What You Can Expect From Speech Therapy {A Guide for Parents} Part Two: How to Get an Assessment

Welcome to the second installment of What You Can Expect From Speech Therapy {A Guide for Parents}. Last week I introduced this series and explained some of the many variables that contribute to how assessments and therapy could look like for YOUR child. Today we are going to talk about how you can go about getting a speech assessment.

So you are worried about your child’s speech and language development. Whether your child is 12 months or 12 years old, things can pop up in your child’s behavior that might make you wonder if there is something going on. Maybe you have an infant who is not babbling, or a toddler who is not talking. Maybe you have a 6 year old with a lisp or a 12 year old who suddenly starts stuttering. What can you do? Who do you contact? How can you have your child assessed by a speech-language pathologist?

First, A Very Important Note

Before we get started, I want you all to know something very important: In the US, you do NOT need a referral from a pediatrician for an assessment in many venues. Thanks to the Individuals with Disabilities Education Act (IDEA) there are FREE or REDUCED COST programs available in ALL STATES for children birth through the 21st birthday. In *most* states you can refer yourself (I have heard some areas need a pediatrician referral but I don’t know where for sure). That means..if you have concerns you can refer your OWN child for an assessment based on YOUR concerns. (More on that below).

A Note About Pediatricians: I love our pediatrician. She is a great doctor. She was a very important member of our team when my daughter first presented with her terrible limp and we were trying to find out what was wrong. She knew the tests to run and made the appropriate referrals. She went to school to be a pediatrician and she is great at her job.

Pediatricians are medical doctors. They specialize in the health and care of children. But they are not specialists in speech and language development. This is a very important thing to remember on this journey because sometimes a pediatrician will advise you to wait when you shouldn’t or advise you to seek an assessment for something that is completely age appropriate. As an SLP I have seen this many a times. They simply are not speech and language specialists. 

The bottom line: GO WITH YOUR GUT. If you have a nagging feeling something is not right and you are not thrilled with your pediatrician’s recommendations, know that you don’t need them for a referral in all circumstances.

Federally Funded Programs

Thanks to federal programs and funding, there are programs and services available to all children in the United States (for those found eligible)  from birth through age 21. They are a result of the Individuals with Disabilities Education Act (IDEA). These programs and services are available at NO COST TO YOU or at a REDUCED RATE if your child is found eligible, so I encourage you to research these programs if you feel your child may need interventions of any kind.

Straight off the IDEA website:

“The Individuals with Disabilities Education Act (IDEA) is a law ensuring services to children with disabilities throughout the nation. IDEA governs how states and public agencies provide early intervention, special education and related services to more than 6.5 million eligible infants, toddlers, children and youth with disabilities. Infants and toddlers with disabilities (birth-2) and their families receive early intervention services under IDEA Part C. Children and youth (ages 3-21) receive special education and related services under IDEA Part B.”( http://idea.ed.gov/ )

Birth to Three

You may have heard of these as referred to as early intervention or early start programming. These services are provided from birth through a child’s third birthday. Though the exact programs vary state to state, children from birth to three are typically seen through some kind of early intervention (EI) program (IDEA part C: You can read about it HERE). In the birth to three age group, services are outlined and documented through an Individualized Family Service Plan (IFSP). This is like a contract between the family and those providing the services stating (among other things) what the present levels of development are for the child, goals for the child to meet in a specific time frame, and the services/programs that will help the child to achieve those goals. (I will talk a bit more about these further on in this series).

If you are concerned about your child’s development, there are a couple ways you can go about getting an assessment through your local early intervention programming. One option, is to speak to your child’s pediatrician who can refer you to the appropriate programs in your area (as I already went over though, you do not *need* a referral to get assessment in most areas. Your pediatrician should still be able to direct you to the right people to talk to). You can also go to your state’s website for information on how to obtain an assessment and any services needed through IDEA Part C. In addition, your local school district may be able to provide you with the contact information for the early intervention programming in your area (sometimes the school district will even be the ones providing this service, depending on your area).

**Some states require you get an screening before you can receive a full assessment (something I forgot to mention and was pointed out by a kind reader). Your child will first need to fail the screening to receive the assessment.

