Outpatient vs School Speech Therapy- What’s the Difference?

School speech therapy services differ from outpatient/private services in several important ways. We often get the question “what’s the difference between school speech therapy and clinic speech therapy?” Let’s break it down.


A big difference between school-based speech therapy and outpatient/private speech therapy is eligibility (how the child qualifies for services). In the school setting, speech services are provided if the child’s difficulty with speech and/or language is impacting his/her access to the educational curriculum and/or function appropriately at school. These guidelines are part of federal law called The Individuals with Disabilities Education Act (IDEA).


Schools must provide the following in order to qualify a child for school based speech services:

  • Demonstrate the child has a disability (within one of the disability categories defined by the state)

  • Provide documentation proving how the disability is negatively impacting the child’s performance in the school setting.

  • Support the notion that the child requires “specially designed instruction” to address the difficulties in speech and language and help the child access the school curriculum

Due to these federal guidelines, a child may demonstrate difficulties in speech and language (including feeding skills) but may not qualify for school based services if the school cannot provide significant proof of negative impact on the child’s school performance.

In an outpatient/private setting, a speech therapy evaluation can be initiated when there is concern about any aspect of a child’s communication development. Following the evaluation, therapy services can be recommended if the results indicate a disorder or delay that is below age-level expectations and is impacting the child’s daily life.


One benefit of outpatient/private speech therapy is that services can be recommended before the impairment has progressed to the more severe level that is often required to qualify for school services. Accessing outpatient/private services earlier (rather than the ‘wait and see’) can reduce the social-emotional impact of communication difficulties and may reduce the overall time required to remediate the concerns.

Another question we hear is “can my child get both school and clinic speech therapy?”. The simple answer- yes!. Following an evaluation, if speech therapy services are recommended, the child can receive both outpatient and school based services. As explained earlier in this post, school based services will focus on the impact the child’s speech and language difficulties have on the curriculum and in the school setting. Outpatient/private speech therapy typically focuses more on the child’s daily life and therefore will incorporate other aspects of the child’s daily life into speech therapy goals.



Blog written by: Mazal Karan, MS, SLP-CF



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