School vs Clinic Speech Therapy: What are the Differences?

speech therapist with child

Early spring is one of the most common times that teachers identify and share concerns with parents about a child’s need for speech and language services. As teachers hit the halfway mark to the school year, they often feel they know students well, many different benchmarking assessments have already been completed in the winter, and spring parent/teacher conferences are right around the corner. Whether your child was referred for services by their teacher or you are interested in pursuing services, here is what you need to know about the difference between speech and language services in the school & the clinic setting.

The Basics of School Services:

  • All public schools are legally required to provide speech and language services to a child if there is an identified need
  • The identified need must be a communication issue that is impacting their educational experience
  • School based services are always free of charge
  • The services take place during the school day by a licensed speech and language pathologist

The Basics of Clinical Services

  • Services are provided through a private clinic & funded through private insurance or cash payments
  • The criteria for starting services is not as rigid & clinic SLPs can focus on communication concerns in all areas of a child’s life
  • Services are completed by a licensed speech language pathologist and may take place at a clinic, virtually, in home, or in a pre-school/private school setting 

How do I start speech and language services for my child? 

In both settings, a child needs to go through a formal evaluation process in order to begin services. At a clinic, parents simply need to schedule an appointment as well as verify insurance information. The evaluation will typically take place in one session and results will be shared quickly after the session.

In the school setting, parents or teachers can make a referral for an evaluation. Typically there is an initial meeting where parents provide consent for the speech pathologist to test & then a second meeting is held about 60 school days later to go over results. These meetings may also include other staff and professionals at the school such as special education teachers, occupational therapists and school based psychologists.

Why are the school evaluations more complicated?

In general, school based services have more steps and more paperwork because the services are federally funded and protected. Parents & children have rights as students attending public school & there are additional rights when considering specialized services such as speech & language. The school based meetings will have lots of paperwork, may have additional staff members present to discuss more than just speech and language skills, and can take up to two hours. 

What to know before school based meetings:

  • Parents have the right to request a speech & language evaluation from the school at any time
  • The school must provide you written notice of any meeting 10 days in advance
  • All paperwork is legally binding, keep copies and make sure you get a copy of the Procedural Safeguards (this document lists all your parent/student rights!)
  • School based services are focused on school success, the goals and discussion around a child’s strengths & weaknesses will likely be focused solely on how the child is demonstrating those skills in the school setting
  • Don’t be afraid to ask questions! At any time during the meeting or a few days later once you’ve have a chance to process the information

Ok, you’ve made it through the evaluation process. Now how are the services actually different? In the school and clinic, your child will be treated by a licensed speech-language pathologist. In both settings the SLP will create specific goals and a timeline to reach these goals. Treatment methods are often the same but the services can still have slight differences in specific skills targeted as well as the setting & session length:

School Based Services:

  • As mentioned above, the session will target communication skills that are impacting their school experience such as answering who, what, when & where questions, growing vocabulary, grammar skills and social language skills in class & on the playground
  • Sessions take place during the school day in the student’s typical classroom or another classroom in the building
  • Sessions are often small group but can be 1:1
  • Schools are more conservative in the level of support they can offer so sessions may be shorter and/or less frequent than clinic

Clinic Based Services:

  • Can take place place in the clinic, home, virtual, school or community setting depending on client need & parent preference
  • Can target communication skills that are impacting children from any area of life including skills at home with family, social skills in all settings, feeding issues, as well as needs identified at school
  • Sessions are always 1:1 unless the client specifically enrolls in a group treatment program
  • Sessions are longer and there may be the option to schedule multiple sessions a week

Ultimately, the goal for all speech pathologists is to improve a client’s communication abilities no matter the setting. There is also no need to choose one service over the other, many children benefit from receiving speech and language services at school as well as through clinic sessions. If you’re interested in learning more about speech, language, or feeding services, contact us today!

Written by Connelly Thompson, MS, CCC-SLP

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