School Based Speech Therapy or Private Practice Speech Therapy: Is One Better Than the Other?
Sometimes school based SLPs and private practice SLPs are the same person! Some school based SLPs, like yours truly, own their own privates practices or work at private practices around school hours or over the summer. Some private practice SLPs start off working in the schools before they found their own practice or they work in both settings part time. Some private practice SLPs, like me, are independent providers and can treat students with related service authorizations when there is not an SLP employed by the school district available to treat them
School based speech-language pathologists (SLPs) and private practice speech language pathologists both offer valuable services and want the best for your child, there is no question about that. Some student families are under the impression that private practice speech SLPs are “real” speech-language pathologists and school based SLPs are “less than” private practice SLPs but that is not true. School based SLPs and private practice SLPs are equals. We are the same professionals just offering our services in different settings and models.
What do school based speech-language pathologists and private practice speech-language pathologists and their services have in common?
Have the necessary credentials to diagnose and treat speech, language, communication, feeding, voice and fluency concerns
Are both healthcare specialists
Document and analyze your child’s progress
Care about your child’s development and success
Use evidence based practice
Earned the same master’s degrees in the same rigorous program
Completed clinical internships in a variety of settings with a variety of clients (even if a communication sciences and disorders student knows 100% they want to work in a school, they will still complete clinical internships and gain experience diagnosing and treating individuals of all ages in other settings such as the university speech and hearing clinic, outpatient clinics, hospitals, skilled nursing facilities, rehabilitation centers, private practices while acting under the supervision and mentorship of a licensed speech-language pathologist)
If the SLP has their CCCs from the American Speech Language Hearing Association, they have met the same clinical fellowship requirements
If the SLP has their CCCs from the American Speech Language Hearing Association, they have passed the same Praxis exam in order to earn their credentials to practice
Met the same state licensing requirements to practice speech-language pathology
If the SLP has their CCCs from the American Speech Language Hearing Association, they complete the same minimum amount of continuing education credits to maintain their CCCs for the duration of their career
If a speech and language evaluation was completed recently enough at school and it provides comprehensive information, the private practice SLP may be able to forego doing another evaluation and start providing speech therapy right away
What is different about a school based speech-language pathologist and the services they provide?
Depending on your state, a speech therapist who has a teaching certificate specifically to work with children with speech and language disabilities can provide speech therapy services in the schools for a certain amount of time before starting their master’s degree in communication sciences and disorders
Depending on your state, a speech-language pathologist assistant (SLP-A) could provide school based speech therapy services acting under the license of their supervising speech-language pathologist
Depending on your state, in order for a speech-language pathologist to work in the schools, they must fulfill requirements to earn a teaching certificate
Depending on your child’s school district, feeding/swallowing and/or voice concerns may not be diagnosed or treated in the schools even though these are within the SLP’s scope of practice
Tax money pays for the speech therapy services and tax money funds Medicaid, which may reimburse school districts for providing speech therapy services to students
Your child will receive speech therapy services only if the IEP team concludes that their disability/delay/disorder is negatively affecting their experience at school (i.e. not participating in class, teachers and peers cannot understand them, they have trouble understanding lessons and educational texts, their spelling errors relate to their articulation and phonological difficulties etc.)
The speech-language pathologist and IEP team determine the appropriate frequency and duration of services as well as if your child will be seen individually or in a group and if in a group, how many other students will be in that group
Speech therapy goals will focus on how to help your child access the academic curriculum
Speech therapy services will take place during school hours and if your child will be treated in the therapy room, your child will be missing class during speech therapy sessions
You will receive speech therapy progress reports every quarter
Your child’s IEP will be updated annually at the bare minimum if they are still receiving special education/related services
Your child will be re-evaluated every three years if they are still receiving special education/related services
Speech therapy services are typically only offered during the school year, unless the IEP team uses data to recommend your child receive extended school year services during summer session
Depending on the school and whether or not the SLP spends money out of their own pocket, speech therapy materials may be limited in the schools
Your child may feel self conscious about receiving speech therapy services at school
School SLPs will be less forthcoming about referring your child to additional professionals (e.g. ENT, pediatrician, neurologist, audiologist, gastroenterologist, registered dietitian) because they are held back by school administration’s fear of the possibility of the school district being responsible for paying for those services if a school staff member makes a recommendation
What is different about a private practice speech-language pathologist and the services they provide?
Services are paid for out of pocket and/or through your health insurance
Speech, language, voice, feeding/swallowing, communication and fluency concerns can be diagnosed and treated regardless of if it negatively impacts your child at school or not
Your child will be treated one on one unless you specifically want them to be seen in a group with their sibling or other children
Depending on the private practitioner, your child may have options to be treated at daycare, school, in person in your home, anywhere private via telepractice, or at a private practice clinic
The frequency and duration of treatment will be determined by the speech-language pathologist, with your agreement of course (if your health insurance is paying then they may have a say as well in frequency, duration and length of treatment time)
The speech-language pathologist may have access to more therapy tools and materials
You have greater opportunities to observe and participate during therapy sessions, which allows you to learn strategies to implement with your child in the moment, which will increase generalization of skills from therapy time to outside of therapy time, which is the overall goal of speech therapy
You will likely have a stronger relationship with your child’s SLP if you are able to observe and participate during sessions
Services can be provided outside of the school calendar and school hours
Your child won’t miss classroom instruction time unless the private practice SLP will travel to their school and work with them during school hours using a pull out service model
Private practice SLPs usually have less people on their caseload than school based SLPs so they likely have more time and energy to focus on the people who are on their caseload
Private practice SLPs will be more forthcoming about referring your child to additional professionals (e.g. ENT, pediatrician, neurologist, audiologist, gastroenterologist, registered dietitian) without being held back by the fear of the school district being responsible for paying for those services
Can a child have both a school based speech-language pathologist and a private practice speech-language pathologist?
Yes, absolutely! For example, some children receive speech therapy in school for a delay, disorder or disability that adversely impacts their academic experience and also see a private practice speech-language pathologist who works on aspects of their speech, language, voice, communication, fluency, feeding and/or social skills that do not negatively impact their academic experience. Other children may receive speech therapy at school during the school year but are not eligible for extended school year services so their families have them work with a private practice speech-language pathologist over the summer. A student may meet all of their school speech therapy goals and graduated from school based services but may work with a private practice SLP to perfect those skills outside of their academic environment or to maintain those skills.
Are school based speech-language pathologists and private practice speech-language pathologists in competition with each other?
No, ideally if a child sees both a school based speech-language pathologist and a private practice speech-language pathologist the two SLPs can collaborate to provide the child with the best possible care. It is essential that families understand that both SLPs are highly educated and qualified professionals. To avoid creating a situation that could pit the school based SLP and private practice SLP against each other, it is imperative that both SLPs and the child’s family understand the limits of the settings and scope of practice each SLP works under.
Speech-language pathologists do valuable and meaningful work no matter what setting they practice in. Contrary to some peoples’ beliefs, school based speech-language pathologists are indeed real speech-language pathologists. School based speech-language pathologists and private practice speech-language pathologists deserve equal respect. One is not better than the other, they just diagnose and treat in different settings and operate under different frameworks.
