School-based speech-language therapy (SLT) is priceless and for many families is the only way their child may gain access to this service. Both convenience and affordability make SLT in the schools accessible, a benefit that cannot be understated. As a former school Speech-Language Pathologist (SLP), I recognize both the value and challenges of children exclusively receiving SLT at school. Oftentimes, school services simply do not suffice, which is when it’s time to seek some additional supports for your child. Some of the limitations of exclusively utilizing school-based services are as follows:
1. Reduced individualized attention- Speech pathologists in schools in Michigan are supposed to be limited to 60 students on caseload. This number includes only students with 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. 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 can be done- 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. 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 I experienced was 20-30 minute sessions, 6-8 times per month (depending on the diagnosis and goal areas). Consider that, 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 were some IEPs I came across where service delivery ranged from 2-8 times per month for 5-20 minutes. 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 can be done- While receiving school-based services is never a bad idea, in order 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. You will be provided updates and strategies you can utilize at home to further ensure generalization of skills.
3. Limitations around eligibility- School-based SLT services require that your child has a significant deficit in communication which is impacting their access to education. If your child has a sufficient delay or impairment which 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, consider the previous points made about 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 can be done- Advocate for your child and learn the importance of early intervention. The amount of growth which 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 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 take a lot longer. Give your child their best possible chance at making progress and limiting their frustration around speaking and listening.
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: Kaitlin Busch, MA, CCC-SLP is a Speech-Language Pathologist at BRAINS in Grand Rapids, Michigan. For over 5 years, she has been working with children and young adults to improve their communication skills. Kaitlin has been drawn to complex diagnostic and treatment cases, working with other disciplines to better understand each underlying communication challenge. Kaitlin has experience providing treatment with individuals and groups, focusing on building off each patient’s unique strengths. Prior to working at BRAINS, Kaitlin provided speech and language therapy in several school districts. Learn more about Kaitlin here.