Frequently Asked Questions

As adults, no matter what age we currently find ourselves in, we usually have an “internal voice” in our heads that tell us when something needs to change. Most of us think about and/or worry about many things in our lives. If you’re coming to this page, it is likely that you’ve already been thinking and/or worrying about something related to your speech, eating and drinking, breathing, sleeping, or some physical changes that you noticed that seem to affect your speech and overall well-being. So, let’s delve into some common concerns adults have.

Common Concerns:

Articulation / Speech Clarity Concerns –

• A specific sound or group of sounds – Ex: a “lisp” that you’ve had since you were a kid, but never seemed to go away; Or you may have noticed that certain sounds or sound combinations are difficult for you to pronounce.

• Overall clarity of your speech – For example, you may feel that people often ask you to repeat yourself. Or you might just be self-conscious about your speech.

• An increased need for public speaking – Ex: your job or school requires you to present your work or give webinars, etc., and you are concerned that your speech may not be clear enough (or other similar concerns).

• Noticing some stuttering or hesitations in your speech – it may be new, or something you’ve received therapy for this before, but you’d like to address it now because now it’s bothering you or affecting you at work or socially.

Physical Concerns –

• Muscle Tension – in your jaw, neck, shoulders, and/or back, that does not seem to be related to any medical condition.

• Breathing Concerns – You may be a mouth-breather or are frequently congested.  
• Sleep Concerns – You may be snoring, have Sleep Disordered Breathing, or Sleep Apnea.

• Frequent symptoms of reflux – even if you’ve taken medication, it has not seemed to help you.

• Hoarse voice, or losing your voice frequently, or that you find yourself straining your voice.

• Voice Projection – You may have noticed difficulty projecting your voice when doing public speaking, or noticed that you run out of breath when you have to do a lot of speaking.

Eating or Drinking-

• Picky Eating – You may have always been a “picky eater” since you were a child, but now feel that it’s impacting your social life – ex: You’re uncomfortable going to restaurants with friends because you worry that there won’t be much you can eat, or worry that they will tease you about your pickiness.

• Nutritional intake – You may have concerns regarding your nutritional intake.

• Specific Food Avoidance – You may have noticed that you’ve avoided certain foods because you felt that they were too difficult for you to eat, and you want to know why and get help.

• Coughing or Gagging during meals – You may have noticed that you cough periodically during meals, possibly on specific textures of foods or certain liquids.

Many of the above-mentioned concerns may be caused by muscle-based issues, sensory issues, as well as oral-structural issues. If you have noticed any of these concerns, or others not specified here, then it’s time to reach out to a professional who can help. That professional is a Speech-Language Pathologist, who is specifically trained in speech, oral-placement, tongue-ties, and Orofacial Myofunctional Disorders. Contact us to set up your appointment today.

Please be aware that Horizon Speech Therapy Services, LLC does not accept insurance. This means that for your insurance company, we are considered an “out of network” provider. You are responsible to pay in full for all services. However, if you have a PPO-type of insurance plan, you may have “out of network” benefits, which means that you may be eligible to be reimbursed (paid back) from your insurance company.  Please contact your insurance company for more specific plan information. 

How does payment work?

When you arrive for your appointment (for both evaluation appointments or therapy sessions), you will be paying in full (out of pocket), for your services. (We accept cash, checks, Zelle, all major debit and credit cards, as well as FSA/HSA cards). You will then get a receipt that contains the diagnosis codes, and procedure codes. If you have a PPO-type insurance plan, you can submit that receipt, along with a medical claim form, to your insurance company. It will be applied toward your “out of network” benefits. Depending on your plan, there is typically a deductible amount that has to be met, and they will determine if you are eligible for reimbursement. The reimbursement is usually a percentage of the money you have paid (typically around 60-80%).

