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Starting the Process Right What happens during an evaluation?

You’ve spent time on the Internet researching all the milestones and you suspect your child may have a speech or language delay. You’ve mustered up the courage to make the initial appointment and you’re walking around on pins and needles, not knowing what to expect during your child’s initial therapy appointment. Rest assured. Step off the pins and needles because the first session is usually pretty straightforward and to the point, and is when the initial evaluation is conducted.

The evaluation usually consists of several components, which don’t necessarily happen in any particular order. For instance, with older kids, I usually begin with the caregivers and get my background and medical history questions out of the way and then proceed to formal testing with the child, but with younger kids, who tend to lose attention quicker, I begin testing immediately. Typically evaluations are comprised of information gathering, some type of assessment, informal review of patient performance and next steps. I additionally like to leave strategies that the family can begin to implement prior to starting therapy, if needed.

During the information gathering portion of the evaluation, your therapist may ask questions related to the child’s medical history, milestones, diet and appetite, area of concern, educational placements, current and past therapeutic experiences, etc. This is the time to be honest and forthcoming with your therapist. The more detailed information you are able to provide, the better. Even if you have completed a questionnaire and feel some of the questions are redundant, it’s best to answer as thoroughly as possible. Some parents feel some of the questions may be invasive, but most likely your therapist has a rationale for asking. If you are uncomfortable with any questions, it is always ok to ask your therapist why that information is needed, always in a nice, friendly tone.

During the assessment portion, your therapist will administer one or more tests to determine the presence and severity of a disorder. Speech therapists conduct evaluations for articulation, language, feeding, phonology, fluency, voice, pragmatics, etc. Some patients require evaluation of one area, while others may need to be evaluated in multiple areas. Ideally, depending on your child’s age, the therapist will want to interact with the child. While it is usually encouraged for parents to be present during the evaluation, it is absolutely necessary that you allow your child to answer and interact as independently as possible. Sometimes parent have a natural tendency to want to answer for their child or provide clues to help their child get the correct answer. Doing this invalidates that response and makes it difficult for the therapist to determine if the child has truly mastered that skill independently.

Sometimes, depending on the test being used, a therapist may be able to use the test as a parent questionnaire for kids who are shy or refuse to comply, but most therapists prefer to do this as a last resort. Most assessments take anywhere from 15-45 minutes to complete. This assessment is what allows the therapist to set the goals that will be addressed, so again it is important to let your child engage as independently as possible, to make sure your therapist is able to set the most accurate and relevant goals.

Typically once the assessment portion has been completed the therapist will give her clinical impressions on whether the child will qualify, along with areas of strengths and weaknesses. If the child qualifies, I like to provide the families with the next steps, so they know what to expect and how long it will take before their child can begin therapy. I conclude my evaluations by answering any questions and leaving a few recommendations the family can work on until therapy begins. Most evaluations are completed within an hour, from beginning to end. Some parents worry that the evaluation may not have been the best reflection of their child’s performance, and while it is possible that is true, your child’s therapist will be able to fine tune and adjust goals once therapy begins.

Evaluations are the first and very important step in beginning the therapeutic process and it is vital to ensure that all information obtained is as accurate and thorough as possible. As a parent, it is the time to make sure all of your initial questions and concerns are handled. You should leave the evaluation, confident and more knowledgeable about your child than when you started the evaluation. If you have any questions about the evaluation process or would like to have your child evaluated, please contact us at 404-606-3755.

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