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What Goes On During Speech Assessment?

What Can You Expect from a Speech Assessment? Althea Ruiz, CSP

Before proceeding with intervention, speech and language pathologists assess, describe and interpret individuals’ abilities. A comprehensive assessment is required to be able to paint a clear picture of the individual’s communication or swallowing difficulty. This entails using standardized tools and informal assessment procedures to evaluate the individual’s receptive and expressive language, articulation, voice, fluency, social, and feeding skills.

The American Speech and Hearing Association’s Preferred Practice Patterns for the Professions of Speech-Language Pathology (2004) indicates that comprehensive speech-language pathology assessment includes these components:

  • Case history, including medical status, education, socioeconomic, cultural, and linguistic backgrounds and information from teachers and other related service providers

  • Patient/client/student and family interview

  • Review of auditory, visual, motor, and cognitive status

  • Standardized or nonstandardized measures of specific aspects of speech, spoken and nonspoken language, cognitive-communication and swallowing function, including observations and analysis of work samples

  • Identification of potential for effective intervention strategies and compensations

  • Selection of standardized measures for speech, language, cognitive-communication, or swallowing assessment with consideration for documented ecological validity and cultural sensitivity

  • Follow-up services to monitor communication and swallowing status and ensure appropriate intervention and support for individuals with identified speech, language, cognitive-communication, or swallowing disorders

Feeding and swallowing assessments involve examination and testing of the muscles needed for feeding and swallowing. Observation of the patient swallowing different consistencies of food and liquid is also carried out. Instrumental procedures such as videoflouroscopy, modified barium swallow, or a fiberoptic endoscopic evaluation of swallowing can be recommended by speech pathologists to supplement and provide additional information on the individual’s swallowing capabilities.

Assessments are usually conducted one-on-one in an area with reduced visual and auditory distractions. Caregivers or significant others are sometimes present. The speech and language pathologist will then describe the procedure. Companions are also discouraged to repeat instructions or lead the individual toward the appropriate answer as this would influence the results of testing.

Speech and language assessments can go on up to two or three hours depending on the case. Assessments may be split into separate sessions to limit the individual’s fatigue. Reevaluations of individuals are done after six months to years after the patient’s initial evaluation. The frequency of reevaluations depends on the client’s needs.

The speech and language pathologist will then write a report integrating and summarizing all the information gathered during assessment. The individual’s current levels of speech and language functioning will be detailed. These results will also be compared to normative data based on neurotypically developing individuals. Impressions and analysis of results are stated, as well as positive and negative prognosticating factors for intervention. Recommendations for intervention are also given (i.e., recommended frequency of intervention, goals to target) and referrals to other specialists are recommended as needed by the client to further progress. A copy of the written report is then given to the client. All records will be kept confidential by the therapist, who will not discuss the client with others unless given consent.


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