School Speech Therapy vs. Private Speech Therapy: Everything You Ever Wanted to Know and Then Some
What are the differences?
Want to know the difference between school speech therapy vs. private speech therapy? Let’s dive on in! We are going to cover almost every difference, along with the pros and cons of each to help you be well informed. (Spoiler alert: Both are great for their own reasons and if you can swing it, both private speech and school speech at the same time will be the best combination for your child).
SLP Qualifications
School Setting: Both in the schools and in the private practice setting, most if not all therapists are master’s level licensed and certified Speech-Language Pathologists (SLP’s). There are some cases that schools may hire bachelor’s level SLP’s conditionally (meaning they will allow them to work for a set amount of time with the condition that they finish their master’s program in a set amount of years).
Private Setting: Both in the schools and in the private practice setting, most if not all therapists are master’s level licensed and certified Speech-Language Pathologists (SLP’s). There are some private practices who hire bachelor’s level SLP’s, called Speech-Language Pathology Assistants (SLPA’s). These SLPA’s are supervised by a licensed and certified SLP, and can not do everything an SLP can.
Costs of Therapy
School Setting: Free! The Individuals with Disabilities Education Act (IDEA) mandates that all PUBLIC schools provide evaluations and therapy services free of charge for those that meet the criteria. Private schools do not have to follow the same guidelines under IDEA because they do not receive federal funding. However, some private schools do partner with the public school district to provide some services to their students. These services and plans may look at bit different than what we discuss in this blog post.
Private Practice: Costs may vary based on SLP, expertise, and location of services provided. Some services may be covered by insurance, and some may not depending on your specific insurance coverage. There are scholarships and grants available to help pay for services not covered by your insurance company, and some therapists also do a sliding scale fee schedule which allows you to pay according to your income. FSA accounts and HSA accounts can also be used to cover the costs of speech therapy services.
Waiting Period
School Setting: The waiting period to complete an evaluation can take a few weeks to a few months. There is a process that must be followed and legal timelines set forth by the government, but typically once you request an evaluation in writing, the school has to have a meeting within 30 days to talk about what your concerns are and if an evaluation is recommended by what’s called the Child Study Team. If the team, which includes you, decides that an evaluation is needed, you sign a consent form which allows an SLP to test your child. The school then has 60 days to complete the testing. After testing has been completed, the SLP will write the report up. Once everything is ready to be reviewed, they will call you in for another meeting to talk about the results and discuss if your child qualifies for a speech or language therapy program. If your child does qualify, then you will sign a consent form for placement and the team will create an Individualized Education Plan (IEP) that says exactly which services your child will be getting and what the school will be working on during therapy time. Especially now during the pandemic school closures, schools are definitely behind in testing and it may take even a bit longer before your child is evaluated and in therapy.
Private Practice: You can most likely find an SLP that has immediate availability to evaluate your child and start therapy in about a week or so after the evaluation report is written up and a plan of care is created. Some in demand clinics may have a waiting list, especially if you are trying to use in-network insurance therapy benefits. In those cases it can be hard to tell how long you will have to wait before being seen. If there are no local therapists in your area with availability, you may be able to find a tele-SLP (same qualification levels as an in person SLP) who can help you immediately via telehealth.
Eligibility to Start Therapy
School Setting: Because the school therapy services are funded by the government through IDEA, there are certain eligibility criteria that need to be met, and it all HAS to relate somehow to the child’s ability to function in the academic environment. That means that sometimes a child might technically have a disorder, but if the child is doing well academically in school (which means average, not necessarily A+) and there are no other impacts socially or with his/her ability to be understood, the child may not qualify for therapy. In these cases the school does not and CAN NOT legally provide therapy services to that child. I have seen it happen before. In those cases, you want to seek out private therapy. For language therapy in school aged children, the Multi-Tiered System of Support/Response-To- Intervention (MTSS/RTI) process has to be met before saying a child is eligible for therapy. This is a series of interventions carried over at least 16 weeks that is made to help curb the amount of children who go into the special education program (and yes, speech or language therapy falls under the Special Education programs). The goal is for children to get interventions and make progress to close the gap between where they are academically (which is below grade level) and where they should be academically on grade level. If a child has not gone through this process yet, when you request an evaluation they will most likely start this process to help prepare for the eligibility meeting. The MTSS/RTI process can be GREAT for children who are not too far behind academically, but not all children will be able to catch up this way. That’s when the language therapy is needed. For more information on the MTSS/RTI process, click here.
