Your First Visit

Approximately 1-2 days before your scheduled speech and language evaluation, you should receive a call from your evaluating therapist.  She will introduce herself and briefly discuss your primary area/s of concern regarding your child’s communication.

This will help the clinician make decisions about what formal tests to select for the evaluation. If we have received your case history form, she might also review your case history and ask any additional questions she might have regarding your child’s developmental and medical histories.  Discussing these items prior to the evaluation allows the therapist enough time for both formal and informal assessments during the actual evaluation.  In general, most initial speech and language evaluations will examine the following areas of communication:

1. Articulation – your child’s ability to produce speech sounds and his/her overall speech intelligibility. Articulation may be examined through administration of a formal test and/or conversational context.
2. Language – your child’s expressive and receptive skills will be assessed through use of formal testing and through direct interactions with your child during testing. Areas of language assessed include receptive and expressive vocabularies, ability to understand and answer questions, following directions and use of grammar and syntax.
3. Oral Motor – an examination of your child’s speech mechanism will be conducted to assess adequacy of structure and function for speech production.
4. Hearing Screening– if your child has not had a recent hearing screening, your evaluating therapist may decide to screen your child’s hearing during the evaluation using a portable pure tone audiometer.
5. Voice and Fluency– Unless there are specific concerns related to voice and fluency (stuttering), these areas are most likely to be informally assessed in the evaluation context. Be sure to let your therapist know if you have concerns in these areas so that she can assess them with greater depth if necessary.
6. Social/Pragmatic Language Skills– through conversational interactions with your child, the therapist will assess your child’s conversational skills including topic initiation, turn-taking, topic maintenance, greeting/parting behavior, etc.
7. Play Skills – for younger children, the clinician may assess a child’s play skills through engaging them in play interactions. Play often reveals additional information about your child’s cognitive, linguistic and social functioning that may not be readily observed through use of a standardized assessment tool.

At the conclusion of the evaluation, your evaluating therapist will discuss her clinical impressions and recommendations for therapy including the frequency and duration (e.g. 1x/week for 30 minutes).   If therapy is recommended, you will be guided to the Client Care Coordinator to create an ongoing appointment.  You will receive a written report of your first visit evaluation typically within 2 weeks after the evaluation.

Before the Evaluation:

Prior to your first visit, you will receive intake forms to fill out. Please be sure to fill out these forms and submit them prior to your scheduled appointment. These forms provide the therapist with important information about your child and the goals you have for treatment.

At the Evaluation:

When you arrive for your first visit evaluation, your therapist will meet you in the lobby. In the first portion of the session, the therapist will interview you and your child about reasons for seeking treatment, family history, problem history, and other factors that could be influencing the issues you are seeing. This will be your opportunity to explain and discuss your concerns with your therapist. Following that initial interview, the therapist will likely want to spend time one on one with the child to evaluate their level of functioning in many different areas. This can include (but is not limited to) emotion regulation, coping skills, developmental age, and psychopathology.  For younger children this can be done through play therapy techniques; teens and older children may be more suited for traditional talk therapy interviewing.

After everyone has been interviewed the therapist will bring the family back together and review a tentative treatment plan, which may include recommendations for therapy services, frequency of services, type of therapy, etc. The therapist will then give clients the opportunity to ask questions about the treatment plan.

Following the Evaluation:

Once services are agreed upon the therapist will guide you to the Client Care Coordinator for new client orientation where you will discuss insurance, payment, and scheduling.

We are excited to meet you and thankful that you chose us to partner with your family!

About the Evaluation

Occupations for a child are anything that a child needs to do to participate in their life to the fullest.

This includes things like:

• Activities of Daily Living (examples: eating, dressing, bathing, toileting)
• Instrumental Activities of Daily Living (examples: helping care for a pet, completing chores)
• School Participation (examples: writing, work behaviors, executive functioning)
• Play
• Social Participation (at home, school, and community)
• Sleep

An occupational therapy evaluation will consider your child’s occupations and potential underlying areas that may be limiting your child throughout their day.  It is our belief that when children are able to fully participate in their desired occupations that improved self-esteem, self-efficacy, meaningful relationships, and joy in life are truly possible.

