Why Would My Child Need Private Speech Therapy…Especially If They Get It In School?

Working in both the private practice and school setting since my time here at Rehabilitation Specialists, I have heard this question often from both sides. My typical answer is, “I am certain your child is getting good therapy in the school setting and is making progress on their goals, but sometimes kids just need a little extra help.” This is the simple answer, but a lot of the time, I don’t convince a parent this way. So, today, I will be getting into a few different caveats of this answer and hopefully help a few parents out there understand the main differences between school therapy and private practice therapy.

First, I think we need to talk about funding resources. Speech therapy funding in the school setting is free to families if the child qualifies for services. This is a major reason families will want to just have their child receive speech in school, which I totally understand as a budgeting parent myself. The funding comes from the state level for special education services. This funding typically pays special education teachers’ resources and salaries, at least partially, which allows the children that qualify to have no fees to their families.

In a private practice, the families are responsible for payment of services. Most of the time, insurance can be billed for services. Families do have to do some research on if their insurance is accepted at facilities, but if not, most clinics offer a discounted out-of-pocket fee or set their fees on a sliding scale based on income.

The second thing I want to discuss on the differences between the two settings are some special education lingo: Free and Appropriate Public Education (FAPE) and Least Restrictive Environment (LRE). A Free and Appropriate Public Education means that children who qualify for special education are entitled to aides and services that would allow them to be successful in the school setting to the same level as their peers. While providing FAPE, a school also has to provide the Least Restrictive Environment for a student, which means limiting the time away from the regular education classroom and away from non-disabled peers as much as possible. For a student with speech and language needs, this may mean providing group therapies and limiting sessions in the speech room as long as the student is making progress on speech and language goals, which must always relate back to the common core standards. Thus, once all speech therapy goals are met that allow the student to participate in their educational experience to the level of their peers, the student no longer needs speech therapy services. (More information can be found at https://www2.ed.gov/about/offices/list/ocr/docs/edlite-FAPE504.html).

In a private practice setting, sessions are usually always in a 1:1 setting (unless it is a specified group therapy or parents/other professionals are involved in the session). Typically, caretakers have a chance to either participate in, watch a session, and/or discuss progress with the therapist at every session. This environment usually leads to intense, individualized practice or teaching of speech and language skills. Therapy goals also do not need to relate to common core standards in the therapy setting but so still need to be measurable and typically show progress for insurance to continue to provide payments (side note: if a client is not making progress, however, it is an indication that the therapy technique is not working or that the client’s abilities have plateaued and that services are no longer appropriate; so, this is actually a good thing!) 

Lastly, lets talk about the scheduling in terms of when children will be receiving services in a school setting vs. a private practice. Obviously, schools are closed in the summer and most children do not have school then. I am sure that if your child is in speech in school, you have heard of extended school year, or services offered in the summer. In Pennsylvania, extended school year (ESY) is offered to students who have a sever disability, as defined in the “Armstrong Group” (Autism Spectrum Disorder, serious emotional disturbance, severe intellectual disability, degenerative impairments with mental involvement, severe multiple disabilities). For students who are not a part of this group, the IEP team needs to consider if the student had a regression of abilities over longer breaks (i.e., winter break) that didn’t go back to where it was before the break. If regression happens without recoupment, then ESY is offered. Many students do not qualify for extended school year services. Also, those who do, typically need to provide their own transportation during the summer, which is not possible for some families.

In the private practice setting, services are typically offered all year. Many families choose to seek out services only during the summer months when their child will not be receiving services in the school setting and some families who do seek out private practice services all year increase their frequency during the summer months to offset the services the child is not receiving from the school at that time.

Here at Rehabilitation Specialists, we accept most insurances, including medical assistance. If you feel that your child could benefit from private practice therapy and you are in the Pittsburgh area, please feel free to reach out to us. Any questions or other input, please leave a comment below!

Until next time!

Kathleen