What Happens During an Initial SLP Assessment
Understanding Speech Pathology Assessments
Speech pathology assessments are conducted to determine whether an individual has speech, language, swallowing, or other communication disorders. They can also be used to diagnose potential communication differences and establish baseline functioning for treatment planning. In this comprehensive guide, we discuss speech-language pathology assessment practices for identifying communication and swallowing disorders.
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- Aspiring SLP generalists are prepared to pursue ASHA certification.
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- Online classes are taught by expert Emerson faculty—most of whom are practicing SLPs who view students as colleagues and collaborators.
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- Full-time (five trimesters) or part-time (eight trimesters) options available.
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- Three onsite experiences build a sense of camaraderie and community throughout the program
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What Is a Speech Pathologist Assessment?
Speech language pathology (SLP) assessments are comprehensive evaluations conducted by certified speech-language pathologists. To become a certified speech-language pathologist, you typically need at least a master’s degree in speech pathology from an accredited program, according to the Bureau of Labor Statistics.
An SLP assessment determines whether a person has communication, speech, and language disorders; swallowing or feeding disorders; and cognitive-communication difficulties. According to ASHA’s Preferred Practice Patterns, assessment is conducted to identify underlying strengths and weaknesses, understand how these impairments affect the individual’s activities and participation, and identify contextual factors that serve as barriers to or facilitators of successful communication and swallowing. Information is gathered from multiple sources to fully understand the individual’s communication needs and determine the best course of intervention.
Different assessment approaches, tools, and measures are used for children, adolescents, and adults. For example, a speech therapy assessment for children typically involves parents, teachers, and caregivers, giving the speech-language pathologist a thorough understanding of the child’s communication needs across different settings. Specialized assessment tools may also be used during pediatric assessments.
Special considerations apply when working with people who are bilingual or multilingual, have learning difficulties or developmental disabilities, or have physical disabilities or sensory impairments that could affect speech and language. The cost of a speech therapy assessment varies based on setting (clinical, educational, or medical) and whether insurance covers the evaluation. Read the guide to learn more about multilingual speech language pathology careers.
What to Expect During an Initial Speech Pathology Screening
During an initial speech language pathology assessment (which may take one or more sessions), the SLP interviews the client. They may also speak with family members, teachers, or other healthcare professionals involved in the client’s care. The SLP uses a variety of methods to determine whether the person has any speech, language, or communication disorders. These methods include:
- Case History Review: Before beginning the assessment, the SLP practitioner reviews the individual’s case history, including medical records, educational background, and socioeconomic, cultural, and linguistic context. According to ASHA’s assessment guidelines, this comprehensive background information is essential for understanding the individual’s communication needs.
- Assessment Measures: The SLP assesses the individual’s cognitive, motor, visual, and auditory function using both standardized and non-standardized measures. According to ASHA practice standards, assessment may include:
- Standardized tests (norm-referenced or criterion-referenced assessments)
- Language sampling in natural communication contexts
- Dynamic assessment (testing, teaching, and retesting to identify learning potential)
- Observation and analysis of speech and language in varied settings
- Review of the individual’s swallowing function, cognitive-communication abilities, and both spoken and non-spoken language
- Determining Service Needs: During the initial SLP assessment, the speech-language pathologist identifies specific areas where the patient needs support. Once these needs are identified, the SLP develops individualized intervention strategies and treatment goals.
When to Seek Speech Therapy for Children
Some signs may indicate that a child would benefit from professional evaluation. According to ASHA’s Developmental Milestones for Communication, speech-language pathologists recommend seeking a professional evaluation if a child:
- Has difficulty imitating sounds or producing speech sounds
- Appears slow to learn new vocabulary or understand words
- Struggles to communicate foundational needs or express wants and needs
- Does not respond consistently to questions or spoken directions
- Has difficulty initiating or maintaining conversation with peers
- Produces limited speech sounds or sounds of poor quality
- Is not combining words together by 18 months
- Cannot be understood by unfamiliar listeners by 2 years of age
- Does not speak in simple sentences by 3 years of age
- Demonstrates reduced verbal fluency or excessive disfluency by 3.5 years
- Experiences changes in speech, language, or swallowing abilities following surgery, illness, or injury
- Has difficulty understanding or using language compared to same-age peers
- Shows signs of hearing loss or concerns about hearing
ASHA emphasizes that if a child lacks several skills, is not learning new skills, or is losing skills they once had, families should consult their pediatrician and visit an ASHA-certified audiologist or speech-language pathologist. A comprehensive evaluation can determine whether these concerns reflect typical development, a language or speech difference, or a communication disorder requiring intervention.
Parents and caregivers can access ASHA’s free Developmental Milestones worksheets for detailed information on communication and swallowing development from birth through age 5. |
Challenges During Speech Pathology Assessments
Several unique situations can pose challenges for speech-language pathologists when conducting assessments. These include working with patients who have language barriers, developmental or learning disabilities, or physical or sensory impairments.
