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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.


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