When you receive a doctor’s referral, contact a speech language pathology (SLP) clinic or office (see a list of certified SLPs at the ASHA National Center). (This link was bad on both sites and needs a replacement or to be removed) The SLP’s office will typically contact your insurance company to determine the exact procedure for scheduling an assessment. You will be asked to fill out a patient history form that will ask questions about the pregnancy and child’s birth, family situation, and medical/social history.
On the day of assessment, the SLP will listen to your concerns and interview you about your child’s history. He/she may ask more in-depth questions about the child’s vocabulary, behavior, and daily routine. There are three main phases to consider: Assessment, Therapy, and Outcomes.
Assessment
After the interview, the clinician will complete formal and informal assessment of the child’s speech and language. Formal assessments are tests that have been given to children across the country in exactly the same manner. Your child’s performance is scored in comparison to the large sample. The tests must be given in a specific order to maintain consistency.
In an informal assessment, the SLP may examine your child’s skills during play or conversation. The exact procedures may be different if your concerns surround speech or language. A speech evaluation will focus on the verbal method of communication — including voice, articulation, fluency, feeding, and general mouth strength and coordination. A language evaluation will determine how the child can express him/herself (sharing thoughts, ideas, feelings), understand others, and participate in general cognition and social skills.
The SLP may give you some very general feedback at the end of the assessment and will use the results of formal and informal testing to write a report. The report will discuss the child’s performance across many aspects of communication and will contain a diagnostic statement. The report may suggest a plan for treatment and will include both long-term and short-term goals. The report is delivered to the child’s doctor and the insurance company.
Therapy may need to be approved by the insurance company, and the company will typically approve a certain number of session (for example: 30 sessions). Once treatment begins, it will focus on the short-term goals described in the report.
Therapy
Therapy will focus on your child’s specific needs, and may use a combination of play or drills to accomplish the goals. The therapist will report on your child’s progress periodically to the doctor and insurance company and may change the goals if needed.
A commonly asked question is “What does my child do in therapy?” The techniques and methods used in therapy to target goals depend upon the child’s needs, the family’s goals and preferences, and the knowledge, experience, and preferences of the clinician providing services.
Speech-language pathologists provide services to children in schools, medical settings, private clinics and practices, and in the home. Therapy may be one-on-one, or in a group. Depending on the age of the child therapy may look like “play” to an observer.
If older children are working on academic communication goals such as reading and writing, therapy may look more like practice drills, worksheets, and school work. For some children, functional communication for basic needs and wants may be the primary goal. The therapist may work with family members to give them skills and coach them on how to best help their child communicate and increase the quality of daily life.
Outcomes
Speech language therapy focuses on making progress toward individual goals that have been developed in collaboration with the client and/or their family. Therapy is not a one-size-fits-all intervention model.
What is most helpful to one client may not be to another, and it is the clinician’s role to guide each client through the process and maximize their potential to improve. During therapy, the clinician continuously evaluates progress and determines the next step. Data is collected each session in order to measure progress and mastery of goals.