How is it assessed?
Assessment
Speech and language disorders present in a variety of ways at different stages in childhood.
In infancy it may present as a limited response to sound while toddlers & preschoolers may have delays in producing first words and word combinations and difficulty interactions with peers. School age children may have difficulties following directions, attending and comprehending oral and written language, and problems producing narratives and using language appropriately in social contexts. Parents are often the first to notice especially as their child encounters other children. A timely diagnosis is crucial since brain development patterns mean that it is easier to learn language and communication skills before the age of five.
Evaluation procedures are usually performed by a speech-language therapist; however a team approach is used. Other members of the team include educational psychologist, audiologists, paediatricians, occupational therapists, teachers, social services and health visitors. Identification of speech and language disorders is also complicated by a co-morbid condition (such as Autism or ADHD).
There are diagnostic criteria that a child must fulfil before he/she is diagnosed with a speech and language disorder. In the UK, routine screening for speech and language delay is not recommended, however this policy is currently under review. For those children that have been identified with a potential problem, usually by a parent or teacher, a Speech and Language Therapist (SALT) evaluates the child uses a variety of formal and informal (e.g. play assessment) methods and observations.
Comprehensive assessments are needed to identify language strengths and areas of impairment and how this has affected communication, social participation and well-being.
A comprehensive assessment involves -:
- Standardised tests (e.g. CELF and Renfrew & Reynell Developmental Language Scales and TROG are also widely used),
- Participation of the child, family and regular caregivers,
- Informal measures such as observation, discussion, questionnaires, checklists; and
- Account taken of a range of contexts: the classroom, playground and home as well as clinical setting – to ensure that children’s functional communication ability is judged.
