Your First Visit

What To Expect At Your Initial Speech Therapy Evaluation

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 evaluation typically within 2 weeks after the evaluation.

What To Expect At Your Initial Occupational Therapy Evaluation

Approximately 1-2 days before your scheduled occupational therapy 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 needs and abilities. Occupational therapy for children focuses on their daily “occupations”, which include:  how they take care of themselves (feeding, dressing, etc.), how they play (manipulate toys/objects and interact with others and their environments), and how they perform school and school-prep activities. If your child has underlying issues that are affecting their abilities to perform those activities, the underlying issues will also be assessed (muscle strength, joint range of motion, attention, sensory processing, etc).

The brief overview you provide 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 has 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.  Depending on your child’s needs, the occupational therapy evaluation will assess some or all of the following areas:

 

  1. Fine Motor Skills – evaluated through standardized tests and formal observations
    1. Grasp and release of different sized and shaped objects
    2. Coloring/drawing/scissors/handwriting (depending on child’s age)
    3. Higher level manipulative skills

  2. Visual Motor and Visual Perceptual skills – evaluated through standardized tests and observations
    1. Visual motor – ability to use eyes and hands together to perform tasks
    2. Visual scanning – ability to move eyes (dissociated from head) in all directions to scan environment
    3. Visual perception – visual memory, visual closure, figure-ground, visual discrimination

  3. Self-Care – typically assessed through parent questionnaire
    1. Hygiene
    2. Toileting
    3. Dressing
    4. Feeding

  4. Play/Social – assessed through parent questionnaire and informal observations during eval
    1. Purposeful play with toys
    2. Interaction with others based on age
    3. Ability to attend and follow rules/directions

  5. Sensory Processing – assessed through standardized questionnaires completed by parents and/or teachers and also assessed through specifically developed clinical observations

 

Sensory processing refers to the way a person’s central nervous system receives sensory information from their environment (through vision, taste, sound, touch, smell, proprioception, and vestibular input) and then responds to this input in functional and sometimes non-functional ways.  If any sensory systems are not correctly functioning, or if your child is unable to accurately discriminate sensory stimuli in their environment, they may demonstrate delayed fine and/or gross motor skills, delayed social skills and self-awareness, decreased ability to regulate behavior and mood, and decreased attention and ability to follow directions and learn new skills.

 

  1. Muscle Strength and Joint Range of Motion – can be formally assessed if this is a primary concern; if no strength or range of motion limitations are of concern, this will typically be assessed through observation of how your child maneuvers through different environments and uses his/her body to execute different movement activities
    1. Occupational therapy will focus mostly on hands and upper extremities

  2. Coordination, Bilateral Coordination, Balance – evaluated through standardized testing and/or clinical observations
    1. Ability to catch, throw, jump, execute new movement sequences

  3. Need for and use of adaptive equipment – please let your therapist know if your child is already using adaptive equipment at home, school, or in community, as they can assess the equipment currently being used and determine need for additional or updated equipment

  4. Feeding – if the only occupational therapy concern you have for your child is feeding (picky eater, gagging, reflux, medical feeding concerns, etc.) please let the evaluating therapist know ahead of time, as this is a specialized evaluation. Your therapist will ask you to bring in a variety of foods to be presented to and/or consumed by your child during the evaluation. It is most beneficial if you can bring in foods that your child does prefer and foods that your child does not prefer. The following will be assessed:
    1. Amount and variety of food your child eats (assessed through parent report)
    2. Sensory and behavioral responses to feeding and foods presented in evaluation
    3. Oral motor patterns for chewing, manipulating, swallowing different textured foods (assessed through observation during evaluation)

 

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 45 minutes).   If therapy is recommended, you will be guided to the Client Care Coordinator to schedule ongoing therapy appointments.  You will receive a written report of your child’s evaluation typically within 2 weeks of the initial evaluation.

What To Expect At Your Initial Physical Therapy Evaluation

Approximately 1-2 days before your scheduled physical therapy evaluation, your evaluating therapist will contact you to introduce herself and briefly discuss your primary area/s of concern regarding your child’s movement and functional mobility. If we have received your case history form, she might also review your case history and ask any additional questions she has 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 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, your evaluating therapist will discuss her clinical impressions and recommendations for therapy including the frequency and duration (e.g. 1x/week for 60 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 evaluation typically within 2 weeks after the evaluation.