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.***

Therapy Tip: Time for More Therapy??

Welcome to Therapy Thursday- the day I give a tip based upon my experience as a pediatric speech-language pathologist and a mother of a child with special needs. Today's tip is:

Private Therapy: To Do or Not to Do??

One question that many parents of children with special needs often ask themselves is: Should I get extra therapy for my child outside of the school therapy program? I have asked myself this question many times over the past several years.

There are many factors to consider when thinking about obtaining therapy from a speech-language pathologist, occupational therapist, or physical therapy in private practice, at a clinic, or in a hospital setting.

Why are you wanting private therapy??
First, as a parent, you have to understand why you want private therapy for your child. Is it because your child has a diagnosis that warrants extra time in therapy? Do you want your child to learn something specific? Is there a problem with therapy from the school?

I have put Jaycee in private therapy at different times in the past few years for a few reasons. The first time Jaycee had private therapy was at 3 years old because she was not feeding herself. I sought out an occupational therapist with experience with Down syndrome with hope to attain the specific skill of self-feeding. I really wanted her to become independent at meals. There have been other times I've gotten Jaycee private therapy because she was recovering from an illness and not attending school. Private therapy replaced school therapy until she started school again. I have also sought out private therapy for issues that the school therapist didn't seem to understand how to address. After the evaluations, I shared the reports with the school, so they could address the problems. In other words, I used private therapy to get someone's expertise in a particular area.

It is really important to understand why you want private therapy and what you hope the outcome will be. When you answer this question, that will help you determine if private therapy will be done short term or a long term undefined amount of time. Three of my private therapy experiences have been short term (around 3 months). But, once I had Jaycee in a long term, undefined therapy situation that lasted over a year. For me, I will never do the long term thing again!

Here's some things to consider:

Pros of private therapy
-Private therapy is almost always a one-on-one session.
-Typically, sessions are 45 minutes to an hour, so private therapy may mean more time in session compared to sessions at the school.
-In private therapy, you will most likely have more of a say on what is being addressed. If there is a particular skill that is important to you, you can ask that therapy address it.
-Because you are taking your child to and from private therapy, you often have more opportunities to speak directly to the therapist, ask questions, and get feedback on how your child is doing.
-If your child has had the same therapist at the school for a number of years, private therapy allows you to get another person's professional opinion. Sometimes, change is good and finding a person with a fresh perspective may make a difference.
-You might find someone with a speciality that isn't available at the school. Sometimes, you don't always have a choice of therapist when it comes to who works with your child at the school. But that isn't the case with private therapy. You can research therapists, find out if anyone has experience with your child's condition, and possibly find someone who has been trained in approaches that interest you.


Cons of private therapy
-Private therapist does NOT always equal better. Sometimes parents think a school therapist isn't as "good" as a private therapist. The truth is that every therapist is unique with their own treatment approaches and experiences guiding them. One is not better than the other. So, don't automatically assume the private therapist is going to be a magic worker. Do your research on the therapist's experience before starting therapy! There are good and bad therapist everywhere!
-Private therapy will most likely bill your insurance or medical card, which can evoke major headaches! So, you will need to do your homework to find out what your insurance covers and if there is a cap on the number of visits a year your child can receive. For instance, some plans will allow 25 visits per year. You will need to know this information and keep track of the number of sessions so you don't go over. Don't assume the private therapist will keep accurate records of this. If your insurance has a cap on the number of visits per year, I recommend you use those visits over the summer when the school may not be providing therapy.
-Private therapy can be very expensive. If you have insurance co-pays or if your insurance doesn't cover the therapy, you may be stuck with an expensive bill. I have personally seen charges for $100-250 per session, so that can add up very quickly if you are paying for it!
-Burnout happens! You do not want to burn your child out of therapy especially if you are paying for it! If your child is going to school, receiving therapy at school, or involved in other activities, private therapy could be too much. I found that private therapy after school was totally pointless for Jaycee because she was so tired. Sometimes, the private therapy in addition to my job and home responsibilities was just too much for me, so I got burned out first.

In the end.....
There are reasons why private therapy may be a good idea. But, it is not for every child and every family. It is a difficult decision to make, especially if you are really concerned with your child's development. I personally always recommend that a child receives therapy from the school since your tax dollars are paying for it. And if you decide to add extra therapy on, I think it's important to understand why you are choosing private therapy for your child, what you hope to get out of it, and how it will affect your family. That will help you determine if the therapy is a success or not.

How Toddlers & Tiaras Changed My Life

I admit it. I have watched the show Toddlers and Tiaras on TLC long ago when I couldn't find anything else to watch on television. If you haven't seen the show, it features toddler and preschool age children doing beauty pageants. Moms are a big part of the show demonstrating how they prepare the child for the contests.

The money and energy the moms spent on these children! Living rooms were transformed into practice stages as the moms coached their children for the big day. I was surprised when I watched mothers give their small children sugar and soda so their tired child could have energy on the stage to perform. I shook my head when moms said their children loved the pageants and the pageants were teaching them valuable life skills when clearly the pageants seemed to fulfill something in the mother too. And if the child didn't place well in the competition or made a mistake, then the mom was mad.

As I watch the small children getting spray tans, putting in false teeth, getting beauty treatments, and other madness I declared, "Even if I did have a child who could do pageants, I would never subject them to such a thing!!"

And then it happened...a God moment....when you learn something about yourself out of no where. I felt God tell me that I was indeed that parent.

"How?" I asked. Jaycee isn't in pageants or any kind of competitions.

