What Happens During an Initial SLP Assessment

Speech pathology assessments are conducted to establish whether an individual has any specific speech and language disorders. They can also be conducted to diagnose potential communication disorders. In this article, we discuss speech pathologist assessment practices for the screening of speech and communication disorders.

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What Is a Speech Pathologist Assessment?

There are multiple avenues to conduct a speech pathology assessment. SLP assessments are conducted by a speech language pathologist. To become a certified speech language pathologist, you typically need at least a speech pathology master’s degree from an accredited program, the Bureau of Labor Statistics notes. 

If you’re wondering what are speech disorders, or what are language disorders, both are important to an SLP assessment. In fact, an SLP assessment determines whether a person has any communication disorders, speech language disorders, swallowing disorders or feeding disorders. Information is gathered from different sources to fully grasp the individual’s speech pathology needs and determine the best course of treatment. 

Different tools and measurements are used during a speech therapy assessment for toddlers and children than for adults. For example, a speech therapy assessment for children may  involve the child’s parents and/or teachers. This helps the speech therapist gain a thorough understanding of the child’s needs. Specialized pediatric speech and language assessment tools may also be used during the initial assessment. 

Special considerations may also be taken when working with people who are bilingual, who have learning difficulties or developmental disabilities, or who have physical disabilities or impairments that could influence their speech. The cost of a speech therapy assessment generally varies.

What to Expect During an Initial Screening by a Speech Therapist

During an initial speech pathology assessment (which could take more than one session), the speech language pathologist interviews the patient. They might also speak to friends, family members or other medical professionals who are treating the patient. The speech language pathologist may use a variety of methods during the initial SLP screening to determine whether the person has any speech and language disorders. They might also screen for any other communication disorders.

Why do some children need speech therapy? Some reasons to seek speech therapy, according to the Children’s Hospital of Orange County, include if the child:

  • Has difficulty imitating sounds.
  • Appears slow to comprehend new words.
  • Struggles to communicate their foundational needs.
  • Struggles to or does not respond to questions or directions.
  • Has difficulty starting conversation with others.
  • Makes limited or poor sounds of quality.
  • Is not stringing words together by 18 months.
  • Cannot be understood by strangers after 24 months.
  • Does not speak in sentences by 3 years of age.
  • Lacks verbal fluency by 3 ½ years .
  • Experiences communicative or cognitive changes after a surgery or injury.

The SLP practitioner may also review the individual’s case history before the SLP assessment. This includes medical records, education, and socioeconomic, cultural and linguistic background. They assess the individual’s cognitive, motor, visual and auditory function using both standardized and non-standardized measures, the American Speech-Language-Hearing Association reports. The SLP practitioner also observes and analyzes the patient’s swallowing function, cognitive communication, and spoken and unspoken language. If the SLP is a child speech therapist, they may use specialized pediatric speech assessment tools.

During the initial SLP assessment, the speech language pathologist identifies where the patient needs assistance. Once they have identified these needs, they develop strategies for intervention.

Challenges During a Speech Pathology Assessment

There might be some unique situations that pose challenges for speech pathologists when they are performing an SLP assessment. These may include working with patients who have language barriers, developmental disabilities or learning difficulties, and/or physical disabilities. Let’s analyze each of these and why they might add challenges during a speech pathologist assessment.

Language Barriers and Multicultural Considerations

There could be some difficulty and need for adjustment of both the SLP assessment and intervention processes if a child speaks more than one language and is not assessed by a bilingual speech pathologist. Of SLPs who reported being bilingual speech therapists, nearly 65% were Spanish-language providers, the American Speech-Language-Hearing Association reports.

In some cases when a patient speaks English as a second language, the American Speech-Language-Hearing Association notes that it can be challenging to identify whether speech irregularities are due to a speech disorder or because the patient isn’t yet fluent in English. In these instances, the speech pathologist may rely more on information they gather from the patient’s family, friends and medical practitioners to make recommendations. 

Bilingual speech pathologists might also look at other factors that could indicate that the person has a speech disorder. The practitioner may assess the patient’s ability to perform bilabial sounds (sounds that require both lips to be spoken correctly). They may also look out for echolalia (where the patient repeats another’s words), how quickly or easily they learn new words in both languages, and whether learning a second language has caused them to develop syntactic errors in their first language.  

Similarly, multicultural factors could influence the assessment process. Phonemic inventories that span different languages and alternative assessments could be used to assist in the assessment and planning of interventions. 

Learning Difficulties or Developmental Disabilities Considerations

Speech pathologist assessment and intervention may need to be adjusted for individuals with learning difficulties and/or developmental disabilities, such as autism. In these cases, the SLP practitioner familiarizes themselves with the patient’s medical history and developmental status to identify whether any speech or language difficulties are due to these factors.

During speech therapy for children with autism, the SLP practitioner may also use specialized tools created to assess speech disorders in individuals with developmental disabilities. For example, the FCP-R (Functional Communication Profile – Revised) can be used to assess the individual communication abilities of the patient. It may include an interview with the parents, the direct assessment of the patient or observing recordings of the patient.

Physical Disabilities Considerations 

Physical disabilities that may affect a person’s speech include hearing impairments and cleft lips. When conducting hearing screenings for children, the American Speech-Language-Hearing Association notes that SLPs will likely work with audiologists and other practitioners. During this kind of speech pathologist assessment for hearing-impaired patients, the speech pathologists may help establish what the patient’s (and their parents’) goals are for therapy. 

When conducting an SLP assessment for someone who has hearing loss beyond early childhood, a speech therapist seeks to understand how the loss of hearing impacts the patient’s communication. The SLP may help determine whether or not a device is needed to aid communication, the American Speech-Language-Hearing Association reports. While conducting the initial assessment, SLP practitioners and audiologists also take the individual’s everyday environments into consideration to create a realistic plan for intervention and treatment.

Next Steps After an Initial Assessment from a Speech Therapist

Speech therapy assessment for toddlers, speech therapy assessment for children and speech therapy assessment for adults—along with treatment and intervention plans—may look different. Regardless, the initial SLP assessment gives the speech pathologist a clear understanding of the patient’s needs. It may also show how parents can help SLPs throughout the treatment and continued evaluation process. 

Are you wondering how to find a speech language therapist job? If the SLP assessment process interests you, you may enjoy exploring speech pathology careers

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