What Happens During a Speech & Language Therapy Evaluation? A Parent’s Guide

Written By Colleen Lincoln, MS, CCC-SLP

f you’ve been wondering whether your child might benefit from speech therapy, scheduling an evaluation can feel like a big step. You may have questions like:

What will they ask me? Will my child have to take a test? What if my child won’t cooperate? Will they automatically recommend therapy?

The good news is that a speech-language evaluation is designed to help you understand how your child is communicating, not to judge them or simply give them a score.

A comprehensive evaluation gives a speech-language pathologist (SLP) a clearer picture of your child’s strengths, areas of difficulty, and how their communication skills affect everyday life.

Here’s what you can generally expect.

1. It Starts With a Conversation

Before formal testing begins, your SLP will want to hear from you. You know your child better than anyone, so your observations are an important part of the evaluation.

Your SLP may ask about:

  • What communication concerns you've noticed

  • When you first noticed those concerns

  • Your child's speech and language development

  • Developmental and medical history

  • Hearing history, including frequent ear infections

  • Your child's communication at home and at school

  • Languages or dialects your child uses

  • Family history of speech, language, reading, or learning difficulties

  • What your child does well

  • What you would most like to see improve

This information helps the SLP understand your child's communication within the context of their overall development.

2. Your Child Will Be Observed

Not everything an SLP needs to know comes from a standardized test. Your child's spontaneous communication can tell us a lot.

Depending on your child's age and communication profile, the SLP may observe how they:

  • Follow directions

  • Answer questions

  • Ask for help

  • Use words and sentences

  • Tell or retell a story

  • Participate in conversation

  • Take turns

  • Communicate wants and needs

  • Use gestures or other forms of communication

  • Interact during play

  • Produce speech during connected conversation

For younger children, this may look a lot like playing together. For older children, the SLP may use conversation, books, pictures, or games. This is especially important because children don't always communicate the same way during a structured test as they do in everyday life.

3. The SLP May Complete Formal Testing

Depending on your child's concerns, the evaluation may include standardized assessments. These tests are designed to look at specific areas of communication and can provide helpful information about how your child's skills compare with those of other children of the same age. The specific tests used will depend on why your child was referred and what the SLP needs to learn.

For example, an evaluation may look at:

Speech Sounds

If your child is difficult to understand or has trouble producing certain sounds, the SLP may evaluate their speech sound production.

This can include looking at:

  • Which sounds your child can and cannot produce

  • Whether errors occur in certain positions within words

  • Patterns in the way sounds are produced

  • How understandable your child's speech is

  • Whether speech errors occur in single words or connected speech

  • Whether your child can produce a sound with support or modeling

A comprehensive speech sound evaluation may include both single-word testing and connected speech samples because a child's speech can look different in these two situations.

Receptive Language

Receptive language refers to what a child understands.

An evaluation may look at skills such as:

  • Understanding vocabulary

  • Following directions

  • Understanding concepts

  • Answering questions

  • Understanding sentences

  • Understanding stories or conversations

Expressive Language

Expressive language refers to how a child communicates their thoughts and ideas.

The SLP may look at:

  • Vocabulary

  • Sentence length and complexity

  • Grammar

  • Describing

  • Answering questions

  • Retelling stories

  • Explaining ideas

  • Using language to communicate for different purposes

Social Communication

For some children, the evaluation may also examine how they use communication with other people.

This can include skills such as:

  • Taking conversational turns

  • Staying on topic

  • Asking and answering questions

  • Understanding social language

  • Repairing communication breakdowns

  • Adjusting communication based on the situation

Not every child needs every type of assessment. The evaluation should be individualized based on your child's needs and your concerns.

4. Hearing May Be Considered

Hearing and communication are closely connected.

If your child has not had their hearing checked recently or if there are concerns about hearing, the SLP may recommend a hearing screening or referral to an audiologist.

Hearing information can be an important piece of the puzzle when trying to understand speech or language difficulties.

5. An Oral Mechanism Examination May Be Included

If your child is being evaluated for speech sound concerns, the SLP may take a brief look at the structures and movements involved in speech.

This can include observing the:

  • Lips

  • Tongue

  • Jaw

  • Hard and soft palate

  • Overall oral structures

  • Range of movement of the speech structures

The purpose isn't to determine whether your child's mouth “looks normal.” Instead, the SLP is looking at whether the structures and movements involved in speech appear adequate for producing speech.

