What a speech evaluation looks like.....

First let me say...
If your child needs a speech-language evaluation...don't worry! It really should be a pretty laid-back experience.

When you arrive at the clinic you and your child will be taken to a therapy room. Therapy rooms typically look "happier" than doctor offices...so no worries your little one won't be scared they are visiting the doctor and getting shots :(

Once inside the room the clinician (aka the speech therapist) will either jump right into the evaluation or begin with some medical history questions.

What type of questions???

Here is a list of some of the questions that might be asked...keep in mind its not all of the questions, just some:

1.) Why are you here today? (meaning...who referred you...your pediatrician, a family member, a teacher, or yourself)

2.) What is your main concern? (are you having trouble understanding what your child is saying, do they not have enough spoken words, are they not following directions, etc...) Basically, whats going on???

3.) Was he/she full-term?
- if premature how many weeks?
- what was the birth weight?
-Any complications during the pregnancy or at birth?
-Was the birth c-section, vaginal? Was he/she breech, were forceps needed, etc...
-What were his/her apgar scores?

4.) Did he/she pass their newborn hearing screening at birth?
-do you have any current concerns with their hearing?
- Have they had their hearing tested recently?

5.) Any diagnosis for cerebral palsy? Hypotonia? Cleft lip/Cleft Palate? Down Syndrome? Autism?

6.) Any hospitalizations since birth?

7.) Any ear infections? How many? Did they clear up with antibiotics? Were they in both ears or just one? Do they have tubes in their ears? When were they placed?

8.) Did your child babble much as an infant?

9.) At what age did your child crawl & walk?

10.) Is there a family history of developmental delays, medical conditions, speech therapy, learning disabilities, siezures, etc...

11.) How does your child make clear their wants & needs? (gesturing, grunting, pointing, etc..)

12.) What words does your child say?

13.) Does your child imitate your words or sounds or phrasing (rising intonation for questions)?

14.) Does your child understand your speech? What you are telling them?

15.) Does your child play "people games" (peek-a-boo, I'm gonna get you) etc..

16.) Do you or your child become frustrated with their communication skills?

17.) What are your expectations for speech/language therapy?

18.) Was your child breast or bottle fed?
- How did that go?
-How did they do and when did they transition to pureed (baby foods)?
-Do they currently eat different types and textures of foods?
-Do they drink from an open cup or sippy?
- Do they use a spoon independently?
-Do they use a straw?


Whew! Lots of questions I know... After the questions..the speech therapist will probably "play" with your child for a while. They are primarily during this time going to try to illicit some communication and see what they can get your child to do spontaneously...

After that...the speech therapist will begin her formal assessment. Typically, a speech therapist will look at 7 domains...

Auditory comprehension (the ability to understand spoken language)
Expressive communication (the ability to use a variety of gestures &/or words, phrases and sentences to communicate a message)
Pragmatics/Functional communication (communicative intentions and ability to follow social rules governing use of language in context)
Phonology/Speech Sound Development: (Sound development and clarity of speech)
Voice: ( vocal volume, pitch, quality and resonance)
Fluency/Prosody(ability to use smooth, flowing and effortless speech with appropriate rhythm and rate)
Oral-motor/feeding: (ability to use facial/oral structures appropriately for facial expressions, speaking and chewing/swallowing)

She will complete the evaluation of these areas through various pictures, observing behaviors, asking you additional questions, and illiciting responses from your child.

At the end of the evaluation...the therapist will typically score the evaluation and let you know the results...and based upon those results therapy will be recommended or not recommended. The frequency of therapy is recommended based on those scores too...Every other week, weekly, monthly, monitoring, etc...

Following the eval and recommendations...you will recieve a full typed report within a couple of weeks detailing what was seen during the eval, the full scores of the assessments, and the recommendations.

I would encourage you that if therapy was recommended and it has been a couple of weeks since the completion of the eval that you keep tabs on scheduling their first speech appointment. Call and ask what you can do to help to speed things along and get your child scheduled. Sometimes we are tied up waiting for the pediatricians to sign a prescription for speech therapy...sometimes its insurance companies, and sometimes WE as an agency need to be reminded to hurry ourselves along too :)