As a speech therapist in private practice, I am privileged to see clients in many different settings. I have delivered speech services in homes, schools, daycare centers and in my own comfortable, cozy office in Morristown, NJ. Each setting has some advantages and disadvantages. As a therapist and parent, I’d like to share some thoughts with other parents who are considering the pros and cons of the various therapy settings for their child.
Convenience and Carryover: Certainly, it can be more convenient for your child to receive speech services in your home or at daycare or school. You don't have to worry about the logistics involved in driving to the therapist's office. Furthermore, it tends to be easier to carry over skills learned in an everyday natural environment.
It's also easier for most parents to participate in therapy sessions at their home. Many young children are comforted by a parent's presence, which also enables the parent to learn how to reinforce the lessons with their child when the therapist is gone. If parents do not want to participate because their child is older, they have other things to do, need to watch other children in the home or believe they may become a distraction to the child, they still can be within earshot of the room. At the therapist's office, the parent is either in the therapy room or a nearby waiting room. It's unlikely that the parent will be able to hear through the door. However, a parent can still be called in for some or part of the session.
Focus: Some children are more focused outside their home or daycare/school setting. It is harder for a child to "escape" to his or her room or the kitchen when in the therapist's office. On the other hand, some children initially may be distracted by the different setting and many toys at the therapist's office.
Siblings present at home also can become a distraction, depending on their age and interests. If siblings are present, I usually try to involve them in a session to help prevent them from distracting the client. In addition, by participating in the session, they can help their brother or sister practice when I am not around.
Materials for Therapy: When you come to the therapist's office, the therapist should have all the materials needed for that day's session at her fingertips. When the therapist comes to your home, she will bring whatever she anticipates needing for that day's session; however, if the session takes an unexpected turn, she may need to improvise, ask you for certain items such as foods, or do without such aids for that day.
Pull-out Versus After School: Children who receive speech services from a private therapist visiting them at school often need to be pulled out of class for therapy sessions. Therapists typically will work with teachers to schedule sessions during non-instruction periods. Regardless, some parents will not want their child to miss any lessons or other activities and would prefer to bring their child to the therapist's office outside of school hours.
Many therapists with young clients have office hours until the early evening and some over the weekend. For busy parents and students, however, an in-school session may be the only alternative.
So, speech at home, in school or in the therapist's office? There's no simple one answer to this question. This is a decision you will need to make based on your and your child’s needs.
Joanne Summer, MA, CCC-SLP, a speech-language pathologist based in Morristown, NJ, has helped hundreds of children improve their speech sound production and language skills. She founded Well Spoken Speech Therapy, LLC, in 2014 after spending 12 years providing therapy to children (K-5) in the New Jersey public school system. In private practice, her clients also include younger children and adolescents. In addition, she treats people of all ages who stutter or otherwise find it difficult to speak fluently—an area in which she has received extensive specialized training.