Modifying Services

Admission and Discharge Criteria in Speech-Language Pathology

Speech-language pathology services are flexible, and the type, frequency, or way in which services are delivered may change as a person’s needs and goals change. Adjustments may include

• changing how often visits happen;
• pausing direct therapy while the person follows a home program; and
• changing the services model (e.g., moving from individual to group sessions or from in-person sessions to telepractice).

Speech-language pathologists (SLPs) may stop services for a planned short time period (e.g., an episodic care model) for some individuals, when clinically appropriate. In these cases, there is a clear plan for when services may resume—for example, when priorities, skills, or outside conditions change.

Modifications can also help with important transitions—such as moving from early intervention to preschool, shifting from school-based services to adult services, or transitioning from inpatient care to community living. Services may stop temporarily—with a clear plan for resuming when skills, priorities, or external conditions change.

Persons with communication disorders and their care partner(s) are active participants in decisions about their care. Adjustments are guided by research on effective dosing (e.g., how many services to provide, how often to provide them) and must also follow employer, state, and/or federal rules. Documentation should explain the reason for changes, describe the plan for resuming or further adjusting services, and stipulate how this care remains connected to the person’s goals.