But I can't afford speech therapy!

As an SLP, I get asked questions about speech and language development time and time again from parents, friends and, many times, even strangers.  Unfortunately my advice tends to be the same regardless of situation:  when in doubt, get an assessment.  Often, I receive reluctance to follow through with this recommendation, but the truth is and assessment IS necessary. Allow me to explain.

Disorders and Delays are Complicated

Any speech, language, or even reading disorder/delay is highly complicated as there are number of underlying issues that could manifest itself as simple speech or language delays or the very ambiguous report of "difficulty with school work".  Unfortunately, I cannot diagnose your child or determine need for therapy services from a 10 minute conversation where symptoms are freely shared.  This is the reason comprehensive assessments are highly recommended as there is no other way to determine if a disorder or delay truly exists.

Response:

"But I don't have the money for this?" is often the response with the expectation that for some reason, I, or any other professional, should wave or discount our assessment/treatment fees.  Unfortunately, this cannot be done.  Allow me to further explain.

Comprehensive Assessments are Costly

A good comprehensive assessment of speech, language and literacy skills is costly for a number of reasons.  It takes time to assess all areas of communication (not just areas of concern) face-to-face with the child.  However, in addition to the assessment period or periods, depending on how long the assessment takes, time is spent scoring tests, analyzing the results, determining underlying deficits and writing the report.  A good comprehensive assessment, will not simply report test scores but will explain how those scores impact various communication areas.  The report will identify underlying disorders and diagnose the child appropriately.  This report, which takes several hours to write (even if a therapist uses a basic template they've created), will share clinical impressions and make recommendations which lend itself to the creation of an individualized treatment plan for your child.  This report is highly detailed and will provide much more to a parent than most medical reports, in which thousands of dollars are charged for very less time consuming procedures.

Response:

"Well maybe I'll just get a tutor. They aren't so expensive." is another fun response I tend to encounter.  It is of course, any parents right to decided what type of help they would like their children to receive but allow me to explain why a tutor won't close the gap for your child.

Closing the Gap, Takes Time AND Specialized Training

Here's the hard truth.  You get what you pay for.  If you pay a tutor, guess what you are going to get?  Tutoring.  That's it.  You'll get your child help with the subjects he/she is struggling with academically.  This will not close the gap because what your child requires is neurological development in the affected areas.  Only a trained professional knows how to facilitate neurological growth in these areas using evidenced based approaches.  Does a tutor know how to improve word retrieval skills so a student can retell a narrative in the classroom or for a book report?  Does a tutor know how to train compensatory strategies to aid in executive function skills to improve organization, initiation, and completion of academic tasks or projects?  Does a tutor know how to improve motor planning for correct production of speech sounds then teach the child how to use those speech sounds to blend and segment words in order to read and spell accurately?  The answer, I can assure you, is NO.  

So the next time you want to question the need for speech and language services, the next time you want to ask an SLP to discount their services, the next time you want to make an SLP feel as if their services are overrated, ask yourself:  Can my child afford to not get the right help?  Can my child go to college if he/she continues on this track?  Because I can assure you, if you do not get the correct treatment, anything else to try will be a band-aid and that wound, will only grow deeper and wider, affecting all areas of your child's development.  So...can your child afford that?