Understanding your insurance plan

Insurance plans can be very complicated and overwhelming. However, it is important to make sure that you understand the details of your specific plan. Every insurance company is different. Not only that, but within each insurance company, there are many different kinds of plans with different levels and amounts of coverage and benefits. Here are some important details that you should be aware of about insurance plans:

• Know the type of plan you have – As mentioned above, there are many types of insurance plans, and they all have different levels and amounts of coverage and benefits, so it is important to know what type of plan you have. Some examples: PPO, HMO, EPO, Medicaid, Medicare, etc. The type of plan is typically written (or has an icon printed) on your insurance card.
• Know your plan’s policies for speech therapy – It is important to know the insurance plan’s policies when it comes to speech therapy. They often have very specific guidelines for when speech therapy is covered or not covered. Keep in mind that feeding therapy, treatment for orofacial myofunctional disorders, and/or tongue-tie related services, still fall under the umbrella of speech therapy, but are specialized areas within the field of speech therapy. Some insurance companies require that there is a “medical necessity” for the therapy, because many insurance companies do not cover sessions that they consider “developmental delays”. However, the ONLY way for insurance companies to truly determine whether or not these services are covered, is to provide them with the diagnosis and procedure codes – which can only be determined following an evaluation.  These codes will be included in your receipt. 
• Out of network benefits – You need to know if your plan has out of network benefits or not. What are “out of network benefits”? Some insurance plans require you to see providers that are “in network“, meaning they have a specific list of providers (doctors, therapists, etc.) for you to go to, who accept your type of insurance plan (that you must choose one of those providers). However, some insurance plans offer “out of network” benefits, which allow you to see any provider that you’d like. Keep in mind that if you are going to a provider who is “out of network“, you are responsible to pay for the services. You are also responsible for submiting a claim form with your itemized receipt. This is necessary for them to process your claim and determine if you are eligible for reimbursement (paying you back some of the money).
• Deductibles – When an insurance plan has out of network benefits, there is usually also a deductible. What is a deductible? A deductible, is a specific amount of money that your insurance company decides will be your responsibility before they begin to reimburse you. So, for example, let’s say that your insurance plan has a $500 deductible. This means that any claims that you put in, up to $500, they will not reimburse you for them. However, after that $500 is fulfilled, they would begin to reimburse you a certain percentage of what you pay for sessions going forward.
• Specified number of therapy sessions allowed – Some insurance plans will only pay for a specified number of sessions. For example, they may only pay for 30 visits – this can be per family, per individual, per year or a specific period of time, etc. It is important to know if this applies to your plan. Additionally, some insurance companies will group together speech therapy with physical therapy and occupational therapy. So, if you (or your child) receive multiple therapies, those 30 visits may be a combined total for all the therapies. Therefore, if your plan has a specified number of therapy sessions allowed, it is important that you know what that number is, and you need to keep track of the sessions you’ve used. Your therapist cannot do that for you.

It is always a good idea to call your insurance company to ask them specific questions about your particular plan. That will help you to stay informed!

A few tips for submitting your receipts:

• Be sure to make copies of your receipts before submitting them, so that you always have a back-up in case they get misplaced by the insurance company, or if it needs to be re-submitted. Plus, its good to keep them for your own records.
• Be sure to download and print out a medical claim form, and fill out all the necessary information. Then, attach your receipt to the claim form and send it in.
• Be sure to submit your claims in a timely manner. If you wait for a long time, and then try to submit large stacks of receipts, it will likely cause problems….It may cause delays in the claims being processed, which in turn delays your reimbursement; Or it may lead to some claims getting misplaced by the insurance company; Or they may get “flagged” by the insurance company as something they should examine more closely, which can then lead to possible denials.

The process of getting started may seem overwhelming. There have likely been a series of questions and concerns that you have been thinking and/or worrying about. You have likely heard a ton of well-meaning advice from friends, family, and even doctors…but you are still confused about what to do. This can be stressful. Well, that’s where we come in. We are here to take off some of that pressure and help you.

So, where do we begin?

The first step is to reach out to us, either by phone, text, or email. You’ll speak directly to a Speech-Language Pathologist (also known as a “Speech Therapist”). In that conversation, we will discuss what you’ve been going through and what your concerns are.

