Speech Therapy What to Expect

Frequently asked questions

How should I schedule my first appointment?

Please see the Forms page for specific instructions

What should I expect at my child’s first appointment?

At the first appointment we familiarize ourselves with your priorities and what you and your child want to achieve. We may conduct an evaluation.

This might include standardized tests, parent interviews, communication sampling methods, reviews of records and any number of informal evaluation methods. If you have a recent speech and language evaluation within the past 6 months, we can use that along with the information we obtain from you to determine initial Treatment Plan and areas of need.

You remain with your child for the duration of the evaluation and during initial sessions.

A certified and licensed speech and language pathologist (SLP) will conduct a child and parent interview. During this time, we observe your child’s communication skills to determine what areas need to be addressed. It is helpful if you can share your opinions on the following:

  • Your child’s strengths and areas of need
  • What you have tried in the past
  • What has and hasn’t worked
  • Your child’s interests and what might best engage him in interaction
  • What helps your child feel comfortable in new environments

***If you are new to the therapy process, we will guide you through these questions to help you avoid information overload***

What happens next?

Following the initial evaluation and interview, you will work with your child’s SLP to determine the best plan for therapy including how often you come in with your child. We determine this together based on other schedules and your family dynamic and needs. There is no preset schedule recommendation. Weekly therapy is the norm but not the absolute and is not always warranted. A treatment plan will be developed over several sessions. Your input is valuable here because how your child communicates in his/her world is most important. Options include periodic consults, weekly therapy, monthly therapy, etc.

How do you handle billing?

We determine this prior to your first appointment. Please note that you are ultimately responsible for payment and we cannot guarantee what an insurance company will determine. We are providers for Premera Blue Cross and affiliates.

We courtesy bill most major insurance plans. Payment for plans other than Premera is due at the time of service.

We will invoice you for balances on a regular basis and rely on those to be paid in a timely manner. We can never guarantee an insurance company will pay for services. Individual insurers make final determination of therapy coverage when they receive the claim. Sometimes pre- authorization is required, and this may involve waiting to begin therapy.

We encourage you to contact your insurance company and familiarize yourself with your plan benefits. We can provide supporting documentation. When entering private speech therapy, it is necessary to be prepared to pay out of pocket.

Billing process. Speech therapy is billed as a “procedure”. One unit is 15 minutes or more. We bill primarily for face-to-face time only. Phone calls, emails, travel time, and site visits are not included. Site visits and meetings may incur additional charges.

We welcome special requests and can give you an estimate for the cost of travel (ex. to attend a meeting that is not in close proximity to us, to have an online meeting with your ABA team).

How long are speech therapy sessions?

The national average is 30 minutes. Most of our sessions are 45 minutes. Please remain on the premises or nearby in Juanita. Please return within 35 minutes.

What is my role as a parent/guardian in my child’s therapy?

We depend on parents and/or caretakers to be active and involved participants in the evaluation and therapy process and encourage attending together with your child. Therapy is a joint process where we collaborate with you and make recommendations for working speech and language goals into your everyday routine.

If you cannot be present it is advisable that we schedule periodic meetings with you. This can be on the phone or at one of our locations and sometimes your home.

We depend on parents and caregivers to give us feedback on what is or is not working, and what is happening with your child’s development. In most cases there are weekly changes. The communication between SLP and parents is most effective when we have regular contact and communication about your child’s specific speech and/or language goals.

For therapy to be maximally effective we need to exchange information on a regular basis.

Please ask questions. We want your child, family and caretakers to feel comfortable, competent and valued in our setting.

Letting us know what information you need helps up be effective. Darcy is often available to schedule periodic consults with you and your child to review current goals and objectives, and to provide ideas for local resources that may be a good adjunct to regular therapy.

We strive for therapy to be a dynamic process that evolves with time and changes as needs change.

What is “Relationship-based Therapy”?

Relationship therapy in regard to speech and language is based on the belief that we need a child to trust and connect with the people around them to facilitate interaction. Paramount to most is that the family-child relationship is the foundation of speech and language development. It encourages growth of "self" and mutual respect.

It is how effective communication occurs in most settings because relationships and communication are two sided, not one sided.

We use a combination of techniques and relationship-based strategies. The most well-known is used often in autism treatment but applies to any type of communication disorder and can be extended to any setting including interpersonal work settings to facilitate communication and other skills.

Relationship therapy includes looking for the child's "ideation", e.g., generating their own language ideas, problem solving and communicating in emotional language, etc. Your child's specific goals and objectives are embedded into the therapy at all times.

We consider the social and emotional states of a child in the development of speech and language skills, and dynamically adapt within therapy sessions to find common ground where we can communicate, work and gain new skills. In other words, we meet your child where they are at that day or at that moment.

With many children who have language disorders this is done on the floor, at a table, with movement and/or with play and interaction.

You can find more information on the most widely used model DIR/DIR-FCD (Developmental Individual Difference Relationship-Based Model) created by child psychiatrist Stanley Greenspan, M.D., and Serena Wieder, PhD. here https://www.autismspeaks.org/what-autism/treatment/floortime.

If my child has food rewards in ABA therapy elsewhere, will we use food upon request?

Rather than food rewards we have successfully used therapies which rely on social interaction and engagement. At PTC we can find something (ex. spin, play in water, scribble for five minutes, etc.) other than food to help a child to feel intrinsic reward and enjoyment for working hard.

We can integrate a healthy snack into the schedule and provide feeding therapy, but we do avoid use of food as a reinforcer for communicating or speaking. We respect that parents may seek that, and we are happy to refer you to a different setting.

If your child is accustomed to getting food rewards during therapy, they sometimes do not integrate easily into an environment without food reinforcers. We want you to find the therapy that best suits you. We do not believe that any environment or therapy is suited to every child.