Your child needs speech therapy. You are feeling a little overwhelmed or don’t know what to expect at their evaluation.
Hi, Chelsea here! I have been a speech-language pathologist since 2015. I have worked in several different settings and have met hundreds of parents who are in your position. It can be scary to start therapy and not know what to expect. Hopefully you will find some answers to common questions here.
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Part 1 Recap
This is a multi-part blog series. Have you read part 1, where we discuss all the WHs of Speech Therapy We help you decide if your child may need therapy, what your options are, and how to choose which therapist or service type/location that may be best for your family. I highly recommend you go back and read part 1, but I will give a quick run down here.
You or someone you know, including your child’s healthcare provider, may see a need for your child to have speech therapy.
Your child may struggle with language development, speech sounds, oral strength, feeding difficulties, vocabulary, grammar, social skills, academic reading or writing, executive functions (e.g. planning, organizing, attention), dysfluent speech, voicing concerns, and more.
There are several factors to consider when choosing speech therapy. Depending on your child’s age, the cost and coverage of therapy, your schedule, and the areas of need or specialty, you may choose to have speech therapy through Early Intervention, the School System, Outpatient Setting (e.g. hospital, private clinic, in-home clinic or university clinic), or through a Private Practice (e.g. virtual, clinic, or in-home).
Now that we had a brief recap, let’s get into what you can expect to happen at an initial evaluation.
Initial Evaluation
Before services can get started in any setting, you will need to complete some form of an evaluation. This is how therapists, regardless of the setting, determine the type and severity of needs, the values you have as a family, and the recommendations and goals that will be the focus of therapy.
Each setting will have its own requirements for an initial evaluation, but here are some general things to plan to complete prior to or at the beginning of the evaluation.
Legal Forms
Each setting has its own legal requirements to uphold. These may include notices of how your child’s information is kept confidential, who can have access to your child’s information, notice of appropriate timelines and completion of tasks, insurance billing and financial responsibility, and more.
Most settings will also have some form of an attendance policy along with other policies that state what they expect from the family/client and their mutual relationship with the therapist and setting.
Demographic Information
- Who is your child
- Who is responsible for them (medically, financially, etc.)
- Insurance Information (if applicable)
Case History Information
I would say most parents tell me they feel unprepared for this portion, because it can be quite detailed. Some of this information may be provided on an intake form and other information may be discussed during a case history interview. As a general rule, you can expect your child’s therapist to ask about background and current status of the following information:
- Medical: surgeries, medications, growth, illnesses and overall health.
- Social & Socioeconomic: living situation, school or daycare attendance, interactions with friends, family, daily routines, screentime, etc.
- Educational: school attendance and performance, strengths and struggles, current IEP or other services provided.
- Cultural & Linguistic Values: types of cultural and linguistic aspects the therapist needs to be aware of and sensitive to in order to provide ethical care.
Many parents question why therapists need all of this information. It is to help us provide holistic care, where we treat the entire child and who they are within their family context. We want to have the full picture in order to fully understand the strengths and struggles as well as provide accurate information and recommendations within the values of the family.
Evaluation Protocol
Once all of the formalities have been completed, the SLP may engage with your child while they complete the case history interview, alternating between playing and talking. Or, the SLP may complete the interview separately from their time with the child.
The SLP has been observing your child since the very beginning and likely has a purpose for each question they ask or toy they use even if it seems like “free play”. This is called informal observation. SLPs can gather a lot of information during this time, but a few things they may be doing are assessing vocal quality, rate of speech, fluency of speech, social skills, body movements (gross, fine, and oral motor), sensory regulation and behavior, and more.
The SLP may complete an informal assessment which may include a screening or informal test to assess certain skills. This may include speech, language, or oral function skills.
They will also likely use a standardized assessment which is a formal test to measure particular skills. Of note, standardized assessments have very specific rules that the SLP has to follow to maintain the validity of the assessment. Therefore, SLPs may *politely* ask that parents not intervene during this time. Even if you think your child “knows” what they are testing, it is key that the SLP follow the testing rules in order to obtain an accurate score.
After the evaluation, the SLP will review the results and work with the family to develop a plan and recommendations. This may take place the same date as the evaluation, during a scheduled conference after the evaluation, a virtual appointment, or even during the first therapy session.
Oftentimes, the recommendations are related to speech therapy, such as how often the SLP plans to work with your child or what areas they will address. But, it may also include things like completing a hearing evaluation, seeking additional therapies (e.g. OT, PT) and/or completing additional testing (e.g. Autism testing, swallow study).
Final Notes
Now you have a basic idea of what to expect at your child’s speech therapy evaluation. Next time, we will go into a little more detail about the process from the evaluation through the first therapy sessions and some specific details per setting and disorder type.
References
Assessment and Evaluation of Speech-Language Disorders in the Schools. Retrieved from: https://www.asha.org/slp/assessment-and-evaluation-of-speech-language-disorders-in-schools/?srsltid=AfmBOorHIqf6wrXFOnX65SnDSp7zz5-MtG6imgI3XHrntDtEK03OltaL
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