Accessing speech therapy
Hi, I have a question for parents who have accessed speech therapy services for their children. Basically--what path did you take to get them?
We have a three year old who is generally doing great, but is difficult to understand. Our pediatrician told us not to bother with trying to go through the school district for speech therapy-- huge hassle, long wait times, and in practice my child would be lower priority than kids with more significant needs and might not even get treated. (I'm sure this is somewhat different for kids who are actually in school, but our child is currently in preschool.) She recommended we go through insurance instead. Her office made a referral to a therapist at Sutter. We had an evaluation with them and the therapist said it would be best to start treatment asap, but she told me that they have a really long waitlist and recommended I find a private therapist who could get started sooner. So now I'm looking into private therapists understanding that they generally do not take insurance. Ok. But I just want to pause for a beat and ask if this is what other people have done too. Is speech therapy something you ended up paying for out of pocket? Is this my best option here, or are most people getting this service covered either by the district or by insurance? How big of a hassle have these things been, how long did you have to wait for services, and where/with whom? If you had to do it over would you do the same thing again? Thanks!
Parent Replies
It really depends on whether you have the money to spend for private, or the tenacity to advocate for public/insurance services. I feel sometimes it's either or, as it is not that easy to get free services especially if, as you say, your child's issues appear mild. I went through the same thing, my child had mild speech and language delays, insurance paid for only a few sessions, and every preschool teacher I talked to said his issues were so mild, public school probably wouldn't even consider referring for evaluation. In the end I decided to pay out of pocket for private speech therapy, which helped a lot. Looking back, I have no regrets, just wish I had started earlier.
There's another option you didn't mention... getting reimbursed by your health insurance plan for speech therapy you paid for out of pocket. We did that for my son. It was extra paperwork and kind of a pain in the butt, but well worth the thousands of dollars we saved. Maybe check with your insurance company about what they will cover and how to do that?
Hello, depending on your insurance provider you may be able to get out of network coverage by requesting a precertification for a specific provider (find the provider first). You can ask for this under network deficiency coverage since they are unable to provide someone in network. We have Aetna and have done this numerous times for various providers, especially therapists. You do pay out of pocket to the provider but then submit a claim and get reimbursed under the precert on file. They are usually approved for 12 months and then you have to call each year to request an extension of the approval. Yes a hassle, but completely worth it to get access to a good provider!
My son has been doing speech therapy since 3.5 years old and I always went through insurance. He has high-functioning autism so speech therapy is covered under the diagnosis of autism. I have Sutter Select EPO and I went on their website for in-network providers. At the time, there was only one provider available and they were in San Francisco. We were put on the 4-6 month waitlist and in about 2 months a spot opened up and he began receiving services. After about a year, they decided to exit him out since he reached 80% intelligibility. I then continued speech therapy through the school district which was once or twice a week for 30 minutes and free. This can only be done with an IEP so your child would have to get assessed by the school district and if determined to have a speech impairment than they would qualify. After leaving OUSD in 2nd grade, my son started at a public charter school which also implemented his IEP and he currently receives speech therapy with a vendor for the school and he sees her at her office as opposed to at school. He’s also been in group speech therapy which is basically social skills and he’s been doing that at Seven Bridges Therapy in Oakland since 2018. They also offer individual speech therapy and take insurance.
So if you are in the public school system you can request an assessment for your child for speech impairment and if they qualify you will have an IEP in which your child will get speech therapy during school hours. The length and frequency are determined during the IEP meeting. It is free and in our experience it wasn’t the best quality of speech therapy, but I felt like it was better than nothing. There are several speech therapists that take insurance. Check out the provider search on your insurance company’s website for speech therapy and get on the waitlists asap. Depending on your availability you could get in sooner than the anticipated timeframe.
Have you looked into https://rceb.org/? You can get a referral to them through your pediatrician, and there is a survey that checks for learning delays that triggers access to these resources. We got free speech therapy through this. Our child definitely had only very mild issues, but we went with the therapy since the docs recommended it. In our case, I'm not sure it was particularly useful, as it was over zoom, and my kid eventually caught up, but in-person might be different.
With my kid, we got speech therapy through the district when he was 4. It was the middle of the pandemic, so our timeline was a bit slower with a backlog. But the private speech therapist we were sent to by our pediatrician suggested going to the district because she had such a long wait-list. If you request an IEP evaluation the school district has a mandated timeline for evaluation to see if your kid qualifies. I believe it's 60 days. The only thing is that at this time of the year, summer break is about to start and that pauses the timeline. So, you would not be able to access services till the fall. In our case, our kid got two weeks of speech therapy before a summer break. It was weird.
All and all, I don't think that it would hurt to pursue multiple avenues and see where he's able to access services first. We've been happy with the quality of services our kid has gotten in his speech therapist through the district, so I wouldn't rule that out for you right now.
Hello! The information you got from your pediatrician about school district services is incorrect. The school district is required by law to serve kids starting at age 3. You would need to go through the assessment process which takes 60 days from when you sign consent for assessment. If your child qualifies, they would not be deprioritized based on the level of need. preschool students can access speech services no matter what school they attend. The school district does function on the school year calendar so you likely cannot get an assessment until Fall, but you can start the referral process now so that your child can start the assessment process as soon as the school year starts.
So, I have done all three- insurance, private, and working on public school. We started once a week with insurance (definitely a long wait) and that therapist said he should be getting more support but she didn't have space. So we started the public school process and are doing private 2ice a week (in addition to insurance) in the meantime.
Once you register for public school and ask for an evaluation, they legally have like a week to get back to you to schedule an initial parent interview, and the evaluation which should take place within 30 days. After that they will tell you what services you qualify for.
Basically, if your insurance will reimburse you for paying out of pocket for private- or you can afford full cost- that is a great place to start. Then I would recommend also staying on the insurance waitlist and begining the public school process.
My experience is with OUSD and it was positive. I asked for an assessment when my daughter was 4yo in private preschool. There is a required timeline in which they must provide an assessment and then the results and plan. We did it toward the end of the school year and in the Fall easily got services at the closest elementary school to us. They has offered 2 half hour sessions a week but only one worked out. It ended up being very helpful though and by January my daughter was graduated out of speech therapy.
I'm starting the process now for my son (3.5yo) and they called on a Tuesday and offered me a Friday assessment. I assume he'll be offered services in the Fall as well.
Good luck!