Age 3 to 21

Once your child turns three (and through his/her twenty-first year), he/she becomes eligible for any necessary services through IDEA Part B. These services (with some exceptions as not all states do things the same) are uaully by the school district in which you reside. This is usually true for preschool aged children as well (3-5) regardless if the child attends a district preschool program, as well as for young adults ages 18-21. (Because programs differ state to state, you will need to contact your local state or school district to inquire about these services, but regardless of who provides them your child is entitled to them if he/she meets the eligibility criteria). These services are provided under an Individualized Education Plan (IEP) which is similar, but different, from an IFSP used in birth-3. You can read more about IDEA Part B HERE. (I will go over IEPs more later in this series).

Now how do you go about getting an evaluation through your school district? The first step is to contact your district’s special education office and ask them for the specific steps you as a parent must make to start the process. In the districts I have worked in, for 3-5 year olds a request must be in writing. **Just like in EI, it is common for your child to first go through the screening process before a full evaluation will take place.

If your child is already in school, speak to your child’s teacher about your concerns and if you still have questions, talk to the proncipal and/or a representative from the special education department to find out what the process is to have your child evaluated. Most schools have a referral process that is followed to begin this process and you will need to find out how you can be involved in this process (i.e a screening may need to happen first, a Student Study Team, Response to Intervention, etc).

How to Acquire Medical Services

Federally funded programming or school based services are not the only ways to go about getting a speech assessment. Speech and language therapy is also available in the medical setting, in hospitals and outpatient centers. These services may be covered by your insurance or they can be paid for out-of-pocket. In order to get an assessment covered by your insurance, you most likely will need a referral from your pediatrician just like when going to any other specialty services like occupational or physical therapy.

Insurances are all very different in what they will cover, and sadly many insurances cover very little speech therapy, if any at all, so it is important for you to check with your insurance provider before you go in for an assessment to make sure it it covered, and is so how much. For example, some insurances only over 20 sessions a year. Other more, others less. Many plans WILL cover an assessment even if they do NOT cover treatment. Also, many plans will not cover things that are considered “developmental” in cause. So…again check with your insurance.

How to Locate Private Services

Another option for getting your child assessed is by pursing an evaluation from a private practice/private practitioner. Private practices may or may not accept insurance, so keep this in mind. Some will be private pay only and be sure to check what payment methods they accept. The good news, is that most private practice SLPs will be able to provide you with a receipt for services that you can them submit to your insurance for reimbursement. Make sure to check with your insurance provider to see if this is a possibility for you as not all insurances will reimburse and as I explained above, they most likely will only cover so many sessions a year, so be sure to have all this information before you get started if you will be depending on reimbursement.

Here are some ways you can locate a private practice/private practitioner in your area:

• Check the American Speech-Language Hearing Association’s (ASHA) online data base for SLPs in your area. You can access this data base HERE.
• Ask your pediatrician. They often will have a list of local service providers
• Ask your local school district’s special education department. They also often will have a list of private providers.
• Part of a mommy group or mommy list-serve? Ask around for recommendations.
• Live near a University? Call and see if they have a Speech and Hearing/Communication Disorders Clinic. Here, graduate level students in Communication Disorders provide assessments and therapy at a minimal cost (and sometimes FREE) under the supervision of a professor.
• Do a Google or White Pages search for Speech-Language Pathologist or Speech Therapy

Another Possible Option: University Speech and Hearing Clinics

A few days after I first posted this, I remembered another option for assessments. Universities that have Speech Pathology/Communication Sciences/Disorders majors often have a Speech and Hearing Clinic on campus that provides free or low cost assessments and therapy by graduate students under the supervision of licensed speech-language pathologists. You can call your local university near you for more information.

Those are the four five main ways to start the assessment process for your child. Once you decide on what type of provider you will be going with for an assessment and make your appointment, it will be time to prepare. What can you expect in the assessment process? That is up next!

Looking for more? A  great book that also covers all this information in more detail and more is (affiliate link->) Childhood Speech, Language, and Listening Problems by Patricia Hamaguchi. I highly recommend it!

To read the other installments in this series, click HERE. 

Don’t want to miss future posts? You can have posts delivered via email! just click HERE (be sure to watch for the confirmation email). You can also follow along on Facebook and Pinterest for even more speech and language information and fun!