Does My Child Need More Speech Therapy?

Natalie Iverson CCC-SLP

A question I get asked often as a pediatric speech therapist in a private practice

(and fellow parent) is whether a child would benefit from both school speech therapy

and private speech therapy. There are a variety of factors to consider when making this

decision.

First, let’s talk about the basic process of school-based services. Typically, a child

is first referred for services either by their general education teacher, the special

education teacher, or the child’s parent. If the child is already receiving services at a

private practice or in another outpatient setting (like a hospital), they may be able to skip

over the earliest interventions provided at school and go straight into an evaluation.

Otherwise, children are often provided with in-class accommodations to determine if

those measures can assist the child’s progress before receiving full services with the

school’s professionals. If those initial interventions are deemed not enough for progress,

then an evaluation is conducted to create an Individualized Education Plan. In this plan

(an IEP), the types, amount, and specifications of services are determined. Goals are

created, the number of minutes per month are determined, and specifications such as

whether your child will be seen in the classroom vs pulled out of the classroom or

individually vs in a group are also laid out. IEPs are required to be updated annually,

though parents can request a meeting at any point in the year to discuss changes.

With the above information, you can ask yourself the following questions: Is your

child already receiving school-based services? Are they receiving any other services in

school (i.e., reading intervention, special education, occupational therapy, physical

therapy, etc.)? Are they already receiving private services? How much therapy, how

often, and with what specifications is your child receiving school services vs private

services? The answers to these questions may help you decide if your child’s current

level of services is meeting your expectations and allowing for optimal progress. Please

consult your child’s current speech therapist(s) to determine progress rather than just

observation. This will allow you to gauge the smaller wins and your child’s over-all

trajectory rather than just the easier-to-see wins. You may also ask yourself, how much

interaction do you want with your child’s therapist. It is likely that you will get more

feedback regarding individual sessions when seeing a private speech therapist as

compared to a school therapist, just by the nature of the setting.

Consider the type(s) and number of goals your child is targeting in speech

therapy. Does your child receive speech therapy in a variety of different areas

(articulation, language, stuttering, social skills, literacy, etc.) or do they only have one

area of focus for their goals? Certain disorder types warrant more therapy than others,

as well. For example, a child with 1-2 sounds in error in their speech may not need as

much therapy to achieve their goals as compared to a child with a motor-planning

disorder such as Childhood Apraxia of Speech. Comparably, your child may benefit

from specialized services with a speech-therapist trained more thoroughly in a certain

area. This therapist could be your child’s school therapist just as easily as an outpatient

(private or hospital) therapist. Consult with a speech therapist to decide what is most

appropriate based on your child’s individual needs.

There are personal situations to consider, as well. As much as we want to help

our children, we want to avoid their burnout (and ours as parents.) Financials

surrounding services are likely to play a role in this. Do the private practices in your area

accept your insurance? If they don’t and grants are not an option, ask about private pay

costs to decide whether this is a viable option for you and your family. School-based

services are free for families whether a child is attending school publicly, at a charter

school, or being homeschooled.

Extra appointments during the day and after school can be overwhelming, too.

The busyness of your family plays a big role in the overall well-being of your child. Your

child in need of therapy (or their siblings, if they have any) may be involved in

extracurriculars after school and on weekends. Maybe your child is burnt out after

attending school in general and needs time to wind down during the after-school hours.

The closeness of private facilities near you (and whether they provide teletherapy

services) may also impact your decision to pursue multiple kinds of services. Looking at

the child as a whole is just as important as their involvement in services.

This article is not an extensive list of therapy-based nor personal factors that can

come into play when considering whether school-based services, private services, or

both is the best option for your child. Hopefully, however, it is a good place to start. We

at Ability Innovations are happy to provide consultations to discuss your options further,

as well.