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What To Do If You Suspect Your Child Might Have A Speech And/Or Language Delay


1.  Become well versed with developmental milestones—including speech and language milestones.  This way you can be clear of what the expectations are at the different ages and various stages along the continuum of development (do a search on the web for “developmental milestones” and you will be provided with a ton of resources to guide you).  This is important because it is possible that your friends/family will have their own “ideas” on what is appropriate (many times based upon their unique experiences) which, although correct, are sometimes not reflective of “typical development”.  You might hear things like “Your father didn’t talk until he was 3 years old and he turned out just fine—look at Einstein!” or “Jackson said his first words at 9 months and by his first birthday he was speaking in mini-sentences!” Both of these statements are not indicative of typical speech and language development—and many times well meaning friends will cause you unnecessary stress 


2.  Schedule an appointment for a speech and language evaluation with a local speech language pathologist (SLP)–try to get a referral from someone you trust.  Most insurance companies will cover the cost (or a portion of the cost) of an evaluation; do your research beforehand and figure out what will be covered.  There might be a list of  SLP’s in your network that you should look in to—again, before you make the appointment—do your research and make sure it is someone who is reputable.  Confirm that the SLP is certified to practice in your state and has the appropriate credentials:  A Master’s Degree in speech language pathology and a certificate of clinical competency, i.e., the credentials should read M.S. (or M.A.), CCC-SLP.  This will ensure she is ASHA (American Speech-Language Hearing Association) certified.  


3.  Before the evaluation:
n                   Confirm cost.  An evaluation can range from $200-$400 to $1,000—depending on where it is performed (clinic, agency, private practice, etc.), who is doing it (typically, more experience=more money) and how comprehensive the evaluation is (i.e., how many tests were performed/how long did the evaluation take, i.e., it could span over multiple visits and/or include a school observation). 
n                   Find a time in your child’s schedule that works.  Do not schedule the evaluation during what is typically his nap time—he will be cranky and tired and won’t perform his best.  Avoid late day appointments—nobody performs well at the end of their day. 
n                   Write out your concerns. Most likely you will be asked to fill out an intake form before your visit.  Take your time filling this out.  It will typically require you to document acquisition of developmental milestones (i.e., At what age did your child start walking? Eat solid foods? Speak first words?), as well as birth history (i.e., pre-natal complications, delivery method, delivery complications, etc. ) and familiar history (i.e., history of speech/language difficulties, learning disabilities, depression, etc.) There will also be a space where you can describe your child’s speech/language development and what you are specifically concerned about—maybe your child says “ba” for everything and he is at an age where he should be at least using words, or, maybe he speaks in full sentences, but his speech is not clear and it is very difficult for others to understand him.  It is possible his issues are language related:  Remember, speech is the act of producing sounds and language is the actual content produced (vocabulary/grammar/syntax/morphology). Receptive language is what your child understands—does she follow directions?, “Sally..go get your shoes so we can go to the park.”, “Greg, put your toys away, we are about to have dinner!” Does she answer questions appropriately, “Name one item we can write with? (PEN!)” During play, does she imitate your actions?  Another area to consider is pragmatic language or “social language”.  How does your child interact with her peers?  Does she greet family and friends with a warm “Hello!”  Can she maintain a topic of conversation?  Can she use language to ask questions? Initiate a topic?   

4.  During the evaluation:

·        Pack a snack and a favorite toy/book and encourage her to share it with the clinician.
·        Don’t be offended if you are asked to leave the room, many children become very distracted by a parent (or both) and don’t perform as well.
·        Alert the clinician if something is different about the day than usual, i.e., your child didn’t sleep well and is tired/daddy is away on business and he is not “himself”, etc.  
·        If your child is sick—cancel.  You want to make sure the test results are accurate and the clinician will appreciate keeping her office (and herself!) germ free.
·        Bring a book/magazine to occupy your time; a typical evaluation can last anywhere from 1-2.5 hours (ask beforehand so you are prepared.)

 5.  After the evaluation:
·            Don’t expect results immediately.  Tests take time to score; reports take time to generate.
·            Request to have the report emailed to you if you have time constraints.  
·            Set up a time to discuss the report and recommendations—it might be easier to do this over the phone.  Plan to then set up a “phone date” in advance so you do not continuously play phone tag.  Clarify areas in the report that are unclear and bring up any concerns you might have. 
·             Request referral(s) if other evaluations are recommended (occupational therapy, physical therapy, etc.)
·                           If speech/language therapy is warranted, ask the SLP who did your report to include target goals as well as a suggested frequency for therapy (twice per week for 45 minutes) in her list of recommendations.  If you liked the clinician who did the evaluation—ask her if she is currently treating clients and if she has room in her schedule.  

6.  An alternative to a full evaluation might be to bring your child in for a consultation.   This will give the speech language pathologist an idea of what your child’s skill level is and if an evaluation is even warranted.  This can also allay your fears at a considerably lower price; most SLP’s charge a session rate for a consultation—which can range anywhere from $100-200.  Another option is to bring your child to a local university that houses a speech and language graduate department.  Your child will be evaluated by Master’s students under intense scrutiny and supervision.  Early intervention (if your child is between 0-3 years old) is another alternative—but this could be time consuming and varies state by state.  Research all of your options beforehand so you can make the best decision for you and your child.

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