Speech Therapy | Telepractice Services | Voice and Swallowing Center | Waldo County General Hospital

Voice Therapy Eligibility

Your doctor will refer you for evaluation and treatment and send a referral to the Voice and Swallowing Center. Most insurances pay for voice evaluation and therapy. After the referral is received, the Voice and Swallowing Center will call you within 24 hours to schedule an appointment.

Speech Therapy Eligibility

  1. I am worried about my child's speech. A state child development agency saw my child and said my child was "not eligible" for service. Does this mean my child doesn't have a speech problem?
  2. Does this mean my child cannot get help?
  3. How could my child be found 'not eligible' and still have disorder in speech and language?
  4. Is the testing the only way my child was evaluated?
  5. What do "eligibility standards" mean for my child?
  6. If I get speech therapy at Waldo County General Hospital, will it be different from the state "special ed" services?
  7. What if I just wait and see how my child does when he/she gets to school? Will my child be more at risk for dyslexia?
  8. What test eligibility standard does Maine use?
  9. How is speech therapy paid for?
  10. Are there laws protecting my child?
  11. What is a 'Standard Deviation (SD)?



1. Question: I am worried about my child's speech. A state child development agency saw my child and said my child was "not eligible" for service. Does this mean my child doesn't have a speech problem?

Answer: No! You can and should seek your own professional opinion about your child's needs. Parents know best! Preschool speech problems can cause difficulties in school, especially learning to read. Talk to your doctor or healthcare provider about a speech evaluation.

The eligibility standard used in Maine excludes children, especially under age three, who may have moderate disorders. These children are at risk for developing difficulties learning to speak and read which can lead to failure in school. Parents are understandable concerned about dyslexia like reading probelms and early speech skill development can help prevent many of these problems.

If you would like more information, contact us at 207-338-9349 or by email at [email protected].



2. Question: Does this mean my child cannot get help?

Answer: No! You already have concerns about your child's speech and you are probably right. You should get help. Early intervention is effective and can prevent later social and reading problems.

If your child is found "not eligible" but still has a speech problem, it just means the state will not provide help for your child. Parents can and often do choose to get help for their children in the community without involving the state.

You can and should seek help for your child. If you have questions about your child's speech, see a qualified, licensed speech-language pathologist.

A speech pathologist (speech therapist) is the qualified professional trained, certified and licensed to diagnose disorders of speech and language development.

When screening children, especially up to age three, the state may use one assessment tool. This assessment may lack the sensitivity to identify early speech disorders and the people doing the assessment may not be adequately credentialed to identify speech disorders. They generally do a good job, but they do not have the training, depth of knowledge or experience to identify many types of speech and language disorders.



3. Question: How could my child be found "not eligible" and still have a disorder in speech and language?

Answer: Your child was given a test. The state determines the cut-off score for who gets help. Tests produce a score. The state determines what score will be used to include children. The state can change the standard to determine how many children will be allowed in service, based on what the state decides.

Different states have different standards.

The score your child gets on a test is not intended to tell you what your child actually needs. The test measures how well your child did on that day and on that test. The test is designed to determine eligibility for service, not primarily for what is best for your child.

The author of the most widely used speech and language test in the United States said:

"Do not use this test to learn what a child needs. This test only establishes a score used by schools to determine who gets 'in' and who doesn't. The test does not reflect what the child really needs to be successful". Secord, Wayne A. Clinical Evaluation of Language Fundamentals 4 (CELF-4) Psychological Corporation.



4. Question: Is the testing the only way my child was evaluated?

Answer: No. The law requires that information about your child's learning style be included. Rating scales and "clinical opinion" of the people doing the assessment can also be used.



5. Question: What do "eligibility standards" mean for my child?

Answer: The state "eligibility standard" determines if your child will be included as a "special ed child." These standards are established by the state and may not reflect what your child really needs.

