Speech Problems For Private School Kids – Where Do Parents Turn?

Parents who enroll children in private schools may experience difficulty finding speech therapy services if their child has a problem articulating certain speech sounds. These children often fail to qualify for speech and language therapy programs typically found in the public schools. And many private speech clinics are expensive and/or inconvenient. So what can private school parents do to assist their child in overcoming speech difficulties?

While most private schools endeavor to develop superior educational and enrichment programs, they typically do not provide speech and language therapy. Generally, these schools simply do not have the financial resources to offer speech services. Consequently, many parents are on their own in finding speech and language help for their child. Unfortunately, even though there are several options for helping children with speech delays, private school students cannot always find a good fit.

Parents may first explore the services available through the public schools. In the typical case, the child will be evaluated by a speech-language pathologist to determine whether or not the child’s speech and/or language delays meet the criteria necessary to qualify for the school’s program. Speech and language services are provided without charge for those children who do qualify. However, there are two caveats here: 1) very few children who could benefit from speech therapy services will be able to qualify and 2) if they do qualify, they might receive therapy only 1-2 times per month. Why is there such limited availability?

Because all school districts operate with limited funds, many programs have too little money allocated to them to provide ideal levels of service. Special education, which includes speech therapy, is one of those programs. Whether or not to provide speech-language services to a particular child is up to the individual school district. This can put private school children at a definite disadvantage. In California, for example, schools only receive state funding for children who actually attend a public school. Therefore, districts may be reluctant to provide already limited services to children for whom they receive no state funding.

Additionally, speech and language services through the public schools, as well as other aspects of special education, are intended for the lowest-performing segment of the population. In other words, a child would have to be very impaired in speech and/or language to qualify for these free services. Many parents who seek out a speech and/or language evaluation in the public schools are told that their child’s “problem” is not severe enough or that the child is developing “normally.” Special education programs in the public schools were not intended for the “mild” or “moderate” speech-impaired child.

Another option for private school parents is to have their child evaluated at a private speech therapy clinic. This approach can be appropriate for many children. However, therapists at private clinics might also tell the parents that their child’s impairment is not severe enough and that he/she is developing according to the speech “developmental norms,” or that a particular sound error can self-correct “as late as 7 or 8 years of age.”

On the other hand, if the private clinic DOES recommend speech therapy for the child, it can become quite expensive. If your health insurance plan covers speech therapy sessions, and often they do not, there will usually be some co-pay required. Even at $20 per session, the total cost for therapy can be significant. For example, a typical course of speech therapy may require two sessions per week over a period of 8-12 weeks. In that case, co-pays would be as high as $480 in addition to transportation costs and the inconvenience of adding that many appointments to your already busy life.

What about the “developmental norms” and the “self-correcting speech sounds” mentioned above? Could some children just “grow out of” their speech problem? While it is true that some children end up moving through the speech development stages and saying all their speech sounds correctly by age 7 or 8, this is not always the case. In my experience, both in clinic settings and in the public school system, children who have not self-corrected their speech sounds by Kindergarten often do not improve without some amount of speech therapy intervention. Kindergarten is a time when children are learning letter sounds and beginning to learn to read. They are also increasingly interacting with other children and adults. Incorrect speech sounds at this age can cause difficulties in learning to read as well as create awkward social exchanges when the child cannot be understood. The child may even begin to lose speaking confidence and/or become frustrated when others cannot understand him.

While many of these children do end up developing reading and academic skills just fine, they may still have a speech difference/delay. I have heard students walking the halls of my children’s private school talking with evident speech errors. For instance, they cannot say the /s/ sound, or the /r/ sound, or the /th/ sound, or their /sh/ or /ch/ or /j/ sounds are distorted. These students are in first through fifth grade, and could not be understood at the last school-wide presentation because they had speech sound errors.

I have heard parents complain that they were unable to understand many of the kids when they got up to speak because of their speech sound errors. I have heard middle-school children who still cannot say their /s/ or their /r/ sounds. They sound “different” at best; “strange” at worst. Everyone notices these speech sounding errors. Most importantly, the child him/herself notices.

