What to Expect During Speech Delay Testing?

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If you are contemplating speech delay testing for your child, you’ve most likely already discussed your concerns with your child’s pediatrician. Your child’s doctor has probably done some general assessing to look for any communication problems he or she might feel warrant further evaluation. You’ve probably also been referred to, or already been to, an audiologist to be sure the communication issues are most likely speech issues and not hearing problems. And, after confirming you should seek out a speech therapist for an initial assessment of your child, you wonder just what to expect during speech delay testing.

Screening for Speech Delay Testing

Sometimes, once your child’s hearing has been cleared by your pediatrician or audiologist, and before a full assessment takes place, a speech-language pathologist (SLP) might do a quick screening beforehand. It really is just to determine the angle the SLP will go when looking to see if there are signs of a speech disorder, and if there are, the SLP will recommend a full evaluation.

This does not necessarily mean that your child has a speech disorder, but that the SLP believes some signs warrant further investigation. More than likely, you’ll concur because you’ve already brought your concerns to your pediatrician. But, sometimes, clinicians will bring their concerns to you, and knowing what to expect is helpful. 

What To Know and Bring Before Speech Delay Testing

Before the full evaluation begins, you most likely will be asked to complete a parent questionnaire. At the evaluation, the SLP may talk with you about your child’s strengths and your concerns, and this is usually done at the beginning so your child can feel comfortable for the evaluation. You’ll want to be honest with all your concerns so that the assessment can be directed where it needs to be, and the direct testing can be targeted.

The paperwork you’ll be asked to fill out will require you to remember/note things about your child’s developmental milestones, medical history, strengths and weaknesses and specific communication concerns. It’s a wise idea to have these things thought out and written before you attend the evaluation so you’ll have it ready.

Things the SLP might want to know about include: pregnancy/birth complications; results of any prior hearing screenings or tests; medical records/assessment notes from other clinicians your child has seen for communication issues; medical history of upper respiratory infections/diseases; family history regarding speech, hearing, language or learning problems in other family members.

As well, the SLP will ask about milestones and knowing the ages that your child did the following will be helpful: babbled; sat up independently; crawled; walked; said their first word; said “mama” and “dada”; age when they combined two-words (for example: more please); if age-appropriate, age they began to recognize letters and/or read words.

Evaluation Basics

Every parent wants to know what to expect during speech delay testing. The evaluations are varied in application based on your child’s unique communication issues. 

The SLP will most likely use informal and formal tests to get a better idea of who your child is and where strengths and weaknesses are. Often, informal assessments are to engage your child as sometimes standardized testing can be dry. Pathologists are trained experts in how to appear to be engaging with a child’s natural personality and interests, while evaluating how the child forms words, enunciates, puts sentences together and processes questions asked. 

The pathologist will also be looking at receptive and expressive language ability. He or she may ask your child questions to which they’ll answer by pointing to the correct pictures, or they may ask your child to repeat things back to them. Most informal assessments still bring forth quite a bit of evaluative information. 

As well, the pathologist will look into the biology of your child’s communication. He or she will pay attention to voice quality and regulation as well as whether your child’s speech flows and the level of nasality that may be present. He or she will ask your child to perform motions and say words with their mouth to get an idea of how the tongue, lips and teeth work together and they may examine your child’s mouth to see the palate, lips and teeth as well. 

Formal tests will vary in the time they take to administer and differ based on what concerns you and your pathologist have. They are typically standardized and based on national norms and percentiles. A typical formal assessment is about 30-45 minutes, and your pathologist may suggest breaking the testing up into sessions or even sessions on different days for a better representation of your child’s abilities. For preschoolers, the latest version of the Preschool Language Scale is typically used. Older children often have testing that assesses problem-solving and language fundamentals as well as vocabulary as well. Usually, children answer questions in formal assessments until they can’t answer a specific number in a row correctly. This sometimes is even above their ‘developmental’ level, so parents often worry if their child is ‘missing’ questions. It is expected that at some point in much of the formal assessment, your child will max out, so don’t worry. 

The pathologist may ask you to fill out an evaluation that assesses your child’s social language (pragmatics) skills also. 

The Wrap-Up

When the evaluation is over, the pathologist will give a detailed written report that not only provides the raw scores for your child’s formal assessment but the clinical notations from the informal assessments as well. The pathologist will go over the results with you in detail, sharing the strengths and deficits your child may have and where the pathologist would address issues in therapy.

If therapy is indicated based on the findings, the pathologist will recommend a schedule, with therapy goals to achieve. These goals will continue to be addressed and revised as therapy happens until developmental milestones are reached, or targets are met.