April 2013

Medical Section: The Difference between School Speech Therapy and Private School Therapy

Author: Jessi Dolnik

At least once a week I am asked by concerned parents, “What is the difference between school speech therapy and private speech therapy?” When you suspect that your child is having a speech or language delay, getting started with therapy can be overwhelming and confusing. Of course, you want to do what is absolutely best for your child. I have had the opportunity to work in a school setting and now practice in a private clinic. This article will outline the differences between these two wonderful resources in our community.

School speech language pathologists and private speech language pathologists who have a Certificate of Clinical Competency (CCC-SLP) as part of their credentials attend the same master’s programs. Their graduate training is identical. Just like with teachers, years of experience, specialization and rapport with your child are all key aspects of getting the most from speech therapy. A child who is excited to go to therapy and motivated to achieve goals will always advance faster. Be mindful of the motivational style your therapist possesses. Also be attentive of the environment that your child will be in: in the back of a classroom, in a cozy therapy room, in a fun therapy gym?

In order to receive speech/language therapy in a public school a child must qualify for services. In order to qualify, a student must meet state criteria on standardized speech and/or language testing. In South Carolina, a child must score 1.5 standard deviations below the mean. This means there must be a rather substantial delay.

Additionally, the speech-language pathologist (SLP) must document that the child’s speech/language impairment is adversely impacting his or her learning in school. As a result, many children with speech/language disorders do not qualify for school services. I’ve seen numerous children “fall through the cracks.” Many times a child will qualify sometime in the future when the disorder is even more pronounced in a more advanced curriculum. In order to receive speech/language therapy in a private clinic, a child does not have to demonstrate such a large delay. Private speech therapists use not only standardized tests, but clinical observation and parent report to determine if the child would benefit from therapy or not.

School speech therapy is free. Private speech therapy, according to your health insurance, may be of no cost to you or may be subject to a co-pay or deducible. Speech therapy is usually covered by health insurance.

If a child does qualify for school-based services, he or she will most likely receive therapy in a group with other children for between 15 to 60 minutes per week. Private speech therapy is typically one-on-one, giving the child the undivided attention of the SLP and the opportunity for far more practice of target skill(s), for 30-60 minutes per week. It is a more intensive treatment model. In a school setting, the evaluation, by law, can take up to 90 days (a third of the school year) and discontinues over the summer. In a private setting, an evaluation is typically scheduled within two weeks; therapy typically begins the week following the evaluation and continues throughout the year until the child reaches set goals and is discharged. (We see many children for therapy over the summer months while they are “off.”)

School speech-language pathologists are excellent therapists and provide high quality treatment, but they are required to function within the confines of school regulations. The ultimate goal of school speech therapy is to help the child benefit from his or her education. The goal of private speech/language therapy is to help the child master communication goals as quickly as possible.

A school speech therapist can send homework sheets with the student for parents to work with a child at home and communicate weekly with the teacher. A school therapist is also required to meet with a student’s parents at least once a year at the Individualized Educational Plan (IEP) meeting. Private speech therapists can invite the parents to participate and/or observe every session. A private speech therapist has the goal of helping parents understand their child’s communication needs and providing parents with the strategies and activities they need to facilitate the acquisition and carry-over of their child’s communication goals across all environments.

A child may receive multiple therapies at school, that is, speech, occupational and physical therapy. Often times, it is difficult for the multiple disciplines to communicate in a school setting. Often, one therapist services many different schools and is pulled in many different directions. In a private multidiscipline clinic, the therapists have the opportunity to collaborate care for the child at every weekly session. This allows for a “whole child” approach to therapy.

One final difference is privacy and confidentiality. Although school practitioners adhere to the highest level of confidentiality, it is still necessary for a child to be placed on an IEP and pulled from class to attend therapy in a group setting. These factors make it impossible for others to not be aware of a child’s therapy process. Private therapy does not require that any paperwork be placed in a child’s school records.

Jessi Dolnik, MA, CCC-SLP is a pediatric speech language pathologist. If you have concerns about your child’s development, call Lowcountry Therapy Center at (843) 815-6999 or visit www.lowcountrytherapycenter.com.

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