The Evidence

Does Online Speech Therapy Work? What The Research Shows

Online speech therapy does work for the children it has been tested with. Where researchers have compared online and in-person speech therapy side by side, they have not found a difference. Those trials are few and mostly small, though, and some groups of children have hardly been studied.

This page sets out what has been tested, with every study named and linked, so you can judge for yourself. It sits alongside how online speech therapy works .

See the evidence table

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The Short Answer

What the evidence says, in four sentences

Online speech therapy is speech therapy delivered by live video. The strongest evidence is for stuttering in preschool children, where a randomised trial found treatment by webcam worked as well as treatment in a clinic.

For school-age speech and language, a systematic review called the evidence limited but promising. For autistic children, under-threes and older children who stutter, there is less to go on.

What Has Been Studied, By Condition And Age

What was studied	Children	Study and design	What was found	How strong
Speech sounds and language, school age	About 162 children across 7 studies, mostly aged 4 to 12	Wales and others, 2017: systematic review of 2 randomised trials, 2 comparison studies and 3 before and after studies	Gains generally similar to in-person where compared; families satisfied	Limited but promising
Stuttering, preschool, by webcam	49 children aged 3 to 5	Bridgman and others, 2016: randomised trial, webcam against clinic	No difference in stuttering 9 months on	Moderate: one well-designed trial
Stuttering, preschool, by telephone	Preschool children	Lewis and others, 2008: randomised trial against no treatment	Stuttering 73% lower than untreated children at 9 months	Moderate, small; telephone, not video
Stuttering, ages 6 to 12, by video	37 children aged 6 to 12	Johnson and others, 2024: trial with no comparison group	About a third met the program's targets by 12 months	Early: no comparison group
Under-threes, parent coaching	Children aged 5 to 37 months across 18 studies	Shin and others, 2025: systematic review, mostly single-case studies	Comparable to in-person where compared; most studies on autism or cerebral palsy	Limited
Autistic children, telehealth	14 studies (2018 review); 9 studies of parent coaching (2023 review)	Sutherland and others, 2018: systematic review; Alatar and others, 2023: rapid review	Comparable to face to face where compared, with little on work directly with children; too little evidence on children's social communication	Limited: small studies, high risk of bias
Reading and spelling, ages 7 to 12	37 children aged 8 to 12 (assessment); 18 aged 7 to 12 (pilot); 9 studies (review)	Hodge and others, 2019: literacy tests scored by video and face to face; Kohnen and others, 2021: pilot with no comparison group; Furlong and others, 2021: rapid review	Close agreement on literacy assessment scores; gains on two of three measures in the pilot; teaching by video feasible and engaging	Low: small studies, low-quality evidence
Scoring assessments by video	25 children aged 5 to 9; 20 aged 4 to 9	Waite and others, 2010 and 2012: scored online and in the room at once	Close agreement on language scores and speech clarity	Good, small samples
Rapport over video	Speech pathologists' ratings of child clients	Freckmann and others, 2017: survey of 32 speech pathologists	No difference in rapport	Low: clinicians' view only

Is Online Speech Therapy As Good As In Person?

In the studies that compared online speech therapy vs in person side by side, online therapy matched in-person therapy for the children those studies included. The clearest test is Bridgman and colleagues' 2016 randomised controlled trial. Its 49 preschool children who stuttered were randomly given the Lidcombe Program by webcam or in a clinic, and nine months later there was no evidence of a difference in their stuttering. In the 2017 review of school-age speech and language studies, four compared telehealth with in-person therapy, and three that ran both groups at the same time found broadly similar gains.

What these studies do not show is that online therapy is equal for every child and every difficulty. "No difference found" in a small study is not proof of no difference, and most children in the research had speech sound, language or stuttering difficulties without other conditions.

Where Is The Evidence Thin?

The evidence is thinnest in four places.

Autistic children. The 2017 school-age review left them out. Most of the under-three studies were about autism or the risk of it, but they were small, mostly single-case studies of coaching parents.
Under-threes. Early intervention by telehealth for children under three mostly means coaching parents. The 2025 review found telehealth comparable where it was compared, but only 18 studies, most with a handful of families.
School-age and teenage stuttering. The 2024 trial of 6 to 12 year olds had no comparison group, and teenagers have barely been studied online.
The long term. Most studies follow children for months, not years.

