I've noticed an interesting pattern lately. I have many kids on my caseload who had Speech in Early Intervention (birth to 3 years old) and then don't end up starting Private Speech until they are four or five years old. There appears to be a gap prior to most parents seeking Private Speech Therapy.
This would make sense, since unless your child has a diagnosis it can be very hard to get Private Speech covered by Insurance. Most of these children were offered 3, 2, or 1 (ouch!) sessions for 30 minutes per week by their local school system. Why pay out of pocket when the school will cover the cost of Speech?
What happens though, is that by four or five years old most parents have tried just school speech services and aren't satisfied with the results therefore seeking additional support. So my answer to the above question is:
a.) If your child's speech needs are complex (meaning more than just working on one or two sounds) don't wait for lack of progress or failure to seek additional speech support. Sign up for Private Speech as soon as you can.
I love, love, love Speech SLPs, and I think they do a wonderful job for our communities and for our children. However, they are bound by a system that is not ideal for advancing your child's speech goals. This is why progress can be made much faster when using Private Speech. Here are just a few of the major differences:
* School Speech: Your child is entitled, through their IEP to 1 x 30 mins / 2 x 30 mins / or 3 x 30 mins per week of speech. This amount of time often includes the time it takes to go retrieve the child from class, get them set up, and then the walk back to class. That 30 minutes is already being eaten away with things other than focused Speech Therapy.
- Private Speech: The child enters the therapy room and Speech begins immediately. The child is signed up for 45 or 60 minute increments. You decide and the clinician decide the amount of time and intensity per week. You and your Private Speech Clinician can increase and decrease as your child's needs change without fear of losing services or having to convene a full Team Meet / IEP Meeting.
INDIVIDUAL vs. GROUP SETTINGS:
* School Speech: Your child will RARELY receive 1:1 therapy. Most Speech Therapy in the schools are done in small groups or are done by the SLP "pushing-in" and coming into the classroom to work with the student and teacher amongst peers. If you have 3 children in a group meeting for 30 minutes per week this time is divided between all three students. So you start with 30 minutes, remove the time it takes for walking to and from the session, getting settled into the session, and then divide the leftover time by 3. Now your child is down to approximately 10 minutes of Speech per week. Is this enough to make change?
- Private Speech: All Speech sessions are done 1:1 UNLESS you specifically sign up for Social Group Speech. Your child is receiving individualized attention. Other children's needs or behaviors are not taking away from the attention placed on your child.
Possibly most important:
* School Speech: School SLPs are bound to work on Speech in a way that directly links to what is being taught in the classroom. This is why School vs. Private Speech, target word lists, are often very different. Many of my colleagues who are School SLPs often report that they spend their session having to use the children's classwork or homework to teach their therapy. Others report that they feel like their therapy sessions begin to feel more like tutoring or study hall when they are asked by teachers to work on class projects or finish exams with the students. SLPs are truly amazing at finding ways to fit our lessons into any scenario but is this how your child's valuable speech time should be used?
- Private Speech: Private SLPs have the freedom to choose what to teach, how to teach it, and when to teach it. If it is most important to your family that your child say their name properly, other things can be put on hold and your requests can be focused on. We have the ability to teach a skill in isolation, separate from curriculum and then work to integrate that skill (generalize) after it's been mastered.
All of the families I work with know that I am a strong advocate for the parents and siblings learning the techniques we use in Speech Therapy and carrying them over into the child's daily routines. A few times a week for 30 minutes (in school) or even 1 time a week for 60 minutes (in Private Practice) is not going to result in timely advancements or change. In Private Practice your family meets weekly, face-to-face with the Clinician and is told exactly what they should focus on that week outside of the therapy session. It provides you the opportunity to sit in on the session and to work with the clinician to learn techniques to support your child's speech development.
It is great that our children are provided support for their Speech and Language Development while in school. It is great that what they are learning in the classroom is being worked on in small group settings and generalized from the therapy room into the classroom. However, nothing compares to 1:1 individualized attention. Nothing compares to getting the full allotted time directed towards Speech and Language Development. Nothing compares to the Clinician seeing your child as a whole and carefully choosing what they deem most important to be targeting that day and then teaching it using the materials and target words they deem necessary. Nothing compares to having that "Village Meeting" between you the parents, and the Clinician, at the end of every session to discuss what to work on and how to integrate it in your daily life.
All of the above are reasons why children who have Private Speech Therapy make larger advancements, faster. It is a team efforts and if you are able to combine School Speech Therapy with Private Practice Therapy which includes strong family involvement then you can expect to see a much more appropriate rate of progress!