So your child didn't qualify, now what?
How to Qualify for Speech at School
Getting services at school is not only convenient, it’s also free. To qualify for speech services there must be a significant delay which impacts their educational learning. Significant delay in California means the 7th percentile or below. In other words, if 100 children were lined up, this would be the person 7th from the last. If your child did not meet both of these criteria:
1. A significant delay (below 7th percentile)
AND
2. Which impacts their educational learning ,they will be found “ineligible” for speech services at school.
Where You Are Now
So maybe your child went through a screening or completed a full evaluation and was found not to be eligible for services through the school district. As a parent or caregiver, you know your child is falling behind, but now is classified as not behind “enough”. What does this mean for you if you’d like them to get speech, but aren’t sure how? Read below for options and a few tips.
Your Options Outside of School Speech
Visit your pediatrician for a referral (more for the insurance route)
Seek out an SLP in your area
1. Visit Your Pediatrician
Parents who would like a formal referral or need one to get services through their insurance may need to visit their pediatrician first.
Pro- The pediatrician can guide you to SLPs in your area with a specific referral and potentially identify those that are in-network with your insurance
Con- The visit creates another step between now and getting started with speech, which takes more time.
2. Find an SLP
Those who know insurance will not cover (any or part of) speech services, or who’d like to get started immediately, may choose to find an SLP by themselves.
Pro- This potentially reduces wait time between now and starting speech. You can find an SLP and set up an appointment for an evaluation as soon as possible. The SLP deals with speech and language concerns everyday. For this reason, they will likely be more familiar with the nitty gritty of developmental norms specific to speech and language.
Con- They may be out-of-network or not covered at all, creating an out-of-pocket expense.
Tip: Before Moving Forward, Call Them
Prior to starting, I’d recommend calling the SLP and your insurance company with the following questions:
Insurance
1. What is my deductible and what percentage of services are covered?
2. What diagnoses are covered?
3. What is my maximum number of sessions covered?
SLP or Speech Clinic
1. How much does a session cost? What about an evaluation?
2. Are you in-network with (your insurance)?
3. Do you accept HSA cards?
4. Do you send out Super Bills so that I can reimburse myself through insurance? (If they don’t bill your insurance directly)
Your Plan Forward
Call your insurance company to see what their process is, and what is covered
Visit your pediatrician for a referral or find a speech provider (SLP) via Google or talk with friends!
While the speech therapy process can be overwhelming and new, it’s essential to be proactive. Decide which plan is best for your family and go from there. And finally, give yourself a pat on the back for being attentive and listening to your gut.
If you aren’t sure if your child is behind or not, grab the 0-7 milestone guide here.