If the therapy is for speech articulation, do twice a week. More frequent practice and feedback is best when trying to replace a motor pattern. Practice at home may not be an option right away. You don't want negative practice.

If this is to address language needs, once or twice a week is fine. There is no strong evidence-based argument for one over the other. You can base the decision off of your preference and what would be the best fit for your child.

Anonymous wrote:I considered factors such as fit, expertise at our need, and location/commute. We went to children’s for a while and they took our insurance; however, we had a $50 copay and a $50 hospital fee charged by our insurance, per session, plus driving there and parking (time and money). We switched to a practice we could walk to, had the speciality we needed, and paid $135 a session. And the SLP pushed my child more (in a good way).

Also you can get exercises to practice at home if once a week works best for you. Also depends on child’s attention span (25 mins versus 50).

Hospital fee? That's crazy.

We did once weekly without insurance. The SLP gave us practice work to do in between sessions.

Twice a week, for me, was a major logistical challenge.

If you can handle the logistics of 2x/wk therapy, I'd start with the practice covered by insurance. Having a kid with a disability is expensive, so save money where you can. If you become dissatisfied, then you can make a switch.

I would do the twice a week, covered by insurance one.

My dd had OT and ST and I only used ones that took my insurance. She got great therapists and did well. I don't think whether or not they take insurance, is indictative of their quality. Meet with them for an eval and get a feel for it.

Twice a week with insurance. Our insurance limited to 30 minute sessions a few times a week.

I would do more often for a shorter time through insurance if your schedule can accommodate it. 40-45 minutes of therapy is actually kind of a lot for a preschooler. When my son was 4 he had 45 minutes 3x/week and when he dropped to 30 minutes 3x/week due to a schedule change with the therapist I actually didn't see any difference in progress.

I considered factors such as fit, expertise at our need, and location/commute. We went to children’s for a while and they took our insurance; however, we had a $50 copay and a $50 hospital fee charged by our insurance, per session, plus driving there and parking (time and money). We switched to a practice we could walk to, had the speciality we needed, and paid $135 a session. And the SLP pushed my child more (in a good way).

Also you can get exercises to practice at home if once a week works best for you. Also depends on child’s attention span (25 mins versus 50).

The different schedules reflect how the therapists make their money, nothing else. The insurance can be billed twice per week. However for the practitioner who accepts private pay, it is more profitable for her to see clients once per week for a longer session.

We are in a position where my preschooler could do speech therapy either somewhere that accepts insurance and would therefore include two 20-25 minute sessions per week, or somewhere that is a private pay practice where it would be once a week for 40-45 minutes.

I’m not sure which scenario is better. Twice a week means more practice and repetition, which seems beneficial, but 20-25 min is short. That also means two days a week with therapy, which means less time available for other activities. On the other hand, more can be done in a longer session, and once a week is also easier to schedule. It frees up time for other things. Which do you think is better at this age?

Also, would you automatically choose the practice that accepts insurance? It would be considerably less money than the private pay practice, but perhaps the private pay practices are generally better?