Clinical Scenario
Claire had been worried about her son Henry for several months. He did not seem to tlak like other children his age and did not say as many words as his older sister when she was a toddler. Claire consulted with Henry's pediatrician at his two-year wellness check. They discussed Henry's medical history and, other than his lack of words, neither had concerns about his development. "He really seems to understand everything we say to him or tell himn to do," Claire explained, "But he barely says anything at all."
She decided to contact her local public school district for a speech-language evaluation. An early intervention speech-language pathologist (SLP) conducted a comprehensive assessment and concluded that Henry had an expressive language delay. As a “late talker,” he qualified to receive early intervention special-education services through the school district. The SLP explained the intervention model employed by the school district in which the SLP would guide the intervention and the parent, through natural daily routines, would directly provide Henry’s treatment. Claire was unsure about moving forward with this plan of care because she envisioned the SLP working directly with Henry. Claire decided to check with another SLP in a private practice setting.
The second SLP described how, if she were treating Henry, she would see him herself for about an hour a week. Claire could either sit in on the session or wait in the waiting area while Henry was in therapy, but she would not be expected to carry out the treatment directly. Claire had a decision to make: Should she move forward with the home-based parent-implemented services offered by the school district or should she consider center-based SLP-directed services? What would be better for Henry?