What Happens in Your Child’s First Therapy Session

A first therapy session is a free, unhurried conversation with you, followed by around 45 to 60 minutes of play. Nobody tests your child. A therapist watches how your child talks, listens, plays, moves and pays attention — and before you leave, you are told plainly what we saw and what we suggest next.

The unknown is the frightening part, so here is the whole visit in order, exactly as it runs at our centre on MPS Road in Model Town, Multan. You need no referral and no existing diagnosis, and you are allowed to arrive with nothing but your worry. If you are still deciding whether to ask anyone at all, start with how to get help for your child.

What actually happens in your child’s first therapy session?

Your child’s first therapy session has four parts: a conversation with you about what you have noticed at home, a play-based assessment of 45 to 60 minutes, a plain-language summary of what we saw, and one thing to try at home. It is an assessment, not therapy, and no child is asked to perform.

The conversation comes first for a reason. You have watched your child every day for years; we get one afternoon. What you have noticed at bedtime, at the dinner table, at the school gate is data we simply cannot collect ourselves.

Then the toys come out. To your child it looks like a stranger who is unusually good at play. To us, each game is chosen to pull one particular skill into the open. That is different from an ordinary week-to-week session, where the therapist is practising a target rather than mapping the whole picture — inside a speech therapy session shows what that looks like later on.

How long does it take, and who is in the room?

Allow about an hour and a half from arriving to leaving. The room holds your child, one therapist, and you — that is it. No panel, no observers, no one-way glass.

You stay in the room, especially with babies and toddlers. A child who can see their parent settles faster and shows us more. If you have other children, leaving them at home helps, though we understand that is not always possible in a real family’s day.

There is no clock pressure on your child. If they need ten minutes hiding behind your leg first, that is ten minutes we were going to spend watching anyway.

What are we watching while your child plays?

While your child plays we are watching five things: how they communicate, how much they understand without gestures to help, how they play with toys and with people, how their hands and body move, and how long their attention holds. Every game on the table is there to bring one of those into the open.

In practice that means noticing small, specific moments:

• Whether your child looks up when their name is called — and how often, not just once
• Whether they point to show you something, not only to ask for it
• How many different words come out, not how much noise there is. If your child hears Urdu at home and English at school, we count words from both languages together — a bilingual child’s vocabulary is the combined total, and mixing the two is normal
• How varied the babble is in a child who is not yet talking, and whether it has the rhythm of a sentence
• Whether an instruction is followed when we deliberately do not point or look at the object
• How a crayon is held, how they sit at a table, how they manage stairs, a ball, a zip
• What happens when a favourite toy is put away — how the protest comes out, and how quickly they recover

None of this is scored in front of you like an exam. It is written down, and it becomes the baseline we measure everything against later.

What should you bring, and what if you have nothing?

Come with nothing and we will still manage. But four things save us guessing:

• Any reports you already have — a hearing or vision result, a diagnosis letter, old therapy notes, a school report. A photo on your phone is perfectly fine.
• Anything a teacher has said, if a teacher is the reason you got in touch.
• A comfort toy or a snack. Familiar things settle a child in a new room, and a settled child shows us far more.
• Your questions, written down — they vanish from your head the moment you sit down.

If you would like to do the history part before you come rather than in the room, our parent form for before your appointment takes about ten minutes and leaves the whole visit free for your child.

What if my child cries, hides or refuses to join in?

It happens most weeks, and it is not a wasted visit. A child who refuses is still telling us a great deal: how the protest comes out, whether they look to you for help, whether they can be settled and brought back, how they cope with something new.

We never force a child to sit, speak or be touched. If your child will not come to the table, we get on the floor. If they will only play with you, we watch you play. And if the day is genuinely the wrong day — a bad night, a missed nap, a child coming down with something — we stop and see you again another day rather than push through it.

Please do not apologise for your child’s behaviour in that room. We have seen it, and nobody there is judging your parenting.

What do you leave with at the end of the first session?

You leave the first session knowing three things: what we saw, what we think it means in plain words, and what happens next. That next step is one of four — nothing more than a review later, a home programme, a therapy plan, or a referral to someone else first. Nothing is decided without you.

If it is a therapy plan, you will not be handed a vague promise. You get the first two or three goals, written in ordinary language, so you can tell whether they are being met — how we set therapy goals explains how those are chosen. The stages that follow the first visit are set out in our step-by-step therapy process.

What would make us send you somewhere else first?

Three things, mainly — and we would rather say so on the day than take a booking we should not have taken. Speech and behaviour are not always speech and behaviour problems.

• Hearing. If speech is the concern, a hearing check comes first or alongside. Repeated ear infections and glue ear are common in young children in Pakistan, and a child who cannot hear the difference between two sounds cannot copy it.
• Lost skills. If your child had words, gestures or play skills and has lost them, that needs a paediatric opinion promptly — not a waiting list.
• Anything medical. Fits or staring episodes, a sudden change in walking or balance, choking or coughing on food and drink, or a child who is losing weight. Those belong to a doctor, and we will say so.

Telling a parent that their child does not need us is a good day here. We support, assess and teach; we do not diagnose medical conditions and we never promise an outcome.

How do I prepare my child so it feels like play, not a test?

• Keep your own tone light. Children read your face long before they read the room.
• Call it going to play with a friendly teacher. Not a test, not a doctor, not an injection.
• Do not drill words or rehearse answers the night before. A coached child gives us a false picture, and we will only have to unpick it later.
• Come after a nap and a snack if you possibly can. Tired and hungry looks a lot like inattentive.
• Do not promise a reward for “doing well” — it quietly turns play into a performance.
• Tell us in advance if your child hates new rooms, loud noise or being touched, so we can set the room up before you walk in.

What if it is easier to explain in Urdu?

Then explain it in Urdu. The first conversation and the sessions that follow run in Urdu or English, whichever your child hears most at home, and you never need the clinical word for what you are describing.

Most parents arrive with their own sentence, not a diagnosis — mera bacha bolta nahi, baat nahi karta, zaban saaf nahi, bacha aik jagah nahi baithta, der se bolna shuru kiya. Say it exactly like that. Whether it turns out to be گویائی کا علاج, a hearing question or nothing at all is our job to work out, not yours.

Ready when you are

The first consultation is free, it takes an afternoon, and it is a conversation rather than a verdict. Most parents leave lighter than they arrived, even when the news is that there is work to do — because a plan is easier to carry than a worry. If you are wondering how long any of this takes, how long speech therapy usually takes is an honest answer rather than a sales one.

You can book a first visit at our Model Town centre in Multan, or online if you are further afield, and we are open Monday to Saturday, 10 AM to 7 PM. If you would rather just ask something first, send us a message — no question is too small, and asking costs you nothing but a minute.