top of page

School Based ST vs. Outpatient ST

The beginning of a new year is marked with excitement for many students and families. The hope of a fresh start and the excitement for the growth you will see in your child is a great feeling. However, this time of year can be overwhelming and some parents may have apprehension regarding school based speech therapy services. Although private/ outpatient and school based speech therapy are both amazing in their own ways, there are some differences in which parents may not be aware.

Speech therapy in an outpatient setting can address numerous areas of communication, feeding, and it can be challenging to ensure that all your child’s needs are being met within the school environment. While effective and efficient communication is always the main goal for speech therapy services, it is important that your child’s speech goals align with your family goals as each individual child and family is very different. While academic speech therapy goals often look different from goals that you and your outpatient provider have established, it is important to ensure that the goals are supportive of each other and are meeting the specific needs of the child.

Although each school district and each school may operate differently, here are some general guidelines regarding the difference in outpatient and school based services.

Outpatient Clinic

Addresses the whole child: In the outpatient setting, we ensure that we are acknowledging and addressing all communication and/or feeding needs of the child. We address numerous areas including but not limited to motor speech production, language, pragmatic, and feeding/ swallowing. We work on any and all deficits that me be impacting your child in all settings.

Multi-disciplinary approach: We work closely with other professionals such as your child’s OT, PT’s, ABA therapist, play therapist, and learning specialists to provide well rounded care. This approach ensures a better chance of generalization of skills for your child.

Across Settings: We aim to work closely with families to see how your child’s communication strengths and weaknesses are affecting home, school, family outings, travel, functionality of day to day life, and community. It is important to make sure children can generalize their skills to other settings. We want to ensure your child can safely and effectively communicate their wants/needs across settings in order to be successful.

One on one: In the outpatient setting, speech therapy must exclusively be one on one for insurance to reimburse. This allows for the most individualized plan and treatment sessions over time. Each child is allotted direct therapy time with their unique goals being the focus of each and every minute of their session.

School Based Speech Therapy

Academic Based: While school based SLP’s have the same credentials and training as outpatient clinicians, they approach their intervention from an academic background instead. For example, while your child may struggle with communication or feeding skills when compared to their peers, but if these challenges are not impacting them at school from an academic or social standpoint, they may not qualify for services at the school. If your child’s feeding and swallowing abilities are not impacting their abilities to function within their school day, a school SLP may not be able to address these areas other than ensuring medical recommendations from outside providers are being implemented safely while at school.

Collaborative Approach: Speech therapists in the school setting can work on direct therapy, but they also can work on a consultative basis. Depending on the child’s need they try to help give teachers the training and support needed to carry over strategies for growth in the classroom. They work with a variety of team members to educate on speech strategies as needed and strategies to build independent communication with the least amount of pull out speech therapy possible.

IEP (Individualized Educational Plan): Speech in schools is considered a direct service, and student can qualify for speech therapy only as a child with a speech impairment, or they can qualify to receive services along with another eligibility. Their goals are written in a way that support academic and social growth within the educational setting.

Treatment Frequency: In a school setting, the child may only receive speech therapy for 1-2x/ week for 30 minutes sessions in a group setting. This often includes 3-5 students and can be challenging to ensure each child’s needs are being met in a way that ensures progress for each child in the areas established in their IEP. School based SLP’s must ensure they following the guideline for LRE (least restrictive environment), meaning they cannot legally pull a child out of class to receive services more than is needed to show progress on goals. This can oftentimes lead to it taking many years for overall long term speech therapy goals to be met.

Both settings can be extremely beneficial for your child, and we usually find communication abilities to improve and generalize better when children’s needs are being met in a multitude of settings. Having realistic expectations of each setting and their differences can help families understand how their child’s and their family goals can be met.


Rated 0 out of 5 stars.
No ratings yet

Add a rating
bottom of page