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Therapy Frequency Recommender

Pick the severity of the communication disorder, the age band, and the service setting, and the tool returns an evidence-based recommended service-delivery intensity drawn from the ASHA School-Based Service Delivery Practice Portal (2024), the Cirrin et al. (2010) systematic review, the Brandel & Loeb (2011) national SLP survey, and the Warren et al. (2007) dose-response review. Returns total minutes per week, sessions per week, typical session length, a recommended service-delivery model (individual pull-out, small-group, push-in, consultation, home visit), an evidence summary with citations, and severity-specific clinical caveats. Built for school-based SLPs, clinic SLPs, early interventionists, and IEP / IFSP / plan-of-care teams.

4 Severity Levels4 Age Bands3 Service SettingsCirrin 2010Brandel & Loeb 2011ASHA 2024Client-Side
Tool details, related tools, and citation

Recommend therapy frequency in under a minute

Pick the severity of the communication disorder, the age band, and the service setting. The tool returns an evidence-based recommended service-delivery intensity drawn from the ASHA School-Based Service Delivery Practice Portal (2024), the Cirrin et al. (2010) systematic review, and the Warren et al. (2007) dose-response literature.

Noticeable communication breakdown in structured and unstructured contexts; standard score 70 - 77 (-1.5 to -2.0 SD) or 33 % delay in one domain or 25 % delay in two domains. The child needs intervention to access the curriculum or the home routine.

School-age elementary band. Services are delivered under an IEP in the school building, typically pull-out or push-in.

Public school pull-out, push-in, or classroom-based services under an IEP. Sessions are typically 20 - 30 minutes each.

Recommended frequency
Total service time
60 – 90 min / week
Sessions per week
2 – 4 sessions

Typical session length: 20 – 30 min

Service-delivery model

School-based individual or small-group pull-out, 2 - 3 sessions per week. Add classroom push-in or consultation for generalisation. Consider a collaborative service-delivery model with the general-education or special-education teacher.

Evidence

School-based frequency under IDEA Part B (34 CFR 300.320(a)(7)) must list the frequency, location, and duration of services on the IEP. The recommended range is drawn from the ASHA School-Based Service Delivery Practice Portal (2024), the Cirrin et al. (2010) systematic review of service-delivery models, and the Brandel & Loeb (2011) national SLP survey. Warren et al. (2007) showed dose-response effects for language intervention in school-age children.

Clinical caveats
  • The recommendation is a starting point, not a prescription. The IEP / IFSP / plan-of-care team is the final authority on the actual service intensity for the child.
  • Frequency must be reviewed at every progress-report interval and the next annual review. If the child is not making adequate progress at the recommended intensity, consider increasing minutes or changing the service-delivery model before concluding that the goal is not achievable.

This tool is a drafting assistant. The IEP / IFSP / plan-of-care team is the final authority on the actual frequency, location, and duration of services for the child. Always confirm the recommendation against your district’s special-education forms, state eligibility documentation, and the child’s present levels of academic achievement and functional performance (PLAAFP).

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  • IEP meeting preparation — draft the service-minutes recommendation before the meeting so the team can focus on the specific child's needs rather than on the baseline number
  • IFSP meeting preparation — draft the frequency, location, and duration of Part C services for the IFSP document
  • Clinic plan-of-care writing — set the starting frequency for a new outpatient SLP evaluation and treatment plan
  • Private-practice insurance authorisation — defend the requested number of sessions per week with a published evidence base and citation list
  • Graduate SLP training — practice reasoning about service delivery intensity across severity, age, and setting combinations
  • New school SLP onboarding — learn the service-delivery-model taxonomy and the evidence base for each combination
  • Parent advocacy — review the current IEP service minutes against the published evidence base for the child's severity and age
  • Special-education coordinator caseload planning — estimate the total service hours needed for a projected caseload before hiring decisions