Then, based on the information you have discussed, we will make a determination of whether an evaluation is needed, as well as what specific type of evaluation is needed. There are times when there has been a previous evaluation, or you (or your child) may already be receiving speech therapy services with another speech therapist. This is not a problem.  In fact, it could be helpful information to determine what next steps are needed.  If this is the case, we ask that you provide us with copies of any documentation that you may have from these other professionals.  

If you’d like to learn more details about evaluations, please click here.

If you have questions, and would like to speak to a Speech-Langauge Pathologist, or if you’d like to schedule an appointment, please contact us.

Where it all begins:  Finding a way of getting nutrition is an instinct and skill that we are born with.  This is why it is so common for babies to be given to the mother for breastfeeding almost immediately after birth.  For most babies and mothers, this is a process that goes smoothly and easily.  However, for some babies, and mothers, this does not go as smoothly as anticipated.  There could be many reasons why a baby might have difficulty – and frequently, it is not due to a problem with the mother’s milk production. So, if this has happened to you, please don’t feel like this is your fault.  All you need is the proper guidance and help to figure out what is going on. 

These problems are not just for breastfed babies – Babies who are bottle-fed also may experience difficulties.  Again, there could be many reasons why a baby might have difficulty.  There are some signs which can indicate that your baby might be struggling. We can help you figure it out.

Whether a baby has or hasn’t had problems with breast or bottle feeding, they can still sometimes struggle with feeding when it comes time to eat baby food/purees.  However, feeding difficulties do not just affect babies! They can also affect toddlers, preschoolers, and any child through the teenage years.

A common term that people are familiar with, is “Picky Eating”. While most people know some of the signs of a picky eater, they are not aware that the picky eating typically begins as a feeding difficulty (at any point in the child’s development). Figuring out the underlying cause of picky eating is essential in order to correct these issues. The professional who can help you make these determinations is a Speech-Language Pathologist specializing in feeding difficulties. That’s where we come in.

If you see any of these difficulties or picky eating taking place, or if you have concerns about your child’s feeding skills, contact us today to set up an appointment.

Every evaluation is slightly different. However, there are some basic steps that occur in all evaluations:

A. Initially, there are several forms that need to be filled out, that give the Speech-Language Pathologist some detailed information about the client’s medical history (and developmental history for children), and describes the areas of concern.

B. An appointment for the evaluation is set up. Evaluations are split into two segments – 1) The parent (or adult client) interview. This is where we will discuss the history, areas of concern, and any prior evaluations. This portion is performed virtually (online).  2) The evaluation.  This is typically performed in-person, but can be virtual if preferred.  The evaluation appointment is approximately two hours in length.

C. At the time of the appointment, the Speech-Language Pathologist may ask the parent (or adult client) additional questions, and then proceeds with the examination and assessment portion of the evaluation.

D. At the conclusion of the evaluation, a discussion with the parent (or adult client) takes place, to review the findings of the evaluation, and recommendations are made regarding what the next steps should be. Lastly, you will receive a written report (typically received a few weeks after the evaluation) that outlines the results of the evaluation, the diagnosis, and recommendations.

The differences occur based on the age and type of evaluation that is needed:

1) Speech / Articulation / Oral-Placement Evaluations – The exact assessments that are administered will depend on the age of the client and the area(s) of concern. However, for all clients, there will be an examination of the oral cavity, looking at all structures and muscles. There will frequently also be an assessment of the strength, coordination, and functioning of these structures and muscles, using specialized oral-placement ‘tools’ designed specifically for use in and around the mouth. Lastly, there will be an assessment of the client’s speech production skills to determine where the areas of strength and weakness are. 

