School-Based Versus Private Therapy Services

chart of differences between school-based and private therapy

Speech-language services can be provided in a variety of settings and environments including in homes, schools, outpatient clinics, hospitals, and nursing homes. Today, I want to focus on the differences between school-based therapy versus private therapy.

You’re probably wondering, “Why in the world should I pay for my child to receive private speech-language therapy services when they already receive it for free through the public school system?” Or maybe you’re thinking, “My child already had an evaluation completed at his/her school and did not qualify, so how would they qualify for your services or why would they need them?”

Here is what you need to know:

Qualifying for School-Based Therapy

There is very specific criteria and requirements set by each state in order for students to qualify to receive speech-language services within the public school system. For example, in Minnesota, in order for a student to qualify for services in the area of articulation or phonology (difficulty producing speech sounds), the child must obtain a score two standard deviations below the mean (or average) in comparison to age-matched peers. In other words, they need to fall at or below the 2nd percentile or demonstrate a “severe” impairment. Let me show you what that looks like…

Normal distribution bell curve
Graph by Pacific Coast Speech Services Inc.

What is the problem with this?

There are many children who are still below average in their skills, or demonstrate mild or moderate impairments, but their impairment is not significant enough to allow them to qualify for services in the school system. This does not mean that these children are performing as they should be, it does not mean they will catch up on their own, it does not mean they might not still show signs of frustration when not being understood by others or struggling academically, and it definitely does not mean that they wouldn’t benefit from speech-language therapy!

The School “Scope of Practice”

Speech-language pathology services in schools focuses on supporting a student’s ability to access the general education curriculum and to achieve success both academically and socially. In this model, there must also be a proven educational impact in order to the child to receive services.  The student is then provided with the most minimal services they need to succeed in a school setting which is referred to as the “least restrictive environment”. All services that the school identifies that a student requires is then provided free of charge to the family.

How is this different from private therapy services?

Private speech-language pathology services are meant to support functioning across all areas of life, not just the educational aspect. In private practice, we are not required to meet this state criteria and instead are able to see clients with ALL levels of impairment from mild to severe who may need our services. There are not specific cut-offs of testing scores in order to receive out services. Instead, we are able to treat any child who is demonstrating delayed milestones, deficits, or disorders, no matter how significant the impact is. The best part about this, is we don’t have to wait until the child is SO far behind their peers to begin therapy. Instead, we can treat sooner and work to close that gap before it becomes more significant.

So, why could there be a potential difference in recommendations given the same diagnosis?

The school evaluating team must prove is that the speech and language impairment is impacting the child’s ability to access the educational curriculum or succeed either academically or socially. There are cases where a student may have a diagnosable speech and/or language impairment, but is not struggling in school. This child might then be a candidate for private therapy services, but not school-based services.

What does school- based therapy “look” like?

Given the constraints that speech-language therapists across the country deal with in schools such as large caseloads and limited time, generally most children are put into groups of two or more. They are typically seen 1-2 times a week (sometimes more if the child has significant needs) in these groups. Sessions usually are 15-25 minutes long  and can vary  between schools. Parents and caregivers typically receive minimal updates on their child’s progress. Generally progress is reported at one annual Individualized Education Program (IEP) meeting and typically a couple of written progress reports throughout the year. In addition, this also means parents or caregivers might only meet with the speech-language therapist  in person once each year at the annual IEP meeting and maybe during parent/teacher conferences if your therapist is available and doesn’t have multiple students scheduled during the same time slot.

What can private therapy services look like?

In private practice, we have have far more flexibility.  Generally, private practices and clinics offer 30-60 minutes sessions. At Socially Sound Therapy Solutions, we offer 45 or 60 minute treatment sessions.  In addition, we are also able to provide individualized, one on one therapy focusing solely on your child and their needs. Furthermore, because we provide in-home therapy services (and even when services are provided in an outpatient clinic model), you get frequent face-to-face time with the treating therapist. Parents are able to see what we are doing at every session or at least get a brief summary at the end of each session! This also allows for education and training to be provided so that you can target these skills at home between sessions.

So, what does this all mean?

School-based speech therapy is an important service for students and supports their educational success. It is free to families and addresses skills critical for learning, such as speech development, the ability to be understood by staff and peers, language development, literacy skills, and social interaction. However, because school services use an educational model, they may not address all areas of functioning that private services can under a medical model. Private therapy services can provide treatment for anyone who needs it and typically achieve more progress, faster! Know that your child can receive both if eligible OR can still receive private services even if they did not qualify for school services. Thus, it is important to investigate all available types of therapy when deciding what best fits your child’s needs.

Find out more about our pediatric services.

Still have questions? Contact us.

How much of my child’s speech should we understand?

Most parents are aware that speech should not necessarily be perfect in the younger ages. Maybe you understand everything that your child says, but grandparents, teachers, aunts, and friends have a more difficult time. First, it is important to know that it is common for familiar communication partners (e.g. parents or siblings) to understand children better than less familiar people. However, have you ever wondered just how much of your child’s speech others should be able to understand?

chart with percent of speech understood by others by age

An easy way to remember is 2/4 utterances should be understood by age two, 3/4 utterances by age three, and 4/4 utterances by age four.

Is your child two years old, but not yet speaking in short utterances that others can understand? Do you have a child that is four years old and is still difficult to understand some of the time? It might be a good idea to seek an evaluation for your child. Early intervention is always better! Visit our website to learn more about the signs and symptoms of speech and language delays or possible impairments and the pediatric services we offer.

Still have questions? Contact us for a free 15 minute consultation.

Dysphagia 101 | Difficulty Swallowing

If you haven’t heard of it before, dysphagia (pronounced “dis-fay-juh”) is the term for a swallowing disorder. There are multiple phases of a swallow and disruption in any part of the sequence has the ability to create difficulty swallowing or an unsafe swallow. Speech-language pathologists focus specifically on individuals with difficulty in the first two stages.

The oral phase includes the managing saliva and foods or liquids to prevent them from spilling out of the mouth, chewing, the coordination of your tongue, lips, and jaw to form a cohesive mass called a bolus, and moving the bolus of food or liquid to the back of the throat.

Next is the pharyngeal phase. This phase includes initiation of the swallow reflex, contraction of the throat or pharyngeal muscles to squeeze the bolus down, and closing off the airway to prevent food or liquid from “going down the wrong pipe” or in other words going into your lungs.

 FUN FACT: When food or liquid get past our natural defenses and go into the lungs instead of the esophagus, this is called aspiration.

Lastly, the esophageal phase occurs when the food or liquid passes is transported from the esophagus into the stomach.

symptoms of dysphagia

Speech-language pathologists can treat patients who suffer from dysphagia using a variety of methods including rehabilitative exercises to improve oral motor and swallowing function, teaching compensatory techniques to improve swallow safety, or a combination of both.

Find out more about our adult dysphagia services here.