Don't use for

  • As a substitute for the IEP / IFSP / plan-of-care team decision — the team is the final authority and must document the decision on the plan document
  • For adult SLP caseloads (acute care, SNF, outpatient rehab) — the age bands and recommendation ranges are paediatric and will not match the adult service-delivery conventions
  • For dysphagia / feeding caseloads — the tool is calibrated for communication-disorder severity, not for swallowing safety (which requires direct clinical assessment and instrumental evaluation)
  • For hearing-impaired children receiving audiological services — the age bands and recommendation ranges do not map to the auditory-verbal therapy model
  • For children with a recent surgical intervention (cleft palate repair, cochlear implant activation, papilloma excision) — acute post-surgical frequency is set by the otolaryngologist, not by the SLP alone
  • To justify a unilateral SLP decision without the IEP team — every frequency decision MUST be made by the full team with parent participation

Why Therapy Frequency Matters

Therapy frequency — the total service minutes per week and the session-per-week count — is one of the most consequential decisions the IEP / IFSP / plan-of-care team makes. Under IDEA (34 CFR 300.320(a)(7) for IEPs and 34 CFR 303.344 for IFSPs) the team MUST specify the frequency, location, and duration of services on the plan document, and the district / agency is legally bound to deliver the specified service. Too few minutes and the child does not make progress; too many minutes and the school SLP caseload becomes unsustainable and the district is out of budget. The decision is so consequential that it is one of the most common trigger points for parent due-process complaints.

Dose-response is real but sparse. The published school-based SLP intervention literature (Cirrin et al. 2010 systematic review; Warren, Fey, & Yoder 2007) shows clear dose-response effects — more therapy minutes produce more progress — but the effect is not linear and there is no single evidence-based "magic number" of minutes for a given severity. The Cirrin review found that individual pull-out at 30 minutes twice per week produced measurable gains for moderate language impairment, and that three 30-minute sessions per week produced larger gains for severe cases. But the effect sizes are modest (median +25 to +40 percentage points over 30-36 weeks of weekly therapy) and the variability across children is large.
ASHA does not prescribe a number. The ASHA School-Based Service Delivery Practice Portal (2024) explicitly avoids prescribing a minutes-per-week number and instead directs teams to "use clinical judgement informed by the child's needs, the published evidence base, and the constraints of the service-delivery context." That is the load-bearing sentence — and the reason a recommendation engine is useful: it gives the SLP a defensible starting point drawn from the published literature so the team can discuss the specific child's needs rather than argue about the baseline number.

The Three Inputs: Severity, Age, and Setting

The recommendation depends on three inputs. Each maps to a specific factor in the published literature.

Severity. The base minutes-per-week range scales with severity. The tool uses four levels (mild, moderate, severe, profound) corresponding to roughly -1.0 SD, -1.5 to -2.0 SD, -2.0 to -3.0 SD, and below -3.0 SD on a norm-referenced standardised test, or to the published state Part C eligibility cuts (25%, 33%, 50% delay in one or more domains). Mild cases typically start at 30-60 minutes / week, moderate at 60-90, severe at 90-150, and profound at 120-240. Higher severity also typically means more individual direct service and less small-group or push-in service.
Age band. The age band modifier accounts for the different service-delivery conventions across the lifespan. Birth to 3 (Part C) uses a 0.75 ×\times modifier because services are family-centred routine-based home visits with parent coaching — the total effective dose is much higher than the visit minutes alone. Preschool (3-5, Section 619) and elementary (5-11, Part B) are the reference band at 1.0 ×\times. Secondary school (11-18) uses a 0.85 ×\times modifier because services increasingly shift to consultation, classroom-based support, and self-advocacy training rather than direct one-on-one therapy.
Setting. The setting modifier accounts for the session-length difference between school (20-30 min), clinic (45-60 min), and early intervention (45-60 min home visit). Clinic and school total weekly minutes are similar for moderate-to-severe cases because clinic uses longer sessions with fewer sessions per week while school uses shorter sessions with more sessions per week. Early intervention uses a 0.80 ×\times modifier on top of the age-band modifier because the routine-based home-visit model relies heavily on parent / caregiver implementation between visits.

