BRAINS

School-Based Speech-Language Therapy vs. Outpatient Speech-Language Therapy: What’s the Difference?

School-based speech-language therapy (SLT) is priceless, and for many families, it is the only way that their child may gain access to this service. Both convenience and affordability make SLT in schools accessible, a benefit that cannot be understated.

Despite this, oftentimes, school-based SLT services simply do not suffice, which is when it’s time to seek some additional supports for your child through outpatient services.

The Benefits of Outpatient Speech-Language Therapy

While school-based SLT can be limited for many families, adding outpatient SLT to the supports your child receives can make a world of difference.

1. Reduced individualized attention – Speech pathologists in schools in Michigan are supposed to be limited to 60 students on caseloads. This number includes only students with Individualized Education Plans (IEPs). At many schools, additional children are seen for “informal” services, which can add 10+ students to that number. Most often, IEPs are written for students to be seen weekly, either once or twice, which means your school-based SLP will inevitably have to see students in groups. Groups can be incredibly beneficial, especially when working on relevant social skills, however, for many kids, this simply limits how much individual attention they are receiving to work on their specific goals.

Let’s do the math. If an SLP is providing 60 kids services twice a week for 30 minutes, this means they have to provide 60 hours per school week of therapy. The math simply doesn’t add up to give each child what they truly need.

What you can do to help – School-based SLT is so beneficial in that it provides therapy in a naturalistic environment. Children spend much of their time at school, so learning skills there will help them to generalize the desired changes. The best option for kids to ensure they receive sufficient individualized attention is to supplement school-based SLT with outpatient services. In outpatient services, kids work individually with a highly trained SLP who can more directly target their specific areas of need. The best-case scenario is when families allow school-based and outpatient SLPs to communicate and coordinate treatment areas. You will see progress MUCH faster this way.

2. Wide range of service delivery – IEP services are almost always written in a range. The most common range we see is 20-30-minute sessions, 6-8 times per month (depending on the diagnosis and goal areas). Therefore, the range of time per month your child will be seen at school in this scenario will be from 2 hours to 4 hours. In an entire month, that simply does not suffice to produce significant outcomes. There have been some IEPs that we have seen where service delivery ranged from 2-8 times per month for 5-20 minutes. What this means is that it is nearly impossible to truly know just how often your child is being seen at school. SLPs in schools are spread too thin and are required to meet the minimum ranges written in IEPs. That’s the law.

What you can do to help – While receiving school-based services is never a bad idea, to ensure your child is making the most progress possible and gaining lifelong communication skills, consider adding outpatient services. Most often, outpatient services will be once a week for 60 minutes. That adds up to 4-5 hours per month in addition to the school-based supports. In addition, you will be able to communicate weekly with your child’s outpatient SLP and be provided with updates and strategies you can utilize at home to further ensure the generalization of skills.

3. Limitations around eligibility – School-based SLT services require that your child has a significant deficit in communication that is impacting their access to education. If your child has a sufficient delay or impairment that qualifies them for an IEP, their speech or language skills likely fall around the 7th percentile. This means 93% of same-aged children have better speech or language skills. Let that sink in. Your child may struggle notably with one specific area of language, or simply struggle a little across the board, but they may not be eligible for school-based services. On the other hand, if your child does meet eligibility requirements, again, it’s worth considering outpatient SLT for individualized attention and the range of service delivery. A child whose speech or language ability falls that far below average simply needs more support than schools alone can provide.

What you can do to help – Advocate for your child and learn the importance of early intervention. The amount of growth that can be achieved when children receive heavy support early can truly make the difference between an average communicator and an above-average communicator. Think about it like learning a second language. If you started when you were little, progress comes naturally. If you start when you’re older, you can still do it, but it’s much harder and takes a lot longer. Give your child their best possible chance at making progress and limit their frustration around speaking and listening.

Schedule a Consultation with BRAINS

Your child deserves to have access to the best possible services to help them improve their communication. School-based speech therapy is a great place to start, but it is your job as their most fervent advocate to pursue outside supports to ensure they make as much progress as they can, which may not be possible with school services alone.
If you have any questions or would like additional information about Speech-Language Therapy at BRAINS, please call (616) 365-8920 to schedule a free 15-minute phone consultation with one of our Speech-Language Pathologists. Immediate openings are available.

About the author: Emily Westerbeek, MA, CCC-SLP, is a Speech-Language Pathologist at BRAINS in Grand Rapids, Michigan. For over 4 years, she has been working with clients across the age span to improve their communication skills. Emily has performed diagnosis and treatment in the areas of ASD, articulation, phonology, receptive/expressive language, social communication, dysphagia, neuro-cognitive disorders (attention, memory, executive functioning, problem-solving), and auditory processing. Emily loves to continually learn new therapy techniques to benefit her clients and keep up to date with the latest research. Emily believes in creating individualized treatment for each of her clients with a family-centered approach, developing strong trusting relationships with her clients and their families.