What Is the Difference Between Public School Speech-Language Therapy and Private Therapy?

Pros and Cons of Speech Therapy in Schools

Sun, Dec 16, 2018

Public School Private Therapy
Qualifying for Services In order to receive public school services, a child must qualify (meet state criteria on standardized speech or language testing – typically 1.5 standard deviations below the mean, indicating a rather substantial delay) A child does not have to demonstrate a large delay, clinicians use standardized tests, clinical observation, and parent report to determine eligibility and if child will respond well to intervention
Treatment Schedule Attending speech-language therapy during the school day may take away from valuable classroom time.Usually receive 15-60 minutes per week More flexibility with scheduling; often possible for the child to be seen outside of school hours, or to be pulled during non-critical subject times.Typically at least 60 minutes per week (more intensive treatment model)
Treatment model Will be seen in small group setting, typically 2-4 students (unless IEP guarantees one-on-one sessions)Services discontinue over the summer One-on-one time with clients allows for the speech-language pathologist’s (SLP) undivided attention, more progress in shorter amount of time, and more practice time on target goals.Year-round services available
Parental Involvement Less face-to-face time with SLP - a school SLP is required to meet with a student’s parents at least once a year at the Individualized Educational Plan (IEP) meeting. More parental involvement is possible; SLPs in private practice can invite parents to participate in and/ or observe every session. Can touch base in person after each session to review goals and homework for carry-over.
Privacy and Confidentiality It is necessary for a child to be placed on an IEP and pulled from class to attend therapy in a group setting while receiving therapy at school. While school SLPs adhere to the highest levels of confidentiality, these factors make it impossible for others not to be aware of a child’s therapy needs. Private therapy does not require that any paperwork be placed in a child’s school records, but it is often beneficial to inform teachers that services are being received. Other students or professionals at the school would not be aware that the child is receiving intervention.
Caseload for SLP Very large caseload - typically one SLP has to provide services to the entire school (and sometimes is split between two schools) Smaller client caseload since services are performed one client at a time

Pros and Cons of Speech Therapy in Schools

The ultimate goal of school speech therapy is to help the child benefit from his or her education. In a school setting, the SLP must be able to document that the child’s speech/language impairment is negatively impacting his/her learning in school. Eligible children receive services free under the Individuals with Disabilities Education Act (IDEA). Therefore, many children with speech/ language disorders will not qualify for school services. A child will often qualify sometime in the future when the disorder is even more pronounced in a more advanced curriculum. The biggest “Pro” is that it is free and convenient. In regard to “Cons”, therapists in the schools carry heavy caseloads which results in group therapy sessions. Groups can be helpful if the other children in the group have similar weaknesses and are compatible. This is not always the case. Therapy in a group is diluted and not totally focused on your child. If there are five children in the group twenty minutes twice a week for therapy, the amount of time your child actually gets in therapy can be limiting. There are multiple long breaks which interrupt therapy making it more difficult to progress. The child misses class which can have both academic and social consequences.

Pros and Cons of Private Speech Therapy

The goal of private speech/ language therapy is to help the child master communication goals as quickly as possible. It is understood that the child’s challenges may not be severely impacting his/ her schoolwork (many often can “get by”), but that there are lasting implications on his/ her school performance and social communication. Intervention should be started as early as possible in an attempt to lessen the child’s communication challenges as he/ she gets older. The “Pros” are that your child receives individualized attention which results in faster progress. You as the parent have ready access each therapy session to ask questions and to have homework to help your child make progress faster as well. There is a flexible schedule for appointments and therapy rooms are kid-friendly. Speech-language pathologists in private settings have access to all of the materials needed for successful therapy. The “Cons” are that in private therapy you may access your health insurance for payment. Therefore, you may have a copayment or coinsurance due at the time of service. If you do not have insurance, you would be responsible for privately paying for the services rendered.

Do I need to seek private speech therapy in addition to school speech?

This question is a problem for school based SLPs. If they say, “yes, your child needs additional speech therapy” or “you need to take him to an ENT”, the school district may be liable to pay for these services. Because of this, many therapists will just say “no” to avoid any conflict. It puts them in a difficult position. You will likely hear a school therapist respond, “I would ask your pediatrician about it”, or “it might be a good idea to do it”. When a parent is unaware of this problem, they may not follow up and get additional private therapy, even when it would be very helpful for their child. Our answer to this question: If you are asking this question and able to afford private speech therapy, yes, we would absolutely suggest you do both! When children are receiving services in both settings, it is important for both clinicians to be in communication. Of course, the ultimate goal is for your child to get past this speech, language and communication problem and put it behind them.