When it comes to speech therapy for children, there are two primary avenues for receiving services: school-based and clinic-based therapy. Each has its own strengths, and when combined, they can provide comprehensive support for a child’s communication development.
Why Both School and Clinic Speech Therapy Matter
School-based services are crucial for helping children meet academic goals, while clinic-based therapy offers an individualized approach, allowing therapists to focus on broader speech and language skills. Together, these services can work hand-in-hand to ensure a child receives the full spectrum of support they need to thrive both in and out of the classroom. One of the key benefits of combining school-based and medical-based speech therapy is the opportunity for consistent, well-rounded care. Both avenues complement each other, making it easier for the child to progress across all areas of life.
School Based Speech Therapy Services:
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Explanation: School based therapy focuses on the skills impacting the child’s education performance or their ability to access the school’s curriculum, meaning there must be a negative impact on academics to qualify. States and districts have guidelines that they follow and are governed by IDEA (Individuals with Disabilities Education Act).
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Cost: FREE!
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Therapy: If your child qualifies in the school, an IEP (individual education program) will be made specific to them. Their IEP may include goals, classroom accommodations, and a schedule of services. Therapy services will focus on skills the child needs to be successful in school. School therapy may be 1-on-1 or in a group setting.
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Qualifications/determination: The criteria to qualify for therapy within the school settings is more involved and can be lengthier than in a clinic. To qualify in the schools, the answer must be yes to the following questions:
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Is there a disorder/disability present? (typically, in the moderate to severe range that meets state/federal guidelines)
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Is there an educational need?
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Is there a need for specialized services?
When qualifying a student, they cannot qualify them from one test and cannot be due to a lack of educational opportunities or second language acquisition. The AEA will complete a full and individual evaluation to determine eligibility. This consists of a combination of standardized tests, informal assessments, classroom observations, teacher interviews, caregiver interviews, and school records review (attendance, behavior, grades, etc.). This process typically takes 30-60 days to complete. Once the evaluation is completed, a team of professionals (typically teachers, therapists, and administrators) will determine if the child is eligible for services based on state and federal guidelines. Then a committee will meet (including caregivers) to determine the best plan for the student.
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Least Restrictive Environment (LRE): In the schools, the goal is for children to remain in the general education classroom unless it’s necessary to remove them. Some therapy services require the student to leave the classroom. The committee must consider LRE when making IEP plan decisions.
Medical Based Speech Therapy Services:
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Explanation: Medical based therapy can vary; however, it typically focuses on building skills to improve their overall ability to effectively communicate. Individuals can qualify with mild to severe disorders/disabilities if the services are determined to be medically necessary through an evaluation.
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Cost: Depends on a person’s individual insurance plan.
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Therapy: The therapist will write goals and objectives to target the areas of need identified in the evaluation. Therapy will focus on those skills. This is typically done in individual sessions at a clinic, and sometimes at a childcare center.
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Qualifications/determination: It is not governed by a specific agency. Most insurances will require a physician referral and some or all of the following:
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1. Results of standardized tests and observations that indicate below average skills.
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2. Clinical judgement/professional opinion of the therapist.
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3. Criteria set by Medicaid or Insurance (some require pre-authorization).
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To qualify: A child is typically scheduled for an evaluation. The therapist will ask questions, administer standardized tests, observe the child, interact with the child (typically through play or a game), and/or give the caregivers checklists/forms to fill out. A child will receive a diagnosis if a disorder is present, and the therapist will determine how many sessions per week are needed/recommended to make progress.
Medicaid/Insurance: This varies based on the type of insurance. Some require the initial evaluation to be submitted for approval before they will pay for therapy sessions, and some allow the child to begin immediately after a disorder/delay was determined by the initial evaluation. The number of sessions authorized may be limited by the insurance policy (i.e. X amount of visits per 90 day period or X amount of visits per calendar year).
By combining school-based and clinic-based speech therapy, children can receive the most comprehensive care possible, allowing them to thrive both academically and in their overall communication skills. Unified Therapy Services offers free speech screenings to help determine if your child would benefit from additional support. Our team of expert therapists provides individualized care in a nurturing environment. Give us a call today at 563-583-4003!
Written by Jennifer Kraft, M.S., CCC-SLP, Department Head, Speech Therapist, and McKenzie Bockenstedt, M.A., CCC-SLP, Speech Therapist.