How to Prepare for a Child’s First SLP Visit
Parenting a child who has recently been diagnosed with a communication, feeding, or swallowing disorder can be overwhelming. Speech-language pathologists (SLPs) are trained to work with clients facing a range of challenges and disorders across the life span.
Parents may be tempted to compare their child’s growth to others, but it’s important to remember that children develop at their own pace. Speech and language skills vary among all children, so it’s critical for parents to consult a professional if they’re concerned about their child’s progression.
Alicia Morrison, professor at Speech@NYU, the online SLP program from NYU Steinhardt, takes a collaborative approach during a child’s first visit so parents know exactly what to expect from the initial diagnostic evaluation stage through the management of intervention planning.
How to Know If Your Child Needs a Speech Evaluation
It is important to identify the developmental milestones as a child grows because milestones guide parents’ and providers’ understanding of speech and language acquisition at each age. If a child demonstrates a potential delay in any of the developmental milestones, the family is referred by a primary care provider to an SLP for further evaluation.
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What to Expect from the First Visit
Following a referral from a primary care provider, the family schedules an initial visit with a speech-language pathologist, which includes a comprehensive interview and diagnostic evaluation.
During the interview process, the SLP may ask a series of questions related to concerns about communication and communication dynamics in the home, at school, and with peers, according to Morrison. The SLP may ask for the following details about the client:
- pertinent personal and family medical history
- psychosocial information
- current communication skills
- developmental skills acquisitions including descriptions of speech, language, hearing, feeding, swallowing, and fine and gross motor skills throughout childhood
After the interview, the SLP begins a diagnostic evaluation using a variety of non-standardized assessment measures to attain the naturalistic communication skills in addition to standardized assessment measures to develop the entire profile of the child. Evaluations may be conducted in a collaborative approach, meaning that parents engage in play with the child so the SLP can evaluate communication interactions. A collaborative approach allows for transparency and comfort throughout the diagnostic process.
“I’m transparent with parents by outlining the evaluative process and describing the comprehensive aspects to the evaluation,” Morrison said. “I want them to see how we interact, and we want parents to participate in selective aspects of the diagnostic evaluation.”
A diagnostic evaluation, according to Morrison, may assess the following:
- Receptive communication: understanding words and language
- Expressive communication: use of spoken language to express intention, thoughts, needs, and wants
- Play interactions: joint interactions with familiar and unfamiliar people and objects
- Augmentative and alternative communication: all forms of communication that are used to express intention, thoughts, needs, and wants
- Pragmatic skills: how a person communicates functionally and socially
- Fluency: the rhythm, speed, and repetitive sounds of speech
- Voice: characteristics of voice, such as quality, loudness, and intonation
Not all SLPs perform feeding evaluations and may refer their clients to SLPs that primarily support feeding and swallowing related difficulties, according to Morrison.
“At the end of the evaluation, many SLPs will discuss some of the preliminary results of the diagnostic evaluation and provide a timeline of analysis of the evaluation material. In some cases, an SLP may recommend an intervention and describe the process to children and parents,” Morrison said. A collaborative model that includes the parents and the child is a standard best practice utilized in the profession.
What to Bring
According to Morrison, SLPs may request that parents bring the following items to the first visit:
- the contact information for and feedback from the physician who referred the child
- a toy and/or object the child likes to play with (something that provides comfort to the child)
- a list of words or sounds that the child produces frequently
- an audio and/or video recording of your child speaking
- a list of common scenarios in which the child is trying to communicate, accompanied by typical responses from the parent or guardian
- a snack and a drink preferred by the child for feeding and swallowing evaluation
- specific questions for the SLP to answer
What to Expect for Next Steps
Many parents hope an SLP can identify a communicative disorder during the first visit, but Morrison said an assessment is a careful process of review, analysis, and synthesis of diagnostic information. Providers take time to analyze information gleaned from the evaluation and will contact parents once the analysis is complete. Above all else, it’s critical to establish an open dialogue between client and provider so that all parties are aligned with the plan of care for the child.
“Most parents want to know how soon things will improve,” Morrison said. “We provide a suspected prognosis, but several variables are included in projecting a timeline.” Interventions depend on the child’s development. Each timeline is person-centered and valued in a collaborative process with the family, clinician, and child.
Following the evaluation, the speech-language pathologist will provide the family with strategies and supportive resources to help the family better understand how to communicate with their child.
“A team approach should be developed very early on,” Morrison said. “It’s not just what’s happening in the therapy room. It’s about what’s happening all around the child and their environment, so we want to be active in supporting a developmental trajectory.”
Citation for this content: Speech@NYU, the online SLP program from NYU Steinhardt