2) Speech & Feeding & Tongue-Tie Evaluations: The format of these evaluations are similar to the speech, articulation, and oral-placement evaluation above. The primary difference is that there is also a more in-depth look at the oral structures (especially if determining the presence, and effect, of tongue-ties and lip-ties) and their functioning, as well as their impact on speech & feeding. For this evaluation, the parent (or adult client) will be asked to bring a variety of foods and drinks with them from home (you will receive an itemized list of what to bring). During the evaluation, the child (or adult client) will be asked to eat those foods, while the Speech-Language Pathologist observes. This allows the Speech-Language Pathologist the opportunity to see how the structures and muscles of the mouth are performing during eating and drinking tasks. 

3) Orofacial Myofunctional Evaluations: The format of these evaluations are similar to the evaluations described above, but are specifically designed ONLY for children over the age of 4 years, teens & adults.  These evaluations include an in-depth look at the facial & oral structures, including: facial symmetry, dental alignment, palatal shape, as well as the presence, and effect, of tongue-ties and lip-ties; and their impact on functioning. The evaluation will be assessing the strength, coordination, and dissociation of facial and oral muscles. Additionally, the parent (or adult client) will be asked to bring a variety of foods and drinks with them from home (you will receive an itemized list of what to bring). During the evaluation, the child (or adult client) will be asked to eat those foods, while the Speech-Language Pathologist observes. This allows the Speech-Language Pathologist the opportunity to see how the structures and muscles of the mouth are performing during eating and drinking tasks. There will likely also be assessment of speech production from both formalized testing and informal conversation and/or reading tasks.

Every therapy session is slightly different. However, there are some basic components that occur in all therapy sessions:

A. The results of the evaluation are used to determine the goals that will be worked on in therapy.

B. Appointments are scheduled typically once or twice a week, and are 45 minutes in length.

C. The therapy session follows a structured format, with specific activities or exercises chosen that target specific goals. These goals are personalized and tailored for each individual child (or adult client).

D. At the conclusion of each session, the parent (or adult client) is provided with home-practice activities or exercises to encourage a review of the skills learned in the session, and foster carry-over of the skills to environments outside of the therapy session (ex: at home or in the community).

The differences occur based on the type of therapy that is needed:

1) Speech / Articulation / Oral-Placement Therapy – The exact exercises that are worked on during the session are determined based on the results of the evaluation. An example of exercises used in the session might be one that improves the strength, stability, grading, and dissociation of a specific oral structure (such as the jaw, tongue, lips, and/or cheeks). There will frequently also be the use of specialized oral-placement ‘tools’ designed specifically for use in and around the mouth. Lastly, there will be exercises and activities which focus on speech production skills associated with the oral-placement exercises that have been chosen. For example, if we are targeting the lips, we would likely focus on speech sounds using the lips (ex: “oo”, “oh”, “w”, “p”, “b”, and “m”). 

2) Speech & Feeding & Tongue-Tie Therapy: The format of these therapy sessions are similar to the speech, articulation, and oral-placement sessions. The primary difference is that there is also a more in-depth focus on the oral structures especially when there is the presence of tongue-ties and lip-ties, because of their impact on speech & feeding. A portion of the session is also spent addressing specific food-related exercises, with the foods & drinks the parent (or adult client) will bring. These exercises also help develop the motor-planning skills necessary for speech & feeding. If there are significant feeding difficulties or picky eating issues, the exercises will also focus on improving the child’s (or adult client’s) ability to eat and drink safely, while also expanding the variety of tastes and textures that the child (or adult client) is able to manage in their mouth, as well as expanding their diet to be more nutritionally balanced.

3) Orofacial Myofunctional Therapy: The format of these therapy sessions are very similar to the speech, articulation, feeding & tongue-tie therapies mentioned above. The difference with these sessions, is that they are targeted to children (over the age of 4), teens & adults.  These involve more active exercises that the client performs themselves – as opposed to young children whose exercises are more passive (the therapist is doing most of the work to effect the muscles and their movements). All sessions include the orofacial exercises, food-based exercises, and speech-related exercises. 

For more information, and for help discovering which type of therapy might be best for your child (or yourself), please contact us at: info@horizonspeech.com.