Frequently Asked Questions

Occasionally, yes.

However, if your child has a speech or language disorder, it’s important to catch it early. Early intervention in a speech or language disorder can help your child avoid a lifetime of frustration in dealing with their communication issues.

It’s always best to err on the side of caution in this situation.

Yes, we are currently in-network and accept HSCSN, Tricare, Medstar, DC Medicaid, Amerihealth, Maryland Medicaid, and Amerigroup. If you have a different type of insurance, though, you may still be able to bill your provider. Consult your individual plan to find out the details.

The amount of time it takes to address a speech or language disorder varies from person to person.

Some of the factors include age, the severity of the issue, type of issue, willingness to stick with the treatment plan, and family involvement.

Your speech therapist will give you an estimate of how long they believe treatment will take.

Yes, we are licensed by ASHA, the American Speech-Language-Hearing Association, to provide speech therapy services in DC, Maryland, and Virginia.

In order to practice as a speech therapist, you need to hold at least a master’s degree.

Our owner and treating clinician, Ana-Maria Jaramillo, holds a Doctor of Speech-Language Pathology (SLPD) degree from Northwestern University and is one of the few SLPDs in the DC metropolitan area.

Speech therapy sessions are usually scheduled for 45 minutes.

In some cases, specifically if you are seeking early intervention services, it’s a good idea for you to be present during your child’s sessions so you can carry over strategies at home.

However, many children tend to have better speech therapy results when they work with a speech therapist by themselves.

If that’s the case with your child, you may be invited into the session at the beginning and the end in order to better understand that session’s goals and how you can help.

Every child is different, so every child needs a unique approach to speech therapy for children.

For very young children, speech therapists use mostly play based interventions.

This is because young children just don’t have the attention span or the cognitive skills. Additionally, research shows that children learn best through play.

These sorts of play based interventions may include:

• Talking and playing

• Using games to encourage your child

• Using books or pictures to stimulate language

• Practicing how to create proper sounds

• Helping you, at the child’s primary caregiver, to understand how you can help

For older children, we use a combination of these play based interventions, as well as table based strategies.

The goal is to help your child, but it’s also to make sure their sessions are fun.

After all, kids are more likely to do something if they actually like doing it.

Speech therapy isn’t just for kids. If you have a speech or language disorder yourself that you’d like help with, speech therapy can help.

In some cases, speech therapy for adults is for an acquired speech or language issue.

This means it’s an issue that occurred later in life, rather than something you were born with.

This can include medical issues like stroke, Parkinson’s disease, or multiple sclerosis.

It can also include recovery from accidents that injure your brain, throat, jaw, or other elements of your face and facial structure.

Speech therapy for adults can also treat people with a congenital speech or language issue that was never treated during childhood, but this is less common.

Some of the most common signs you as an adult may need speech therapy include:

• Declining memory

• Declining ability to produce language

• Declining ability to understand others

• Others having difficulty understanding you

• Hoarseness

• Mumbling

• Declining speech volume, speaking in a whisper

If you or a loved one is experiencing these, it may be a sign of a speech or language disorder.

If you’re an adult and you’d like to seek out speech therapy, the first step is a speech therapy assessment. Once we determine the root cause of your speech or language concerns, we’ll begin treatment.

Everyone’s treatment plan is different, but yours may include:

• Exercises to strengthen your oral muscles

• Breathing exercises to improve your resonance

• Cognition exercises

• Problem-solving exercises

• Memory and organization exercises

• Conversational exercises

• Mindfulness exercises to reduce anxiety

Our speech therapists are also trained in myofunctional therapy, specifically targeting tongue thrust/reverse swallowing and/or tongue ties. Myofunctional therapy involves following a 13-week program at minimum designed to correct the resting posture of the tongue at rest in addition tongue placement and movement during speech, swallowing (specifically when eating and drinking), and when sleeping.

In the case of a tongue tie, myofunctional therapy is typically required before and after a tongue tie release. Dentists will frequently require a speech therapist to sign off on a tongue tie release procedure before it is able to occur.

Feeding therapists assist with children who are considered “picky eaters” or children who are struggling to accept food with different textures, flavors, or food that is considered “nutrient dense”. Our feeding therapy program follows a protocol called “SOS Approach to Feeding”, or “Sequential-Oral-Sensory Approach to Feeding.” This program prioritizes understanding the needs of the child as a whole to tackle the feeding difficulties while promoting confidence and independence at meal times.

Some children feel more comfortable and communicate more naturally in familiar surroundings. Working in an everyday environment allows the therapist to observe your child’s communication during real activities and practice skills where they are regularly needed.

It can also create opportunities for collaboration with parents, caregivers, and educators while reducing the time and stress associated with traveling to a clinic.

Mobile therapy may be a good option for children who:

• Feel anxious or uncomfortable in clinical settings
• Attend daycare, preschool, or private school
• Benefit from practicing skills during everyday routines
• Need additional caregiver involvement and education
• Have transportation or scheduling challenges
• Need support using newly developed skills outside therapy sessions

Eligibility depends on your child’s age, clinical needs, location, proposed therapy setting, and appointment availability.

Dr. Jaramillo works with children who have a variety of speech, language, communication, oral-motor, and myofunctional needs.

