35% of clients disengage before their therapy goals are met.
Speech pathology practices build long-term therapy plans — but a significant proportion of clients drop out before those plans are complete. We analysed retention patterns across the profession. Here's what the data shows.
Routiq — Australian Speech Pathology Report 2026Speech pathology is one of Australia's fastest-growing allied health professions.
Speech and language therapy is designed for sustained progress.
Client behaviour says otherwise.
Childhood speech delays require 10–20+ sessions for meaningful change. Adult swallowing therapy is ongoing. Stuttering programs run 6–12 months. These are not one-off consultations — they're structured programs that require sustained attendance to deliver outcomes.
Speech Pathology Australia, AIHWClient attrition is the single biggest drag on practice revenue.
Speech pathology has one of the highest per-client lifetime values in allied health — $2,200+ for a typical paediatric therapy plan. Every client who disengages early is a significant revenue loss.
A consistent pattern across every speech pathology practice we analyse.
Across the practices we reviewed, the same story repeated — the majority of clients are lapsed beyond their therapy schedule, reachable by SMS, and have never received a behaviourally-informed message prompting them to return.
What follows is representative of what we typically see in speech pathology practice databases.
In a typical speech pathology practice database, more than half of all clients have not attended a session in over 90 days. Many have incomplete therapy plans and haven't been contacted.
Typical client recency distribution
Most speech pathology practices rely on individual therapists tracking their own caseloads and parents remembering to rebook. When life gets busy, families fall off — and nobody follows up.
Practice management software manages bookings. It was never designed to bring clients back.
Four reengagement segments hiding in every speech pathology database.
What reengagement looks like for a 1,000-client speech pathology practice.
Based on ~60% lapsed beyond 90 days, at standard Australian speech pathology consultation rates.
| Segment | Estimated Pool | Reengagement Rate | Recovered | Revenue |
|---|---|---|---|---|
| Therapy Plan Dropouts | ~180 | 8% | 14 | $15,400 |
| Review/Maintenance Lapsed | ~60 | 12% | 7 | $4,620 |
| Initial Contact Only | ~150 | 5% | 8 | $17,600 |
| No-Show Recovery | ~30 | 25% | 8 | $1,760 |
| Total — First Pass | 37 | $39,380 |
Plan Dropouts: 14 clients × 5 remaining sessions × $220. Review Lapsed: 7 clients × 3 sessions × $220. Initial Contact: 8 clients × 10 sessions × $220. No-Show: 8 clients × 1 session × $220.
Modelled on Australian speech pathology rates. Conservative reengagement assumptions.These numbers aren't optimistic. They're conservative.
“Our clients are mostly children — isn't reengagement different?”
It is. Parents are the decision-makers. Behaviourally-informed messages address parental barriers — time, cost, uncertainty about progress. The child's speech hasn't stopped developing. The parent just needs the right information at the right moment to act.
82 principles. 20 that work for speech pathology.
Routiq's messaging engine is built on behavioral science frameworks from seminal works in psychology and economics — adapted specifically for parent-as-decision-maker dynamics in paediatric therapy.
Goal Gradient + Commitment & Consistency: They're closer than they think.
Social comparison (keeping up with peers), shrink the change (30-minute check-in, not a full session), pratfall effect (zero guilt for no-shows — mornings with little ones), and default effect (a specific spot already available).
The 3-touch behavioural escalation sequence.
Every campaign follows the same evidence-based structure. Three messages. Three psychological mechanisms. Automated and personalised.
Goal Gradient
“Lily mastered 3 of 5 target sounds. A few more sessions and she'll be there. We'd love to help her finish strong.”
Default Effect
“We've kept a spot open for Lily on Wednesday at 3:30pm with Emma. Reply YES to confirm or let us know a better time.”
Social Proof
“Most families who pause and come back say they wish they'd returned sooner. Lily's progress is still there — we just need to build on it.”
Personalised with their child's therapy history, therapist name, and therapy plan progress.
Three layers no one else has.
Routiq knows Lily mastered 3 of 5 target sounds, her therapist was Emma, and she's completed 8 of 12 planned sessions. It doesn't just know a client is “overdue” — it understands their therapy journey.
Parent-as-decision-maker protocols. 82 principles from seminal works in psychology and behavioral economics — adapted for the specific barriers parents face: time, cost, uncertainty about whether therapy is “working.”
Daily monitoring across every therapist's caseload. Messages sent from your own practice number at the right moment. Replies handled instantly with AI-powered clinical context. Works across evenings, weekends, school holidays.
Where Routiq sits.
| Capability | Front Desk | PMS | Routiq |
|---|---|---|---|
| Therapy plan tracking | If they check the file | Stores data, doesn't act on it | Yes — protocol-based |
| Same-day no-show follow-up | When staff remember | No | Automatic, within hours |
| Behavioral science messaging | No | No | 82 principles, systematic |
| Parent-specific messaging | Ad hoc | No | Parent-as-decision-maker protocols |
| AI-powered reply handling | During office hours | No | Instant, 24/7 |
| Multi-therapist caseload scaling | One therapist at a time | Manual per therapist | All therapists, daily |
| Predictive dropout flagging | No | No | Yes — early warning system |
Your PMS holds the data. Routiq turns that data into recovered clients.
Reengagement isn't a campaign. It's a system that compounds.
8 clients recovered per month at a blended $440/client (2 sessions avg). Each recovered family often continues for multiple sessions — the value compounds.
By month 6: 48 recovered families generating $21,120+ in cumulative revenue — plus ongoing therapy sessions as families continue their plans.
What this means for your practice.
The pattern is universal. The opportunity scales with your database size. Based on $660 per recovered client (avg 3 sessions at $220).
| Your Database Size | Conservative Recovery | Moderate Recovery |
|---|---|---|
| 500 clients | $9,900 | $19,800 |
| 1,000 clients | $19,800 | $39,600 |
| 2,000 clients | $39,600 | $79,200 |
| 3,000 clients | $59,400 | $118,800 |
| 5,000 clients | $99,000 | $198,000 |
Based on $660 per recovered client (avg 3 sessions at $220) and industry-standard 60% lapse rate across speech pathology practices. Excludes ongoing therapy revenue from clients who continue beyond initial recovery.
Industry benchmark: 15–25% of lapsed clients can be successfully re-engaged via targeted campaignsWithout Routiq
Individual therapists manually tracking their own caseloads
Revenue dependent on new referrals and NDIS intake
No visibility into incomplete therapy plans
Parents forgetting to rebook between school terms
80% of marketing budget on acquisition
With Routiq
Every therapist's caseload monitored daily
Revenue from families you've already assessed
Automated behavioural campaigns for every segment
Parent-as-decision-maker messaging protocols
Fraction of the cost, 10x the ROI
You already did the hard part — assessing their needs, setting goals, building trust with the family.
Those families didn't leave because therapy wasn't working. They left because life got busy and nobody followed up.
Their child's speech hasn't stopped developing. They just need the right nudge.
How many families are you losing to silence?
routiq.
Clinical Intelligence Meets Behavioral Science
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Speech Pathology Australia
Australian Health Practitioner Regulation Agency (AHPRA)
Australian Institute of Health and Welfare (AIHW)
NDIS Pricing Review
Jobs and Skills Australia
Australian Bureau of Statistics (ABS) Census
Medicare Benefits Schedule Data
Bain & Company / Harvard Business Review
WebPT
Dialog Health
PMC Systematic Reviews
Practice analysis data from Routiq platform analysis. All data anonymised and presented as industry patterns. February 2026.