The reality is, the longer parents wait to correct their child’s speech problem, the harder it is to overcome. Any speech pathologist will tell you that. What some speech pathologists will not tell you is that many of these speech sounds can be easily corrected by showing parents a few simple techniques to teach the sound, then giving them guidelines on how to reinforce the sound and how to help their child carry the correct sound over into conversation. Parents also should know that they can work with their child earlier than some guidelines suggest. Many of the speech sounds can be taught to children as young as age 3. Children learn quickly when they are young, and they are usually very receptive to new ideas, especially when they are given effective praise for their efforts. Some children improve dramatically with just one month of parent-driven home speech therapy.

Many private school parents notice that their child has a speech delay. Seeking an answer, they may have researched their options and found that none seem to give them exactly what they need to help their child. Or, they might delay starting speech therapy because of cost or inconvenience. However, these parents need to realize that time is of the essence in speech sound development. If your child is at least 3-4 years old, the time might be now!

The Importance of Speech Therapy Certification

Speech therapy is an important service offered within the category of healthcare services. A more specialized medical career, speech-language pathologists work with patients of all ages, and with a variety of challenges, in order to help them communicate more clearly with the world around them.

It is a highly regulated profession, in most cases requiring practitioners to obtain a certification, but also one that is both diverse and interesting. Geared toward those interested in teaching, as well as therapeutic services, a career as a speech therapist can be highly rewarding for the right individuals.

Becoming a Speech Therapist

Prospective students who are interested in a career as a speech-language pathologist will need to fulfill specific educational requirements in order to do so.

In the US, Canada and other countries, practitioners who seek certification are required to complete a minimum of a Master’s degree in speech-language pathology, though there are a few shorter programs available.

In the UK and a few other areas, national registration with regulatory healthcare organizations is sometimes obtainable with a Bachelor’s degree, or other accelerated educational programs as well.

Regardless, in all cases, a Master’s degree is still highly recommended since it is more preferable to employers, and offers the most in employment options and career advancement.

Gaining Certification in Speech Therapy

In order to become certified, students will need to provide proof of having graduated from an appropriate accredited educational program, which makes them eligible to take the national certification examination.

Licensing is required in most states and provinces in the US and Canada, and in some cases, certification is required in order for practitioners to become licensed to practice within their state.

Additionally, as mentioned above, since it is such a specialized profession, most employers today require that candidates be certified before they will be considered for hire.

Certification examinations in the US are provided by and maintained by the American Speech-Language-Hearing Association (ASLA), which awards the title of Certificate of Clinical Competence in Speech-Language Pathology, or CCC-SLP.

Canadian graduates can take the certification exam offered by the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA), which will provide practitioners with a Certificate of Clinical Certification.

In both cases, practitioners are required to be a member in good standing of the issuing professional organization, and they are required to keep up their certification through the accruement of a specific amount of Continuing Education hours each year; failure to do so can result in loss of certification, and the need to re-test to regain this qualification.

Certification is handled somewhat differently in some areas however, such as in the UK, where registration with the HCPC acts as the main proof of ability.

Only graduates of programs that are both accredited by the Royal College of Speech & Language Therapists (RCSLT) and recognized by the HCPC enable graduates to register with the HCPC.

There are a select few specialty certifications that can be earned through separate programs associated with the RCSLT, but these are not required for HCPC registration, and are typically taken after a practitioner has been working for some time, has gained considerable work experience, and would like to specialize in one area of therapy over general therapy.

The Importance of Accreditation

In all cases, one of the most important considerations that any prospective student needs to make before they enroll in a speech-language pathology degree program is whether or not it is accredited.

Students are only eligible to obtain certification if they have graduated a recognized, accredited program, which serves as a measure that each student has been provided the most accurate, up to date and complete education and training as possible.

