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Location, Location, Location

Updated: Dec 3, 2022


How to Choose Your Speech Language Pathologist (SLP): You Guessed it... Location

Part 2 in our ongoing series How to Choose Your SLP.


During the first installment of this series we talked about Setting, where we discussed Early Intervention (EI), school-based therapy, and private practice. For EI and schools, there is typically a predetermined location (e.g., EI will usually come to your home, while school-based therapy takes place, well, at school).


If you are pursuing therapy with a private practice, however, there is a lot more to consider in terms of location.


So, knowing this, let's look at some possibilities. Your child needs help, and you've decided to pursue speech therapy at a private practice. But...

  • You live outside of the city, an hour or more from the closest speech practice.

  • You're down the street from your nearest SLP, but getting the kids out of the house on time is impossible.

  • Your SLP has been traveling to you at your home, but your child is just too distracted and is running amuck every session.

  • Your child has been receiving speech therapy in the clinic and is doing great, but they aren't generalizing any of their skills to outside of sessions.

  • Your child communicates great with adults, but is struggling to communicate in school or on the playground with peers.

Finding the right location for speech therapy to take place is hugely important to a child's success. What works for one child might not work for another. A family might have different needs or capabilities based on where they live.


If you have a situation similar to the above, you might feel stuck - what can you do to make things work?


Read on for suggestions from us at Talk Time (based on my experience working across many different locations with patients and their families).


Find Your Fit


Not every SLP is the right fit for every family. And not every family is the right fit for every practice. But the right fit is crucial for your child to make progress in speech therapy.

Let's look at some of the factors to consider when choosing an SLP:

  • Setting

  • Location

  • Philosophy

  • Price

  • Knowledge

  • Communication

This post will walk you through the second of the six factors: LOCATION.


What Are Your Options?


Whether you already have an SLP or you're just starting the conversation with a new private practice, make sure to ask about your options. Every practice's capabilities and level of flexibility will be different. You want to make sure to find someone that is able to provide a good fit for your child and your family.


But in order to start that conversation, you need something to go off of. So let's take a look at some different location options that a private practice could potentially offer:

At the Clinic


Many private practices have a brick-and-mortar office space where you can meet your clinician for sessions. Usually these have a separate waiting room where you might be greeted by a receptionist. At your scheduled appointment time, your SLP will meet you and walk you to a private room where the session will take place.


Basically, it works the same as a pediatrician's office - except the sessions are hopefully more fun for your child!


Going to a clinic may be extra work for you depending on travel time, how difficult it is to get your child into the car, etc. But it can also be helpful for establishing a routine. Your child knows that it is time for speech. They travel to the clinic. They get excited to see their SLP and to pick out toys and games from the game closet. When it's time to leave, your SLP cleans up the mess.


The clinic can be a very peaceful, quiet place to conduct therapy. It is a controlled environment. This might be great for your child, because it allows them to focus on their work without distractions. But sometimes this can make it difficult for children to generalize their learned skills outside of the speech room. Make sure your SLP is working with you on a home program to encourage carryover of skills across environments.


Some clinics will have additional benefits. For example, if the private practice includes occupational therapists (OTs), there may be a shared gym area where sessions could take place. This would also give your SLP the opportunity to consult with OTs about your child's sensory and motor needs. A clinic also has the opportunity to offer group or dual sessions, which are especially handy if your child is working on communicating with peers. Plus, you'll get the chance to meet other parents whose children have needs similar to your own.


One thing to watch out for -- make sure that your clinician is inviting you back into the clinic room to give you regular updates on your child's treatment and progress. If your child is under 3, we would most likely recommend that you're present for the entire session. For older kids, you might be invited back for the last 5 minutes. Otherwise, you might be kept informed via email or phone calls. It can be difficult to have conversations in the waiting room, and this important time to check in with parents is often overlooked in the clinic setting.


Pros

  • Going to the clinic establishes routine.

  • There are lots of resources for treatment.

  • It is a quiet, controlled environment where it may be easier to focus.

  • Your SLP may have opportunities to consult with other therapists.

  • There is no clean up for you.

Cons

  • You have to travel to the clinic, which may or may not be difficult depending on location, travel time, traffic, etcetera.

  • It may be difficult for your child to generalize skills outside of the clinic environment.

  • Quality communication with parents can be overlooked.

In Home

Virtual

At School

Meet in the Middle

The Community

Which locations are possible totally depends on your SLP and/or private practice. Some SLPs may work strictly in the clinic or in home, while others might do a combination of everything (ahem, Talk Time).