Before the Evaluation:

• Once your evaluation is scheduled, you will be asked to fill out client paperwork prior to your first visit, this paperwork must be completed prior to the day of evaluation.
• We will also need a prescription from the referring physician. Our office staff is typically able to get this for you.
• Your evaluating therapist will reach out via phone call or email to introduce themselves and confirm your appointment a day or two before the appointment.

At the Evaluation:

• The therapist will interview you regarding your child’s history, current participation strengths and needs, discuss what goals you have for your child and family, and begin to establish rapport and trust with your child.   The therapist will then focus on what possible underlying issues / needs may be creating barriers for your child to meet the goals you and your therapist discussed. This will be done through clinical observations and also through standardized testing if appropriate.

A few examples:

• It could be that coordination delays and decreased core strength is impacting their ability to complete tasks such as climbing playground equipment, participating in PE, handwriting, and riding a bike.
• It could be that visual perception delays are making it difficult for your child to write.
• It could be that your child seems to over react in social situations and there is an underlying sensory processing need making their days challenging.
• It may be that underlying oral motor and sensory needs are impacting your child’s ability to eat a healthy diet.

Our goal is to investigate possible underlying contributing factors and create an individualized plan which celebrates your child’s strengths in order to address their needs and goals.  Sometimes, two appointments may be necessary in order for the therapist to complete a thorough and detailed evaluation. The therapist will establish a specific plan of care and goals for your child.

After the Evaluation:

If therapy is recommended, the Client Care Coordinator will assist you in scheduling ongoing therapy.  You will be provided with a copy of the evaluation report approximately 2 weeks after the completion of your evaluation.

We are excited to meet you and thankful that you chose us to partner with your family!

 Before the Evaluation:

• Once your evaluation is scheduled, you will be asked to fill out client paperwork prior to your first visit, this paperwork must be completed prior to the day of evaluation.
• We will also need a prescription from the referring physician. Our office staff is typically able to get this for you.
• Your evaluating therapist will reach out via phone call or email to introduce themselves and confirm your appointment a day or two before the appointment.

During your first visit, the therapist will review your case history and ask any additional questions she has regarding your child’s developmental and medical histories. The therapist will be most interested in your goals for therapy – what will success look like? The therapist will observe your child participating in a variety of “play” activities in our sensory-motor gym in order to informally assess his/her strengths and needs. The information you provide will help the clinician make decisions about what formal tests to select for the evaluation.

In general, most physical therapy evaluations will examine the following areas of physical characteristics and gross motor development:

1. Range of Motion – the movement of a joint from end range to end range. This is assessed through the passive or active movement of a joint. Specific measurements may be taken if a joint appears limited.

2. Strength – is typically evaluated based on clinical observations of your child’s quality of movement with various gross motor skills and transitions between positions. Strength may also be formally assessed using a standardized test depending on your child’s age.

3. Muscle Tone – the amount of muscle contraction at rest. This is assessed by the resistance felt during passive movement. Increased muscle tone is noted by increased resistance or rigidity of the muscle. Low muscle tone is noted when the muscle feels loose or floppy.

4. Balance – is evaluated through clinical observations and/or standardized testing.

5. Gait – the manner of walking. This is evaluated through observation. The therapist may ask permission to video your child to be able to assess and analyze his/her gait pattern more in-depth. This may also include running and walking up and down stairs.

6. Posture – position of the body in standing or sitting. This not only includes the orientation of the head, neck, and trunk, but also the symmetry and alignment of the hips, legs, and feet.

7. Gross Motor Skills – crawling, running, jumping, and other large movements of the body. The therapist will assess the ability of your child to perform certain skills as well as their quality of movement.

At the conclusion of the evaluation, the therapist will guide you to the Client Care Coordinator for your new client orientation. If ongoing therapy is recommended, you will discuss this with our office staff and we will try to find a day and time that works best for you and your child. You will receive a written report of your child’s evaluation typically within 2 weeks.