Using the Consultative Model in Speech-Language Pathology

 73.6% of speech-language pathologists surveyed from 10 countries reported having a waiting list in their workplace, with waiting times ranging from 0 to 42 months (McGill et al., 2021). This statistic highlights a significant problem in the field of speech-language pathology. What can parents do to support their child’s speech and language development while stuck on these lengthy waitlists?

The Consultative Model

We propose a shift in perspective: the consultative model can be a lifeline for families needing support with their child's speech and/or language development. This approach empowers parents and caregivers with tools, strategies, and guidance, ensuring children receive support. We encourage speech-language pathologists to embrace and offer parent consultations.

What Does the Consultative Model Look Like?

The consultative model is flexible and tailored to meet the unique needs of each family. It can include:

• Scheduled Consultations: One-time/as-needed, weekly, or monthly sessions with families.

• Insurance Coverage: Some plans may fully or partially cover these consultations. We always encourage families to check with their insurance providers. New CPT codes for parent coaching have been added to some plans. 

• Parent Coaching: Conducted via Zoom or phone.

• Home Video Review and Analysis: Reviewing everyday interactions/activities to identify opportunities for language support and providing coaching on strategies. 

• Language Sample Analysis: Providing insights into a child’s current communication stage and strategies to support progress.

• IEP/ Treatment Plan Review: Parents can receive feedback and suggestions to improve their child's current goals in their treatment plan or IEP.

• Education: Provide parents with foundational knowledge to help them feel more confident in supporting their child. For example, if their child is a gestalt language processor you might focus on understanding gestalt language processing, the Natural Language Acquisition framework, and how to support children at various stages of language development.

In the U.S., speech-language pathologists can offer this service nationwide as long as they are not directly servicing the child (per ASHA guidelines, they must hold a license in the state where the child resides for direct services).

Action Steps for Parents and Professionals

For Speech-Language Pathologists:

• Advocate for the consultative model within your workplace.

• Suggest it as an option to employers or colleagues if it’s not already in place.

• Private practitioners can consider adding consultations as a standalone service or alongside their main offerings.

For Parents:

• Inquire about consultation options when contacting clinics with waiting lists.

• Explore private practice providers who offer consultative services.

A Real-Life Success Story

Starting Point:

In January 2024, a family began monthly consultations for their son, who was minimally speaking and at stage 1 of gestalt language development. His communication consisted mostly of delayed echolalia from favorite media, such as “Hey Duggee.” He had been introduced to PECS at school but wasn’t using it effectively to communicate. Frustration and dysregulation were frequent at home and school.

The Process:

• The family submitted videos and language samples before each consultation.

• A robust speech-generating AAC app was introduced and customized for his needs.

• Educational materials were provided, and the family learned how to program and use the app effectively.

• Team collaboration was encouraged, ensuring continuity of support.

One Year Later:

By January 2025, the child had made remarkable progress:

• He was communicating across stages 1-3, using a mix of gestalts, mitigated gestalts, and referential single words.

• Frustration levels significantly decreased, and he was more regulated and thriving as a home-schooled student for the time being.

Family Feedback:

The family shared their experience:

“Wow what can I say........ W is neurodivergent and has complex needs and challenges but the rollercoaster on the whole is smoother with an increased understanding of how to support his needs and for him to thrive. A year ago he was really frustrated, he had many single word gestalts from PECS requesting and some limited gestalts but not many mitigatable and not really any in the different topics e.g. shared joy/ commenting, help, self-advocacy....His mitigatable gestalts have increased, covering all the topics. He uses more language to communicate to us rather than mainly stimulatory. His communication is far more functional and therefore his frustration levels are reduced.”

Why Choose the Consultative Model?

When asked why they opted for consultations, the family explained:

“I didn't feel we were getting the right support at home or direction and knowledge for W to progress. W had up until this point been using PECS and sentence strips. A communication book was being created but it was passed to the teaching staff to complete, and I although I tried to help didn't know what I was doing! Your guidance through this immensely tricky time was amazing. There were many changes taking place at school but his lack of AAC/ Robust AAC, staff being unaware of GLP and strategies meant a decline in W's wellbeing and frustration as he no longer had a voice.” 

Book a consultation with us

Book a 45-minute virtual consultation with an NLA-Trained SLP from our partner clinic, Social Butterfly Inc. to get support, answers and guidance as a parent or professional supporting gestalt language processors. English & Spanish consultations are available.  Book your consultation here.  

Find a local speech-language pathologist

Find a ND-affirming speech-language pathologist by visiting our registry. These SLPs are all knowledgable in echolalia, gestalt language processing and child-led therapy and many offer virtual consultations as well. Visit the Meaningful Speech registry here.