Speech-language pathologists, sometimes called “SLPs” or “speech therapists,” are professionals who help all ages (babies through adults) improve their communication. At minimum, SLPs have a master’s degree in their field, but can also go on to receive additional training, such as through clinical or research-focused doctoral programs. To practice, SLPs must pass a national certification exam, after which they receive a “Certificate of Clinical Competence” (CCC-SLP) through the American Speech-Language-Hearing Association (ASHA), in addition to licensure through their state organization.

The goal of speech-language pathology services is to help individuals communicate to the best of their ability. SLPs also collaborate with related professionals when developing treatment plans, such as psychologists, physicians, social workers, occupational therapists, audiologists, and educators.

For more information about speech-language pathologists, visit the American Speech-Language-Hearing Association (ASHA) website here: https://www.asha.org/public/speech/

Speech-language therapists can help with the following areas of communication:

• Speech sounds: The way sounds are produced

• Language: Understanding and speaking to others with developmentally-appropriate vocabulary and grammar

• Literacy: Reading and writing as a form of communication

• Fluency: Speaking fluidly and smoothly

• Voice and resonance: The quality and tone of a person’s voice

• Hearing, especially as it impacts a person’s speech and language

• Feeding and swallowing: SLPs can also specialize in challenges with feeding and swallowing, due to the overlap with body structures involved in talking

• Cognitive aspects of communication: The “thinking skills” that are required to communicate, such as paying attention, remembering, organizing, problem-solving, and executive functioning

• Social aspects of communication: The social skills and social awareness that a person needs to interact and communicate across social situations

• Communication modalities: The different ways a person can communicate a message, such as through speaking, sign language, assistive technology, and other forms of augmentative and alternative communication

These skills can be addressed across the lifespan and in multiple settings, such as at home, school, or transition to adulthood. For more information about speech-language pathologists, visit the American Speech-Language-Hearing Association (ASHA) website here: https://www.asha.org/public/speech

If you have a baby under 12 months of age, you may wish to schedule an appointment if:

• Your baby has a high likelihood for developing a communication problem (e.g., due to another diagnosed condition or family history of a communication problem)

• Your baby is not meeting communication milestones for their age, such as babbling, playing face-to-face games with others, or using their body to communicate (e.g., with body language, gestures)

• See a list of communication milestones for babies here: https://www.asha.org/public/developmental-milestones/communication-milestones-birth-to-1-year/

If you have a toddler 12 months old or older, you may wish to schedule an appointment if:

• Your toddler has a hard time communicating with others, such as saying words, playing face-to-face games with others, or using their body to communicate (e.g., with body language, gestures)

• Your toddler has a hard time understanding simple words and instructions

• You have concerns about an undiagnosed or suspected condition, such as a developmental delay or autism

• Your toddler has a high likelihood for developing a communication problem (e.g., due to another diagnosed condition or family history of a communication problem)

• See a list of communication milestones here: https://www.asha.org/public/developmental-milestones/communication-milestones/

• You and/or others have a hard time understanding your child when they speak

• Your child has a hard time putting words together to speak in sentences

• Your child has a hard time understanding others and following instructions

• Your child seems to have difficulty playing with other people and/or participating in their daily routines

• You have concerns about an undiagnosed or suspected condition, such as a developmental delay or autism

• Your child has a diagnosed or suspected condition that has the potential to impact their communication

• See a list of communication milestones here: https://www.asha.org/public/developmental-milestones/communication-milestones/

If you have a school-age child, you may wish to schedule an appointment if:

• You and/or others have a hard time understanding your child when they speak

• Your child has a hard time using words to express themself (e.g., speaking in sentences with a variety of vocabulary words)

• Your child has a hard time understanding others and following instructions

• Your child seems to have a hard time with back-and-forth conversations and/or participating socially in their daily routines

• Your child has a hard time with reading and writing and/or communicating to succeed at school

• You have concerns about your child’s transition to adulthood and related social or communication challenges

• You have concerns about an undiagnosed or suspected condition, such as autism

• Your child has a diagnosed or suspected condition that has the potential to impact their communication

If you are an adult or are the caregiver of an adult, you may wish to schedule an appointment if:

• You/the adult has a diagnosed developmental condition that has the potential to impact your/their communication, such as autism, Down syndrome, fragile X syndrome, Prader Willi syndrome, hearing loss, or other neurodevelopmental condition

• You/the adult would like support related to participating in activities of daily living, higher education, or employment

A screening is a short (e.g., 10 – 15 minute) structured activity that looks for “signs” or “red flags” of a possible communication challenge. If the individual is “flagged” as having signs of a possible communication challenge, then a full assessment would be recommended. Screenings do not “rule in” or “rule out” any diagnoses. They simply provide guidance about whether a full assessment would be useful.

An evaluation (also called an "assessment") is a longer set of activities designed to thoroughly evaluate an individual’s strengths and needs. Based on the information gathered during an evaluation, the specialist may provide a diagnosis that describes the individual’s communication needs. You will also receive recommendations for how to support the individual’s communication development moving forward.

What happens during an evaluation can vary greatly, depending on the needs and preferences of each family. Typically, evaluations involve both structured (e.g., formal testing) and unstructured (e.g., informal play or conversation) interactions between the individual, the specialist, and family. Family member(s) and/or other key people in the individual’s life are also interviewed to learn more about the individual’s communication skills across settings.

KCCD offers autism screenings to evaluate the likelihood of autism. Formal autism evaluations that result in a medical diagnosis are available on a case-by-case basis. Dr. Kinard is a speech-language pathologist who is clinically and research-certified in administering the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2), part of the gold standard approach to diagnosing autism. She brings over 15 years of experience in the field of autism, including publishing over 15 scientific articles on autism and collaborating on interdisciplinary autism diagnostic teams at the Carolina Institute for Developmental Disabilities at UNC Chapel Hill, a University Center for Excellence in Developmental Disabilities.

