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Getting Started with us!

If the following is confusing, we will explain everything to you over the phone!

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evaluation assessment, Brooklyn Letters
Speech-Language Pathology

If you are seeking speech, language, and feeding services, you will need to work with one of our licensed speech-language therapists/pathologists: New York State requires that you work with a licensed therapist skilled in these areas if you or your child needs help with enunciation, expressive (oral) language, receptive (auditory) comprehension, social pragmatic skills, feeding, fluency (stuttering), etc. If the individual does not need help with their oral expressive and receptive language skills or oral expressive language skills, he or she can work with one of our literacy specialists (this is different than working with a licensed therapist) if there are literacy concerns. However, some students have what is called a language disorder (expressive and/or receptive language difficulties) and these students need therapeutic literacy intervention performed by our language therapists. This might be eligible for out-of-network reimbursement. If the literacy intervention is considered language therapy, we will need the right ICD-10 code(s) to justify a language therapy approach to your child's literacy intervention. ICD-10 codes which indicate language therapy include language disorder, expressive/receptive language disorder, phonological disorder, autism spectrum, social pragmatic communication disorder, other developmental disorders of speech and language, developmental disorder of speech and language, and sometimes diagnosis such as a specific learning disorder, a specific reading disorder, or a specific impairment in written expression.

In order to start therapeutic services by our speech-language therapists/pathologists, we need written justification from NY licensed therapists or medical doctors regardless of their affiliation with Brooklyn Letters. This documentation typically includes ICD-10 code(s). We will also need current goals. These goals can come from recent reports or from current professionals working with your child. If you do not have any of these codes, we can help!

Literacy Tutoring

For literacy tutoring by our literacy teachers, a non-therapeutic service, we need up-to-date goals. Literacy tutoring performed by our literacy specialists is not eligible for insurance reimbursement.

If the literacy intervention cannot be justified by an ICD-10 code (see above), the literacy intervention is considered educational and can be performed by our literacy teachers. New York State believes the ICD-10 code for dyslexia is educational (learning) and not as a Communicative Disorder, e.g. Language Disorder. One day New York State will update their position on dyslexia. Please note that most neuropsychological evaluations do not include decoding and encoding (spelling goals); they mention the need for decoding and encoding intervention. If literacy goals are not included in the neuropsychological evaluation, our first session(s) will include creating these goals. Also, many schools use their methods or commercialized products for creating literacy goals. Unfortunately, some of these tools are not up-to-date with current scientific standards (it's Corporate America ). Fortunately, we use up-to-date assessment tools to reliably identify where your child needs help. Overall, you are in good hands with us, and we will guide you along the way!

If you have up-to-date evaluations/assessments and goals, you can most likely skip reading the rest of this page.

If you are not interested in our intervention services but just need an assessment/evaluation/consultation, we also offer evaluation services!

Consultations, Assessments, & Evaluations:

If you live in New York City, Long Island, and Westchester, we are here to help! We work with all ages, including babies, adults, and everyone in between!

Phone and Doorstep Consultations

$150-$200: We offer in-home and on-the-phone consultations. Consultations are appropriate when you are not ready for an evaluation/assessment (see below).

English Home Based Evaluations and Assessments:

TIER 1 and TIER 2: $175-$1000 (See below).

English Office-Based Evaluations and Assessments

TIER 1 and TIER 2: $300-$1200 (See below).

Please note that we can rent space throughout NYC to accommodate evaluations and assessments since we are not a brick and mortar company.

Bilingual/Multilingual Assessments TIER1 AND TIER2 Home and Office-Based:

Bilingual/multilingual evaluations are billed at a higher rate than monolingual English evaluations and assessments. Bilingual/multilingual in-home and at-school evaluations/assessments are usually marked up an additional 30 to 50% due to the additional work required to assess more than one language. Office-based bilingual/multilingual evaluations and assessments are an additional cost due to the expenses of renting space.

Apraxia Evaluation/Assessments:

  • $700-$1000 Apraxia Evaluation performed by Dr. Melissa (see below for more information). She is one of the top NYC experts on apraxia of speech!
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TIER 1 EVALUATIONS & ASSESSMENTS (Home, School, English, Multilingual) Performed by Licensed Speech-Language Pathologists/Therapists

Evaluations include at least a one-hour in-home or at school visit where we ideally meet you and your child, review previous reports, testing, etc., and within ten business days, a 1.5- to 3-page report with professional impressions, recommendations, and goals (if services are recommended) are produced. This report can be presented to private schools and professionals outside of Brooklyn Letters. It cannot be used for IEPs (see TIER2). It helps establish the need for significant but mild articulation and expressive language therapy and for updating current therapy goals.

