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Speech & Language Evaluation: What to Expect

Many parents wonder what a speech and language evaluation looks like. Though it may differ depending on the child’s age, here is a general overview so you can feel prepared (and prepare your little one, too!). 

1. Case History

Before the evaluation, your Speech-Language Pathologist (SLP) will ask you to complete and return a case history form. This will include personal information as well as family, developmental and educational history. There will be a section concerning speech and language history so the therapist can adequately prepare for the evaluation. This section will include questions about speech and language milestones, how your child is currently communicating and will provide an opportunity for you to share your concerns surrounding speech and language.

2. Parent Interview

Since parents and caregivers are the best informants, it’s important that they be included in the evaluation process. Getting a parent or caregiver perspective is crucial, thus the parent interview is typically the first portion of the evaluation.  Most evaluations start with discussing speech, language and play skills as well as parent or teacher concerns. The SLP will ask questions related that the case history form you completed and what your goals are for the speech and language assessment. If it’s not appropriate or your don’t feel comfortable holding a discussion around the child, a phone call can be arranged prior to the evaluation session.

3. Behavioral Observations

After the SLP has a good idea of parent concerns and goals for the evaluation, they will get to know the child informally, during play and conversation.  This is a great opportunity to build rapport with the child before the formal testing begins. Usually, the SLP will introduce age appropriate toys and games and observe the child informally. During this time, the SLP will be keeping certain areas of development in mind such as play skills, pragmatic/social skills, speech intelligibility and conversational abilities. Typically parents will stay in the testing room, may participate in play or may watch the SLP and child interact. The SLP will ask follow up questions after getting to know the child.

4. Oral Motor Examination

An oral motor examination is an assessment of the facial structures used for speech. If an oral motor examination is warranted and appropriate, the SLP will examine the child’s facial symmetry, dentition, and take a look inside their mouth. They will also ask your child to make certain movements (silly faces!) with their lips and tongue. We realize this may be uncomfortable and feel scary for a young child so we make it quick and have some tricks to make it fun!

5. Formal Assessment

There are many standardized speech and language tests used to examine different skills. Some areas that may be tested include: articulation, apraxia of speech, receptive/expressive language, fluency/stuttering and reading/writing.  An SLP will use different tests for a toddler with delayed language and an elementary school student with reduced intelligibility. As such, this portion of the evaluation will vary greatly depending on a child’s age and speech and language concerns. During this portion of the assessment, the SLP will administer 1 or more standardized tests to the child.  Many standardized tests are norm-referenced, meaning the test yields a score or multiple scores used to compare your child’s scores to those of same aged children.

Assessments for toddlers are typically play-based, completed on the floor and involve parent and caregiver input. For preschool and elementary school children, parents are asked to watch quietly. These often involve looking at pictures in a book (test stimuli), following directions and answering questions. For older children reading and writing may be tested as well to assess all aspects of language.

6. Language Sample

A language sample is used as a way to analyze speech intelligibility and expressive language skills. The SLP may elicit a sample during play, while looking at a picture scene, or while reading a wordless picture book. The SLP will either write or record the language sample for analysis. Depending on the flow of the session, the SLP may take a language sample before or after formal assessment.

7. Discussion of Results and Recommendations

At the end of the evaluation, the SLP will briefly discuss initial impressions and recommendations with you. They will discuss whether therapy is warranted, as well as the recommended frequency of therapy sessions. If necessary, the SLP will recommend assessments in other disciplines at this time (occupational therapy, physical therapy, developmental evaluation). In some circumstances, the therapist may schedule a second evaluation session to complete necessary testing if the time frame allotted was not enough.

Check out our key developmental milestones resource to see if an speech-language evaluation is right for your child.

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