So, your child has been referred to speech and language therapy, and they have finally reached the top of the waiting list. Hurrah! What happens next? You will very likely receive an assessment appointment. Some departments have other ways of doing their initial contact, either through some sort of parent information session, or through a short “drop-in” type appointment. However, after this, if it is thought that your child needs speech and language therapy, you too are likely to receive an assessment appointment.
Exactly what will happen will depend on a variety of factors – the age of your child, where the appointment is due to take place and what the concerns are. However, for the moment we will assume that you are going to attend a clinic with your child.
Usually, the therapist will start off by chatting to you about your child. They will ask you about a range of things such as:-
- What your concerns are
- How your child responds when they are struggling
- What their play and behaviour are like
- Whether they eat and sleep well
- Their early development – ie did they feed well as a baby? When did they first crawl, sit, walk and say their first words?
- Their medical history, general health and hearing
- How they are getting on at school or nursery (if applicable).
Sometimes, the therapist might send you a questionnaire in advance to fill in and return on the day of the appointment. Then they will look through this and ask more about various aspects.
While this is happening, the therapist will probably have various toys out for your child to play with. This enables them to relax, get used to the environment and explore. Often young children are quite clingy to begin with and this is just fine. In some places, you may find that there are two therapists (or one therapist and an assistant) and one adult will play with your child while you are talking through the case history with the other one.
Next, the therapist will do some work directly with your child and “assess” them. This sounds potentially scary, but hopefully, your child will have no idea that this is what is happening. With very young children (under 3 1/2 or so), I hardly ever do any formal assessment, but instead, I just play with the child, with whatever they are interested in, for a while. I have some particular games or toys I may get out, but we still tend to just play!
However, while I am playing, I’m looking at lots of different things. Is the child using the words he knows regularly? Is he using his words to communicate? Is he using any other ways to communicate as well (pointing, gestures, screaming, changing intonation etc)? Is he able to follow any instructions? Is he able to take turns with an adult? Does he try to copy? Does he give eye contact? Is he frustrated? Does he play with a range of toys and will he let me join in with his play? The answers to all these questions will dictate how concerned I am about a particular child, and what advice I will give. I am usually more concerned about a child who isn’t really communicating effectively than I am about a child who can get across everything he wants to say without using words.
With older children, the play part of the assessment might be more about having a general chat with your child about their day, what they like to do, their friends – whatever they want to chat about. Again, the therapist will be listening and looking out for all sorts of information as they are chatting. Hopefully, your child will just be relaxed and having fun though.
With older children, there is likely to be something a little more formal as well. This is likely to mean sitting down with your child and looking at a specific set of pictures and asking questions about them. You can find out more about some of the specific assessments we use and what is involved by looking here, here and here.
Once the play and assessment portion of the session are finished, the therapist is likely to chat to you again. Here they will summarize what they have seen and heard throughout the session, let you know whether they think there is reason to be concerned or not, and give you advice and suggestions about what might happen next.
If the appointment takes place in school, then it may run a little differently and may well include some observation of your child in school as well. You can find out more about that and why your therapist might want to do that here!
Here are some suggestions for getting the most out of your child’s assessment appointment.
- Be prepared. Take any previous reports with you (from audiology, paediatricians etc). Also take your child’s red book or any baby book that you kept with you as this will help you to remember when they achieved particular developmental milestones.
- Make a list of things you want to say or ask and take it with you. Don’t feel embarrassed about referring to this during the assessment – the therapist won’t mind.
- Arrive early. Parking is notoriously difficult at clinics and hospitals and you don’t want to feel stressed about being late while you are circling the area looking for somewhere to park!
- Take your child’s favourite toy and a snack with you. This will make them feel relaxed and comfortable.
- Ask if you are unsure about something. There are suggestions about things to tell your therapist here.
If you have found this post useful, do check out our e-book, which is full of practical advice to help you and your child at every step of the way through the speech therapy process.