Thin evidence is not evidence that online therapy fails. It means a parent should watch how their own child responds, and a speech pathologist should review whether video is working. When in-person help may be the better choice is set out in the guide to whether online speech therapy suits your child .

Can A Child Build A Bond With A Speech Pathologist Over Video?

Speech pathologists report building rapport with children over video about as well as in person. In a 2017 survey by Freckmann, Hines and Lincoln, 14 speech pathologists working by telepractice and 18 working face to face rated their rapport with child clients, and the scores did not differ. It measured the clinicians' view, not the children's, so it is a start rather than an answer. Keeping a young child engaged on screen is covered in the guide to whether your child will sit still for online therapy .

Can A Speech Assessment Be Done Accurately By Video?

Language and speech clarity can be scored by video almost as they are in the room. In two University of Queensland studies, children aged 4 to 9 were assessed by one speech pathologist in person and another online at the same time: language test scores agreed closely, and ratings of how clear speech was matched exactly 70% of the time and within one point every time. Checks of how the mouth is built and moves agreed less well: overall agreement was high, but on half of the individual checks it was only poor to fair. More on how an online assessment works.

What Gets In The Way, And What Helps?

The problems the research reports are mostly practical. A 2022 review of 14 studies, 10 of them Australian, found dropouts, lag and frozen screens were the most common complaints, along with worries about rapport. The same studies found families saved travel, valued the familiar home setting, and rural families could reach a service they otherwise could not. A steady connection, a quiet room and a parent nearby remove most of the problems; what you need at home for a session lists them.

What Does Speech Pathology Australia Say About Telehealth?

Speech Pathology Australia, the national body for the profession, says telepractice is appropriate when it is based on the best available evidence and its outcomes are at least equivalent to standard speech pathology care. It also expects the same professional, ethical, legal and privacy standards as any other service. A parent can turn that into questions for any provider:

Is the clinician a Certified Practising Speech Pathologist?
Has the clinician considered whether video suits this child, and will they say if it stops working?
How is progress measured, and how will we know it is working?
How is our child's information kept private and secure?
What happens if the connection drops?

More questions are in how to choose an online speech pathologist .

How Online Speech Therapy Uses This Research

Dr Lauren Crumlish (PhD), Certified Practising Speech Pathologist, assesses every child before therapy starts, measures progress and adjusts the plan, including whether video still suits the child. None of the studies on this page is hers. How sessions run is set out on how online speech therapy works , and the kinds of work she does by video include stuttering, speech sounds and lisps ,language and toddlers and late talkers .

Sources

The Studies

Every study and statement this page draws on, linked to the publisher or the research record. Read 15 November 2026.

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Questions Parents Ask

Questions About Whether Online Speech Therapy Works

Does online speech therapy work?

For the children it has been tested with, yes: trials comparing online and in-person speech therapy for children have not found a difference. The trials are few and mostly small, and the evidence is thinner for autistic children, under-threes and older children who stutter.

What did the preschool webcam trial find?

The 2016 randomised trial compared the Lidcombe Program by webcam with the same program in a clinic for 49 children aged 3 to 5, and found insufficient evidence of a difference between them. It is the strongest single comparison of video and in-person speech therapy for children. How stuttering work runs by video is on the stuttering page.

How strong is the under-three evidence?

Encouraging but weak. A 2025 review of 18 studies of telehealth early intervention for children under three found it comparable to in-person help where the two were compared, but most studies followed only a few children, only four were randomised trials, and most were about autism or cerebral palsy rather than late talkers.

Is telehealth speech therapy effective compared with face to face?

In the studies that compared the two for children, results have mostly been similar: a 2016 randomised trial found no difference for preschool stuttering, and three of four school-age speech and language comparisons found broadly similar gains. The studies are few and small, mostly with speech, language or stuttering difficulties, so a speech pathologist should still check whether video suits each child.

What makes online speech therapy work better?

A steady internet connection, a quiet room, a parent close by for younger children, and a clinician who checks whether video is working. The most common problems in the research were dropped connections and lag, not the therapy itself.