What To Expect During An Early Intervention Speech-Language Evaluation

I recently wrote a blog post called, Help!  My Toddler is Not Talking.  In that post I explained what you should do if you suspect your toddler may have a speech or language delay.  You can contact your toddler’s pediatrician, research speech therapists in your area, or ask about early intervention services. 

The next step to determine if your toddler has a speech or language delay is to have an evaluation completed.  If your child is between ages 0-3 this can be done by early intervention services.  These programs are federal programs under Part C of the Individuals with Disabilities Education Act (IDEA), and evaluations are free.  Plus, you don’t need a referral from your pediatrician to get services.  You can find out more information about your state’s program on this website http://nichcy.org/babies/services.

Here’s how the early intervention program assessment process works:

Before the assessment/evaluation:

• First you will be given paperwork to complete.  This can range in topics from health and developmental information, a release of information form, and a permission to assess form.  You may also be asked to fill out insurance and financial information if you choose to have insurance pay for all or part of your toddler’s services. 

• Next, your toddler may be screened for speech-language, fine and gross motor, and social emotional development during a meeting with the early intervention staff.  This usually includes a questionnaire type screening and will help determine if a formal assessment/evaluation is needed. 

• If a formal assessment is needed it is usually conducted at your toddler’s childcare facility or in your home.  Most early intervention programs like to provide services in a child’s natural environment.     

The assessment/evaluation:

• The early intervention evaluation is usually completed by two or more professionals depending on the types of services you’re seeking for your toddler (most programs require 2 different evaluations as part of their state’s standards).  This can be a speech-language pathologist (SLP) and a developmental evaluator

• The evaluation will start with a parent interview.  The SLP will ask you many questions regarding your toddler’s speech and language development and when he or she met certain milestones.  The SLP should also ask what your concerns are about your child’s communication as a parent or caregiver.  If the evaluation is conducted in your toddler’s childcare facility, the SLP should interview your child’s teachers and caregivers to get more information about how he or she communicates in that setting.  Also, other professionals who work with your toddler can be interviewed upon parental permission. 

• Next, the SLP may want to see how your toddler interacts with other children at home (such as siblings) and/or children at his/her childcare setting.  This will help the SLP to gather even more information about your toddler’s current speech and language skills.

• The SLP will then begin the evaluation process.  She may start by building rapport with your toddler.  She usually does this by playing and talking with your child.  By establishing rapport, your toddler will usually cooperate and feel more comfortable with the SLP during the evaluation. 

• Next, the standardized testing procedures begin.  Standardized tests compare your child’s speech and language skills to other children his age.  One particular test we used when I contracted with Georgia’s early intervention program was the Preschool Language Scale-5 (PLS-5).  Here is a description from Pearson Education, Inc.    

            The PLS-5 offers a comprehensive developmental language assessment, with items that range from                     pre-verbal, interaction-based skills to emerging language to early literacy! This interactive, play-based                 assessment provides you with comprehensive, reliable, and trusted information about language skills for             children birth through age 7.

• After the standardized test, the SLP will formally or informally observe and evaluate your toddlers articulation (how he/she makes sounds), voice (if his/her voice is healthy, hoarse, nasal, etc.), fluency (how fluent his/her speech sounds), and oral motor structures (if his/her lips, tongue, jaw and other oral motor structures appear to be intact and functioning properly for speech production). 

The assessment/evaluation results

• The SLP will compile her results and write a formal evaluation report to determine if your toddler qualifies for services from your state’s early intervention program. 

• The evaluation is given to the early intervention staff, and they will call the parent/caregiver to meet in person to discuss the results.

• If speech therapy is recommended, they will write an Individualized Family Service Plan (IFSP) which will lay out goals for your child to reach.  Of course, parental input is needed to determine what goals are appropriate for your child.  You are an important part of your toddler's IFSP.   

• Next, speech therapy will begin.   Please keep in mind that speech therapy won’t start immediately.  Services will start based on the legal timelines set for each state.   

This is just an overview of what the assessment process will look like.  Please note that each state has different assessment standards and timelines.  Not all assessments will be alike. 

Now that you know how the early intervention program assessment/evaluation process works, we will talk about speech therapy and what your toddler's sessions will look like next.  Stay tuned!