By: Jennifer Tripoli M.S., Speech Language Pathologist
You and your child may wonder what to expect when participating in a speech and language evaluation. Many children (and parents!) feel less anxious when they know ahead of time what they will be doing. Of course, the outline of a speech and language evaluation depends on the age of the child and the areas of need. Below is a general outline for a speech and language evaluation:
1. Parent Interview
Parents are the best reporters of their child’s development. They know their child and can paint a clear picture of their child before the speech pathologist begins the formal assessment. A formalized assessment does not always “pick up” everything that should be known about a child. A caregiver or parent’s role in a pediatric speech and language evaluation is crucial in helping the speech pathologist determine your child’s needs. During this interview, the therapist will usually ask you why you have come in for an evaluation, and ask about your concerns and goals for the evaluation.
2. Case History
A case history usually includes a medical history and developmental history. Typically, the speech pathologist is able to review provided information prior to the evaluation, but often there are additional questions that need to be answered.
A medical history includes any medical issues that your child has encountered since birth or before birth. Often this includes, but is not limited to pregnancy/birth history of the mother (e.g. complicated pregnancy, premature birth, complicated delivery), major surgeries, procedures or tests (e.g. tonsillectomy/adenoidectomy, ear surgeries, brain surgeries, hearing screenings/tests, MRI/CT, etc.), significant illnesses, infections or injuries (e.g. chronic ear infections, chronic congestion, respiratory illnesses) and/or hospitalizations.
It is also important for the speech pathologist to be aware of any specialty physicians your child has seen such as otolaryngologists, gastroenterologists, neurologists, etc. A developmental history is taken in order for the therapist to understand your child’s developmental progression. Developmental histories include all areas of development; not just speech and language milestones. They can include when your baby first sat unassisted, crawled, walked, babbled, etc.
3. Speech and Language Concerns
During this part of the evaluation, the therapist will ask more detailed/specific questions related to your child’s speech and language skills. The types of questions will depend on your child’s age and the type of evaluation. The therapist will ask you questions related to your child’s expressive language skills, receptive language skills, social/pragmatic language skills, oral motor skills, and speech sound production.
4. Discussion of Previous Therapies
It is important that your therapist knows what services your child has participated in previously. Has your child received early intervention services? School based services? Other private therapies? You should be prepared to explain the other therapies your child has participated in including occupational therapy, developmental therapy, physical therapy, or behavioral therapy. Please be specific in the goals of each of the therapies if applicable.
5. Formal Assessment
The point where the therapist begins the formalized assessment can vary significantly depending on the age and deficits of your child. For a young toddler, this part of the assessment may be play based. The clinician will likely be observing your child’s current communication skills in a play setting while administering a standardized or norm referenced test. The therapist may ask to observe you playing with your child.
For a preschool or school aged child, a standardized/norm referenced test would likely be administered depending on the abilities of your child. This would yield a score that will compare your child’s skills to other children his/her age. A standardized test will likely be your child looking/naming pictures in a book and answering questions.
The clinician will also interact with your child in a less structured way by engaging in conversation or asking questions related to his/her life. The therapist may also take a language sample, which will analyze your child’s expressive language skills and speech intelligibility (ability to be understood by others). Additionally, the therapist will likely complete an oral motor assessment if appropriate in order to examine your child’s oral structures. An oral motor assessment usually asks the child to do certain movements with his/her lips, tongue, jaw and face. The therapist may also have your child eat/drink something. Though this is not a feeding evaluation, it is often difficult to separate speech and feeding skills.
6. Discussion of Results and Recommendations
Toward the end of the evaluation, the therapist will discuss your child’s results and make recommendations for any further evaluations needed. If your child would benefit from therapy, a recommended frequency would be given (e.g. weekly therapy, twice weekly, monthly, etc.) At this time, you can ask questions regarding the evaluation or your child’s prognosis.
Think your child may need a speech and language evaluation? Learn more about speech and language services provided at Easter Seals DuPage and Fox Valley here.