Six Service Delivery Models

The ASHA School-Based Service Delivery Practice Portal (2024) and the Cirrin et al. (2010) systematic review recognise six service delivery models. The recommendation engine picks the appropriate mix for each severity / age / setting combination.

Individual pull-out. The SLP pulls the child out of the general-education classroom to a dedicated therapy room for 20-30 minutes of one-on-one therapy. This is the modal model for school-based moderate-to-severe cases and is the easiest to schedule, the easiest to progress-monitor, and has the strongest published evidence base for articulation and expressive-language goals.
Small-group pull-out. The SLP groups 2-4 children with similar goals and delivers therapy to the group for 20-30 minutes. This is the modal model for mild and moderate articulation caseloads and has published evidence for peer-mediated goals (pragmatics, narrative) as well.
Classroom push-in. The SLP delivers therapy inside the general-education classroom, either by co-teaching with the general-education teacher or by pulling a small group to a corner of the room. Push-in is the strongest model for goal generalisation because the child practices the target skill in the real-world context.
Consultation. The SLP meets with the general-education teacher, the special-education teacher, or the parent (no direct child time) to coach them on implementing target strategies across the day. This is an efficient model for mild cases and secondary school-age students and is often combined with a lower direct-service frequency.
Home visit (Part C). The SLP visits the home or childcare setting for 45-60 minutes with the parent / caregiver and the child. The visit includes parent coaching embedded in daily routines (feeding, play, bath). This is the modal Part C service-delivery model under IDEA and is documented in the IFSP.
Tele-practice. The SLP delivers any of the five models via secure video. Tele-practice has a published evidence base comparable to in-person delivery for school-age articulation and language caseloads (Grogan-Johnson et al. 2013; ASHA 2024) and is the only viable option for rural school districts without a full-time SLP.

Caseload and Workload Considerations

The Brandel & Loeb (2011) national SLP survey and the ASHA 2024 Schools Survey found that the average U.S. school SLP caseload is 48 students, with wide variation across states (range: 18-88). At 48 students each receiving 60 minutes / week of direct service, the school SLP is delivering 48 hours of direct service per week plus IEP meetings, evaluations, documentation, and travel — a mathematical impossibility in a 40-hour work week. The practical consequence is that real-world caseloads compress individual service minutes below the evidence-based recommendations.

The ASHA Workload Approach. To address the caseload-minutes collision, ASHA recommends the "Workload Approach" (ASHA 2002, 2024) which accounts for all SLP activities — direct services, evaluations, IEP meetings, documentation, consultation, travel — rather than the student headcount alone. The Caseload Workload Calculator (linked below) implements the Workload Approach and flags caseloads that are over capacity.
The progress-monitoring escape hatch. When the recommended frequency is not mathematically feasible given the district's caseload cap, the IEP team has three options: (1) increase the caseload cap (typically requires a district-level decision), (2) change the service-delivery model to a more efficient one (small-group, push-in, consultation), or (3) document the reduced frequency explicitly and monitor progress carefully with the plan to increase frequency if progress stalls. Option (3) is the most common in practice but carries the highest due-process risk if the child does not make adequate progress.

Frequently Asked Questions

Next Steps

IEP Goal Generator — draft the SMART annual goals that match the recommended service intensity

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Early Intervention Eligibility Calculator — confirm IDEA Part C / Section 619 eligibility before setting frequency

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Speech-Language Milestones Checker — anchor the severity estimate to the ASHA + CDC (Zubler 2022) age-expected milestones

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MLU Calculator — compute baseline mean length of utterance from a 50-utterance language sample to inform severity

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IPSyn Calculator — compute baseline Index of Productive Syntax to inform severity for expressive-language cases

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DSS Calculator — compute baseline Developmental Sentence Score to inform severity

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PCC Calculator — compute baseline Percent Consonants Correct to inform severity for articulation cases

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Stuttering Frequency Calculator — compute baseline percent of stuttered syllables to inform severity for fluency cases

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