Move Your Family, Keep Your Speech Services
I’ve gotten the following question from clients, friends and friends of friends numerous times over the course of my career:
“we are moving but can we still keep our speech services?”
The answer is actually not so simple. In a given year, almost 20% of Americans families will move, either locally, across state lines or internationally, according to the 2010 US Census. A good number of these families have children and, as I’ve said in previous blog posts, as many as 10% of the total pediatric population presents with a communication challenge. So, this is no trivial issue – it is a source of uncertainty and anxiety for potentially millions of families every year. I will focus on general steps for seamlessly retaining your speech services (i.e. with a minimal hiatus) for: 1) early intervention; 2) pre-school services; 3) school-age services. I will discuss both public and private options as well as considerations for easy, intra-city moves, inter-state moves as well as international moves. With this general information, I hope you, the parent of a child tackling his or her speech challenge, will be more empowered to get started finding a speech therapist as soon as possible whatever the location of your “greener pastures” may be.
Photo courtesy Orange County Archives
Speech Therapy in my Area
First, let me say, and this may be obvious, if you’re moving within the same municipality, there should be minimal to no interruption of services. However, if you live in a large city, like New York City — where I live and work, moving from the Upper West Side of Manhattan to Brooklyn, would almost definitely mean getting a new therapist. Even though, as the crow flies, it’s only a few miles from the Upper West Side to even right across the Brooklyn Bridge, speech therapy as a service is often a highly local experience, for both family and for the therapist. Even therapists who may travel quite widely within a geographical area have to be careful to keep cases clustered — they simply need to be time and travel-efficient. And families traveling to the SLP’s place of work should be careful not to burden themselves with too much lengthy and frequent travel. However, in these cases where you’re moving within the same city, it is really helpful to speak to your Early Intervention (EI) or Committee on Preschool Special Education (CPSE) coordinator about a month before your move to see if, in the best case scenario, you can have someone lined up as soon as you arrive at your new home. School-based services will only change if you change schools and in most cases, the Individualized Education Program (IEP) for our child would make him or her instantly eligible for services at the new school. For securing new private services, I would recommend Speech Buddies Connect, our fast-growing network of great private speech-language pathologists (SLPs) that can help you “connect” with a therapist well in advance of your move.
Moving within the State
Let’s assume that your move will not in fact be so local. And let’s start with early intervention (EI). As you likely already know, EI services require that a child be eligible for those services, based on the results of a standardized assessment. Moving within a state generally shouldn’t affect your child’s eligibility for services. It is possible the new municipality you’re moving to will have more or less stringent eligibility requirements and may therefore order a re-evaluation to determine eligibility. This would be somewhat more likely if you child has been in services for nearly six months, or the time that your child may be require to be either formally or informally re-evaluated. Generally speaking however, you should have minimal interruption in services as long as you inform your current Service Coordinator (SC). He or she will be able to help you get in touch with an SC in your new town or city. Also, it can’t hurt to do a little digging of your own via google and your state’s EI website. Here’s a list of EI programs across the US by state or territory. When you get in touch with someone, be sure to ask for a local contact. EI is actually administered at the local level so to get things moving as quickly as possible, make sure you have that local contact. And you need to talk to this local EI contact first. This person can refer your child’s case to a local EI agency who has a roster of SLPs who can staff your case. This is crucial: the local municipal contact is the “gatekeeper” here. You can’t find an SLP you like and hope to have this SLP assigned to your case; it really is more of a top-down situation in which the local EI Official Designee (OD) refers your case to this agency, which then finds your SLP.
If your child is currently in preschool services under CPSE, an in-state move should prove to have minimal impediments to a timely transition of the case to a new provider. As you know, CPSE is generally not provided by a staff SLP at your child’s school; just as often services take place in the home. So, CPSE is more like EI in terms of staffing dynamics. Because it can take some time to find a provider you feel is a good fit and whose schedule and geographical coverage area match yours, I again recommend getting this process started a least a few weeks before your move. Depending on the location, directly contacting a local SLP you hear good things about or that you can find on Speech Buddies Connect, can be a great place to start. In NYC, this is a bit more difficult as we have a rather opaque and odd system of assigning CPSE SLPs via approved agencies and independent contractors. But in many places, particularly in the middle of the school year, this can afford you some lead time to securing your SLP.
Moving from State to State
If you’re moving out of state, this list of EI programs is still a great place to start. It’s really important to understand that each state has different eligibility requirements as well as protocols for how these services are paid for. For example, in New York State, where I practice, EI services are 100% free to families, regardless of income level or disability; if your child qualifies, your services are free. In other states, there may be a co-payment due per session and/or your primary insurance company may be directly billed for services. In general, for out-of-state moves, expect to have to submit your child for re-evaluation. And again, the earlier you initiate this process with someone on the ground in your new city, the better your chances of a having a minimal gap in services. It goes without saying that an international move will be a totally different story. However, in most developed, G-20 countries, EI services are quite robust and more likely than in the US to be government-funded.
What about my IEP?
For those moving in-state, the Individuals with Disabilities Education Act (IDEA) stipulates that your new IEP must adopt your child’s current IEP or issue a new one; either way, services would continue throughout that school year. For out-of-state moves, your child’s IEP would have to honored until either a new evaluation is administered, if one is called for, or a new IEP is issued that would supersede the previous IEP. So, in theory, for both in-state and out-of-state moves your services could continue the day you arrive in your new location, provided that the necessary groundwork has been laid. So, again the earlier you can contact an administrative contact in your new school district (CPSE is organized around your home district), the better your chances of experiencing a minimal service gap. For international moves, generally speaking, services are strong for the preschool (age 3 to 5) age range. In some countries, you may have to weigh the prospect of a possibly lengthy waiting list versus getting those services immediately but having to shoulder most of, if not all, the financial burden.
School-Age Speech Services
When it comes to school-age services, if your child is receiving private speech therapy services, I can’t think of a better, more active and robust network of great SLPs than Speech Buddies Connect. The system allows you to see a comprehensive profile, verify credentials are areas of expertise, find out whether an SLP takes insurance, among other important things, as well as directly connect with those SLPs. However, if your child is receiving school-based services via an IEP, the process for finding a new SLP is much the same as that for CPSE, described in the previous paragraph. If you move within your state, services should continue without interruption; if you move to another state, you would be able to continue up until a new evaluation was requested and the older IEP was either cancelled or reissued. For both in-state and out-of-state moves. You would likely need to do minimal groundwork before the move as in the vast majority of cases, your child would simply work with whichever SLP was on staff at his or her school.
For international moves, I recommend you look more closely at how and where services are delivered. In the United States, kids tend to get their speech service either in their schools (via an IEP) or in a private clinic. In the UK, this may not be the case. Schools may not necessarily be the primary setting for intervention. So, I would suggest a country-specific search, particularly via that country’s website for its national health service. As I mentioned above, there can be substantial waiting lists on some of these countries. I’ve heard 6 months is a minimum reasonable expectation in Canada, the United Kingdom and Australia. So, depending on your family’s situation, private services may be he best route.
The bottom line here is that just as it’s often advantageous to intervene early to treat a speech or language disorder, it is often incredibly helpful to be early to the game in facilitating contact with those who will sign off on your child’s speech services, whether it be your local municipal and/or state EI agency, your local CPSE coordinator or school-based therapist. And if you are primarily seeking private seeking, or would like to temporarily supplement the public services you are due, Speech Buddies Connect is the place to turn to first for the best private SLPs.