ASSESSMENTS

Assessments may be a screening assessment, or a formal and/or diagnostic assessment.

Screening assessment

A screening assessment may be conducted to determine if there is a difficulty requiring further formal assessment, or if the issues are of a specific nature eg, articulation, stuttering. Screening tools, informal observations, checklists or formal assessment tools – or a combination of these assessment methods – may be used. A screening assessment typically takes up to an hour to complete, relevant to the individual’s needs.

Formal and/or diagnostic

A formal assessment may be conducted when comprehensive and detailed information about a client’s speech and/or language difficulties is required. This may be at the request of the client, the client’s parents or in some instances from a third party funding body. The assessment may be required to assist with the formal diagnosis of the underlying speech, language, and/or literacy difficulty, as well as to assist with the development of treatment goals. A range of standardized assessment tools will be used to conduct a formal speech pathology assessment.

The speech pathologist will decide which areas need to be assessed, depending on the presenting difficulties however a comprehensive diagnostic speech pathology assessment typically covers all of the following areas:

• Receptive Language
• Expressive Language
• Speech (Articulation/Phonology)
• Voice
• Fluency
• Social Communication (Pragmatics)

Other areas which may be assessed depending on the presenting difficulties, and the age of the client include play, and literacy (possibly including phonological awareness, reading, writing, and spelling).

Assessment procedure

In general, a speech pathology assessment is conducted one-on-one in a quiet and comfortable setting free from distractions.

Parents or significant others may observe the assessment session and the speech pathologist will explain what is going to happen and what the observer can or cannot do during the assessment (e.g. the observer may not prompt the client to respond by repeating the questions during the assessment).

A formal and/or diagnostic speech pathology assessment typically takes longer than a screening assessment, and in some instances up to 3 x 1 hour long sessions may be required.

As part of the assessment procedure the speech pathologist will obtain a comprehensive case history looking at the client’s presenting difficulties, past medical history and prior attendance at speech therapy or involvement with other health professionals. This usually occurs at the beginning of the first assessment session.

After the speech pathologist has obtained a case history they will continue with the planned screening or assessment tasks.

THERAPY

Individualised therapy goals are established after the assessment has been completed. Information gained from the assessment, the Family’s priorities, and consultation with relevant others, as well as developmental needs, contribute to goal setting.

Individual 30, 45 or 60 minute therapy sessions usually occur weekly or fortnightly, depending on the needs of the client.

Therapy sessions normally include a review of homework and previously learnt skills, introduction of new skills, and homework setting.

Typically, the new skills established in the therapy session become homework for the client, or child and parents, to practise at home. Clients and Parents are trained in how to do therapy and taught to think as a therapist. For example, if a child is working on an articulation program the parent is taught how to respond to a child’s speech attempts:

• If correct – praise and move on to the next one
• If incorrect -support the child by breaking down the task and modelling the speech sound at an easier level, then build it back up. That may sound complicated to parents new to speech therapy but it’s not, and it’s the therapist’s job to help parents feel competent doing this.

HOME PRACTICE

Home practice is an important part of speech therapy and therapy is much more successful when home practice is done (usually 10-20 minutes a day). Progress is likely to take much longer if minimal practice is done. Home practice can be built into activities of daily living eg. When driving in the car, walking to school, having a bath, cooking.

REVIEW

Review sessions are important to monitor progress over time, particularly for people with stuttering or articulation issues. It can be very easy for skills to revert back. For example, if a Parent was used to a child producing a /f/ sound instead of a /th/ sound, then the child could gradually go back to saying /f/ without the Parent being aware if it, because they were used to hearing the child speak that way previously. A review session allows the Speech Pathologist to make sure that the therapy skills have been maintained over time.