The Complete Guide for a Toddler Speech Evaluation

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So your child has a speech evaluation coming up? You might be asking yourself, “What happens at a toddler speech evaluation?” Well, let me give you some insight: the who, when, where, and what.

First let me say, don’t stress about it too much. You know your child, and the team that is evaluating him or her just wants to know get to know them too. As the parent (or guardian), just have in mind what your main concerns are and some of the major strengths your child has too.

Toddler speech and language evaluations vary quite a bit depending on where you are getting the services from, and what the main concern is for your little one. I’ll run through various scenarios to help you figure out what your toddler’s speech evaluation might look like.

Why should your toddler get a speech and language evaluation done?

There are many reasons why you might want to get your child evaluated for speech and language concerns. It might be that a doctor noticed red flags during a visit, or you might have your own worries about your child’s communication skills.

Speech-language pathologists can treat a variety of cases in early childhood including children with receptive language difficulties, expressive language deficits, speech delays, autism, and more.

A quick overview of these main types of disorders or difficulties might be helpful as you begin to explore speech and language evaluation and treatment.

Receptive language

Receptive language is what children understand. This skill set is foundational to all other communication because if your child cannot understand what is being said, they will have difficulty using words on their own. A deficit in receptive language might mean your child does not follow directions well, or they are unable to answer simple questions or point to objects when they are named.

Expressive language

Expressive language concerns are probably the most common thing parents worry about at this age. Expressive language refers to what the child can say or communicate to others. If your child seems to understand most of what you are saying but does not say any words (or less than a typical amount) this is considered an expressive language issue.

When expressive language is your main concern, it can be helpful to have a list of words or phrases that they can say on their own. If there are some words that they repeat after you, but don’t say independently, do not include them on your list.

RELATED ARTICLE: Receptive Language vs Expressive Language

Speech Delays/Speech Sound Disorders

This category includes any children that are talking but are hard to understand. If you or those around you often have difficulty knowing what your child is saying, then a speech therapist can work on their clarity.

If this is your main concern, then it’s helpful to write down some of the words you understand and how they say them. This can give the speech therapist a better idea of what to look for.

Where does a toddler speech evaluation take place?

Speech therapy can happen in a lot of different places. There are several ways to access speech therapy, and your toddler’s doctor will hopefully send you in the right direction. A quick google search with something like “toddler speech therapy near me” can also be a great place to get started.

1. Hospital: Some children can get medical speech therapy through a hospital or doctor’s office. Your toddler will likely come in to the hospital and get evaluated by a speech therapist there.
2. Clinic: There are tons of private speech-therapy clinics that offer speech therapy for preschoolers and toddlers.
3. School: Some toddlers may get a speech evaluation at a local school, even before they are preschool-aged.
4. Home: Depending on where you live, there are many places that offer speech therapy services in your home. That may sound great to you, or a little intimidating.

When do toddlers get a speech-language evaluation?

Most often toddlers with speech and language concerns get a referral from a doctor. Following the referral, your pediatrician may give you some options on where to get a toddler speech evaluation.

If you have concerns about your child’s speech (and your doctor hasn’t mentioned it, or you haven’t seen your child’s doctor in a while), you can reach out to the local school district or a speech therapy clinic.

Related Article: Does My Toddler Need Speech Therapy?

Once you decide where you will get evaluated (check out the section above) then you can contact them and set up an evaluation time that works for everyone.

Some places will only have time during the workday, while others might have options before or after the workday, or even on the weekend.

Who will evaluate your toddler?

Your child might be evaluated by a team of people (depending on all of the concerns you have and the location) or just by a speech-language pathologist.

In some therapy models, the child is tested by both a speech-language pathologist and another provider, often a special education teacher. In my home state of Nebraska, we have to have two professionals at each evaluation.

However, in clinics and hospitals, and maybe even in different states, a speech therapist will be the only one testing your child.

Lastly, there are some states that their early intervention team consists of early interventionists that work with all sorts of children with different concerns at early ages. They are not specialized in one specific area of development, rather they can help with a variety of areas.

If you would like to know before the evaluation, feel free to ask who will be in attendance when you are scheduling. (Or if it’s already scheduled, but you still want to know, just call and ask!)

Additionally, if your child has multiple concerns (not just speech and language) they might do an evaluation with another person, like an occupational therapist or physical therapist.

What happens at a toddler speech evaluation?

There are two main types of evaluation.

The first type of evaluation starts with getting an overall look at several different skills your child has. Testing might be done in the areas of cognition (thinking/problem solving), fine motor skills (things you do with your fingers), gross motor skills (big movements, like running and jumping), social/emotional skills (how they interact with others and how they react to things/people around them), adaptive skills (how independent they are in different areas), and of course, speech and language.

This type of testing is done in order to get a whole picture of the child’s skills. Some children might have the biggest problems in speech or language, but they might also need help in areas like adaptive skills or motor skills. Doing an evaluation like this helps the team know about your toddler’s strengths as well, and allows a more holistic view of the child.

The second kind of toddler speech evaluation is much less broad, and focused only on speech and language. When a doctor has referred your child for speech service, they may only test in the areas of speech and language.

A speech language pathologist will likely use a few kinds of tests, both formal and informal. The formal tests may be a series of questions for parents or caregivers to answer, while the informal tests will just be observing your child through interactions.

If the main concern is language, your child will be tested both in expressive language (what they are able to say/communicate) and receptive language (what they can understand)

However, when the main concern is about speech or how easy it is to understand your child, they may test both language and speech.

How does a speech therapist assess a child? (The Various Parts of an Assessment)

Background Info

In order to get a full picture of what your child needs, there will be a series of background questions that cover medical history. You will also likely be asked about your biggest concerns and any other relevant information you want to share.

Physical Exam

When your child has a speech or language concern, oftentimes a speech therapist will perform a physical exam of the speech mechanism, including the mouth, tongue, teeth, throat, and maybe your child’s nose and breathing function. This is helpful in determining if there is a physical reason your child is having a hard time with communication.

Overall Skill Check

Depending on when/where you are getting evaluated, your child might participate in evaluations that have to do with skills outside of (but connected to) speech and language like cognition and adaptive skills (what a child can do on their own). This helps inform the therapist if there are underlying causes of the speech and language difficulties, or if the disorder is only in the area of communication.

Language-Specific Testing

All speech therapists should give some kind of language assessment where they explore the abilities of the child’s receptive language (what they understand) and their expressive language (what they can say/communicate).

Speech-Specific Testing

If your child is difficult to understand, testing will be done to explore which sounds or patterns or child is having difficulty with. Often, this will be a series of pictures your child will name, and the clinician will take notes on how accurately your child produced each sound in the word.

RELATED ARTICLE: Is Your Child Not Talking Clearly?

How long does a toddler speech evaluation take?

There is definitely a range for how long to expect when it comes to a toddler speech evaluation. You can expect that it will take between 1 and 2 hours total, depending on what the clinician is trying to assess. The timing can also vary depending on your child’s willingness to participate during the evaluation.

Hopefully, this bit of information has you feeling more confident and comfortable with what will happen during your toddler’s speech evaluation. If you have any other specific questions about the process, please drop a comment below!