The word ‘evaluation’ can sound intimidating, especially for parents and children who have never before experienced a pediatric speech therapy evaluation. There can be apprehension in not knowing what to expect when something is new. In reality, an evaluation for therapy is not intimidating or scary. This article aims to explain what a typical speech therapy evaluation will look like to ease any potential anxiety.
Before the speech therapy evaluation, you will likely receive paperwork to fill out about your child’s history, your concerns, and insurance information. This is frequently sent to you ahead of time so that you can fill it out at your leisure and bring it completed to the evaluation so you have less to worry about on the evaluation day. This information seeks to help you to better understand your insurance benefits in regards to therapy, to allow you to express the concerns that you have for your child, and gives the therapist valuable information to guide their evaluation.
At the Clinic
When you arrive at the clinic, the speech therapist will greet you and your child. Sometimes it takes a few minutes (and maybe a toy or two!) for your child to warm up to the therapist. Most of the time, the kids are excited to play with new toys and have no problems separating from their parents. It is important for the therapist to have time alone with your child to begin to create the vital therapeutic alliance that will help them improve quicker. This time alone also allows the therapist to see what the child can do without the child wanting to rely on their parent.
Once the therapist takes your child to the therapy room, the formal speech therapy evaluation begins. The speech therapist will have chosen a formal standardized assessment tool ahead of time based on the presenting diagnosis and concerns. If your child has speech sound concerns, the therapist will frequently begin the evaluation with an oral-mechanism exam. This means they will examine the structures involved in speech sound production (lips, teeth, tongue, palate, etc.) and make note of any difficulties and/or abnormalities. This is a quick and non-invasive external examination. Sometimes children have low tone or increased tone, a short lingual frenulum (the ‘tie’ holding the tongue to the bottom of the mouth), or other physical factors that may contribute to or be responsible for speech deficits.
After the oral-mechanism examination, a formal assessment is typically administered. For speech sound errors, the test consists of having your child name pictures while the therapist transcribes the child’s speech sounds using phonetics. For receptive and expressive language concerns, the test consists of structured situations with specific questions targeting language skills using toys and materials to keep your child engaged. Fluency and pragmatic language can also be assessed through standardized tests. No matter the skill, the test will be chosen based on your child’s age, presenting concerns, and skill level.
Throughout the evaluation, the speech and language therapist also informally evaluates your child using observation and play. Many speech and language skills can be observed through a simple activity such as rolling a ball back and forth or playing with pretend food. If needed, the therapist also uses parent interview to obtain further information about the child’s skills.
After the Evaluation
Once the formal evaluation is finished, the therapist will bring your child back to you. The next 10-15 minutes are spent discussing the preliminary results of the evaluation. At this point therapist will be able to tell you if there are delays with your child’s speech and/or language, and what the next step should be. Sometimes the next step is further testing, while other times it is appropriate to begin skilled therapy sessions. Every child is different, so evaluation and therapy plans are based on each individual child’s skills, needs, and the parent’s desires.
Be cautious of a therapist who does not discuss the results of the evaluation with you or include you in deciding on priorities. The family is a large part of a successful therapy program and you are crucial to your child’s success in therapy. If you feel that the results of the evaluation do not match the skills and needs of your child, consult another therapist to obtain a second opinion.
If you have any concerns about the evaluation, before, during, or after the appointment, always feel free to contact your therapist or therapy clinic with questions!
Contributed By: Rachel Jacob, CCC-SLP