Online speech therapy and Urdu parent coaching for families in the USA

Many of our US families are juggling more than one system at once: a toddler in Early Intervention while an older sibling has an IEP at the local public elementary school, and perhaps a private speech or ABA provider billed to insurance on top. Others are recent arrivals on work or student visas who are still learning how the American pathways fit together at all. In both cases, an Urdu-speaking guide who can join the dots is a relief rather than another appointment.

We also work with families who spend long summers in Pakistan, or who are weighing up an eventual move back, and want their child’s progress to hold across the distance. Sitting in Multan, we can keep coaching straight through those trips — and if the move does happen, families often carry on with us from South Asia or from a Gulf posting such as the UAE or Qatar without starting again with somebody new.

We plan around the clock rather than pretending it does not matter. With the US roughly nine to twelve hours behind Pakistan, the reliable slots are a parent’s early morning, before the school run and the commute, or the late evening once the children are asleep. Both map to a normal working hour in Multan, so nobody is doing therapy at 3am and calling it commitment.

Sessions are a plain video call on a phone or a laptop, in Urdu, English or a mix of both. We like to watch your child play through the camera so we can coach on real behaviour as it happens, then pause and talk it through — that is far more useful than working from a described version of a moment that happened last Tuesday.

We sit alongside them, never in place of them. In the United States, evaluation and funded therapy come from three routes: your state’s Early Intervention program before the third birthday, your school district and its IEP from age three, and private therapy through your health plan at any age. We are the between-sessions coach who helps you prepare for those meetings and keep the work going at home.

Practically, that means helping you get ready for an evaluation or an IEP meeting, understand what is being proposed and what it will actually look like on a Tuesday afternoon, and keep language and behaviour work alive at home so the funded services land on firmer ground. If the vocabulary is new to you, our plain-English guides to what early intervention means and what an IEP is are a good half hour before your first meeting.

Because eligibility and coverage rules differ so much from state to state and plan to plan, we never make promises about what your program, district or insurer will fund. We help you ask the right question of the right office, and then we support the plan you actually end up with.

No. Speaking Urdu at home does not cause a speech delay and does not make one worse. A genuine language delay shows up in both of a child’s languages, not in one of them. Count your child’s words across Urdu and English together — that combined total is the real vocabulary, and it is the number a good assessment should be looking at.

This matters because the advice to “just speak English at home” still reaches Pakistani-American families regularly, sometimes from people who mean well. Professional bodies including ASHA have been clear for years that bilingualism is not a cause of language disorder. What it does cost you is real: a grandparent your child cannot talk to, and a parent speaking to their own child in the language they are least fluent and least playful in. Speak the language you can be warm and silly in — our guide on bilingualism and speech delay goes into the detail.

A first video call runs to about an hour. We take a history, ask what your child does on their best day and their worst, and then ask you to play with them for a few minutes while we watch and stay quiet. Most of what we need comes from those few minutes: how your child asks for things, whether they look to you when something goes wrong, how they cope when the game changes.

You leave with two or three things to try, not twenty. Tomorrow morning it might be as small as holding the cereal box up and waiting five silent seconds before you open it, or naming what your child is already looking at instead of quizzing them with “what is this?”. We then review it with you on the next call — what worked, what fell apart, what to change — because a home plan nobody reviews is just a printout.

We will also tell you when we are the wrong people. Speak to your paediatrician the same week — and do not wait for us — if any of the following is true:

• Your child had words, gestures or eye contact and has lost them.
• No babbling by around 12 months, no single words by around 18 months, or no two-word phrases by around two years.
• Your child does not respond to their name or to loud sounds, or has had repeated ear infections.
• Coughing, gagging or choking on food or drink.
• Anything about your child’s breathing, seizures or sudden loss of skills.

Hearing is checked before anyone calls something a speech problem — that order never changes. If you would rather talk it through with a person than read another page, message us and tell us what is worrying you and we will answer honestly, including if the answer is that you need somebody local instead.