Mobile speech therapy may support children with:

• Autism-related communication differences
• Expressive language disorders
• Receptive language disorders
• Mixed receptive-expressive language disorders
• Social communication difficulties
• Articulation and phonological disorders
• Childhood apraxia of speech
• Oral-motor disorders
• Orofacial myofunctional disorders
• Tongue thrust or reverse swallowing
• Tongue-tie-related speech and oral-function concerns
• Other pediatric speech and communication needs

If you are unsure whether the program is appropriate for your child, contact Dr. Jaramillo to discuss your concerns.

All mobile speech therapy services are provided by The Voz Institute’s founder and owner, Dr. Ana-Maria Jaramillo, SLPD, CCC-SLP.

Dr. Jaramillo has extensive experience supporting children and families in homes, schools, pediatric hospitals, outpatient rehabilitation facilities, and developmental settings. Her approach emphasizes individualized care and collaboration with the important people in each child’s life.

Yes. Dr. Jaramillo is a bilingual English/Spanish speech-language pathologist.

Therapy may be provided in English, Spanish, or both, based on your child’s language background, communication needs, and individualized goals. Your child does not need to be bilingual to participate in the mobile program.

No. The mobile program currently offers speech therapy only. Occupational therapy, physical therapy, and feeding therapy are not currently available through the mobile program.

The Voz Institute continues to offer these disciplines through its clinic-based services.

Depending on your child’s needs and the policies of the proposed setting, sessions may take place at:

• Your home
• Daycare
• Preschool
• Private school
• Another appropriate community setting

Sessions outside the home require permission from the school, childcare provider, or other setting. The location must also provide an appropriate environment for therapy.

Mobile speech therapy is available throughout Washington, DC proper, subject to scheduling and travel availability.

Areas served include Adams Morgan, Capitol Hill, Chevy Chase, DC, Cleveland Park, Columbia Heights, Dupont Circle, Georgetown, Kalorama, Logan Circle, Mount Pleasant, The Palisades, Tenleytown, Van Ness, Woodley Park, and other DC neighborhoods.

If you are unsure whether services are available at your address, contact Dr. Jaramillo to check availability.

We also service parts of Maryland, including Bethesda and Chevy Chase, MD.

If you are uncertain whether your address falls within the service area, contact Dr. Jaramillo before completing the intake process.

Each mobile speech therapy appointment is 60 minutes long. This includes approximately 50 minutes of direct therapy and 10 minutes of caregiver education.
Ongoing therapy is usually recommended once or twice per week, depending on your child’s evaluation results, clinical needs, treatment goals, and appointment availability.

The process begins with a comprehensive speech-language evaluation. Dr. Jaramillo will learn about your child’s developmental, medical, educational, language, and communication history and assess the areas related to your concerns.

Following the evaluation, you will receive:

• A written diagnostic report
• A personalized treatment plan
• Individualized therapy goals
• A recommended frequency for ongoing treatment

You do not need to know exactly what is causing your child’s difficulties before requesting an evaluation.

Caregiver education remains an important part of the mobile therapy program, even when a parent or caregiver cannot attend the session in person.

When therapy occurs at a school or daycare, the method used to provide the caregiver debrief will be arranged in advance. Depending on the setting and your family’s needs, follow-up may be provided through an agreed-upon method after the direct therapy portion of the appointment.

The private-pay model allows treatment recommendations to be based on your child’s individual needs rather than an insurance company’s limitations or authorization requirements.

It also gives Dr. Jaramillo greater flexibility when scheduling appointments and providing care in homes, schools, childcare facilities, and other community settings.

The current private-pay rates are:

• Comprehensive speech-language evaluation: $700
• Ongoing 60-minute therapy session: $175

The evaluation fee includes a written diagnostic report, personalized treatment plan, and individualized therapy goals.

If additional testing or consultation is recommended, any associated fees will be discussed with you before those services are provided.

No. Mobile speech therapy is a private-pay service, and The Voz Institute does not bill insurance directly for these appointments.

Payment is due at the time of service. A credit card will be securely kept on file and charged after each appointment.

Possibly. If your insurance plan includes out-of-network benefits, you may submit a Superbill to your insurance company for possible reimbursement.

A Superbill will be generated and emailed to the caregiver on the second of each month. Reimbursement is not guaranteed and depends entirely on your individual insurance plan and benefits.

We recommend contacting your insurance company before beginning services to ask about out-of-network speech therapy coverage, deductibles, reimbursement rates, and documentation requirements.

In many cases, speech therapy may qualify as an eligible medical expense under a Health Savings Account or Flexible Spending Account.

Because individual plans differ, we recommend confirming eligibility with your HSA or FSA plan administrator before beginning services.

Mobile speech therapy is provided in person. Dr. Jaramillo travels to an approved location, such as your home, daycare, preschool, or private school, and works directly with your child.

Teletherapy is provided virtually through a secure video platform. Your child participates remotely rather than meeting with the therapist in person.

The most appropriate option depends on your child’s clinical needs, location, comfort level, and ability to participate in each format.

Email Dr. Jaramillo at ana-maria@thevozinstitute.com or call The Voz Institute at (202) 734-4884. Let us know that you are interested in mobile, in-home speech therapy.

When contacting us, please provide:

• Your child’s age
• Your Washington, DC address or preferred therapy location
• A brief description of your concerns
• Your preferred language or languages for therapy
• Your general scheduling availability

We will discuss your child’s needs and location, confirm whether the program may be a suitable fit, identify a possible evaluation date, and provide the required intake paperwork.