School-based vs Private Pay vs Medical-based Speech Therapy

A recent blog post by Socially Sound Therapy addresses the differences between School-Based versus Private Therapy services. Areas reviewed include:

– criteria for qualification
– impact on communication (educational/functional)
– progress documentation timelines
– meeting/consultation with parent (timelines)
– cost
– number of children per session
– session time

For more detailed information, you can view the blog post here.

School Based Therapy

This is the most recognized area for speech-language therapy. Below are brief descriptions of the identifiers of this intervention:

Criteria
Qualification guidelines are established by the district or state. For example, a student may qualify for services if they are a certain number of standard deviations below the mean of testing (more explanation on what that means here).

Impact on Communication
Along with qualification criteria for eligibility for services, there has to be a true disability that impacts the student’s academic and/or social-emotional well-being.

Progress Documentation
Parents are provided with progress reports (from their IEP – Individualized Education Plan) each grading period. They also receive documentation for the initial evaluation, as well as re-evaluations (every 3 years).

Meeting/Consultation with Parents
Typically, IEPs are reviewed and amended every 12 months. As always, you can contact your school speech therapist to discuss progress via a scheduled time during their conference period.

Cost
Services for speech-language therapy in the public school system are free.

Number of Children Per Session
This is a variable, depending on: the caseload size at the school, the availability of the therapist, the schedule of services for your student, and the needs of the student. For example, a student may benefit from a small group setting to address social skills, or may need individual ‘drill’ time to work on the production of /r/.

Session Time
This is another variable, depending on the needs of your student. Sessions can range from 1-3 times per week, at 15-30 minutes per session. Students can receive direct therapy, or consultation time.

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Private Pay Therapy

This type of speech-language therapy is entered into directly between the therapist and the patient/family, with no go-between (such as the schools or insurance companies). Below are brief descriptions of the identifiers of this intervention:

Criteria
No qualification guidelines; child should show a need for direct intervention. Level of need could be mild-severe.

Impact on Communication
Focus on functional communication skills across all areas of daily life.

Progress Documentation
Parents are provided with progress reports typically every 3-6 months. They can also receive documentation for the initial evaluation, as well as re-evaluations (6 months – 12 months).

Meeting/Consultation with Parents
Typically, results of sessions are discussed with the parent at the end of each visit. If seen in a daycare or alternate setting, therapist can provide daily note that summarizes areas addressed.

Cost
Fee-for-service. Rates are variable by therapist, needs of child, etc.

Number of Children Per Session
Typically, sessions are one-to-one. If part of a social skills group, for example, number can vary.

Session Time
This varies, depending on the need of your child. Sessions can range from 1-3 times per week, at 30-60 minutes per session.

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Medically-based Therapy

This type of therapy includes the primary care physician and the patient’s insurance company. Below are brief descriptions of the identifiers of this intervention:

Criteria
Qualification guidelines are established by the insurance company. For example, a patient may qualify for services if they are a certain number of standard deviations below the mean of testing (more explanation on what that means here).

Impact on Communication
Along with qualification criteria for eligibility for services, there has to be a true disability that impacts the patient’s functional communication or feeding-swallowing skills.

Progress Documentation
Submission of documentation/clinicals depends on the type of insurance (government/commercial). Authorizations are generally allowed in 3-6 month intervals, with a re-evaluation of need at 6-12 month intervals.

Meeting/Consultation with Parents
Typically, results of sessions are discussed with the parent at the end of each visit. If seen in a daycare or alternate setting, therapist can provide daily note that summarizes areas addressed.

Cost
Fee-for-service, full or partially paid by insurance company. Family may be responsible for copay or deductible (commercial insurance plans).

Number of Children Per Session
Typically, sessions are one-to-one. If part of a social skills group, for example, number can vary.

Session Time
This varies, depending on the need of your child and the parameters of the visits approved by insurance. Sessions can range from 1-3 times per week, at 30-60 minutes per session.

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At times, a child can qualify for both school-based and medically-based services.

This all depends on those qualification criteria that each district/insurance company uses. Private services are available at any time, as long as your child demonstrates a need.

I hope that this blog helped you understand the differences between school based speech-language therapy services, medically-based speech-language therapy, and private pay services. As each child is different, their treatment options should be tailored to their needs.

Love and light,
Leanna, your friendly speech therapist