Articulation/Enunciation/Speech Sounds (ages 3+ only if the individual exhibits difficulties with a few age-appropriate speech sounds): $175-$250

Mildly Delayed Expressive Language (babies-47 months): $200-$300. Three-year-old children with expressive language delays might qualify for a TIER2 evaluation depending on several factors to be discussed by one of our speech pathologists over the phone (free).

Articulation and Expressive Language Concerns: (one visit, babies-47 months) $300-$450. Three-year-old children with moderate to severe expressive language delays will most likely require a TIER2 evaluation depending on several factors to be discussed by one of our speech pathologists over the phone (free).

Social Skills Assessment (18-47-month-old children): $150-$200 We use a standardized empirically validated parent-report questionnaire to help assess pragmatic language development in 18- to 47-month-old children. This assessment helps identify children with delays in pragmatic language development (i.e. the use of language in a broad variety of everyday settings and in interaction with other people) compared to children of the same sex and age in months; to identify children whose expressive language skills should be further evaluated with a comprehensive speech and language assessment. We mail you the questionnaire, you fill it out, mail it back to us and we score it, provide you with the results, and schedule a 30-minute phone consultation.

Codes

We can furnish an ICD-10 code for insurance purposes with a TIER1 Evaluation if the child has articulation difficulties that are not normal for his or her age or if the child has a significant expressive language delay or disorder. We are out-of-network providers and do not accept any third-party payments, but you may be entitled to reimbursement under the out-of-network provisions of your insurance policy.

Please note that a TIER2 Evaluation is recommended for the following circumstances:

When there are feeding concerns (any age).

When there are fluency/stuttering concerns (any age).

When there are significant moderate to severe early language and communication delays (0-36 months).

If the articulation concerns involve more than a few age-appropriate speech sound errors (ages 3+).

If your child is 3 years old and has significant moderate to severe expressive language delays.

If your concerns involve receptive language or literacy (any age).

If your child is greater than four years of age and has delayed language development.

Free Phone Consultation

If you are interested in a private evaluation or assessment, you will speak with a licensed speech-language pathologist on the phone for free to help best determine if your child should be considered for a TIER1 or TIER2 evaluation/assessment.

TIER 1 EVALUATIONS & ASSESSMENTS (Home, School) Performed by Licensed Literacy Specialists/Teachers

Decoding & Spelling Assessments

$200-$300 Decoding and Spelling (Encoding)

These include at least a one-hour in-home visit where we meet you and your child, a review of previous reports, testing, etc., and within ten business days a 1.5- to 3-page report with professional impressions, recommendations, and goals (if services are recommended). These evaluations are not diagnostic in nature and are best for tutoring purposes for creating decoding and spelling goals. Low test scores will indicate that the parent should follow up with a psychologist for additional testing (we can recommend them to you!).

Our Literacy Teachers cannot produce ICD-10 codes as they are not licensed therapists.

TIER 2 EVALUATIONS & ASSESSMENTS (Home, School, English, Multilingual) Performed by Licensed Speech-Language Pathologists/Therapists.

$250-$1000* TIER2 Evaluations are more comprehensive than TIER1 Evaluations and include literacy evaluations performed by licensed language therapists. TIER2 evaluations are perfect for private CPSE and CSE evaluations. A TIER2 Evaluation is recommended when a child has more than a few speech sound errors that aren t appropriate for his or her age, and there are significant concerns related to understanding and using oral and written language, particularly when the child is 48 months and older.

  • $300-$500 for Moderate to Severe Early Language and Communication Skills (0-36 months)
  • $300-$500 for Articulation/Enunciation/Speech Sounds (3 years and up) when the individual is having difficulties with more than a few age-appropriate sounds
  • $700-$1000 Apraxia Evaluation performed by Dr. Melissa (see below for more information)
  • $300-$500 for Fluency/Stuttering (2 years and up)
  • $250-$400 for Feeding (any age)
  • $300-$500 for Early Literacy Skills (4-6 years and up)
  • $300-$600 for Literacy (Written Language – Reading and Writing)
  • $300-400 for Expressive Language (3 years and up)
  • $400-$800 for Expressive and Receptive Language (3 years and up) for students who need their receptive language evaluated and have significant expressive language delays.
  • $400-$500 for Expressive Language and Articulation (3 years and up)
  • $500-$800 for Expressive and Receptive Language, Articulation (3 years and up)
  • $600-$1000 for Expressive and Receptive Language, Literacy, and Articulation (4 years and up)

All of our TIER 2 Evaluations occur over one visit at a quiet space in your home. If you are interested in office space, see below. These visits are 1-3 hours long, and your child will be given breaks. Occasionally, a child is unable to complete the testing with the appropriate amount of time allowed for assessments. We reserve the right to charge an additional $150 fee to schedule a follow-up appointment to complete the testing when these circumstances arise.

