1. Hearing screening-Because hearing is so critical to speech and language abilities, a hearing screening will probably occur first. This is not likely to be a thorough hearing test (which is generally performed by an audiologist), but a quick check that the child can hear a 20 or 25dB tone at about 4 different frequencies. If the child fails the test, a more complete hearing test may be warranted.
2. Oral-peripheral exam- The speech-language pathologist (SLP) will look inside the child's mouth for any physical differences that might contribute to speech difficulties, such as a tongue-tie, abnormally high palate, signs of a partial or sub-mucous cleft palate and an abnormal bite. Additionally, he or she may do some tests of tongue coordination or strength.
3. An articulation test-The child will name pictures that assess all speech sounds in all word positions. The SLP will also listen to the child in conversational speech to listen for additional errors and overall intelligibility.
4. Language tests-These can be quite lengthy and will assess vocabulary, syntax (sentence structure and grammar), comprehension, and appropriate use of language. Both receptive language (understanding) and expressive language (production) will be assessed.
5. Conversation samples will be taken and evaluated for articulation language abilities and possibly for voice disorders or stuttering, if these are a concern.
It can take quite a bit of time to score the tests and evaluate the language samples, so you will probably wait until another day to find out the results. If the only concern is articulation, voice, or stuttering, however, the SLP may be ready to discuss results and make recommendations right away.
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