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  • Erin Gaul MS, CCC-SLP

Private Therapy Vs. Early Intervention.

A post in an SLP group had me thinking about why a family may want private speech therapy for their 0-3 child vs. early intervention. After all, it’s free and EI therapists come to you! So, is there even a debate? Sure, but we'll start with the pros.




Pros of Early Intervention:


· Cost: In the state of PA, it’s free of charge, which is a huge help for a lot of families. I can’t speak for all of EI, but I do hear families can be charged in other states.


· Travel: There’s none involved. The therapists come to you in the child’s most natural, least restrictive environment. This is usually home or daycare.


· Family Centered: If you are present at your child’s EI sessions, your therapist will directly communicate strategies you can incorporate with your child.


· Hands-On: Due to the family centered model, you will be able to watch, learn, and actively try strategies with the ability to ask questions as needed.


Cons of Early Intervention:


· The model: While teaching the family strategies is ALWAYS necessary, some little ones have more intense and complex needs and truly benefit from an individualized therapy model. EI will often discourage direct treatment because sessions are about teaching the family how to help their child. While this is, of course, important, some children need one-on-one therapy in addition to parent coaching.


· The natural environment: Sometimes a child will not cooperate in their home or daycare. They are used to doing what they please, and a therapist entering their space is not always welcome. Children are comfortable in their space; so comfortable, that they have many opportunities to walk away, become distracted by their usual activities, have siblings or other family/friends who may interrupt therapy, etc. Daycares in particular tend to be loud, and speech sessions attract lots of other kids wanting to participate! Adorable, sure, but not necessarily productive for your child’s needs. It can be difficult for the therapist to take control of the child’s environment, resulting in less than productive sessions.


· Frequency/duration: In EI, you are very much limited to session time/duration. In my experience, it almost didn’t matter the child’s needs. Due to the parent/caregiver training model, children only received therapy 1x/week for 60 minutes. This was because the parent was expected to learn how to work with their child, therefore able to provide “therapy” seven days a week. I often had to fight with service coordinators to increase services when a 1x/week session was not enough to teach and model strategies needed for a more complex child.


· Limitations: This piggy backs along with the model of EI. Due the parent coaching, therapists are limited in treatment strategies for their clients. Let’s say a child could benefit from PROMPT, feeding protocols, or even a specific diagnosis, this is not always permitted, if at all. I was never allowed to specifically comment on my areas of specialties such as PROMPT, Childhood Apraxia of Speech, etc. That was left for the private/medical model, not EI.


So…to answer the question why private speech could be a good supplement to EI:


· The ability to choose frequency and duration based on what your child needs not what s/he is allowed.

· The ability to find a specialized therapist

· Obtain diagnoses if appropriate

· Receive direct treatment in addition to at-home strategies

· Therapy is in a controlled environment where child may be more likely to participate; less distractions


I write this post based on my experience only and in no way mean to dissuade families from utilizing EI services. I have seen EI work beautifully! I have also experienced the challenges and frustrations first hand. It’s always important IMO to know the facts about all options, and I find it my responsibility to be a part of the conversation.


More questions about private speech therapy? Is it right for your child? Get in touch!

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