Then clarity: Many times, I have subjected Jaycee to private therapy for additional physical or occupational therapy to address her delays related to her Down syndrome and low muscle. I told myself it was for Jaycee's betterment. But, it could be argued that it was for my benefit too. Let's face it, if she learned a new skill it would ultimately help me as well. For instance, one year I took her to private occupational therapy for months driving an hour one way so my 3 year old could learn to feed herself. Her fine motor skills were a struggle. Feeding herself would be good for her but I could also finally eat with Jaycee at the same time.

There were things Jaycee liked in private therapy but there were certainly things she didn't like. If she had a good day in therapy, I bragged on her. If it was a struggle, I would sometimes get mad that I had wasted time and money for her to do this all for nothing. Yikes! Maybe I wasn't a pageant mom but instead I was a crazy therapy mom!

I would practice the assigned therapy homework with Jaycee during the week cluttering my house with balls, a trampoline, and other equipment. I begged her to do these exercises and drove us both crazy as I tried to motivate her to do things that would help improve her life. Gosh! I was the person I said I wouldn't be!

What a reality check from this reality show!

The past few years I have looked at possible extracurricular activities through these questions:
-Will Jaycee truly enjoy it?
-What is my motivation for doing this?
-What this bring joy or stress to our relationship?

In the end, this show reminded me of the mom I wanted to be.

Private Therapy: To Do or Not To Do

One question that many parents of children with special needs often ask themselves is: Should I get extra therapy for my child outside of the school therapy program? I have asked myself this question several times over the past several years.

There are many factors to consider when thinking about obtaining therapy from a speech-language pathologist, occupational therapist, or physical therapy in private practice, at a clinic, or in a hospital setting. (Keep in mind, I'm writing this as a mom and a speech-language pathologist.)

Why are you wanting private therapy??
First, as a parent, you have to understand why you want private therapy for your child. Is it because your child has a diagnosis that warrants extra time in therapy? Do you want your child to learn something specific? Is there a problem with therapy from the school?

I have put Jaycee in private therapy at different times in the past few years for a few reasons. The first time Jaycee had private therapy was at 3 years old because she was not feeding herself. I sought out an occupational therapist with experience with Down syndrome with hope to attain the specific skill of self-feeding. I really wanted her to become independent at meals. There have been other times I've gotten Jaycee private therapy because she was recovering from an illness and not attending school. Private therapy replaced school therapy until she started school again. I have also sought out private therapy for issues that the school therapist didn't seem to understand how to address. After the evaluations, I shared the reports with the school, so they could address the problems. In other words, I used private therapy to get someone's expertise in a particular area.

It is really important to understand why you want private therapy and what you hope the outcome will be. When you answer this question, that will help you determine if private therapy will be done short term or a long term undefined amount of time. Three of my private therapy experiences have been short term (around 3 months). But, once I had Jaycee in a long term, undefined therapy situation that lasted over a year. For me, I will never do the long term thing again!

Here's some things to consider:

Pros of private therapy
-Private therapy is almost always a one-on-one session.
-Typically, sessions are 45 minutes to an hour, so private therapy may mean more time in session compared to sessions at the school.
-In private therapy, you will most likely have more of a say on what is being addressed. If there is a particular skill that is important to you, you can ask that therapy address it.
-Because you are taking your child to and from private therapy, you often have more opportunities to speak directly to the therapist, ask questions, and get feedback on how your child is doing.
-If your child has had the same therapist at the school for a number of years, private therapy allows you to get another person's professional opinion. Sometimes, change is good and finding a person with a fresh perspective may make a difference.
-You might find someone with a speciality that isn't available at the school. Sometimes, you don't always have a choice of therapist when it comes to who works with your child at the school. But that isn't the case with private therapy. You can research therapists, find out if anyone has experience with your child's condition, and possibly find someone who has been trained in approaches that interest you.


Cons of private therapy
-Private therapist does NOT always equal better. Sometimes parents think a school therapist isn't as "good" as a private therapist. The truth is that every therapist is unique with their own treatment approaches and experiences guiding them. One is not better than the other. So, don't automatically assume the private therapist is going to be a magic worker. Do your research on the therapist's experience before starting therapy! There are good and bad therapist everywhere!
-Private therapy will most likely bill your insurance or medical card, which can evoke major headaches! So, you will need to do your homework to find out what your insurance covers and if there is a cap on the number of visits a year your child can receive. For instance, some plans will allow 25 visits per year. You will need to know this information and keep track of the number of sessions so you don't go over. Don't assume the private therapist will keep accurate records of this. If your insurance has a cap on the number of visits per year, I recommend you use those visits over the summer when the school may not be providing therapy.
-Private therapy can be very expensive. If you have insurance co-pays or if your insurance doesn't cover the therapy, you may be stuck with an expensive bill. I have personally seen charges for $100-250 per session, so that can add up very quickly if you are paying for it!
-Burnout happens! You do not want to burn your child out of therapy especially if you are paying for it! If your child is going to school, receiving therapy at school, or involved in other activities, private therapy could be too much. I found that private therapy after school was totally pointless for Jaycee because she was so tired. Sometimes, the private therapy in addition to my job and home responsibilities was just too much for me, so I got burned out first.

In the end.....
there are reasons why private therapy may be a good idea. But, it is not for every child and every family. It is a difficult decision to make, especially if you are really concerned with your child's development. I personally always recommend that a child receives therapy from the school since your tax dollars are paying for it. And if you decide to add extra therapy on, I think it's important to understand why you are choosing private therapy for your child, what you hope to get out of it, and how it will affect your family. That will help you determine if the therapy is a success or not.