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As a seasoned Speech Pathologist with over eleven years of experience in both school and private practice settings, I have frequently encountered the interchangeable use of the terms "screening" and "evaluation." I hope to clarify the distinction between these, especially for parents seeking guidance on their child's speech and language development.
What is a screening? A screening serves as a quick, one-on-one assessment providing a snapshot of a child's skills. Typically lasting between 15 to 30 minutes, the duration may vary depending on the setting and the specific areas being evaluated. A parent may request a speech and language screening for their child through their local public school. Speech Pathologists in private practice may provide complimentary screenings, while others may charge a nominal fee for this service.
What skills are considered during a speech and language screening? A speech and language screening assesses various aspects, including speech articulation (pronouncing sounds), language comprehension and expression, fluency (rate and rhythm of speech), vocal quality (how the voice sounds), and social interactions. Additionally, clinicians may observe aspects such as emotional regulation, attention span, and play skills.
What do screening results reveal? Screening results are usually categorized as "pass/no additional testing at this time," "refer to other professional,” "evaluation recommended," or "monitor only/follow-up.”
A "pass/no additional testing at this time" result suggests that speech therapy is not needed and the assessed skills align with age-appropriate expectations.
A Speech Pathologist may recommend “refer to other professional.” These professionals may include any of the following: a developmental pediatrician, occupational therapist, physical therapist, audiologist, ENT, or psychologist. There are several reasons for a referral to another professional including complex needs beyond the scope of the SLP’s expertise, medical concerns, or educational needs.
An "evaluation recommended" result implies that the child exhibits skills below age expectations, necessitating a more in-depth assessment to identify specific areas of need.
For instance, if a child struggles with articulating a specific sound, the clinician may use the screening to introduce the sound by providing a model for the child to observe and imitate. Additional guidance may be offered to help the child produce the sound, such as providing verbal feedback on lip and tongue placement. If the child is unable to produce the sound with assistance, it suggests a potential difficulty in acquiring the sound independently. An evaluation can pinpoint the exact breakdowns in speech production and provide valuable baseline information. Furthermore, "trial therapy" measures during the evaluation can help determine additional strategies that may be needed to address the child's specific challenges. It's widely recognized among clinicians that adopting a "wait and see" approach is outdated, as intervening early typically yields more favorable outcomes.
A “monitor/follow up” result indicates a need for monitoring or follow-up in 3-6 months. It suggests that while there may not be an immediate need for therapy, there are some concerns or areas of development that warrant further observation over time. This time frame allows professionals to determine if speech or language issues persist, improve, or worsen. Some changes may occur naturally over time.
How does an evaluation differ from a screening? An evaluation either follows a screening or occurs in the absence of a screening. It involves a comprehensive assessment process. This typically includes gathering medical and developmental history. Evaluations often last at least an hour and may span multiple sessions, depending on the complexity of the assessment. Formal assessments revealing standard scores with percentiles are commonly used during evaluations to identify strengths and areas requiring intervention. Additionally, informal assessments may be used and provide detailed insights.
Many clinicians also utilize dynamic informal assessment techniques involving interactive exercises to explore a child's learning potential. By testing specific skills, providing targeted intervention, and retesting, clinicians can assess the effectiveness of therapy and develop individualized treatment plans.
How are results reported? After a screening, you can expect a concise summary of the findings, whereas an evaluation typically results in a comprehensive report. Speech and language evaluation reports outline the assessments conducted, overall performance observations, and diagnostic insights. An evaluation can confirm the presence or absence of a speech and/or language disorder. Evaluations also include recommendations for the duration, intensity, and frequency of speech therapy sessions, accompanied by both short-term and long-term treatment goals if warranted.
In conclusion, understanding the distinction between screenings and evaluations is essential for effectively addressing speech and language concerns in children. By navigating these processes with clarity, parents and caregivers can ensure timely and appropriate interventions to support their child's communication development.