Thursday, August 25, 2016

Guest Post- 5 Ways to Get Free or Affordable Speech Therapy


It's Therapy Thursday! This is the day I share something based upon my experience as a pediatric speech-language pathologist and a mother of a child with special needs. Today, I am bringing you a guest writer who will share something new.

Lisa Geng, who writes over at http://pursuitofresearch.org/ has a great tip for you today:

5 Ways to Get Free or Affordable Speech Therapy

By: Lisa Geng
Perhaps your child is a late talker without a diagnosis and you are looking for a bit of help.  Or perhaps your child was just diagnosed with apraxia and you are searching for a lot of help.  Either way navigating how to secure appropriate therapies can be a daunting task.  Below are 5 ways to secure free or affordable speech therapy.

1. Early Intervention

In the US you don’t have to wait for your pediatrician to refer you for an evaluation for services through Early Intervention  if you have a concern about your child’s development in the following areas -call.

  • Hearing
  • Cognitive development
  • Speech
  • Social-Emotional development
  • Language
  • Self-help skills

If your child is 3 years old and qualified they’ll get something called an IEP to attend your town school’s special needs preschool program.  For speech therapy and related services check this speech therapy matrix which goes by severity to see approximately how much therapy your child should be entitled to.  Even though securing appropriate therapy through the school is your child’s federal right, it may not be easy and you may want to use outside the school professional evaluations to help you advocate.  Which brings us to:

2. Insurance

While your child is legally only entitled to appropriate therapy through the school IEP, privately you can seek the best.  And why not seek the best?  Don’t choose your child’s professionals as you do your sports teams and only go to those within a certain radius of your home.  If you have to drive a bit further to find someone amazing for at least a definitive diagnosis, and to help oversee therapy, help in setting short as well as long term goals for the IEP, and help monitor progress, it’s highly recommended.

Main thing to remember is don’t just take “no” for an answer when looking to secure insurance for speech and occupational therapy, as well and other related services for your child.   For insurance it’s all about the coding used.  Make sure you don’t have a diagnosis with the word “developmental” or “childhood” in it as that implies the condition is one that the child will outgrow on their own without therapy and will be denied.  For example apraxia is a motor planning disorder, and there are various neurological codes to help secure coverage for that.

If autism or apraxia is suspected or diagnosed by an SLP you’ll want to confirm or rule out global soft signs of hypotonia, motor deficits, and/or sensory processing disorder with either a pediatric neurologist or developmental pediatrician.

Some codes are red flags for denials. A great code to use if you have a child with apraxia is 781.3 which is “lack of muscle coordination /coordination disorder.” This shows a physical diagnosis, which is typically covered, versus a developmental diagnosis, which is typically not covered.

-If there is an associated expressive language disorder with the apraxia, which is commonly the case, use #784.6 which is “other symbolic dysfunction.”

If #315.3, 315.31, 315.39, or 315.9 are used, these are developmental codes and may not be reimbursed.

Note: In the ICD 9 medical code book, #315.4 is Dyspraxia Syndrome. The confusion is that is that many of the #315 codes are developmental, but not this one.

The code for apraxia is under ICD-9 Codes. Insurance Code Website

-Oral/verbal apraxia is a neurologic disorder so never use the word developmental (admin note: or childhood/CAS) or a code that is “developmental” in the report or on the bill.
-Useful ICD codes for Apraxia of Speech are #315.40, #784.69, #781.3. The latter code is also one used for Hypotonia, Sensorimotor Integraton Disorder, and Coordinaton disorder, which may be associated with apraxia of speech.

“apraxia, acalculia, agnosia, agraphia” is 784.69. Generally, codes in the 700 series are used for organic disorders. You should have neurological information supporting use of this code/diagnosis and should be able to answer the following questions:

  • Is there a statement from a neurologist or pediatrician supporting a neurological component?
  • How is this child’s verbal apraxia different from an articulation disorder?

For more insurance tips and sample letters for your child’s professionals as well as for the insurance company visit this page.




3. University Speech and Hearing Clinics

Check Google to see if there are any universities near you that have a speech and hearing department.  Through them you can typically get free or very low cost therapy provided by a graduate student overseen by the PhD that runs the department.  

4. Sponsorship

There may be an ELKs or similar organization near you that sponsors special needs children.  My son for example was sponsored by the ELKs in NJ for both speech and occupational therapy.  According to the Elks “Nationally and locally, the Elks have worked diligently to better the lives of handicapped youngsters. The Order has a long history of supporting Special Olympics events, donating special equipment and supplies to the families of disabled children, sponsoring the treatment and research of many illnesses that affect children, and arranging for medical personnel to provide free in-home therapy services.”  Check to see if there are any sponsorship opportunities for your child.

5. Placing An Ad

This one may seem risky, however it was shared at one of the Cherab support groups as a highly successful way of securing inexpensive appropriate therapy.  The mom placed an ad looking for an SLP for her child and asked for references and resumes and was shocked at both the amount and the quality of the SLPs that responded to her local ad.  Of course not all areas of the country or world may have the same response level, but may be worth a shot.

The mom wrote

“THERAPY idea for all of you parents!!!
I know a lot of you are stuck without ANY help from social security, Medicaid, etc and are paying out of pocket, or HUGE copays for therapy … WELL…
I posted a job offer on indeed.com asking for a private therapist, and I offered 30$ for 30 mins or 60$ an hour for therapy sessions a few days a week (right now, I am paying 100$ a week for TWO sessions that are 30 mins long… ugh)
Anyway, within a week, 2 people responded. I have hired one of them. She is AWESOME and the GREAT thing is, she is going to come TO my home…
So feeding therapy with vomiting doesn’t have to happen at an office! WOOOOOOT!
A lot of these therapists are really wanting to be private contractors… they just don’t have enough people to start. Just wanted to share this info.
(By the way, my daughter is too old for Early Intervention and she is already in a pre-k class, special education at school. just FYI)“

~~~~~~~

Lisa Geng

Author and Executive Director at The Cherab Foundation

Lisa Geng got her start as a designer, patented inventor,and creator in the fashion, toy, and film industries, but after the early diagnosis of her young children she entered the world of nonprofit, pilot studies, and advocacy. As the mother of two “late talkers,” she is the founder and president of the nonprofit CHERAB Foundation,co-author of the acclaimed book, The Late Talker, (St Martin’s Press 2003), and is instrumental in the development of IQed, a whole food nutrition meal replacement. Lisacurrently serves as a parent advocate on an AAN board for vaccines, and is a member of CUE through Cochrane US. Lisa is currently working on a second book, The Late Talker Grows Up and serves as a Late Talkers, Silent Voices executive producer. She lives on the Treasure Coast of Florida.


***This post originally appeared here.  Reposted with the author's permission.***

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