To find out which college programs are accredited, prospective students are recommended to contact their country’s professional organization in Speech-Language Pathology, as these groups are typically involved with accreditation of educational programs, and maintain a list of them.

In the US, the ASHA is partnered with the Council on Academic Accreditation (CAA) in Audiology and Speech-Language Pathology, and together helps grade and approve all acceptable programs, and uphold educational standards of their approved programs.

Canadian accreditation is handled by the CASLPA in partnership with the Council for Accreditation of University Programs in Audiology and Speech-Language Pathology (CACUP-ASLP). UK accreditation, as mentioned above, is handled by the RCSLT in conjunction with HCPC requirements.

Although it may seem like getting a certification might be challenging, students who are dedicated to their new profession, and are interested in getting the best education they possibly can will benefit greatly from their effort.

Not only will they have access to the best jobs in their profession, but they will reap the many other benefits that certification offers, such as career advancement and increased salary as well.

Speech and Language Therapy for Children With Autism

What is it?

The goal of speech therapy is to improve all aspects of communication. This includes: comprehension, expression, sound production, and social use of language (1). Speech therapy may include sign language and the use of picture symbols (2). At its best, a specific speech therapy program is tailored to the specific weaknesses of the individual child (1). Unfortunately, it can be difficult to create a child-specific, evolving, long-term speech therapy plan (1, 3).

The National Research Council describes four aspects of beneficial speech therapy-

(1) Speech therapy should begin early in a child’s life and be frequent.

(2) Therapy should be rooted in practical experience in the child’s life.

(3) Therapy should encourage spontaneous communication.

(4) Any communication skills learned during speech therapy should be generalizable to multiple situations (4).

Thus, any speech therapy program should include practice in many different places with many different people (2). In order for speech therapy to be most successful, caregivers should practice speech exercises during normal daily routines in the home, school, and community (1, 5). Speech therapists can give specific examples of how best to incorporate speech therapy throughout a child’s day (6).

What’s it like?

Speech therapy sessions will vary greatly depending upon the child. If the child is younger than three years old, then the speech therapist will most likely come into the home for a one hour session. If the child is older than three, then therapy session swill occur at school or in the therapist’s office. If the child is school age, expect that speech therapy will include one-on-one time with the child, classroom-based activities, and consultations between the speech therapist and teachers and parents (2).

The sessions should be designed to engage the child in communication. The therapist will engage the child through games and toys chosen specifically for the child. Several different speech therapy techniques and approaches can be used in a single session or throughout many sessions (see below).

What is the theory behind it?

Children with autism not only have trouble communicating socially, but often also have problems behaving. These behavioral problems are believed to be at least partially caused by the frustration associated with the inability to communicate. Speech therapy is intended to not only improve social communication skills, but also teach the ability to use those communication skills as an alternative to unacceptable behavior (1).

Does it work?

Many scientific studies demonstrate that speech therapy is able to improve the communication skills of children with autism (1). The most successful approaches to speech therapy include: early identification, family involvement, and individualized treatment (3). There are many different approaches to speech therapy and most of them are effective. The table below lists some of the different approaches. In most cases a speech therapist will use a combination of approaches in a program.

Type of Speech Therapy

Definition

Does it Work?

Augmentative and alternative communication (AAC)

broad term for forms of communication that supplement or enhance speech, including electronic devices, picture boards, and sign language

Yes (2)

Discrete trial training

therapy that focuses on behavior and actions

Yes (1)

Facilitated communication

communication technique that involves a facilitator who places his hand over the patient’s hand, arm or wrist, which is placed on a board or keyboard with letters, words or pictures

No (1, 3)

Functional communication training (FCT)

use of positive reinforcement to motivate the child to communicate

Yes (4)

Generalized imitation

child is encouraged to mimic the therapists mouth motions before attempting to make the sound

Yes (5)

Mand training

use of prompts and reinforcements of independent requests for items (referred to as mands)

Yes (6)

Motivational techniques

therapy techniques that focus on following the child’s lead and capitalize on the child’s desire to respond

