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Public School Services vs. Private Speech Therapy Services: Understanding the Differences


To understand the differences between public school services and private services it’s best to start at the beginning by asking yourself, “what is best for MY child?” At The Speech Spot, our goal is to educate, counsel, and provide the best care for our clients. We know that the decision to have your child evaluated or tested for a disability can be overwhelming. Outlined below are some common differences, questions, and concerns we get when parents call to inquire about what therapy with us would look like verses their school district. All information about school services was pulled from the Missouri Department of Elementary and Secondary Education's website. We also have several therapists on staff that have years of experience working in the public schools. Our goal is to educate parents on their rights and navigate what is best for their child, their family, and their financial requirements. We know that choosing a therapist and therapy team to work with is a big decision and we are happy to answer your questions as best we can or guide you to find the answers.

Question 1: “My child receives speech/language therapy at school, is that enough? Do they need private therapy in addition to those services?”

The answer to that is not so simple.

Bear with me because this first part may get confusing, but I’ll try to be as clear as possible.

The main reason for receiving speech/language therapy through the public school is that a child meets the following criteria:

1) the child’s decreased skills negatively affect their educational performance

2) the child has a recognized disability (in this case, a disability may include one or more of the following: Autism, Deafness/Blindness, Emotional Disturbance, Hearing Impairment and Deafness, Intellectual Disabilities, Multiple Disabilities, Orthopaedic Disability, Other Health Impairment, Specific Learning Disability, Language Impairment, Sound System Disorder (Articulation & Phonology), Speech-Fluency, Speech-Voice, Traumatic Brain Injury, Visual Impairment/Blindness, Young Child with a Developmental Delay).

In Missouri, public school programs are federally funded for children ages 3 to 5, to receive speech-language therapy through the public preschool. In order for a child to qualify they must score 2.0 standard deviations below the mean in 1 developmental area or 1.5 standard deviations below the mean in 2 developmental areas. In Missouri, for children Kindergarten and older, to qualify for language services at a public school, a child must have 2 composite scores (meaning receptive and expressive language combined) that are 1.75 standard deviations below the mean. To qualify for speech, the child’s speech skills must be at least 1 year delayed OR if that is not met, the child’s speech must be severely unintelligible, meaning the child has many errors that makes his/her speech not understood by anyone. More information on how students may/may not qualify for school services can be found on DESE’s website, The Department of Elementary and Secondary Education.

Clear as mud, right??! Luckily, the therapists administering the tests would go over these results with you and explain where your child’s score falls.

Question 2: Will my child qualify through public school?

Maybe. Because no one has a money tree (but if you do, please let me know!), we always tell families to talk to their child’s school (this may be the classroom teacher, principal, school counselor, Speech Therapist, etc.) and see if they think the child would qualify for school services. A parent can request an evaluation of his/her child’s skills through the public school. Once the school receives this request, they have 30 days to determine if they suspect a disability (see disabilities listed above) and then 60 days to complete the testing and provide you with results. Although the process is lengthy, school evaluations are thorough and provide everyone with lots of helpful knowledge about your child’s learning style, strengths, and weaknesses. We often recommend taking advantage of the school services if you think it’s best for your child and your situation.

Question 3: Can my child not qualify for therapy at school but still qualify for private therapy?

Yes. Private therapy offers an alternative solution in which children that may not qualify for school programs can receive the help they need. Private speech therapists are not required to follow a standardized state law because we do not receive state funding for providing services. Private therapists use standard assessments and scoring guides to evaluate and determine if services are recommended. However, private practitioners are allowed to use clinical judgement as well to determine if services are necessary. We cannot stress enough the importance of early intervention and detection if you suspect your child has a disability. Receiving services early can result in decreased therapy duration and bridging the gap in development your child may be experiencing before the gap gets wider and wider.

Question 4: What can I expect at the evaluation?

We will thoroughly look at your child’s speech/ language, voice, fluency, and social skills and look at their skills doing different tasks/activities to make sure that when we refer your child for therapy that therapy is definitely needed because we know how expensive private therapy can be! We are also able to use our clinical judgment (the skills we’ve developed over many years of schooling and working as a therapist) to determine whether or not a speech or language disorder is present. A private therapist should be willing to talk to you on the phone before an evaluation is even scheduled to talk about your concerns and see if he/she recommends an evaluation. But remember, just because your child has an evaluation, doesn’t mean he/she will necessarily need speech-language therapy. There is just enough of a concern that having an evaluation would be a good idea.Knowledge is power and will give you great insight into your child’s learning style, development, and current level of functioning.

These are just a few of the most common questions and notable differences between school services and private services. Overall, the goal for all providers (school or private) is to provide services to children who are identified as having a need for the services. All children would benefit from a specialized service such as speech therapy, but treatment sessions in or out of school need to be goal driven with a delay present. Everyone should have a clear understanding of the goals and treatment plan moving forward after the evaluation. All therapists love working with children and seeing them meet their goals. Watching a child achieve their goals after weeks, months, or even years of therapy is amazing for all involved. It fuels what we do!

If you EVER have any questions about your child’s speech or language skills or what is typical or not, or are confused by your school evaluation or recommendation please reach out to Kate or Liz at The Speech Spot. We would be happy to discuss with you your concerns.

Resources for Missouri Public Schools and Eligibility & IEP’s:

https://www.showmemsha.org/pdfs/MSHA-Handbook

https://dese.mo.gov/sites/default/files/The%20Parent's%20Guide%20to%20Special%20Education%20October%202017.pdf

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