Are you debating between private clinic vs. school speech services for your child? As a parent, you are constantly given advice on how best to raise your kids. Everyone has a different opinion, but of course the opinion that matters most is YOURS! You, ultimately, know what’s best for your child.

But sometimes it’s stressful to know what is best, and it can be helpful to get some tips from an outside perspective – especially if that person is knowledgeable and considered an expert in your area of need.

Today’s blog post is designed to help parents understand the difference between private clinic services vs school services for speech-language therapy, including the pros/cons of each!

I am a licensed, certified speech-language pathologist who has worked in both a pediatric private clinic and in a public preschool/elementary school. I’m also the parent of a baby in speech-language services! So I hope this post is informative and helpful! Let’s dive in –

IMPORTANT TO NOTE: School based speech-language pathologists are licensed and certified to treat within the EXACT SAME scope of practice as a private clinic based SLP. For reference, SLPs can treat the following –

• Language Disorders
• Articulation / Phonology Disorders
• Fluency Disorders
• Social Skills / Pragmatics
• Augmentative and Alternative Communication (AAC)
• Voice Disorders
• Cognition (memory/problem solving/executive functioning)
• Hearing (related to communication)
• Swallowing Disorders

(I will write another blog post soon explaining each of these! Send me an email if you have any questions!)

What Exactly Are School Based SLP Services?

Great question. Most people don’t know this, but school services are not just for public school students, nor are they only for school-age kids.

The Individuals with Disabilities Education Act (IDEA) was first passed in 1975 and it guarantees a free, appropriate public education to all students – including those with disabilities. That means that if your child meets eligibility criteria (I’ll explain later) then he/she can receive speech-language therapy through your local public school system.

What you may not know is that this applies to kids from birth to high school graduation or age 21 (whichever comes first)!

That means your little 2 year old can *potentially* receive government based early intervention services. And your sixteen-year-old can also receive services at his/her school!

Does your child go to a private school? The IDEA still covers them too! If your child needs speech-language services, then the need has to be met. Regardless of where they are or how old they are.

As an SLP, this makes me very, very happy! I believe that everyone should have access to therapies, and the younger we intervene the better!

What Exactly are Private Clinic Based SLP Services?

It’s pretty much exactly what it sounds. Your child will go to a private clinic (likely specializing in pediatric services) to receive speech-language therapy. Sometimes this is at a large facility that also offers physical and occupational therapy. Sometimes it may also offer a developmental preschool or other services. Or it may be an individual provider – possibly doing therapy out of his/her home or traveling to clients’ homes!

Typically, at a private clinic you or your insurance are paying for the speech therapy services. Also, you child is usually working one-on-one with the therapist compared to the school therapist that usually works with children in groups.

Now for the official compare/contrast –

Pros/Cons of School Based Therapy

PROS:

• It’s free! Like completely.
• It’s convenient – you child is already in school and the therapist comes to to the classroom to either pull them out or push in to provide services. You don’t have to transport them anywhere! (Unless not school-age, then it depends on how early intervention is set up your area)
• It’s reliable – if your child’s therapist quits/moves/whatever, then the school system is legally obligated to continue providing services. They will move therapists around or hire someone else!
• Your child’s teacher can know how to help – The majority of educators want to know everything they can to better serve their students. If the teachers know that your child has difficulties with xyz, then they can continue working on those concepts in the classroom.
• Your child may get extra support or accommodations in the classroom – a child in the school system who receives speech-language therapy typically has an Individualized Education Program (IEP) and can potentially get accommodations such as extended time, text to speech, speech to text, small group testing, etc.
• The school district may have a more lenient eligibility criteria than the insurance company – meaning that even though your child only has difficulty with correctly producing a couple sounds, he/she can still receive speech services even if test scores weren’t low enough to meet insurance standards. But this depends on the district!

