Speech and language therapy (SLT) services are vital in assisting children with speech, language, or communication disorders. However, various barriers limit the provision of this service in an equal and adequate manner. This study examines these barriers in the UK, the USA, Canada, Australia, and Türkiye and explores how school-based speech and language therapies contribute to removing these barriers in these countries. Key barriers, including workforce shortages, equity, accessibility, geographical and financial constraints, and lengthy waiting lists, impact the quality and provision of SLT services. Embedding SLT services within the school may provide timely, targeted, and sustainable interventions, thereby improving accessibility and availability. A qualitative comparative method was employed to analyze service provision in the five countries and identify differences and similarities in barriers to accessing SLT services. The findings indicate that while improvements are needed in all countries, Türkiye faces unique challenges that require comprehensive reforms, as there are relatively few speech and language therapists. The service is not accessible for many children, which perpetuates these barriers. Establishing school-based SLT services and integrating relevant training into teacher education curricula should be prioritized, as this will equip future educators with the knowledge and competencies for their active support.