Yes (7)

Peer mentors/circle of friends

use of children who are trained to interact with the autistic child throughout the day

Yes (8)

Picture exchange communication system

method of using picture symbols to communicate

Yes (9)

Relationship development intervention

trademarked treatment program that centers on the belief that individuals with autism can participate in authentic emotional relationships if they are exposed to them in a gradual, systematic way

Yes (8)

Sign language/total communication

language of hand shapes, movements, and facial expressions (especially useful for ages 0-3)

Yes (1)

Story scripts/social stories

actual stories that can be used or adapted to teach social skills

Yes (1, 8)

Is it harmful?

There are no reports of speech therapy being harmful.

Cost

The cost of speech therapy is covered by the government through the Individuals with Disabilities Education Act (IDEA). The amount of speech therapy provided in this setting may be suboptimal and thus should be supplemented with private therapy. Private speech therapy can be expensive (approximately $100/hour)

Speech therapy requires parental investment of time. In order to be most effective, parents should be fully integrated into the therapy program and should seek out opportunities to practice communication throughout the daily routine. With time, this should become a new way of life.

Resources

Autism is a condition covered under the Individuals with Disabilities Education Act (IDEA). Services covered by IDEA include early identification and assessment and speech language pathology (speech therapy). This law protects the rights of patients with autism and provides guidelines to assist in their education. It covers children from birth to age 21 (U.S. Department of Education Web site). Pediatricians can provide contact information for the state early intervention program (for children 0 to 3 years old). School districts will coordinate special services for children 3-21 years old.

Parents of nonverbal children should consider incorporating PECS.

Signing Times is one of many companies selling systems that help to teach children sign language.

American Speech-Language-Hearing Association. (2006). Principles for speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span: Technical report.

Charman T, Stone W. Social and Communication Development in Autism Spectrum Disorders: Early Identification, Diagnosis, and Intervention. New York, The Guilford Press, 2006, pp. 115-266.

Paul R, Sutherland D. Enhancing early language in children with autism spectrum disorders. In Volkmar FR, Paul R, Klin A, et al. Handbook of Autism and Pervasive Developmental Disorders, Third Edition, Volume Two. Hoboken, John Wiley & Sons, 2005, pp 977-1002.

References

1. Goldstein, H. 2002. “Communication Intervention for Children with Autism: A Review of Treatment Efficacy.” Journal of Autism and Developmental Disorders v32 n5 p373-96 Oct 2002.

2. Diehl, S.F. 2003. “The SLP’s Role in Collaborative Assessment and Intervention for Children with ASD.” Topics in Language Disorders v23 n2 p95-115 Apr-Jun 2003.

3. Lord, C. 2000. “Commentary: achievements and future directions for intervention research in communication and autism spectrum disorders.” J.Autism Dev.Disord. 30(5):393-398.

4. Committee on Educational Interventions for Children with Autism, C.L.a.J.P.M.E.2001. “Educating Children with Autism.” Committee on Educational Interventions for Children with Autism, C.L.a.J.P.M.E. The National Academies Press.

Ref Type: Book, Whole

5. Koegel, L.K. 2000. “Interventions to facilitate communication in autism.” J.Autism Dev.Disord. 30(5):383-391.

6. Safran, S.P., et al. 2003. “Intervention ABCs for Children with Asperger Syndrome.” Topics in Language Disorders v23 n2 p154-65 Apr-Jun 2003.

7. Light, J.C., et al. 1998. “Augmentative and alternative communication to support receptive and expressive communication for people with autism.” J.Commun.Disord. 31(2):153-178.

8. Keen, D., et al. 2001. “Replacing prelinguistic behaviors with functional communication.” J.Autism Dev.Disord. 31(4):385-398.

9. Ross, D.E., and R.D. Greer. 2003. “Generalized imitation and the mand: inducing first instances of speech in young children with autism.” Res.Dev.Disabil. 24(1):58-74.

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