What to Expect at a First Evaluation

The words “evaluation” and “assessment” can sound clinical and high-stakes. For many families, knowing what to expect makes the appointment much less daunting. The short version: it’s mostly observation, conversation, and play.

Hearing evaluation: do this at the same time

Before or alongside your child’s speech-language evaluation, request a formal hearing test from a paediatric audiologist if one has not been completed recently.

A speech-language pathologist cannot fully assess or plan for a child’s communication without knowing their hearing status. Hearing loss — including conductive hearing loss from fluid in the ear — affects how a child processes speech input and directly shapes what an SLP finds and recommends. Many children with undetected hearing loss have spent months or years in speech therapy without the underlying cause being addressed.

If you ask for an SLP referral, ask for an audiology referral in the same conversation. The two evaluations are complementary, and the SLP will want the audiologist’s results.

Before you arrive

Most evaluations begin with paperwork — a developmental history, a questionnaire about your child’s communication, and a release of information if the SLP wants records from other providers (your GP, a previous evaluation, nursery or school).

Things worth preparing in advance:

• A brief list of words and phrases your child uses regularly
• Any recent hearing test results — if a formal audiological evaluation has been done, bring the report; if not, mention it to the SLP so they can factor it into their recommendations
• Notes on what you’ve noticed — even rough notes (“started doing X around 18 months,” “stopped saying Y around the same time”)
• A short video on your phone, if you can get one. Children often communicate differently in clinical settings than at home. A two-minute clip of your child playing or having a snack can give the SLP invaluable information.

What happens during the evaluation

A speech-language evaluation for a young child typically includes some combination of:

Parent interview — the SLP will ask you detailed questions about your child’s developmental history, communication at home, and your specific concerns. This is not a test of your parenting — it’s information gathering.

Observation — the SLP will observe your child in play, often setting up situations designed to prompt communication: offering a toy that needs help to open, pausing expectantly, or narrating what they’re both doing. Much of the clinical information comes from watching, not from formal tasks.

Standardised assessments — for older children or more complex presentations, the SLP may use a standardised tool that gives them comparative data. These are typically play-based or picture-based activities, not paper tests. Results come as scores that compare your child to a reference group of similar-aged children.

Articulation/intelligibility sampling — for concerns about speech clarity, the SLP may use picture naming or spontaneous speech to get a picture of which sounds are present and which are developing.

What happens after

At the end of the appointment — or in a follow-up session — the SLP will share what they found and make recommendations. These typically fall into:

• No concerns identified — development appears to be within the typical range. The SLP may give you some general home strategies and suggest when to follow up.
• Monitoring — some concerns noted but not yet enough to meet criteria for services. A follow-up evaluation in three to six months is often recommended.
• Intervention recommended — the SLP has identified an area (or areas) where support is warranted and will outline what that might look like.

Whatever the outcome, you should leave understanding what the SLP observed, what they recommend, and what you can do at home in the meantime.

If your child didn’t “perform”

Young children frequently don’t produce their best communication in a clinical setting. This is not a failure of the evaluation — a good SLP accounts for it. They’re trained to read what they see, to gather information from your report, and to factor in the atypicality of the environment. If you felt the appointment didn’t capture your child fairly, mention it — and consider asking whether a home visit, nursery observation, or second session might give a more complete picture.

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