When a child's speech, language, or communication development starts to be a concern, it might not be clear to a parent what to do next. Is a referral needed for speech therapy? Should they go to the child health clinic (neuvola) first? And who pays for the speech therapy?
There are various routes to accessing speech therapy. The suitable path depends, among other things, on the child's age, situation, need for support, and the type of speech therapy involved.
The most important thing is that a parent doesn't need to know beforehand whether their child needs speech therapy specifically. If the child's speech, language, communication, or interaction is a cause for concern, the matter can be raised with a professional who monitors the child's development.
Where should you start?
For a young child, the natural first place is often the child health clinic (neuvola). It's best to describe your concern as concretely as possible. For example, a parent could describe:
- how much the child speaks
- how the child understands speech
- how they express their needs and thoughts
- whether others can understand the child's speech
- whether the child uses gestures or other communication methods
- what the interaction with the child is like
- how any difficulties are seen in ordinary everyday life
If the child is in early childhood education or at school, observations made there can also be useful. The child's situation can then be looked into more closely, and if necessary, they can be referred to a speech and language therapist's assessment or other studies.
If you are wondering when you should seek speech therapy for your child, also read our article When does a child need speech therapy?.
What is investigated in a speech therapist's assessment?
A speech therapist's assessment forms an overall picture of the child's communication and language skills. Depending on the child's situation, the assessment may look at, for example:
- understanding of speech
- vocabulary and concepts
- sentence formation
- speech clarity and speech sounds
- narrative skills
- interaction
- play
- communication methods
An assessment doesn't always mean the child sits at a table doing test tasks. Especially with young children, skills can be observed during play and shared activities. Parent interviews and observations from daycare or school can be an important part of the whole.
Based on the assessment, the therapist considers whether the child needs speech therapy or other support, and what kind of support methods they could benefit from.
Is a referral always needed for speech therapy?
It depends on how the speech therapy is organized and who pays for it.
Speech therapy or assessments arranged through public healthcare are accessed according to the healthcare provider's own service path. If the child needs longer-term rehabilitation, their situation can be assessed in healthcare and a rehabilitation plan can be drawn up for them.
It may also be possible to acquire speech therapy privately at your own expense. In this case, practices may differ and the process is not necessarily the same as in rehabilitation organized by public healthcare or Kela.
If you are unsure which route fits your child's situation, you can start by discussing it at the child health clinic or another healthcare unit treating the child.
What about Kela's demanding medical rehabilitation?
Some children receive speech therapy as demanding medical rehabilitation organized by Kela. Demanding medical rehabilitation is intended for situations where a child has a significant difficulty in coping and participating in daily life due to an illness or disability and therefore needs rehabilitation.
The need for rehabilitation is assessed in healthcare, and an appropriate rehabilitation plan is required for the rehabilitation. The actual rehabilitation is applied for from Kela.
Once Kela has granted speech therapy, the family can choose a service provider from among Kela-approved service providers, in accordance with the granted rehabilitation and Kela's terms. Kela's decision defines what kind of rehabilitation has been granted to the child.
Read more about Kela speech therapy at Sensis Terapia.
How do you choose a speech therapist?
When speech therapy has been granted and a service provider can be chosen, it's worth looking for a therapist whose services match the child's needs and who can carry out the granted therapy. You can ask the therapist, for example:
- whether they have available client places
- whether they work with children of the same age as your child
- whether they have experience with the child's core rehabilitation needs
- where the therapy can be carried out
- how cooperation with the family, daycare, or school is organized
In good therapy, the interaction between the child and the therapist is also important. The child should be able to gradually feel the therapy situation is safe and suitable for them.
You can learn more about Sensis Terapia's speech therapy for children on our service page.
Where does speech therapy take place?
Speech therapy doesn't necessarily take place at a practice. Depending on the child's rehabilitation plan and the way the therapy is organized, visits can be carried out, for example:
- at the therapist's practice
- at the child's home
- at daycare
- at school
- via remote connection when it suits the child's situation and rehabilitation goals
Therapy carried out in the child's own everyday environment can have specific benefits when the goal is to get the communication methods to work in the very situations where the child needs them daily.
What happens when speech therapy begins?
The first sessions are for getting to know the child and their immediate environment. The speech therapist familiarizes themselves with the child's goals and previous studies, and discusses with the family in which situations communication works well and where more support is needed.
At the same time, the therapist gets to know the child. Especially with a young child, there is no rush to start doing actual exercises immediately. Building trust and functional interaction is an important part of the start of rehabilitation.
Gradually, ways to practice the goals that are suitable for the child are sought in therapy, and thoughts are given to how the same skills can be supported in ordinary everyday life as well.
If you want to read more about what speech therapy is like in practice, read our article What happens in speech therapy?.
What if the speech therapist has no vacancies?
The availability of speech therapists varies by region and time. If the first therapist does not have the possibility to take a new client, it is worth contacting other service providers operating in the area.
In rehabilitation organized by Kela, service providers can be sought using Kela's service provider search. If it is difficult to find a suitable therapist, it may also be good to discuss the situation with the body monitoring the child's rehabilitation.
You don't have to wait for certainty when there's concern
A parent doesn't need to know whether the child has a language disorder or needs speech therapy before they can talk to a professional. It is enough that something in the child's speech, understanding, communication, or interaction development is on your mind.
The first step can simply be raising the concern. After that, the child's situation can be looked at together and it can be clarified whether a closer assessment or support is needed.
If your child's situation is on your mind, you can contact us to ask more.
Author
Bettina Paasila
Speech and language therapist
Looking for a speech therapist?
Sensis Terapia provides speech therapy for children in the Helsinki metropolitan area. You can get in touch to ask about available client places and whether Sensis Terapia's services suit your child's rehabilitation decision and needs.