6. The SLP Puts All the Pieces Together

This is one of the most important parts of the evaluation. Your child's results shouldn't be based on one test score alone.

The SLP considers multiple sources of information, including:

  • Your concerns and observations

  • Your child's developmental history

  • Direct observation

  • Formal assessment results

  • Informal assessment

  • Speech samples

  • Language samples

  • Hearing information

  • Your child's communication in everyday situations

The goal is to develop a complete picture of your child's communication.

7. You’ll Talk About the Results

After the evaluation, your SLP should create a report and follow up to explain what they found. You may learn that your child's communication skills are developing as expected, that certain skills would benefit from monitoring or additional support, or that your child meets criteria for a speech or language disorder.

The SLP may also discuss:

  • Your child's strengths

  • Areas that need support

  • Whether speech and/or language therapy is recommended

  • Recommended therapy goals

  • How frequently therapy may be appropriate

  • Strategies you can use at home

  • Whether additional evaluation or referrals are recommended

And remember: an evaluation does not automatically mean your child needs speech or language therapy. Sometimes an SLP may recommend monitoring, provide strategies for home, recommend another professional evaluation, or determine that a child's skills are within the expected range.

The purpose of an evaluation is to determine what your child needs, not to find a reason to provide therapy.

What If My Child Won't Cooperate?

This is one of the most common concerns parents have. Children are children! They may be shy, tired, distracted, nervous, or simply uninterested in doing what an unfamiliar adult asks them to do. That doesn't mean the evaluation can't be successful.

SLPs have many ways to gather information, including play-based activities, conversation, observation, caregiver report, and informal assessment. For children who are reluctant to participate or whose speech is difficult to understand, clinicians can adapt how they collect information to get a more representative picture of the child's skills.

You don't need to prepare your child to “pass” the evaluation. In fact, it's much more helpful for your SLP to see your child's communication as it naturally occurs.

How Can I Prepare for My Child's Evaluation?

You don't need to study or practice with your child beforehand. Instead, come prepared to share what you've noticed.

It can be helpful to think about:

  • What are you most concerned about?

  • When did you first notice the concern?

  • What does your child communicate well?

  • What is difficult for your child?

  • Can unfamiliar people understand your child's speech?

  • How does your child communicate at home versus school?

  • Are there situations where communication becomes easier or harder?

  • Has your child had previous speech, language, hearing, or developmental evaluations?

  • What would you most like your child to be able to do?

If you have previous evaluation reports, school documents, or information from other providers, bring those along if they're relevant. Most importantly, don't worry about giving the “right” answers. Your honest observations are what help your SLP understand your child's real-world communication.

What If My Child Speaks More at Home Than They Do During the Evaluation?

That's completely okay. Children may communicate differently depending on the person, environment, activity, or level of comfort. That's why caregiver input is so valuable.

If your child does something regularly at home but doesn't demonstrate it during the evaluation, tell your SLP. Likewise, if you notice that your child's communication changes dramatically when they're tired, excited, frustrated, or around unfamiliar people, that information matters.

A good evaluation looks beyond a single moment in time.

What Makes a Good Speech & Language Therapy Evaluation?

A good evaluation should leave you with a better understanding of your child, not just a collection of numbers.

You should come away knowing:

What is my child doing well?

Where are they having difficulty?

How does this affect their everyday communication?

What can we do to help?

And perhaps most importantly:

What are the next steps?

Speech and language development is complex, and every child brings a different combination of strengths, needs, experiences, and communication styles to an evaluation. A thoughtful assessment considers the whole child and uses multiple sources of information to guide recommendations.

Considering a Speech and/or Language Therapy Evaluation?

If you've been wondering whether your child's speech or language skills are developing as expected, you don't have to wait until you're certain there is a problem. An evaluation can give you information, clarity, and a plan.

At Speechie Street, my goal is to make the evaluation process comfortable, collaborative, and meaningful for both children and their families. We'll talk about your concerns, identify your child's strengths, and work together to determine what support, if any, is appropriate.

Not sure whether your child needs an evaluation? Start with my guide: Does My Child Need Speech Therapy? 10 Signs Parents Should Watch For.

If you're ready to take the next step, contact Speechie Street to learn more about pediatric speech and language evaluations in East Nashville.

Colleen Lincoln, MS, CCC-SLP
Next

Speech Delay vs. Language Delay: What's the Difference?