Does your child have their first speech and language therapy appointment? Are you unsure what to expect? That is ok! All parents feel the same way! Every service and every speech and language therapist has a different approach but here is what generally could happen in an initial appointment.
1. Case History:
Sometimes the speech and language therapist receives a very detailed referral about the child’s strengths and areas of need. Sometimes, these referrals do not have a lot of detail for example the referral may just say “difficulty pronunciation” or “their speech is not clear”. If this is the case the speech and language therapist will need a lot more information.
The speech and language therapist will want some background information from you. They may ask about your ch
ild’s strengths and their areas of need. They may ask about the child’s co
mmunication history like when they babbled, their first words, when they started putting sentences together. They may ask about your child’s play and what they are interested in. You may also be asked about your child’s developmental “milestones”, such as the age at which they sat up, walked. This is important to try to find out if your child’s needs are specific to communication or is it within the context of your child’s over all development. If your child is in preschool or school they may ask about how your child is getti
ng on academically and socially there.
The speech and language therapist may ask you what you would like to work on with your child or what your priorities or goals are!
If you have any records, for example reports from other clinicians i.e. psychology, occupational therapy, reports from school or private assessment reports please bring them with you! This is great background information for your speech and language therapist.
Next thing is the speech and language therapist will do is complete an assessment on your child’s speech or language or both! Speech and language are two separate things.
Speech is HOW we say sounds in words – so in other words our pronunciation. Children learn how to use speech sounds by listening to the sounds they hear in the languages around them. Most children start by babbling and then progress to using sounds in words, sentences and conversations. Children’s use of speech sounds develops at different ages and they will not be able to use all of the speech sounds adults do straight away.
Language refers to the words we use and how we use them to share ideas and thoughts, make requests, ask questions and to advocate for ourselves. Language includes:
· Vocabulary: What words mean (This is also called semantics). Some words have multiple meanings. For example, “bark” can be the noise a dog makes or bark the material that makes up a tree.
· Grammar: such as verb tenses, plurals, pronouns etc. How to put words together to make sentences. (This is also called syntax and morphology).
· Understanding of language (This is also called receptive language) such as understanding different question words, following verbal instructions (auditory memory) etc.
*Please note this is in relation to analytical/neurotypical language development*
This assessment may be formal or informal. What does this mean?
Formal assessments need to be completed in a specific way. They are standardized. This means this will compare your child’s communication skills to peers the same age as them. This may indicate if your child has average speech/language or if your child has mild, moderate or severe speech/language difficulties. Usually formal assessments include books with pictures your child may need to point to or name, objects/toys or they may need to listen to the speech and language therapist reading a story. This is dependent on age.
Different standardized assessments include (this is not a comprehensive list):
· Preschool Language Scales (PLS)
· Clinical Evaluation of Language Fundamentals 5 (CELF-5)
· Clinical Evaluation of Language Fundamentals Pre-School
· Goldman-Fristoe Test of Articulation, Third Edition
· Rossetti Infant-Toddler Language Scale
· New Reynell Developmental Language Scales
· DEAP: Diagnostic Evaluation of Articulation and Phonology
· Renfrew Action Picture Test (RAPT)
Informal assessments are not standardized on the rest of the population. Informal assessments allow the speech and language therapist to tailor the assessment to the child’s specific strengths, interests and needs, which formal assessments sometimes fail to do. Formal assessments are not standardised on autistic children, children with learning differences or children with additional needs so for these children they often benefit from an informal assessment. Informal assessments may be structured where the child sits at the table and the speech and language therapist may show them pictures or give them tasks where they need to follow instructions. Informal assessments may also be play based and unstructured. The speech and language therapist may take note of the child’s communication skills during play.
Sometimes, the speech and language therapist does not cover everything in the first appointment, and they might arrange a follow up assessment appointment. This is to get a comprehensive view of your child’s communication skills. Formal assessments especially can be quite long and challenging for the child so it is often best practice to break this up into 2-3 sessions.
The speech and language therapists may ask you to keep note of how your child communicates at home by writing down what they say or taking a video of your child communicating at home. They also might ask if they can phone or visit your child’s school or pre-school to get an idea of how they communicate in other environments and to get an idea of how your child is interacting with peers and how they are engaging with the academic curriculum.
When the speech and language therapist has a good understanding of your child’s communication strengths and needs, they will give you feedback either orally or written in a report. Then they will make a plan and will discuss the next steps with you.