If you suspect your child has a speech or language disorder, you may have taken the first step and requested an evaluation – either with the Early Intervention Center in your community, your public school, or a private therapist.
How do you prepare?
Really, just make sure your child is happy, well-fed, and well-rested. Take a water bottle if necessary. Visit the restroom beforehand. All those things you’d do if you were going somewhere that you’d have to sit with your child for up to an hour.
Depending on where your child is being tested, the amount of time might range from a half-hour to several hours. Some locations might be more flexible as far as spreading out the testing over several sessions for small children with short attention spans. Others might try to get it all done in one morning. If your child is very young, I would recommend trying to split it up into half-hour sessions. Also, it’s better to leave other children at home, to minimize distractions.
What kind of testing should be done? Ideally, a comprehensive speech-language evaluation should include at least these 5 things:
- HEARING SCREENING – This is to rule out the contribution of hearing difficulties to the problem. Be sure to tell the examiner if your child has experienced frequent ear infections or has tubes in his ears. This hearing screening might consist of 2 parts:
- PURE TONE TESTING: This is where your child wears headphones and raises his hand if he hears the beep.
- TYMPANOMETRY TEST: This is where the clinician puts something that looks like a big ear thermometer into your child’s ear and it changes the pressure in there. It tests middle ear function.
- ORAL-MOTOR EXAM (this might also be called an Oral-Peripheral Exam or Oral-Mechanism Exam) – This is to make sure all speech structures are working properly. It can rule out other underlying disorders and may help identify conditions like Childhood Apraxia of Speech. This exam may include:
- SPEECH STRUCTURES: Checking the child’s face, lips, teeth, tongue, jaw and palate to make sure everything looks ok and is moving normally.
- VOICE AND AIR PRESSURE: Checking the child’s voice quality and air pressure by seeing how long he can hold out an ‘Ah’ sound.
- SPEECH-MOTOR SKILLS: Checking the child’s ability to perform rapid speech movements — can they produce sound combinations with normal speed and rhythm? Is it effortful?
- INTELLIGIBILITY TEST – This can determine whether your child is on track for speech in spite of any errors. It involves listening to the child speak in conversation and marking how many words were intelligible to the listener. The clinician can also mark down any sound and language errors that the child exhibits in conversation.
- ARTICULATION TEST – This test can tell you if your child’s speech errors are typical or are a concern. It involves asking the child to produce target words and sentences to see what sound errors they might have. This will be a STANDARDIZED test, meaning it will compare how your child performs to typical children her age.
- LANGUAGE TEST – These tests can tell you if your child is having difficulty understanding or producing meaningful language. They look at the big picture of communication rather than just sound errors. These tests are designed to measure expressive language and receptive language. They involve asking the child to follow directions, respond to questions, label pictures, choose appropriate sentence structure, describe an object, tell how things go together, label items, etc. This will also be a STANDARDIZED test to compare how your child performs to typical children her age.
POSSIBLE OTHER TESTS:
- LANGUAGE PROCESSING TEST – This is similar to the other language test; however, it focuses on whether or not your child has trouble with language due to issues ‘behind the scenes’. There may be neurological problems with causes unknown that make it difficult for the child to understand language. A child with a language processing disorder might have trouble with attention, following directions, memory, organizing a cohesive story, and things like that. This will also be a STANDARDIZED TEST.
- AUDITORY PROCESSING TEST – This also involves the child’s ability to process language, but it is focused specifically on the child’s ability to use his auditory system in conjunction with his brain to make sense of the language signals he receives. The child may have difficulty understanding speech when there is background noise or identifying the difference between sounds that are similar.
- SOCIAL LANGUAGE TEST – This test can tell you if your child is using language appropriately in social settings. It is often given to children suspected of being on the autistic spectrum or who may be socially delayed for other reasons. It is STANDARDIZED and helps the clinician know what goals to work on to help the child.
By now you are probably overwhelmed at the thought of all these tests! Keep in mind that your child may not need all of them, and a good clinician will know how to keep your child engaged and when to stop to give him a break. It’s OK to voice any concerns you might have ahead of time.
What happens after testing? It may take a week or two for the clinician to process and score all the tests. Then you will most likely be called in to go over the results and decide where to go from there. What if it looks like your child has a speech-language disorder? Don’t panic! You are not alone. It is estimated that between 5-10% of school-age children have a speech-language disorder. (The percentage varies depending on who did the survey and what criteria they used.)
Just congratulate yourself that you caught the problem and are getting your child help early so that they can improve their academic and social success!
If you want to find out more about how you can help your child with speech and language at home, please visit www.clarityspeechandlanguge.com.