Speech Therapy: What Makes a Good Assessment?

January 28th, 2015 by

Speech Therapy SessionLike a car mechanic, we need to get under the hood to see how our patients “work”  in their communication engine so that we can best help improve their speech and language skills.  There are many standardized tests.

They help us look at the many domains of speech and language.  We need a framework, we need a base of comparison with other children or adults  to make good treatment decisions.

Preparing for the Assessment

Before assessing, get all the information you can about your client.  From observation, interviewing caregivers, teachers, doctors , spouses.  Read any relevant clinical information about your client that you can.  Try to have the correct testing materials.  Know what information and scores you need to get services.  Try to have a plan and then a plan B, C, etc.

For example, I have gone to a patient’s home and found that the child may refuse to take the “test” or that the “test” I thought would work doesn’t.  There are functional assessments that yield scores.  I do those and then get “my hands dirty” and play.  An informed play assessment can help you to describe behaviors and communication.

I have found that a well-written description can get services in the absence of scores.  However insurance companies are becoming more strict; be thorough in your description.

The Assessment

Standardized assessments  are given in a formalized fashion.  Here are some tips to get the most out of the short time you have with your patient/client.

  • Know the assessment instrument. That can help you be more flexible when giving it and be more discerning about specific subtests.
  • Handle the materials, practice on your or your friend’s children. Practice scoring.   You can see how some tests are given on YouTube.
  • Be Flexible. I initially present items in a formal way.  But I have found that you do learn more if you can see how much help a child, or adult needs to complete an item.
  • Is one repetition enough?  Do I need to provide more gestural cues, or a phonetic cue?  What If I change the wording?  I can write this information in my report.
  • Be aware of how the patient/client is feeling, the environment, time of day etc. If a client has just had Physical Therapy, they may be too tired to answer questions.
  • Check caregiver, doctor, patient expectations of the assessment. I always check with the caregiver, teacher, patient. If there is some skill that they want me to assess and work on.  If I miss an area of concern then I am not helping the client as I should.
  • Be aware of when the client was last assessed. If they were assessed by another company, try to find out which assessment was used.  If you are giving the same one within six months it can yield invalid results as the client might remember the items.

A good assessment does not have to be “by the book.”  The basic elements should include:  good preparation, knowing the assessment instrument and flexibility during the process.

About the Author:

Sandra Alexander has over 20 years of experience in the speech therapy field. In 1994, she received her Master’s Degree in Communicative Disorders from San Diego State University and in 1985 she received a B.A. in Communicative Disorders from the University of Redlands. She is also a returned Peace Corps Volunteer who taught speech therapy in Ecuador from 1987-1989.

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