CONS:

• Typically not as much therapy time offered. Schools are closed for summer, winter break, spring break, and a multitude of other holidays in-between. Also there are professional development days and numerous school events or conferences that can conflict with therapy. I assure you that therapists are trying their best to see your child, but unfortunately, their hands are often tied with other obligations or school requirements.
• Schools are known for an abundance of group therapy. Due to high caseloads and obligations/requirements referenced above, school based SLPs are often forced to group kids together – typically in groups of 4. Sometimes this is excellent and highly motivating for the children! They can learn from each other and practice valuable skills like turn-taking in a conversation. However, it still means less individualized attention, less repetitions during drill, etc.
• Typically less parent involvement. Parents are required to attend the annual IEP conferences to discuss updates on their child’s progress/goals. And many SLPs send homework or ideas for continued practice with parents. However, they typically aren’t allowed to watch sessions or have lengthy training conversations/sessions with the therapist.
• I don’t personally view this next one as a con. At the school where I work, tons of kids are pulled for different services and many students beg me to take them every day. But for a lot of parents, they don’t want their child labeled with an IEP or be in special education. I totally get that. There’s no hiding it if you get school based services, but you can try to hide it from teachers/peers with private therapy. **You should know that they probably already realize your child has difficulty with xyz and they probably don’t care. Everyone has something they need to work on. Acceptance and positive parent-talk are huge!**

Pros/Cons of Private Clinic Therapy

PROS:

• Individual therapy sessions mean that the SLP is totally focused on your child and his/her unique goals. It also means that the therapist is better able to customize the sessions to incorporate special interests or hobbies that your child enjoys.
• Typically they can offer longer sessions such as 120 minutes weekly (2 sessions of 60 minutes each) vs. 60 minutes weekly (2 sessions of 30 minutes each). However, this is only a pro if your child actually needs that much time. Many children will do exceptionally well with just 60 minutes weekly.
• Typically you can watch sessions and receive coaching on how to continue working with your child at home. Instead of just getting a paper handout or a conversation once a year, you can talk to your child’s therapist multiple times a week to stay updated on progress and how you can help him/her at home.
• Specialized SLPs! In the school setting, it is really hard to specialize because you are forced to treat whoever is put on your caseload. However, private clinics can accept/reject clients based on what kind of disorders the therapist actually wants to work with. Private SLPs may specialize in autism, speech-sound disorders, fluency, reading, etc. Obviously this is a huge plus for your child to be treated by someone who has invested extra education and years of experience into that one area.

CONS:

• Can be costly, especially if your insurance doesn’t pay for it and you have to pay out of pocket.
• Not as convenient – you have to drive them and figure it out with work/school schedules. This also means potentially missing out on some free time or extra-curricular activities that occur after school.
• Some clinics have long wait lists, and depending on your area it may be hard to find the ideal therapist/clinic that you’re looking for.
• You have to look out for scams. Private clinics/therapists, unlike schools, are trying to make a profit. Sadly, there are a lot of scams out there. Your child should only be seen for the amount that he/she actually needs – not more. You don’t want the clinic/therapist billing for unskilled work (aka your child simply playing and the therapist not interacting with him/her). Every minute should count and be purposeful. (Caveat here – most therapy sessions will involve lots of play based interventions so play does not equal bad! It’s so so good if you see more play based interactions than drill work, especially with language/AAC/autism/cognition kids!)

So…What Should I do??

If you’re having a hard time deciding between private or school based therapy, then my advice is to do both.

At a young age, therapy is purposeful play time and good therapists will help prevent child burn out. Plus early intervention is crucial! For young kids, I would maximize services as much as you’re financially able to do so. If it was me and I had insurance that would pay for private, then I would try to do both.

However, I don’t always recommend both long term. If your child is older and has been in therapy for ages – check their motivation level. Do they hate it? Then they aren’t getting anything out of it = quit! If therapy sessions are getting in the way of valuable things you or them would rather do instead = quit!

Decide on your priorities and what really matters. Therapy is great, but it isn’t more important than the happiness and overall well being of your child!

If you still aren’t sure and have more questions, then I’m happy to talk you through it and offer free advice! Send me an email at chloebschoolslp@gmail.com or DM me on instagram!

I hope this was helpful, and I wish you all the best! If you want to know more about what a school SLP does, check out this blog post!

– Chloe B | School SLP