The State of Maine has made it harder for children to "qualify for services," only identifying moderate to severely disabled children under age three as "eligible". For children over age three, the standard includes a number of steps where the child must first fail before being able to be fully assessed and become eligible for help.

Preschool children with a moderate disability may be found "not eligible" for services yet still have a disorder that may adversely affect speech, language and learning to read.



6. Question: If I get speech therapy at Waldo County General Hospital, will it be different from the state "special ed" services?

Answer: Our therapists work collaboratively with many different agencies, including the state. When you get therapy here, your child receives an individualized plan, based on your child's learning needs.

Our therapists work closely with parents, family members and preschools to closely involve them in the child's development.

Your child will be working with highly qualified, licensed and nationally-certified professionals. Scheduling and providing services are based on your child's needs.

Our therapists are skilled in providing therapy that can help prevent your child from being labeled with dyslexia when they get to school.



7. Question: What if I just wait and see how my child does when he/she gets to school?

Answer: If your child starts school with a speech delay and does not have basic language-reading readiness skills, there is a 75% chance your child will never become a competent reader.

Children with delays in their speech and language have a greater risk of learning difficulties and dyslexia. The saying "good talkers tend to be good readers" is true.



8. Question: What test eligibility standard does Maine use?

Answer: For young children (birth to age 3), the state has determined eligibility at 2 standard deviations (SD) below the mean in one area of development or 1.5 standard deviations below the mean in two areas of development.

From Maine Special Education Law Chapter 101: The level of developmental delay required for eligibility will be defined as any of the following (unless the measures used, such as hearing and vision tests, have different criteria for establishing abnormal development):

(a) A delay of at least 2.0 or more standard deviations

below the mean in at least one of the five areas of development listed above; or

(b) A delay of at least 1.5 standard deviations below the

mean in at least two of the five areas of development
listed in 1(A) (1), above. [20 USC 1435(a) (1)]

Other information can also be used in making a determination, including observing the child's learning style and the opinion of the people involved in the assessment. For children age three and up, the child must have a delay in the moderate-to-severe range as determined by tests and rating scales.

You can find these rules and regulations online at the Maine Department of Education web site.



9. Question: How is therapy paid for?

Answer: Most insurances pay for speech therapy evaluations and many pay for speech therapy.

Sometimes, a professional assessment of your child's speech uncovers additional information that may help the state determine your child is eligible for education services.

The place to start is an evaluation to find out exactly what your child needs.

Talk to your doctor or health care provider about a referral or contact us directly for more information at 207-338-9349 or [email protected].



10. Question: Are there laws protecting my child?

Answer: Yes; there is a federal law called Individuals with Disabilities Education Act (IDEA).

Each state then develops its own regulations to meet the law, including establishing eligibility standards.



11. Question: What's "standard deviation?"

Answer: This isn't a question we get very often. Some information about standard deviation (SD) is helpful to explain some of these confusing eligibility numbers and what they mean for your child.

A standard deviation is a statistical measure of how "spread out" test scores are and establishes a "normal range." The chart below shows how these scores look when they are spread out.

The chart illustrates how few under age 3 children will actually "qualify" using the 2SD standard.

Children in the range of the red arrow (chart below) will not qualify under state guidelines.

This means that 18% of children fall below average on testing, but only 2% will qualify for services under Maine Department of Education guidelines.

There are very few children under age three, who score at 2 SD — only the most severely delayed.

Even with teams allowed to use informed clinical opinion to determine eligibility, this standard assures some children will not receive therapy who have disorders in speech, language and learning.

Those children stuck in the middle, not severe enough to qualify but still scoring low, are at risk of not being identified until academic problems emerge in 1st, 2nd or 3rd grade.

That's why we support parents who seek an independent, thorough assessment of their child's needs. Here at Waldo County General Hospital, we would want nothing less for our own families.



For more information, call the Speech Therapy Department at 207-505-4409 or email [email protected].


Print