Your Child’s Speech and Language Assessment: How to prepare and what you can expect

Joanne Jones Author

Here are 6 points covering what you need to do before your first SLT assessment and 6 points explaining what will happen at the assessment.

Here are 6 points covering what you need to do before your first SLT assessment and 6 points explaining what will happen at the assessment. Although this may vary slightly in different countries and is written from a UK point of view this information will help you to make the best use of you appointment time no matter where in the world you are.

How to prepare for your first Speech and Language Assessment :

1.Get a hearing check. 

Your child’s hearing may not be obviously affected but they may have intermittent hearing loss. In the UK you may wait a long time for your (Speech and language Therapy) SLT appointment so you want to have this done while you wait. You don’t want to wait that time and then they say they won’t do anything until your child’s hearing is checked. You need to do this first.

2. Stop the dummy and the bottle.

Use of a dummy is one of the first things a SLT will ask you about. Again you could wait for your appointment then be put back to the bottom of the waiting list until your child has stopped using their dummy. Some NHS departments won’t see children who are still using a dummy or even still using a bottle.

3.Tongue tie check.

You don’t want to get your SLT appointment and then it to come to light that speech therapy isn’t going to work as well because of a restriction in your child’s tongue. Look on the internet and make sure you know what different types of tongue tie look like. Some practitioners are not very experienced so you need to be informed. Get this checked out prior to your appointment.

4. Take videos.

Take some videos of your child in a natural situation, out in the park, in the shopping centre, in your garden or in the home. Take short clips in different situations. Your Speech and Language Therapist (SLT)They will only see one little snap shot of your child in a single environment whether its a clinic or hospital setting or at nursery or even if they do come to your home.  Seeing several little clips of your child in different settings and situations allows the therapist to see the child and their skills in a much more holistic way. This can be particularly important if your child isn’t very good with strangers and won’t show themselves in their best light, or they might not be very well, or they might not show their most challenging behaviours at or the ‘quirky’ things they do at the appointment. Get these things on video and show them to you SLT.

5. Developmental history.

Let the therapist know everything that has happened over your child’s life, how your pregnancy was, how your birth was, any relevant information about that neonatal period, when they were  born, how their feeding was initially, how it was at weaning, when did they first walk, when did they first make sounds, did they babble. This information is really important for the assessment.  Have it to hand so that you can tell the therapist in a succinct away. 

6. Overview of your child’s skills.

Prepare a written overview of the skills your child has. You are going for help, you are looking for answers and wanting to know where your child is up to, but, you know your child best. The therapist will only see your child for a short period of time and they need as much information as possible. Have a think about your child’s skills, their attention and listening, their comprehension, can they understand you if you don’t use gesture, do they answer to their name, are they talking, is their speech clear, can your neighbour or grandma understand them, what is their interaction like? Try to cover all the different aspects or skills involved in language development.  What is their play like, what do they like doing best, what interests them, what is the best way to get their attention.

What will the appointment be like?

Here are 6 things that the SLT will most likely do at the assessment:

1.Ask questions.

You should expect to be asked lots of questions. The SLT has one hour to get as much information about your child as possible within that time. There was a break her Joanne so you may want to add something? She will ask all about their medical history and what they can and can’t do. They will want to know what is difficult for them, and what things are easy?

2. Observe and interact.

They will spend time interacting with your child. The format will depend on your child’s age. They may get down on the floor and play with your child, or join your child in play. They will be trying out different strategies and seeing what your child responds to. What may just look like someone on the floor playing is actually the assessment. Seeing where you child’s up to, seeing how they respond to different interactions, looking at how they play with toys, these are the assessment. Paper based, scored up assessments that you might think of as speech therapy assessments don’t come into use until the child is 5 or above. In the preschool/early years language is developing in a very natural way. The therapist needs to see how your child is playing and what is going to help them to take the next step in language development.

3. Assess speech sounds. 

If you have an older child and their speech sounds are difficult, the therapist will often use a standardised assessment tool. This enables the therapist to pick out patterns of speech sounds that your child has and see if these are age appropriate. If not, the therapist may provide some support to improve their repertoire and clarity of sounds.  (Gap in this section too, might be worth adding age at or when speech sounds would be considered?) 

4/5. Provide a summary of where your child is up to and strategies you can implement to help them.

The SLT won’t diagnose your child with autism, or developmental language disorder, or say your child is apraxic. That’s not the point of the initial assessment and it would be concerning if after one hour a SLT gave that kind of information unless they were verifying someone else’s assessment. They would need to get to know your child more than that but they can tell your child where your child is up to in terms of their language development. They won’t say your child is one or two years behind, that’s not necessarily useful. (In America they sometimes estimate the percentage delay but that doesn’t mean much to a speech therapist in the UK.) What they should tell you is where your child is doing well, what the next things they need to achieve are, and how you can help them to make those steps. For example, they may say your child is at the stage where they have very single channelled attention, they can look and stick to a task of their interest for a good amount of time but they can’t let you join in that play or shift their attention away from that play and on to you. The next step is for you to be able to play alongside your child and gently join in, so maybe get your car to crash alongside theirs or follow their car along. You would to know the next steps and be given some examples of how to meet them. If you get that you’ve got everything you need at that point to be able to help your child. If you don’t come out with these things then it is ok to ask for them. Use the language you now know. You can say let me know where my child is up to, what are the next steps, and can you give me a few tips on how to get there? Any speech and language therapist is going to understand that and know what you want from the appointment.

6. Decide upon and inform you of future input from services

At the assessments conclusion you may be offered one to one sessions with a SL therapist. These would be most beneficial if they are used to teach you how to support your child to reach their next developmental steps in more depth.  Communication happens all day every day and if the speech therapist is just using strategies within the confines of appointments it won’t have as good an effect on your child’s development as if she is teaching you how to do it. We want to get a really good rapport with the child and when the child has a speech, language and communication delay that can be tricky but when you know where they are up to and how to go in on their level suddenly that relationship starts to blossom. That is the key. 

Sometimes the SLT might want to see them again, possibly in a different setting for example at nursery or in your home (if the service allows) if they have seen them in the clinic. The first appointment may be the first of two or three assessment sessions.  Or you may be asked to get back in touch in a few months if they feel that thing are going ok, your child is not really that far behind, and that it is worth seeing if they continue to develop at their own rate naturally. They may also suggest that they make some other referrals, to a paediatrician or occupational therapist (OT) or a physiotherapist and they will talk to you about that and give you the reasons for it. 

Preparing for your appointment and knowing what to expect will enable you to go in to your child’s assessment feeling empowered and to come out feeling informed as you knew the right questions to ask. Knowing the right questions to ask and asking the right person at the right time is crucial in life. Engaging with the Can Do Approach will give you, as a parent or carer, the knowledge you need to ask the right questions and the skills you need to support your child alongside any other SLT they receive.