Private Speech Therapy vs. School-Based Speech Therapy: What's the Difference?

If your child is receiving speech therapy at school, you may wonder whether private speech therapy is necessary. Or perhaps you've been told your child doesn't qualify for school-based speech services, but you still have concerns about their speech, language, or communication development.

These are common questions we hear from families, and the answer isn't always straightforward!

While school-based speech therapy and private speech therapy are both provided by licensed speech-language pathologists (SLPs), they serve different purposes. Understanding the differences can help you make informed decisions about your child's communication needs and determine what type of support may be beneficial.

Let's break down the differences between school-based and private speech therapy, including how children qualify for services, what therapy looks like, and when it may be helpful to pursue both.

What Is School-Based Speech Therapy?

School-based speech therapy is provided through a child's school district, often in collaboration with an Area Education Agency (AEA) in Iowa. These services are designed to help students develop the communication skills they need to access their education and participate successfully in the school environment.

In Iowa, students may qualify for speech-language services through special education when they have an identified speech or language disability that adversely affects their educational performance and requires specialized instruction or support.

School-based speech therapy may address:

• Speech sound production (articulation), such as difficulty producing /r/, /s/, or /th/ if those speech sound errors are negatively impacting reading development.

• Language development, including understanding directions, answering questions, and using age-appropriate vocabulary and grammar.

• Social communication skills, including conversational turn-taking and understanding social cues.

• Fluency, including stuttering.

• Voice disorders and other communication needs.

What does school-based therapy look like?

School-based speech therapy is often provided in small groups, although individual therapy, classroom-based support, and consultation with teachers may also be appropriate depending on a student's needs.

Goals are developed through the Individualized Education Program (IEP) process and focus on helping students participate in their educational environment. For example, a child may work on following classroom directions, participating in classroom discussions, or producing speech sounds clearly enough to communicate with teachers and classmates.

School-based speech therapy is provided at no cost to families when a child qualifies for services through the public school system.

What Is Private Speech Therapy?

Private speech therapy is provided outside of the school system, typically in an outpatient clinic or private practice. These services are available to children and adults and focus on improving communication and related skills that affect everyday life.

Unlike school-based therapy, private speech therapy is not limited to communication skills that impact a child's educational performance. Instead, treatment can address a broader range of communication needs across home, school, and community settings.

Private speech therapy may address:

• Speech sound disorders and articulation difficulties.

• Expressive and receptive language delays.

• Childhood apraxia of speech (CAS).

• Stuttering and fluency disorders.

• Social communication and pragmatic language skills.

• Feeding difficulties and picky eating.

• Voice disorders.

• Cognitive-communication skills such as attention, memory, and executive functioning.

• Other communication difficulties that affect daily activities and quality of life.

What does private therapy look like?

Private speech therapy typically involves individualized treatment based on a child's specific strengths, challenges, and family priorities.

Sessions are often provided one-on-one, allowing the speech-language pathologist to focus on the child's individual goals and adjust activities based on their progress.

At a private practice, therapy goals may include improving speech intelligibility, developing language skills for everyday conversations, increasing independence with communication, improving feeding skills, or helping a child feel more confident communicating with others.

Private therapy is generally paid for through private health insurance, Medicaid, or out-of-pocket payment, depending on the practice's accepted payment options and the family's coverage.

5 Key Differences Between Private and School-Based Speech Therapy

Although both settings provide valuable speech-language services, there are several important differences.

1. Eligibility for Services

One of the biggest differences is how children qualify for therapy.

In the school system, a child must meet specific special education eligibility requirements. Having a speech or language delay does not automatically mean a child qualifies for school-based speech therapy. The communication difficulty must adversely affect their educational performance and require specialized instruction or support.

Private speech therapy has different eligibility considerations. A child may benefit from therapy even if their communication difficulties do not significantly affect their ability to participate in school.

For example, a preschooler who struggles to produce certain speech sounds may communicate effectively with familiar adults and participate in classroom activities. They may not qualify for school-based services, but their speech sound difficulties may still benefit from early intervention through private speech therapy.

2. Therapy Goals

School-based therapy focuses on communication skills that support educational participation and success.