The important thing is to know the possibilities and to ask about your options. Consider which locations work best for your child and your family -- logistically, financially, and personally.


Scenarios


These are all fictional scenarios to help you in your decision to understand what setting might be best for your child.


John

John is almost 3 years old. He has been receiving therapy in his home and making excellent progress with his speech therapist. His teachers recently expressed concerns that John wasn't accessing language at daycare. His parents are concerned that progress at home isn't translating to John's other environments.


John's parents discuss their concerns with their speech therapist. They decide as a team to start having therapy sessions in the daycare instead of at home. His speech therapist works to educate and train teachers as well as to generalize John's skills from home therapy over to the classroom environment so he can begin to use more expressive language with his peers.


Amy

Amy is an Autistic teenager who uses high-tech AAC as her primary means of communication. As she has gotten older, she began voicing her dislike of therapy activities during both clinic and home sessions. This is leading to low motivation, task refusal, and occasionally outbursts of frustration.


Amy's speech therapist opens up a conversation with Amy and her parents about how to make speech therapy work for her again. Amy discusses that she doesn't care about the goals they are working on, but mentions several other things she does want to practice -- like going to pick out a toy at a toy store or ordering food at a restaurant by herself. Now, Amy and her therapist have monthly sessions in the community where Amy can build her hands-on, functional communication skills using her AAC device.


Tanya

Tanya is a very busy 8 year old girl with a packed after-school schedule. She does not qualify for public school services, so her family is looked at private practices to help her work on her /r/ and /l/ sounds. Getting therapy is important to her and her family, but logistics seem impossible.


Tanya's family looks for a speech therapist who offers to provide therapy within their daughter's private school. Once a week, she gets pulled out of her classroom and works on her sounds with her therapist in the library. As Tanya improves and begins to generalize her sounds, her therapist decides to conduct therapy within the classroom setting!


Carmen

Carmen is a little 18 month old girl who is not meeting her communication milestones. Her family lives over an hour from the nearest clinic with availability and Early Intervention has not been a good match for their family. Her family want to do more to support Carmen's language but they aren't sure what to do.


Carmen's family finds a speech therapist skilled in virtual therapy and parent coaching. They have weekly 30 minute virtual sessions that are a combination of parent coaching and direct interaction with the child. This includes specific parent skills for the family to implement at home and the use of video modeling to provide concrete feedback on how parents are doing. Carmen's family feels empowered by all of the education they are receiving, and Carmen is beginning to use new words!


Marco

Marco is a five year old boy with a language delay. He lives in the heart of the city where traffic makes travel very difficult, especially during after school hours. Clinics with availability take too much time to get to and therapists with availability are outside of their area. Marco's family is searching for a solution.


Marco's family finds a therapist who offers flexible locations. Working with the therapist, they find a library that is halfway between the speech therapist's office and Marco's home. They use a study room as a Meet-Up Spot each week. And, as an added bonus, Marco sometimes pops out of the study room to work on using language at the library setting!


Wesley

Wesley is a ten year old Autistic boy with ADHD. He has some language delays and is easily distracted. Speech therapy at home has been difficult since Wesley has several siblings around and many distracting toys. Wesley's therapist is concerned that Wesley isn't making progress as fast as he could be.


Wesley's speech therapist has a conversation with his family, and they decide to try two different locations. Wesley has two sessions per week -- one session in the clinic and one session in home. The clinic sessions focus on teaching new, more challenging skills in a focused and quiet environment while the home sessions focus on generalization of learned skills and functional use of language in a more distracting environment.


Ready, Set, Talk Time



So let's see how Time Boston fits into the Location category.


At Talk Time Boston we are passionate about offering flexible options for every individual client's needs. We don't currently have a clinic space, but we do everything else -- I personally see children in all of the other locations each and every week. Further, we are always checking in with families and re-evaluating our clients needs, and are ready to switch up the location at a moment's notice.


Why Talk Time?

  • We know that there isn't just one solution, or one perfect location, for every family.

  • We do our best to make treatment accessible to everyone, regardless of distance or financial means.

  • We intimately know the pros and cons of each of these locations and will work to find the best one(s) for your child's treatment plan.

  • No matter the location, we make sure there is constant communication with caregivers to ensure carryover of skills outside of sessions.

  • We believe in making each and every location fun and meaningful for the kids.

WANT TO LEARN MORE?


Check out our services and our intake process on our website here.


And, if you think our private practice is the right fit for your family, please reach out to us:

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