Private Practice: All that is needed for a child to receive therapy is a diagnosis of a speech or language disorder which happens through the evaluation process. There is no need to justify an academic impact to start therapy. If you want to use insurance benefits, a doctor’s referral is typically needed before your child is able to be evaluated and treated.
Choice of Therapist and Schedule
School Setting: You typically don’t get your choice of therapist. Most school therapists are great and usually have some knowledge in all different types of disorders instead of specializing in a certain area. Sometimes a school only has one therapist available, or they may have multiple therapists available. You usually also don’t get a say in when your child get’s seen for speech/language therapy, but it will be sometime during the school day.
Private Practice: You as the parent have the choice of who you want your child’s SLP to be. You can find a therapist that is able to see your child in the afternoons or on weekends even. You can even search for a speech therapist who specializes in your child’s specific disorder, or find a therapist who has been trained in a specific program, such as Lively Letters, Visualizing and Verbalizing, PROMPT, etc.
Setting
School Setting: School therapies are almost always provided in the group setting. This can be GREAT for children who have difficulties socializing or sharing. Often children learn a lot from each other. SLP’s try to group the children together as similarly as possible so they are all working on the same things, but sometimes that isn’t possible. This also means that the therapy time is shared with other children in the group, which can be as little as 2-3 children or sometimes even up to 8 children. In some unique cases, therapy may be provided one-on-one if it is needed. The services can be provided in the classroom, or the children may be pulled out of the classroom to the SLP’s room.
Private Practice: Therapy is almost always provided one-on-one. This is great for seeing progress quickly, but not ideal for those children who need some help with their socialization skills since it’s pretty difficult to work on things like sharing with peers or talking with peers when its just the child and the adult. Some clinics offer social groups as a part of their services, but this is not very common. Therapy services can be provided in a clinic setting, in your home, or sometimes even in your child’s daycare.
Plan Type
School Setting: An Individualized Education Plan (IEP) is created for your child, where it lists what they can and can’t do in various areas (reading, writing, math, social-emotional skills, independent functioning, and communication). This IEP also states what types of support and therapy they will get, how often, and what goals the team will be working on. A great part of IEP’s is that since it is all academically related, they can also provide accommodations for your child in class. This means that if they need extra time to finish their assignments, items read aloud on tests, or if they need directions repeated in order to do well in class, the IEP team can put this on the plan. These are things that the average child does not normally get, but IF there is a need for it because of the documented speech/language disorder, your child can get these things to help them do better in school! This plan is updated at least once a year when the team (which includes you) gets together to talk about the child’s progress and what is needed for the next IEP year. All professionals who work with your child in the school will have access to a copy of this IEP so they know exactly what accommodations your child needs (however, it is kept strictly confidential and on a need to know only basis).
Private Practice: A Plan of Care is created based on the evaluation results and your input as to what you want your child to be able to accomplish. It lists the goals that we want the child to reach within about 6 months time, along with how often and what type of therapy is provided. Often times the specific techniques or therapy approaches that will be utilized will be on this Plan of Care as well. This Plan of Care is typically shared with your child’s physician. Given your permission, we can also provide the evaluation and plan of care to the school as well to keep them informed of your child’s progress.
Goals
School Setting: Since the therapy is in a group setting and everything is related to the child’s academic functioning, a school SLP may only choose 2-4 goals to work on for the IEP year. The goals chosen should be the ones that will have the most impact on the child’s academic functioning. This can be easily done in the school setting because the school SLP’s can talk to the teachers about what their biggest concerns are and help address this through the IEP goals.
Private Practice: Since the therapy is one-on-one, private SLP’s have the opportunity to work on many goals in one plan of care. The goals also don’t have to be prioritized as the ones that will have the most academic impact. Private SLP’s can work on filling in the gaps in basic skills that have not yet been mastered, and also make goals based on what YOU want to see your child do. This type of therapy is more concerned with the child’s functioning in everyday life and in your home environment, although academic based goals can be set as well. This may take a bit of extra work on the part of the private SLP (ie. reaching out to the teacher or school based SLP), but a good SLP will be able to collaborate with other professionals and also help support academic skills as well.
