In case you missed it: It’s Not the Years of Experience, It’s the Type of Experience That Matters!

A few weeks ago I guest posted on Scanlon Speech Blog regarding which areas parents should focus on when selecting the right speech language pathologist for their child. In case you missed it here’s my take of what criteria does matter when it comes to clinician selection.

I have to admit that this post was actually indirectly inspired by a casual question from my mother.  I was shopping around for a new family doctor and when I found one, the first thing my mom asked me was: “How many years of experience does he have?” That got me thinking about how often I hear this question from parents of the children that I serve.  And the answer is quite often. But let us deconstruct this question for a minute. Is it truly reflective of what the parents want to know? The parents are of course inquiring about how experienced is the practitioner in treating their child. But will the answer they receive correlate with the appropriateness of care?

The answer is of course a resounding: “No”! And that is because this question is phrased incorrectly. There are many wonderfully qualified speech language pathologists out there and even though many of them have eons of experience in our field, not all of them are alike in their areas of specialization.

Take myself for example. I specialize in working with multicultural adopted and non-adopted language impaired children with severe behavior difficulties.   If a child has alcohol related deficits, psychiatric impairment, or social pragmatic language deficits, I am your SLP. However, if parents of an internationally adopted child call me asking to assess their child’s swallowing difficulties, or determine what AAC device is best suited for them, you can be sure that I will be referring them to relevant professionals, since swallowing and AAC are not my areas of specialty.

While it is true that selecting the right SLP is often quite difficult, parents can use the simple guidelines below to narrow down their therapist selection.

Let’s begin with basic professional credentials. A speech language pathologist must have a Master’s Degree (MA), or its equivalent, from a reputable academic institution of higher learning.

They must also have a Certificate of Clinical Competence (CCCs) from the American Speech Language Hearing Association (ASHA) as well as an SLP license from each state in which they practice. So even though an SLP with a NJ license may live in the tri-state area (NY, NJ, and PA), unless they have a license from the other two states (NY and PA) as well, they can only practice in NJ.

Additionally, if a parent is looking for a bilingual evaluation/therapy for their child, having an SLP simply speaking the child’s language is not sufficient. It is highly recommended that they find an SLP with bilingual training/certification in the treatment of bilingual/multicultural children. Such certification indicates that the SLP has completed the necessary academic coursework and is proficient in the issues surrounding normal and disordered speech-language acquisition of bilingual children in dual languages.

Now let’s discuss ‘experience’. Here it gets a little tricky. Saying: “I want the therapist with a gazillion years of experience” is just not going to be all that useful for kids requiring specialized speech-language services. It can’t be just any experience; it has to be the right experience! After all do you really want a therapist with 30 years of school-based experience when you have a two year old non-speaking toddler who needs an SLP specializing in early intervention?

Similarly, just because an SLP has 25 years specializing in articulation disorders may not mean that they have received specialized training in treating children with Childhood Apraxia of Speech (CAS).

Thus, when choosing the right therapist total years of experience may not be as important as the quality of that experience. Hence it’s a good idea to inquire first about the SLPs areas of specialization and then about their years of experience in those specialized areas in order to find out how long have they been successfully treating children with similar speech-language issues to your child’s.

Another important aspect to choosing the SLP is finding out how up-to-date they are on current treatment methodologies as well as whether these methodologies are based on the latest evidence based practice and not on limitedly researched – little known techniques.

Professional development is hugely important in our field. To maintain state licensure and national certification all SLPs are required to take professional education courses in order to stay up to date with all the relevant research and new treatments developed in our field. ASHA minimally requires SLPs to accumulate 30 professional education hours every 3 years by attending courses in person, taking them online through qualified providers, or by conducting workshops and presenting at conferences.

Professional development provides SLPs with an opportunity to use evidence based techniques supported and tested by research to treat a variety of communication based disorders. Consequently, when selecting your therapist it is important to find out just how up to date are they on the current treatment methods and methodologies pertaining to your child speech and language deficits. You can always find out this information by politely questioning the therapist regarding their background and “resume highlights.”

When choosing a therapist it is also very important to ensure that you understand and agree with the therapist’s methods and approaches. For example, if your child is diagnosed with CAS or severe phonological speech difficulties does it make sense for him/her to spend session time on performing non-speech based oral motor exercises such blowing horns, puckering lips, moving tongue from side to side, etc without producing any ACTUAL speech sounds (the goal of speech production).  Similarly, if your child is a toddler, it probably does not make sense for him/her to spend most sessions doing worksheets and drills when he/she needs to be engaged in play based, child centered therapy.

Don’t be intimidated by the therapist’s credentials and your lack of knowledge, if something they said doesn’t make sense. Feel free to ask follow up questions, look up pertinent information online, or consult with other parents and professionals. While you should not use the internet to diagnose your child’s problems, it can be used as a valuable learning tool to look up information and to share ideas with other parents who experience similar difficulties.

Now that we have specified general selection criteria, let’s talk about how to initiate your search for the right SLP. The best way is again to go online. Start your search by going to the ASHA website and clicking on the ‘Find Professional Button’ located in the top of the page and then follow the instructions on the screen. Fill out your search criteria carefully but don’t be too specific. For example, if you live in a really small town, try looking up an SLP in your state capital or the entire state for that matter but don’t forget to specify the language of the practitioner if that is relevant to your query.

Once you have located several candidates, you can narrow down the search by trying to learn something about them online. ‘Google’ the clinician’s name or the name of their practice to see whether they have a website.  Find out if they have written any articles, maintain a blog or have been profiled by any organizations.  See if their practice is on Facebook or join local parent forums to see if any parents in your area have heard anything about their professional reputation.

To make sure that your practitioner’s licensure is up to date, visit your state’s speech language accreditation website and type in the last name of the professional. Typically, a window will pop up listing the therapists’ names alphabetically, find the one you are looking for and check if their license is active. Finally, armed with your research, create a list of questions that you might have for the practitioners and start making phone calls. Find out all the pertinent information and don’t forget to ask about rates which may differ depending on what services the practitioner is providing.

Please note that many private practitioners do not accept insurance due to the hassle of multi-client billing as well as extended wait for reimbursement. They may instead provide you with a letter for your insurance company, containing the necessary diagnosis and treatment codes, incurred fees as well as a brief description of services provided, and will expect you to apply for reimbursement on your own.

Furthermore, parents should not automatically assume that the cheapest therapist they find in the area is the best therapist to go with. There are a number of factors which go into establishing assessment and therapy fees.  When comparing rates, its ok for parents to ask all practitioners regarding the breakdown of their fees (e.g., assessment cost) as well as what type of work/services do the fees cover, prior to making a decision regarding which practitioner to go with.  After all, there are certainly plenty of times when a significant difference in price also translates into a significant difference in quality.    Hence, there are occasions when it might be worth to pay more to get more especially when it comes to comprehensive assessments establishing the direction of care for the child.

While finding the right SLP for your child may require some time, effort, and preparation on your part, s/he may be just a few keyboard clicks away. So Happy Searching!

 Useful websites:

• Find a Professional SLP on the ASHA website: http://www.asha.org/proserv/
• State Contacts & Licensure Requirements: http://www.asha.org/advocacy/state/
• Universities and Multicultural/Bilingual Emphasis Programs http://www.asha.org/practice/multicultural/opportunities/hbi.htm