, regular sessions are more effective than long, exhausting ones.
Use pictures and cards. Reinforce the photos, notes, or communication boards used by the therapist to support word-finding.
Rehearse everyday situations. Practice common phrases they want to use, like ordering from a menu, calling a friend or talking with neighbors.
Give gentle hints. Offer clues or gestures to help them find the right word, but let them try first before you speak up.
Celebrate wins. Praise small successes to boost motivation and build confidence.
Repeat words clearly. Speak words or sentences slowly and clearly so they can hear and imitate what you’re saying.
Keep track. Record in a notebook or through an app what’s getting easier or harder for your loved one and share those observations with the speech therapist.

Speech therapy going high-tech

Technology is transforming speech therapy, making treatment more effective, convenient and engaging. Artificial intelligence (AI), modern apps and programs let patients practice speech and language skills at home through interactive, fun exercises. Some tools even provide instant feedback on pronunciation, helping patients make faster progress toward clear communication.

Voice amplification devices can help patients better communicate with their family members. Some individuals with conditions like Parkinson’s disease demonstrate decreased volume in their voice and may also have reduced precision in their articulation, making it very difficult for others to hear them. “Voice amplification devices are small, portable amplifiers equipped with personal microphones that enhance the audibility of speech, particularly in noisy environments,” says speech therapist Adria Thompson, founder of Be Light Care in Richmond, Kentucky.

AI is rapidly expanding options for patients. Modern augmentative and alternative communication, known as AAC, tools can help individuals preserve or recreate their own voice, complete with natural intonation and inflection, which is especially valuable for patients with degenerative conditions. “Patients with degenerative conditions can record prompts to bank their voices, or families can upload existing videos and audio,” says Thompson. “This is incredibly important for a person’s identity and for ensuring that their communication still feels like them.”

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Paul Wynn, a veteran health care writer, has spent over a decade immersed in the caregiving community, both as a family caregiver and as a journalist covering caregiving issues for national publications.