Speech Therapist Evaluation & Treatments

If you or your child have been referred to a speech language pathologist (SLP) for a speech pathologist evaluation, you’re probably wondering what to expect. SLPs work with patients of all ages who have a variety of needs, such as children with speech and language disorders who have trouble with language, sound or articulation (such as stuttering), people who have suffered a traumatic brain injury from an accident, those with communication disorders and stroke victims who have issues with swallowing and speech.

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What Is a Speech Pathologist Evaluation?

Before a speech pathology evaluation, it’s common to have  an initial screening, which is a fairly quick scan of a person’s abilities and issues done primarily through observation and interaction. When a screening determines that a speech disorder probably exists and that a person could likely be helped by SLP intervention, a more thorough speech pathology evaluation is recommended to get a complete picture.

The difference between a screening and an evaluation is primarily one of depth. Here are some of the components an evaluation may include:

  • More time spent in direct observation; for instance of a child in a class of peers or an adult during an interview.
  • Interviews with family or relevant professionals; such as teachers or doctors.
  • A case history including such things as cultural and linguistic backgrounds and a medical history.
  • The use of standardized assessment tests that measure different characteristics of language, speech, comprehension of spoken language, non-spoken communication, focus and brain-to-speech function.

What Happens During an Evaluation by a Speech Therapist

A speech therapy evaluation might be conducted at home, at school, at an office or a combination. It might take one session or multiple sessions, depending on the level of information needed about a person’s abilities. The therapist may ask questions of family members or teachers to gain valuable insight from those who have spent the most time with the person.  Standardized tests help the speech language pathologist determine a person’s skill level in a variety of abilities.

Tests for the youngest children (as early as three months to three years) might study gestures, words and use of phrases or sentences. Pediatric speech evaluation for slightly older children (from about three to six years) may explore letters, numbers and sounds, self-awareness and social awareness, and how the child uses syntax and non-verbal communication. Tests for elementary-grade children (from about five to 12 years) include such skills as association, categorization, words with multiple meanings and similarities/differences. Evaluations through adolescence and young adulthood (anywhere from 12 to 24 years) test basic skill levels of things like vocabulary and grammar, but also measure critical thinking and language-based interactions with peers. Evaluations for older adults–for instance, those who can’t speak due to a traumatic brain injury or a stroke–may assess cognitive ability through nonverbal formats, such as gesturing and the ability to correctly interpret spoken language and identify nouns and verbs shown to them in pictures. 

SLPs have master’s degrees in speech pathology; this degree that helps them learn the subtleties in language and speech difficulties. They may work with children, bilingual populations, with patients who are hearing-impaired, or with patients who have autism spectrum disorder. They work in a variety of settings according to the Bureau of Labor Statistics including hospitals, offices of physical therapists and audiologists, in private practice and in educational services. 

Next Steps After a Speech Language Pathology Evaluation

A speech language pathology evaluation can cover a lot of ground. For instance, a sample evaluation report of a 3-year-old boy assessed his articulation of consonant sounds (he had difficulty with the “r” in giraffe, the “pl” in plate, and the “v” in vacuum, for example), whether he could correctly identify spoken words (receptive vocabulary) by pointing to corresponding pictures, the quality of his voice, the speed at which he spoke and his ability with expressive language. The evaluation concluded with a good prognosis, “provided his continued participation and motivation. In addition to intervention, he will also have a language-rich learning environment at school and extensive support from his classroom teachers.”

While some speech disorders may remain despite intervention, there are multiple kinds of speech therapy that may help a person change and develop in needed areas. Finding the proper speech therapy is the next step after an evaluation. 

Types of Speech Therapy Treatments

Here are some therapies and treatments for the primary issues that speech language pathologists are trained to treat:

  • Fluency: Stuttering is one fluency disorder (PDF, 121 KB), in which a speaker gets stuck on certain sounds or words. Cluttering is another, in which a speaker loses clarity due to dropped or added pauses or syllables, constant word revisions or topic-shifting. Treatment is dependent on the subject’s age, the severity of the problem and the reasons behind it, such as a coexisting condition like autism spectrum disorder. Treatment may include speech modification, stuttering modification focusing on the physical difficulty of speech, conditioning, increasing speech efficiency, desensitization to fear or anxiety and medication.
  • Articulation: If a child has difficulty pronouncing a certain sound, that’s an articulation disorder (a common one would be replacing an “r” sound with a “w” sound, meaning that “rooster” would come out “wooster”). A speech language therapist starts by isolating the sound so that the child might copy it, giving cues as to mouth shape and tongue position. After a child masters this, the therapist may move on to syllables where the sound is used, then words, then phrases, then sentences, then reading aloud from stories then using the sounds in conversation.
  • Cognition: Problems with cognition include focus and attention, perception, memory, reasoning, executive function and problem-solving. They may be issues for patients of many ages, from children who have attention-deficit hyperactivity disorder to older adults who are developing dementia. The issue might range from mild to severe. Therapy includes exercises to retrain cognitive processes, techniques to compensate for deficits (such as smartphone apps to help memory problems), and education of both the subject and family members as to recognizing specific issues and helping the subject compensate.
  • Voice: If a person’s voice is too hoarse, too high or low in pitch, too loud, or not easily understandable, he or she may benefit from voice therapy. In some cases, especially in a speech-intensive occupation, the subject may have developed vocal nodules, polyps or cysts. While there are medical treatments for some conditions – such as Botox injections or surgery – voice therapy is an important component. The therapy includes incremental changes in vocal behavior, volume, energy and rate of speech over a series of sessions.
  • Other Treatments: There are also voice therapies for situations in which a person wishes to change the attributes of his or her voice because of its impact on daily life. Transgender people may desire to have their voice match their gender more distinctly, as feminine and masculine voices often differ in pitch, resonance, intonation and volume. People who have strong accentsperhaps from another region of the United States, or perhaps from another countrysometimes find it difficult to communicate easily with others. In both situations, working with an SLP helps people hear, identify and modify the qualities in their voice that they desire to change.

Collaborating on Speech Evaluation and Treatments

When working with a speech language pathologist on nearly any sound, speech or language situation, the evaluation and treatment may be more effective when the SLP is able to collaborate with family members and with relevant professionals: teachers, caregivers, audiologists and doctors as needed. Speech therapy evaluation for toddlers, children and adults may benefit by having the participation of those who surround the patient and may help with consistency, practice and goals.

Sponsored Online Speech Pathology Programs

Earn Your Online Master’s in Speech Pathology from Emerson College

  • Complete degree in as few as 20 months
  • No GRE Required for all 2021 Cohorts
  • 5-term and 9-term study options
  • Now accepting applications

Sponsored Program


NYU Campus

Earn Your Master’s in Communicative Sciences and Disorders Online at NYU Steinhardt

  • Live, online classes of no more than 15 students
  • Scholarships available
  • Now accepting applications

Sponsored Program


Earn Your Master of Science in Communication Sciences and Disorders Online from Baylor University

  • Complete degree in as few as 20 months
  • Full-time and part-time options available
  • Same standards as the on-campus program, which has 50+ years educating SLPs
  • Now accepting applications

Sponsored Program


Last Updated January 2021