Language Barriers and Multilingual Considerations
Assessment and intervention processes may need adjustment if a child speaks more than one language and is not evaluated by a bilingual speech-language pathologist. According to ASHA’s Profile of Multilingual Service Providers, Year-End 2024, of SLPs who self-identified as multilingual service providers, approximately 67.7% provide Spanish-language services. This means that many multilingual children may not have access to bilingual evaluation and treatment.
In cases where a patient speaks English as a second language, it can be challenging to identify whether speech irregularities are due to a speech disorder or represent typical characteristics of second-language acquisition and development. In these instances, ASHA practice guidelines indicate that the SLP may rely more heavily on information gathered from the patient’s family, teachers, and healthcare practitioners when making diagnostic and treatment recommendations.
Assessment Strategies for Bilingual Populations:
Bilingual SLPs may examine several factors to determine whether a communication difference represents a disorder:
- Assessment of the individual’s ability to produce bilabial sounds (sounds requiring both lips)
- Observation for echolalia (repetition of others’ words)
- Evaluation of how quickly or easily the person learns new words in both languages
- Analysis of whether learning a second language has caused grammatical errors in the first language
- Use of phonemic inventories that span both languages
- Implementation of alternative assessment approaches tailored to bilingual development
According to ASHA competency standards for bilingual service delivery, bilingual SLPs must demonstrate native or near-native proficiency in both languages, knowledge of typical development for both monolingual and bilingual speakers, ability to administer and interpret assessments in both languages, and cultural competency when working with diverse populations.
Learning Difficulties and Developmental Disabilities
Assessment and intervention may need adjustment for individuals with learning difficulties or developmental disabilities, such as autism spectrum disorder. In these cases, the SLPs familiarize themselves with the patient’s medical history and developmental status to identify whether communication difficulties are related to these conditions.
For children with autism, the SLP may use specialized assessment tools to measure communication abilities. Assessment approaches may include parent interviews, direct observation of the child, analysis of video recordings, and standardized measures designed for use with individuals who have developmental disabilities. The goal is to understand the individual’s functional communication strengths and needs across different contexts.
Physical and Sensory Disabilities
Physical disabilities that affect speech include hearing impairments and cleft lip/cleft palate. When conducting hearing assessments for children, ASHA guidelines indicate that SLPs often work collaboratively with audiologists and other specialists. According to current ASHA data, approximately 15% of school-age children experience some degree of hearing loss in one or both ears.
When assessing individuals with hearing loss, speech-language pathologists seek to understand how hearing loss affects communication abilities and daily functioning. ASHA practice guidelines indicate that SLPs may help determine whether a hearing device is needed and work with the individual and their family to develop realistic intervention plans that address communication needs in everyday environments.
For individuals with physical conditions affecting speech production (such as cerebral palsy or dysarthria), the SLP may use alternative and augmentative communication (AAC) assessment approaches to identify the most effective communication strategies and technology to support functional communication.
The Role of Assessment in Treatment Planning
The initial SLP assessment provides the foundation for effective intervention. Different assessment approaches—whether for toddlers, school-age children, adolescents, or adults—yield information that guides treatment planning and helps families and professionals understand communication strengths and needs.
Following the assessment, the SLP collaborates with the patient, family members, teachers, and other healthcare professionals to develop an individualized treatment plan. This plan may include direct therapy, consultation, and coaching with family members and teachers, modifications to the communication environment, use of assistive technology, or a combination of these approaches.
Next Steps After an Initial Assessment
After the initial assessment, the SLP will provide a written report that includes:
- Summary of the assessment results and findings
- Diagnosis or description of communication status
- Recommendations for treatment or further evaluation
- Specific goals and objectives for intervention
- Information about how families can support communication development at home
The SLP may recommend follow-up assessments to monitor progress, adjust treatment goals as the individual improves, or address new communication concerns that emerge.
Exploring an SLP Career
If the assessment and treatment process interests you and you enjoy working with people of all ages and communication needs, you may want to explore speech-language pathology careers. The field offers diverse opportunities in schools, hospitals, clinics, private practice, and telepractice settings, as well as specialization areas such as bilingual service delivery, pediatric communication disorders, voice and swallowing, and cognitive-communication disorders.
Information Last Updated: April 2026
Sponsored online speech pathology programs
Master’s in SLP: Study Online Full or Part Time
Speech@Emerson enables you to earn an MS online and pursue SLP certification in as few as 20 mos. Learn the same curriculum as the on-campus program. Study FT or PT.
- Aspiring SLP generalists are prepared to pursue ASHA certification.
- Students can earn an Emerson Master of Science in Communication Disorders online in as few as 20 months.
- Online classes are taught by expert Emerson faculty—most of whom are practicing SLPs who view students as colleagues and collaborators.
AD
Online MS in Speech-Language Pathology from Pepperdine University
Pepperdine University’s online Master of Science in Speech-Language Pathology program combines a robust, innovative curriculum rooted in Christian values with a full-time or part-time option that features online learning, on-campus intensive experiences, and comprehensive clinical field practicums to prepare skilled, compassionate students for careers as speech-language pathologists.
- Full-time (five trimesters) or part-time (eight trimesters) options available.
- No GRE scores required.
- 400+ supervised, clinical learning hours are done at schools/clinics local to students
- Three onsite experiences build a sense of camaraderie and community throughout the program
AD