TIER2 Evaluations include a 2 to 10-page report (higher costing evaluations result in extended reports and visa versa), including professional impressions, recommendations, and goals. Please allow us up to 10 business days to produce the report. If you need the report in less than ten days, it can be expedited for a fee of $100-$200 depending on how quickly you need the turnaround. For higher costing evaluations ($600 and up), we might require additional time to complete the report (10-15 business days). Results are discussed over the phone or in-person if the data is scored at the time of the assessment. If a parent requests a follow-up meeting to discuss the results in person, this will be billed at the professional s hourly rate.

We can recommend and start intervention before the report is finished because we will know directly after or soon after the evaluation if intervention is warranted and will be able to establish goals. These two essential pieces can be figured out before the report is submitted to you. With your permission, we can share this information with a 3rd party.

ICD-10 codes are furnished if the individual has a significant delay or a disorder. We produce speech and language disorder ICD-10 codes. For an ICD-10 code related to literacy or a learning disorder, e.g., dyslexia, we recommend that you follow-up with additional testing performed by a licensed NY State neuropsychologist. We have many great recommendations!

*Office-Based Assessments: Please note that we can rent space throughout NYC for an additional fee. Please note that office-based assessments are billed at higher rates, e.g., $20-40 more per hour to cover our rental expenses.

*Bilingual/Multilingual Assessments: Bilingual/Multilingual evaluations/assessments are usually marked up an additional 30 to 50% due to the additional work required to assess more than one language.

About Childhood Apraxia of Speech Evaluations

($700-$1000 for Manhattan). *Additional fees for areas outside of Manhattan

What is Childhood Apraxia of Speech

Childhood Apraxia of Speech (CSA) is a pediatric speech disorder. In contrast to difficulties with articulation (enunciation), a child with Childhood Apraxia of Speech cannot get their mouth movements to the right place at the right time. This will result in not only speech errors but also disruptions to the flow of speech.

Who might have Childhood Apraxia of Speech

Childhood Apraxia of Speech can occur on its own or in combination with other speech and language disorders. Often children with Childhood Apraxia of Speech have not made progress with traditional speech therapy. Some children with Childhood Apraxia of Speech make inconsistent errors when repeating the same word. Sometimes children with Childhood Apraxia of Speech may speak in a way that sounds slow or choppy.

How is Childhood Apraxia of Speech Diagnosed

Childhood Apraxia of Speech is a misunderstood and often misdiagnosed speech disorder. Childhood Apraxia of Speech is difficult to diagnose because the symptoms can appear very similar to speech-language delays and other speech-language disorders, especially when a child is very young or has a limited vocabulary. There is no gold standard test for Childhood Apraxia of Speech so it must be diagnosed by careful and systematic exclusion of other highly similar speech disorders. Although there is no single test for Childhood Apraxia of Speech, the scientific literature has identified tasks that can differentially diagnose children with high accuracy. Accurate diagnosis depends on a skilled and experienced practitioner to understand and use these science-based methods. Methods for differential diagnosis of CAS from other pediatric speech sound disorders vary by the age and communication abilities of each child. Evaluations of CAS must include an evaluation of the motor speech system, examining in detail both the types and amount of sounds and syllable shapes a child has, in addition to the underlying movement patterns and overall quality of the rate, rhythm, and intonation of speech.

All of our TIER 2 Evaluations occur over one visit at a quiet space in your home. These visits are 1-3 hours long, and your child will be given breaks.

Occasionally, a child is unable to complete the testing with the appropriate amount of time allowed for assessments. We reserve the right to charge an additional $150 fee to schedule a follow-up appointment at your home to complete the testing when these circumstances arise.

TIER 2 Evaluations include a 2 to 10-page report (higher costing evaluations result in extended reports and visa versa), including professional impressions, recommendations, and goals. Please allow us up to 10 business days to produce the report. If you need the report in less than ten days, it can be expedited for a fee of $100-$200 depending on how quickly you need the turnaround. For higher costing evaluations ($600 and up), we might require additional time to complete the report (10-15 business days). Results are discussed over the phone or in-person if the data is scored at the time of the assessment. If a parent requests a follow-up meeting to discuss the results in person, this will be billed at the professional s hourly rate.

We can recommend and start intervention before the report is finished because we will know directly after or soon after the evaluation if intervention is warranted and will be able to establish goals. These two essential pieces can be figured out before the report is submitted to you. With your permission, we can share this information with a 3rd party.

ICD-10 codes are furnished if the individual has a significant delay or a disorder. We produce speech and language disorder ICD-10 codes. For an ICD-10 code related to literacy or a learning disorder, e.g., dyslexia, we recommend that you follow-up with additional testing performed by a licensed NY State neuropsychologist. We have many great recommendations!