It may surprise many people to hear there is a difference in speech therapy services in the schools versus in an outpatient/private practice setting. The difference is in how children qualify for services and also how the services are delivered. Having worked in both settings, I am able to speak on these differences through my firsthand experience and knowledge. Let me start by saying both private and school speech therapy are beneficial and worth pursuing if your child is in need. Both settings have their pros and cons and SLPs in both settings receive the same training and qualifications. Therapies in both settings are focused on the same ultimate goal: to improve patient’s overall communication.
The first difference I want to touch on is qualifying for therapy. In private therapy, the child may receive services if they exhibit one or more speech errors (for example, saying wat instead of rat), their caregivers express concern with their speech, language, or social development, and/or they demonstrate below average skills in one of the areas listed above on standardized or informal testing.
In school therapy, the criteria for qualifying for therapy varies from state to state. In our area (Kentucky and Ohio), the child must have either a documented negative academic impact or documented negative social impact. What that means is the child’s teacher, school administration, etc. must have written proof of the child’s speech, language, or social skills affecting their academic work. For example, if a child is using /f/ instead of /th/ and on their spelling tests they are writing words the same way (putting fere instead of there, or feafer instead of feather) then it is reasonable to assume their speech error is affecting their academics. Since the child may not hear the difference between /f/ and /th/ learning to spell words with /th/ will be much more difficult. A documented social impact could include situations like the child not wanting to participate in group/classroom discussions due to their speech or other children bullying the child due to their speech. The teacher should have these situations in writing with dates to show the SLP during the evaluation process.
The second difference I’m going to mention is how services are delivered. In private therapy, your child will be seen individually which allows for more focused attention and increased practice. In the schools, your child will most likely be seen in a group of 3 or more students. This is due to the large caseload and multiple time constraints of school based SLPs. Though your child should make progress even in a group setting, the progress may be slower than what you would see in a private setting. Your child will not receive the one on one attention or the same amount of practice opportunities that are available in a private setting. However, one pro of group therapy is children see they are not the only ones with speech difficulties. They are able to be placed in groups with children who have similar goals. For example, in the schools I would try to group 3-4 kids together who all needed work on /r/. A pro for private practice is that children’s parents have the opportunity to watch or even participate in therapy. Having parents involved in the therapy process enables them to have the skill and confidence to help their child communicate effectively outside the therapy room. The therapists at Interactive Therapy Services, PLLC. encourage parents to ask questions during the sessions and alotte time during the session for parents to practice the skills modeled by the clinician.
Many parents of children who receive speech therapy through the school will ask the SLP if they think their child needs outpatient/private speech therapy in addition to school speech therapy. Most likely the SLP will say something like ‘if you feel it’s necessary’ or ‘it’s really up to you as a parent’. These vague answers are given because depending on how the SLP words the response, for example if she says “yes, your child could benefit from outside speech services” then the school will likely have to PAY for the outside services. The state (aka school) has to pay for any services your child needs that cannot be met through the schools service providers. So a ‘no’ or a vague ‘if you feel like it’s necessary’ answer takes the school district off the hook for the bill. However, this may lead you to believe that your child doesn’t need to seek services for the summer or once a week during the year even though it could be of great benefit. My response would be if you are asking this question and can afford private therapy then it is definitely worth seeking outside services. I know many families who have their child see the school SLP during the school year and pick up private speech therapy during the summer using their allotted insurance visits.
Thank you for taking the time to read our blog and explore our website. If you’re interested in learning more about private speech services or would like assistance on figuring out how many speech therapy sessions per year your insurance will allow, feel free to reach out to us on our contact page or call (606) 465-9754.
--Jen Vice M.S. CCC-SLP
Co-Owner of ITS, PLLC.
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