What parents ask before they ever pick up the phone.

Trust the gut. A few specific things to watch for. If your three-year-old has fewer than 50 words, if your child is hard to understand by people outside the family, if your kindergartner cannot rhyme, if you have heard "they will grow out of it" for two years and you are not sure, the 15-minute call is exactly what it is for.

Some specific milestones the CDC tracks: by 12 months, most babies say "mama" or "dada" and turn to look when their name is called. By 18 months, most children know around 10 words and follow simple one-step directions. By 24 months, the typical range is 50+ words and the start of two-word phrases. By age three, family members understand most of what your child says, even when grandma or a stranger does not. By kindergarten, your child can rhyme, identify the first sound in a word, and tell a short story with a beginning and an end.

Missing one milestone is not a diagnosis. Missing several, or staying stuck on the same one for three to six months without progress, is the kind of pattern the 15-minute call is built around. If we are not the right fit, we will say so and tell you who we think would be.

Most kids will not, and that is fine. Sessions are not desk work. We move, we play, we follow what your child is drawn to that day. The behaviors you might worry about, climbing on the couch, asking the same question 14 times, hiding in the corner, are clinical data. They tell us how your child seeks input, regulates, and engages. We design the next ten minutes around what we just learned.

You are not too early. Some of our highest-leverage work is with babies and toddlers who have not yet started speaking. We focus on joint attention (the moment a baby and an adult look at the same thing together), gesture, imitation, first signs, first words, and the play patterns that make language possible. Speech therapy starts before words do.

Both can be valuable, and they are not the same thing. School SLPs do important work, often in groups, often 30 minutes a week, on goals tied to the Individualized Education Program (IEP). Private therapy is one-on-one, longer, and we set the goals together with you. School SLPs are not allowed to work on goals outside the IEP. We are. Many of our families do both. We coordinate with your child's school SLP whenever you want us to.

We are out of network on purpose, which means you pay us directly and we send you a superbill after every session for your insurance. Many plans reimburse 50 to 80% of out-of-network speech therapy.

Every plan is different. Before you start, call your insurance and ask one specific thing: "What are my out-of-network benefits for speech-language therapy under CPT 92507 and 92523?" That gets you a real answer. ASHA's reimbursement resources have more detail on out-of-network billing.

Most likely, partially. Common Virginia plans (Anthem, CareFirst BlueCross BlueShield, Aetna, Cigna, United Healthcare, Tricare) all offer some out-of-network speech therapy benefit, but the percentage, the deductible, and the visit cap vary. Call the member-services number on the back of your insurance card and ask one specific thing: "What are my out-of-network benefits for speech-language therapy under CPT 92507 and 92523, and what is my out-of-network deductible?" That conversation usually takes five minutes and gets you a real number.

If you tell us your insurer on the 15-minute call, we can share what we have heard from other families with that same plan. We are not a billing service, but we have watched a lot of superbills succeed and fail, and we can usually tell you what to ask.

We tell you the per-session rate on the 15-minute call, before you commit to anything, before we ask for any payment information. We do this because the cost is a real factor for almost every family, and we would rather you find out from us in a five-minute conversation than from a surprise invoice. Most families also use the superbill to recoup 50 to 80%.

Real talk. Speech therapy is a real expense, and we have not met a family who did not have to plan around it. Most families pay out of pocket per session and then submit the superbill for partial reimbursement. After reimbursement, the effective per-session cost depends on your specific plan and our rate, which we share on the 15-minute call. We would rather have that conversation honestly than gate the number behind a sales pitch.

If the cost is not workable for your family, tell us on the call. We sometimes have flexibility on cadence (every other week instead of weekly, or coaching-only sessions instead of direct therapy). If we are not the right fit financially, we will help you find someone in your area who is, or point you to Virginia Early Intervention if your child is under three.

A superbill is a detailed receipt with everything your insurance needs to consider out-of-network reimbursement: dates of service, diagnosis codes, procedure codes, our credentials, and what you paid.

You upload or mail it to your insurance. They process it as an out-of-network claim. Any reimbursement is mailed to you, not us. We will hand you the first one and walk you through the upload.

Sessions are structured but they look like play. We use the games, books, toys, and real-life scenarios your child is already drawn to, so we can get more reps on a specific goal without the meltdown. We track progress every session, on the goal, on the kid's engagement, on what made it click. At the end we spend a few minutes with you. We share what we did, what we noticed, and one or two strategies to try at home this week.

Yes to all three. In-person and virtual sessions both work for most ages and most goals. Many families choose a blend, especially during sick weeks, busy seasons, or travel. Same therapist either way.

Children birth to 18. Babies, toddlers, preschoolers, elementary kids, middle and high schoolers. We do not age them out of the practice, so if we start when your kid is two, we can still be there when they are twelve.

Most kids do best with one or two sessions a week. Some need more during a hard stretch, fewer when things are clicking. We will start somewhere reasonable and adjust based on what you see at home and what we see in session.

Yes. Autistic kids are a core part of our practice. We work from a neurodiversity-affirming framework, which means we build on how your child already communicates rather than trying to make them communicate the way a textbook expects. Functional communication, connection, play, and the language strategies that fit your child. Whether your child is fully speaking, a gestalt language processor, scripting, or using AAC (augmentative and alternative communication, the tools that let kids talk when speech is not their primary path), we meet them where they are.

Yes, deeply. We expect to talk to you every session, sometimes only for a few minutes, sometimes longer. Consistency between session and home is one of the strongest predictors of progress. We will share strategies, answer questions, and make sure you walk away knowing one or two specific things to try this week.

Send us a message through the contact form, or email Fireflytherapyservicespllc@gmail.com. We reply within 1 to 2 business days, set up your free 15-minute call, listen to what you are noticing, answer every question, and tell you what we think the next step is. Sometimes that is starting therapy with us. Sometimes it is a referral. Either way, you walk away with a plan.