Parent Participation
School Setting: Parents are invited to the IEP meeting which must be held at least once a year. Goal reports that show a child’s progress towards their goals are sent home when everyone gets report cards. Some school SLP’s are able to send home homework with notes on how you can help your child at home by working on the same things they work on in therapy. However, school SLP’s are very busy and not all have the ability in their schedule to do this. They should always be available by email if you have a question, or if you request to set up a meeting to talk about your child. However, it is not possible for you to sit in on your child’s therapy sessions and learn the specific techniques in action this way. This is because most therapy happens in the group setting and there are laws concerning privacy and confidentiality that basically stop others who aren’t working directly with the child from knowing what’s going on with any child in any special education program without a parent’s explicit written consent.
Private Practice: Parents are typically encouraged to participate in therapy sessions to learn the strategies they can use to work with their child outside of speech therapy when applicable. If this is not possible, at the bare minimum parents are given an overview of what was done during each therapy session, the child’s progress, and some homework tasks that can be completed.
Re-Evaluations
School Setting: A meeting to discuss whether a re-evaluation is needed or not has to happen by law every 3 years, or sooner if there is a concern that needs to be addressed before that. That doesn’t mean that a re-evaluation will always be recommended. In the school setting, re-evaluations are usually recommended if there hasn’t been much progress made, if all the child’s goals have been met and the therapist isn’t sure what else to work on, or sometimes if a child is doing so well that they are ready to be dismissed. The re-evaluation process may take a bit longer than the initial evaluation process if it is decided that a re-evaluation is required.
Private Practice: Re-evaluations typically happen every 6 months to update goals, determine progress, and make new goals for the next 6 months. If a child has met all their goals sooner than 6 months, a private therapist may decide to re-evaluate sooner.
Duration of Therapy
School Setting: Therapy is usually provided only when school is in session. During winter, spring, and summer breaks therapy is usually not provided. For some severe cases, summer school therapies may be recommended, but that is typically only about 1.5 months of the whole summer break or so.
Private Practice: Therapy is usually provided all year round. Some private therapists may choose to take vacation during winter or summer breaks during which the therapies will usually be cancelled unless the SLP has made arrangements for someone else to cover her caseload.
Exit/Dismissal Criteria
School Setting: Therapies in the school only happen as long as the child needs it. Remember, since everything has to be tied to a child’s education, a child may either continue to need the therapies through high school, or do so well with the therapies that by 4th grade they have caught up and show no difficulties academically. This does not always necessarily mean that a disorder doesn’t continue to exist, but that it isn’t affecting the child negatively in the education environment.
Private Practice: Therapies continue until the child has tested within normal limits and there are no functional limitations, meaning that they are performing at an average level compared to other children their age in their communication skills. Sometimes a child may be dismissed from therapy if they cancel or are “no shows” a certain amount of times in a given period. In those cases, you will want to find another therapist, or figure out if a home based therapist or teletherapy would work better for your family so you don’t have to cancel as often.
Overview of the Differences
As you can see, both private and school speech/language therapies have their own advantages. The school setting is geared to help your child succeed in the academic settings, while the private setting allows more leeway for parent participation and helps your child to succeed in your home life and everyday life. I highly suggest seeking both services for your child. Keep in mind, if you ask a school SLP if your child needs private therapy, they will almost always beat around the bush and never tell you a straight up “yes.” This is because since they are federally funded/governed and technically supposed to provide all the services a child needs to succeed, if they say “yes your child needs private therapy” they are opening up the school to a liability to cover the payment for the private therapies. We all know that therapy outside of school will only help a child succeed further even faster- and the best private SLP’s will collaborate with your child’s school SLP’s and even teachers to make sure that everyone is on the same page working for what is best for your child.
Don’t be afraid to reach out to your local school to find out more about getting speech or language services for your child.
When you are ready to start with private speech therapy, give us a call for a free consultation so we can discuss how we can help you and your family! We are highly rated and serve all of Florida via teletherapy, and Palm Beach County in person! Make sure to check out our reviews on Google.