Private therapy can address a wider range of functional communication goals, including skills that affect a child's ability to communicate at home, interact with family and friends, participate in community activities, and navigate everyday situations.

For example, a school-based SLP may work with a student on following multi-step classroom directions, while a private SLP may focus on understanding and remembering directions during everyday routines at home.

Both goals are valuable, but they address different areas of need.

3. Individualized Attention and Treatment

School-based speech therapy may be provided individually or in small groups, depending on the child's needs and the school's service delivery model.

Private speech therapy is commonly provided one-on-one, allowing the therapist to tailor activities, treatment approaches, and session pacing to the individual child.

This individualized attention can be especially helpful for children who need more focused practice, have complex communication needs, or benefit from a specific treatment approach.

4. Frequency and Duration of Therapy

The frequency and duration of school-based speech therapy are determined through the IEP process and are based on the student's individual needs.

Private speech therapy offers additional flexibility in determining treatment frequency and session length. Depending on the child's needs and clinical recommendations, therapy may occur once or multiple times per week, with sessions typically lasting 30 minutes.

This flexibility can be helpful for children who need more frequent opportunities to practice specific skills or who would benefit from a more intensive period of intervention.

5. Parent and Family Involvement

Family involvement is important in both settings, but private therapy often provides additional opportunities for parents and caregivers to participate directly in treatment.

At a private practice, families may have opportunities to observe sessions, discuss progress, learn strategies to use at home, and collaborate with their child's therapist to establish meaningful goals.

We believe communication development doesn't stop when a therapy session ends. Helping families understand how to support communication during everyday routines can make a meaningful difference in a child's progress.

Can My Child Receive Both School-Based and Private Speech Therapy?

Absolutely! In fact, some children benefit from receiving speech therapy in both settings.

School-based and private speech therapy are not competing services. They can complement one another by addressing different aspects of a child's communication needs. And school-based and private-practice speech therapists often collaborate to provide the best care for the child and family.

For example:

• A child may receive school-based therapy for articulation while attending private therapy to address childhood apraxia of speech.

• A student may work on language skills in the classroom while receiving private therapy to develop more functional communication skills at home and in the community.

• A child receiving school-based speech therapy may benefit from additional individualized treatment to address persistent speech sound errors.

• A child may receive school-based language support while attending private feeding therapy to address limited food variety or difficulties with eating.

When children receive therapy in multiple settings, communication between providers can be helpful. With appropriate family consent, school-based and private SLPs can collaborate to share information, coordinate goals, and support consistent strategies across environments.

When Should I Consider Private Speech Therapy for My Child?

You don't have to wait until your child struggles significantly in school to seek help for speech or language concerns.

Consider scheduling a private speech-language evaluation if:

• Your child's speech is difficult for unfamiliar people to understand.

• Your child becomes frustrated when trying to communicate.

• Your child has difficulty understanding directions or expressing their thoughts.

• Your child is not meeting expected speech and language milestones.

• Your child stutters or demonstrates signs of disfluency.

• Your child has difficulty interacting with peers or participating in conversations.

• Your child has difficulty trying new foods, eats a very limited variety of foods, or demonstrates other feeding concerns.

• Your child was evaluated by the school but did not qualify for services, and you still have concerns about their communication development.

Early identification and intervention can help children develop important communication skills and reduce the frustration that sometimes accompanies communication difficulties.

If you're unsure whether your child would benefit from therapy, a speech-language evaluation can help determine their current abilities, identify areas of concern, and provide recommendations for next steps.

Speech Therapy at Connect Therapy in West Des Moines, Iowa

At Connect Therapy, we believe every child deserves the opportunity to communicate, connect, and participate in the world around them.

As a private speech therapy practice in West Des Moines, Iowa, we provide individualized speech, language, and feeding therapy for children with a variety of communication needs.

We work closely with families to understand their concerns, identify meaningful goals, and develop treatment plans that reflect each child's unique strengths and needs.

Whether your child already receives school-based speech therapy, does not qualify for school services, or has never received speech therapy before, we're happy to help you explore your options.

Have questions about your child's speech, language, or feeding development? Contact Connect Therapy to learn more about our services or schedule an evaluation. We're here to help your child build the skills they need to communicate with confidence!