Invidual Speech Therapy vs. Group Speech Therapy?

Dear Nicole–
My son has been receiving speech and language therapy for about a year now (he is four years old) and his therapist just told me that she thinks he would benefit from group speech therapy–I guess my question to you is–How can his therapist work on my son’s goals while working on the other child’s goals too?  And…do you think individual therapy is always better?  I just don’t want to waste his time–his schedule is so packed and I want to make sure we are getting the biggest bang for our buck–we are paying out of pocket for his therapy and it really adds up per month.  I also expected that group therapy would be cheaper and it’s not!  Any insights would be really helpful…..

Hi Alli,
Thank you for your question.  I know paying for private speech therapy can be very expensive..have you looked into getting reimbursed from your insurance company?  Many insurance companies will reimburse for either a set number of sessions within a specified time period–i.e., 30 therapy sessions every three months, or they will reimburse a percentage of the bill–i.e., 80% of the charge.  Your speech therapist will have to code her bills appropriately and write supporting documentation; you will have to expect to make a few annoying calls to your insurance company–but the benefits far outweigh the time commitment and stress (remember, insurance companies do not want to part with any money–sooo..don’t let their antics get you down.)   If insurance reimbursement isn’t an option, you could look into your state’s early intervention program.  Again, it is a process to get your child enrolled–but if they qualify, the benefit is free therapy.  If all else fails, you can always ask your therapist if she can give you a discount–the worst she can say is “no”.

Now–to get to the meat of your question.  Group therapy can be a very important part of your child’s therapeutic intervention and it is recommended for a number of reasons.   Many times when a child is learning new speech sounds or linguistic concepts, they are typically mastered within the realm of the therapy room first–then the challenge becomes “generalizing” these outcomes outside of therapy–so, once your child can produce a perfect “r” during therapy, your therapist will make sure you are aware of his progress and request follow through at home–once the child can say the sound perfectly across different places (home, school-etc) and with different people (mom, sibling, teacher-etc.) the sound is considered generalized and subsequently mastered.  Many times a child will perform beautifully within the confines of the therapy room, but as soon as a care giver is invited into the room, or the child is taken outside of the therapy room, they exhibit difficulty.  To help the child generalize this newly learned skill, your child’s speech language pathologist will recommend group therapy–this way she can work on generalizing these skills and facilitate mastery.

The main reason group therapy is recommended is to target pragmatic language or the “social”  language we partake in every day.  Successful communication takes mastery of the subtleties of interactive language–i.e., how to appropriately initiate conversation, “Hi Nicole, how was your weekend?”, terminate a conversation, “It was great talking to you, I will see you again tomorrow!” and maintain a topic of conversation.  Many times a child is willing and eager to communicate but he doesn’t understand the “rules’ and communication becomes strained and ultimately breaks down.  Forging successful friendships and relationships with others can be very very difficult for the child who has pragmatic language difficulties. 

Some children receiving speech therapy will be given what is known as a “mixed mandate”–where both individual and group therapy is recommended, i.e., twice per week the child will receive individual therapy and once per week–group therapy.  I know it may seem like the group therapy should be cheaper because there are 2-3 other kiddies getting therapy as well–but the reality is your therapist is working much harder to facilitate a group session-and setting up a group (which can take time) in which the children will complement each other is not an easy feat.  Likewise, making sure each childs’ goals are targeted within each session takes more than skill and dedication–it takes a lot of planning. 

So–if your child’s Speech Language Pathologist is recommending group therapy and all along you have trusted her with your child’s care–follow through on her recommendation–your child will become a better communicator and this will, in turn, increase their self esteem and help them maintain conversation(s) and develop long lasting friendships.