If you are looking for a formal evaluation of autism that can result in a medical diagnosis:

A team approach is recommended for a medical diagnosis of autism. The diagnostic team may include professionals such as neurologists, psychologists, and speech-language pathologists. Speech-language pathologists are considered critical team members, since a core criteria of autism involves challenges with communication skills.

To offer a team approach, the Kinard Center has established connections with other medical providers in the community, such as psychologists, who can collaborate on the evaluation process. Autism evaluations that can result in a medical diagnosis are offered on a case-by-case basis, depending on the availability of these additional medical providers to participate on the team. The Kinard Center will coordinate this process for you.

If you are looking for an informal autism screening:

You are welcome to request an autism screening that does not result in a medical diagnosis of autism. In this case, a single-discipline approach with one autism expert would be implemented. You would receive feedback on characteristics associated with autism, such as the estimated likelihood that a child has autism and recommendations for next steps. A medical diagnosis of autism could be pursued afterward if desired or indicated.

See the American Speech-Language-Hearing Association page for more information about a speech-language pathologist’s role in autism testing: https://www.asha.org/practice-portal/clinical-topics/autism/

The American Speech-Language-Hearing Association (ASHA) has resources for caregivers to help you think through what is “typical” development for a child’s age versus what are “red flags” of a possible communication challenge: https://www.asha.org/public/developmental-milestones/communication-milestones/

You are also welcome to schedule a consultation to talk through your concerns before scheduling a formal evaluation.

Speech-language therapy is important for boosting or supplementing the communication skills of individuals who, for whatever reason, are struggling to communicate with others.

• In the toddler and preschool years, speech-language therapy can be essential for helping children develop communication skills during critical periods of development, when the brain is rapidly developing, flexible, and making connections. The skills children gain in these early years form the foundation for their communication later in life.

• In the school years, speech-language therapy continues to support children as they develop more complex communication skills, helping them both academically and socially, including the transition to adulthood

• In the adult years, speech-language therapy frequently drops off for many individuals as they leave school, but individuals still may benefit from services focused on transitioning to independence, maintaining skills, and navigating communication skills that are required in new settings, such as workplaces, community settings, and higher education.

Research shows that 11 - 18% of toddlers (1.5 - 3 years of age) are considered "late talkers." These children are delayed in speaking and/or understanding others' speech, and there isn't a clear reason why (for example, they don't have hearing loss or brain injury).

Most of these children go on to develop language skills that are "typical" to other children their age. However, some children do not catch up and will need specialized support to develop communication skills.

How can we tell which "late-talkers" will need extra help? Here are some signs that a child may need speech-language therapy to learn to talk:

• Your child doesn't use a lot of gestures to communicate (e.g., waving, shrugging, pointing, blowing kisses, clapping, etc.)

• Your child has a hard time understanding what others are saying

• There is a family history of late-talking or language disorders

• The child has other conditions that may impact communication development

Consider scheduling a language evaluation if any of these apply to your toddler and your toddler isn't meeting their communication milestones. If you are uncertain, you are welcome to schedule a consultation or screening before scheduling an evaluation.

To see a list of communication milestones by age, please see: https://www.asha.org/public/developmental-milestones/communication-milestones/

For an academic review on language delays versus disorders, please see: https://www.mdpi.com/2076-3425/11/5/654

Services are offered in person in Cary, North Carolina and surrounding areas. Currently, in person services are provided in homes, daycares, or other community settings. We also offer telehealth options for our services, including consultations, evaluations, and therapy.

How frequently you receive speech-language therapy depends on the results of the evaluation, as well as your preferences and needs. Children first beginning speech-language therapy generally receive therapy at least weekly, whereas individuals who are transitioning out of speech-language therapy may need less frequent check-ins. The Kinard Center values an evidence-based and family-centered approach, so this decision will be a collaboration between the family and their clinician, based on the family's needs and the available evidence of what will best help the individual develop communication skills.

The Kinard Center is currently a private-pay (out-of-network) practice and does not directly bill insurance companies. Payment is due at the time of service. This allows us to provide highly individualized, flexible care without the session limits or diagnostic restrictions often imposed by insurance networks.

A superbill is a detailed medical receipt that includes all the information your insurance company needs to process a claim (including specific diagnostic and procedural codes). Upon request, we will provide you with a superbill after your visits. You can then submit this document directly to your insurance provider to request reimbursement for out-of-network services.

Reimbursement depends entirely on your specific health insurance plan and your out-of-network benefits. While many families do receive partial or full reimbursement for speech-language evaluations and therapy, we cannot guarantee that your insurance company will cover the services. We recommend calling your insurance provider before your first appointment to understand your benefits.

To avoid surprises, we recommend calling the member services number on the back of your insurance card and asking the following questions:

• Do I have out-of-network benefits for speech-language pathology services?

• Do I have out-of-network benefits for neurodevelopmental evaluations? (Mention that it will be conducted by a speech-language pathologist, not a psychologist).

• Do I have an out-of-network deductible to meet first?

• What percentage of the fee will be reimbursed once my deductible is met?

• Is a referral from a primary care physician required to receive reimbursement?

It is usually a very simple process that can be done online in just a few minutes. Here is how it typically works:

1. We will provide a secure PDF of your superbill after your session.

2. Log into your insurance provider's member portal or mobile app.

3. Go to the "Claims" section and select "Submit a Claim."

4. Upload the PDF of your superbill.

If your plan includes out-of-network benefits and you have met your deductible, your insurance company will process the claim and mail a reimbursement check directly to you.