Selecting a Private Therapist for Your Child with Developmental Language Disorder

Family Corner
Written By Diana Miller

Written By:

Karla K. McGregor, Ph.D., CCC-SLP & Amy Tyler-Krings, M.A., CCC-SLP

Boys Town National Research Hospital

 

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In the United States, most children who receive treatment for developmental language disorder (DLD) do so in their public schools. They have Individualized Education Programs (IEPs) that include support under the category of speech/language impairment, specific learning disability, or both. Sometimes, caregivers wish to supplement school services because they view them as limited in amount or focus. Additionally, many children with DLD receive no services at school because they do not qualify under state or district guidelines. A child can have DLD but still be ineligible for an IEP in U.S. schools.

Here are some tips if you are seeking a speech-language pathologist (SLP) to assess or treat your child outside of the school setting.

Check credentials

To practice, an SLP must be licensed in the state(s) where they work. In most cases, this means a board has reviewed the person’s training and trustworthiness. In the U.S., most states require that a licensed SLP has a master’s degree (either M.A. or M.S.) in speech-language pathology. Some may have earned a Doctor of Speech-Language Pathology (SLP.D.) or a Doctor of Philosophy (Ph.D.) degree in the field of communication disorders. Most states also require completion of supervised clinical practice and passing a licensing exam, as well as a background check and completion of some state-specific training around protecting vulnerable populations. Maintaining licensure requires ongoing continuing education.

If you see the initials ‘CCC’ after a provider’s signature, it means that they have earned a Certificate of Clinical Competency by passing a national exam and completing a fellowship under the direction of a mentor. In all states except North Dakota and Hawaii, a licensed SLP will have earned or surpassed the equivalent of the CCC. ‘BCS-CL’ stands for board-certified specialist in child language. Board certification in child language is relatively rare; it requires extensive experience and expertise.

When choosing a therapist, make sure they have a master’s degree and a license to practice speech-language pathology.

Look in the right places

Outside of the school setting, you can find an SLP in private practice, an outpatient clinic associated with a hospital, or a university-affiliated clinic. University clinics are typically teaching programs. Graduate students who have not yet earned a master’s degree provide the services, but they are supervised and mentored by SLPs who are credentialed.

Find a provider who is a good fit for your child

SLPs are rarely generalists. Instead, they focus on a given age group and condition. To find someone who has the right expertise to help your child with DLD, you might ask:

  1. What is your area of expertise? Their answer will help you understand if the SLP has experience with children's language challenges.

  2. Can you share your training and experiences that are relevant to my child’s specific needs? For example, you might want to know if the SLP is experienced in addressing the reading problems that often accompany DLD. Or, if your child is multilingual, ask what languages the SLP speaks and whether they have worked with multilingual children.

  3. What can I expect from an evaluation? A quality evaluation does not rely on a single measure. It might include a combination of standardized tests, dynamic assessments, language samples, informal observations, and caregiver or school reports.

  4. How will we set goals for my child’s treatment? Goal setting is essential for tracking progress. Goals should be based on results from the evaluation as well as family and child priorities.

  5. What will my child’s therapy involve? Understanding the therapy process can help you support your child better.

  6. Can you describe your approach to caregiver involvement? Knowing how to reinforce therapy at home can enhance its effectiveness. Be cautious of a provider who does not allow for participation or observation.

  7. How is progress measured and shared? Clear metrics for progress can help you see the benefits of therapy.

  8. Can you provide references from other parents/caregivers? Hearing from other families can give you confidence in the SLP’s abilities.

Address practicalities

There is no quick solution for DLD, and long-term treatments are costly and time-consuming.

  1. Ask about insurance coverage, and if your child is eligible, ask whether the provider accepts Medicaid.

  2. Ask about schedules. You will want after-school or weekend appointments if your child is in school.

  3. Ask whether telehealth options are available. Telehealth will be especially important if you live far from a provider. Be aware that there are some restrictions on providing telehealth across state lines. If you are interviewing a potential SLP who lives in a different state, ask whether they are able to serve your child.

Watch for red flags

Here are some to consider:

  1. Unclear or unreasonable expectations: Be wary if the SLP makes unrealistic promises about the speed or extent of progress. Therapy takes time and effort.

  2. Poor communication skills: An SLP should be able to speak to evidence-based practices. If the SLP struggles to explain their methods, goals, or progress clearly, it might be a sign of poor practice.

  3. Lack of individualized treatment plans: Effective treatment plans should be tailored to each individual’s needs. Be cautious if the SLP recommends a one-size-fits-all approach or "program."

  4. Inadequate progress tracking: Good SLPs regularly track and communicate progress. Be cautious if there is no clear method for measuring improvement or if progress reports are vague.

  5. Unprofessional behavior: This includes being consistently late, unprepared, or dismissive of your concerns.

You should explore other options if you notice any of these red flags.

By selecting an SLP who possesses the right qualifications, addresses your child’s needs, fits the practicalities of your situation, and exhibits excellence and professionalism, you and your child can have an optimal therapeutic experience.

To locate providers who are board-certified in child language, visit Consumers - American Board of Child Language and Language Disorders.

Further reading: You might also benefit from these DLDandMe posts:

Diana Miller
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