What is a speech evaluation and why is it important?
What is a speech and language evaluation?
A speech and language evaluation is a comprehensive assessment of a child’s communication skills carried out by a licensed speech-language pathologist (SLP). During an evaluation, an SLP assesses domains such as receptive language (i.e., understanding of language), expressive language (i.e., use of language), pragmatic language (i.e., social use of language), articulation (i.e., production of speech sounds), voice, resonance, and fluency. The length of an evaluation is dependent upon a child’s age, reason(s) for referral, language level, and number and type of assessments administered. While an evaluation for a 12-month-old may take an hour, one for a 14-year-old may take up to 3 hours or need to be carried out over multiple session dates.
Why is a speech and language evaluation important?
Speech and language evaluations are invaluable, as they allow us to determine if speech therapy is warranted. They provide clinicians with the information needed to pinpoint a speech and language diagnosis/diagnoses (e.g., expressive language delay, childhood apraxia of speech, etc.) if one or more is appropriate. Additionally, evaluations allow SLPs to gather quantitative and qualitative information on a child’s strengths and areas of weakness that inform subsequent treatment and goals. They also provide baseline data on a child’s current speech and language skills that can then be used to measure progress and growth with therapy.
When should I seek out a speech and language evaluation?
You should seek out an evaluation if you are concerned about your child’s communication skills. Pursuing a speech and language evaluation doesn’t necessarily mean your child needs speech therapy. An evaluation will answer your questions about your child’s current language skills and the ways in which intervention may benefit your child if an SLP finds it to be warranted.
How often should a child receive a speech and language evaluation/re-evaluation?
I always recommend an evaluation prior to starting therapy with a child unless they’ve recently received a comprehensive school-based or outpatient evaluation in the last 6 months. Taking into consideration a child’s age and language level, I typically recommend a speech and language evaluation every 6 months to 12 months. This allows us to document progress, reassess goals, and modify our therapeutic plan accordingly.
What is included in the evaluation process?
Reason for referral: Before starting a speech and language evaluation, it is important for SLPs to understand a family’s reason for seeking out an evaluation. During this conversation, relevant background information and medical history is also obtained.
Play-based and behavioral observations: Prior to starting any structured tasks, an SLP often observes how a child engages with familiar family members, how they respond to unfamiliar people, and how they play with toys, if applicable.
Standardized testing: Regardless of a child’s age and ability level, it is critical to administer standardized testing measures that allow us to gain in-depth information on a child’s current speech and language skills as compared to peers. Standardized tests must be selected carefully and take into account factors such as language, culture, and hearing and vision status that may impact a child’s performance.
Informal assessment: While standardized tests are an important component of speech and language evaluations, they certainly don’t paint the whole picture. I always encourage families to interpret standardized testing scores with a grain of salt. For this exact reason, it’s also crucial to incorporate informal assessment during an evaluation. Informal assessments don’t provide us with standard scores or percentile ranks, but they allow us to observe how a toddlers engages with toys or how a school-age child participates in conversation. Often times, I do some “trial therapy” during my evaluations to see how a kiddo responds to therapeutic activities.
Summary of findings: After an evaluation is complete, an SLP will review a summary of their findings with families. This should include results of both standardized testing and informal assessments, a review of speech and language diagnosis/diagnoses if one or more is appropriate, a discussion of whether speech therapy is warranted, and a conversation surrounding necessary referrals (e.g., audiology, ENT etc.). After the evaluation, SLPs should provide a written report containing all this information as well as recommended goals for therapy and strategies to implement at home.
Can evaluations be carried out virtually?
Yes! Although evaluations may look different when carried out on an online platform, like Zoom, rather than in person, they most certainly are an effective way to determine if speech therapy is warranted for a child.
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