The Speech Therapy Assessment: Complete Guide for a Successful Evaluation
The assessment is the foundation of any speech therapy intervention. Discover how to conduct a comprehensive evaluation, choose the right tests, and write an effective report.
The speech therapy assessment is the foundational act of the therapeutic relationship. It allows for establishing an accurate diagnosis, defining rehabilitation goals, and proposing a tailored therapeutic project for the patient. For the young speech therapist, mastering the assessment is a major challenge that determines the quality of all future care. This complete guide accompanies you through all the steps of the speech therapy evaluation.
🎯 The objectives of the speech therapy assessment
The speech therapy assessment fulfills several essential functions that go far beyond simply evaluating the patient's abilities. It is a complete clinical act that lays the groundwork for therapeutic intervention.
Evaluate
Objectively measure the patient's abilities and difficulties in the relevant areas
Diagnose
Establish an accurate speech therapy diagnosis that will guide therapeutic management
Objectify
Provide quantified data to track progress and evaluate the effectiveness of treatment
Recommend
Propose a tailored therapeutic project with clear goals and indications for rehabilitation
Beyond these clinical objectives, the assessment is also the moment of the first encounter with the patient. It is an opportunity to establish a trusting relationship, understand their experiences and expectations, and involve them in their care project.
💡 Initial assessment vs renewal assessment
The initial assessment is the most comprehensive and longest. Renewal assessments, conducted during or at the end of care, are more targeted and aim to evaluate progress and readjust goals. Both are essential for quality care.
📚 Preparing the assessment: keys to success
A successful assessment requires preparation in advance. This preparation optimizes the evaluation time and allows for better adaptation to the specific needs of the patient.
Before the appointment
Analyze the prescription
Identify the reason for consultation, the mentioned history, and the examinations already conducted
First telephone contact
Gather initial information, explain the process, request useful documents
Prepare the materials
Select tests suitable for the age and reason, check that everything is available and in good condition
Documents to request
- Medical prescription (mandatory for billing)
- Health booklet for children (growth curves, health assessments)
- Previous assessments (speech therapy, psychological, medical)
- School reports and notebooks for learning difficulties
- Reports of additional examinations (audiogram, ENT assessment, imaging...)
⚠️ Adaptation to the patient
The preparation must take into account the patient's specifics: age, presumed pathology, cultural and linguistic context, possible associated disorders. An assessment for a 4-year-old child is not prepared the same way as an assessment for an aphasic adult.
🗣️ The anamnesis: gathering information
The anamnesis is the first step of the assessment. This in-depth interview with the patient and/or their family allows for understanding the history of the disorders, the living context, and the expectations regarding the care.
Areas to explore
Developmental history
Pregnancy, birth, psychomotor development, early language acquisitions
Medical history
Illnesses, hospitalizations, surgical interventions, ongoing treatments
Family context
Family composition, languages spoken, family history of language disorders
Educational/professional background
Schooling, difficulties encountered, accommodations in place, professional situation
Interview techniques
The anamnesis is an art that is learned through practice. It involves gathering as much relevant information as possible while establishing a climate of trust.
- Open questions: Allow the patient or family to express themselves freely before targeting
- Active listening: Reformulate to ensure understanding and show your attention
- Observation: Note behavior, non-verbal communication, interactions
- Empathy: Welcome emotions without judgment, especially the parents' concerns
- Structuring: Guide the interview while remaining flexible according to responses
💡 Practical advice
Prepare an anamnesis framework tailored to each type of assessment (oral language child, written language, neurological adult...). This will help you not to forget anything while maintaining the necessary flexibility to follow the course of the interview.
"A well-conducted anamnesis is already half of the diagnosis. It allows understanding the patient in their entirety, not just as a carrier of a symptom."
— Dr. Marie Dupont, phoniatrist
🛠️ Enrich your assessments with modern tools
DYNSEO applications allow for observing the patient's abilities in an ecological and playful way, in addition to standardized tests.
Discover our tools →🔬 The clinical evaluation: observation and informal tests
Beyond standardized tests, the clinical evaluation relies on careful observation of the patient in context. This qualitative dimension is essential for understanding the patient's functioning and adapting care.
What to observe
Spontaneous communication
Oral language in a natural situation, intelligibility, fluency, pragmatics of communication
Comprehension
Reactions to instructions, requests for repetition, signs of comprehension difficulties
Attention and behavior
Attention capacities, fatigue, behavior in the face of difficulty, motivation
Interaction
Eye contact, turn-taking, adaptation to the interlocutor, social skills
Informal tests
In addition to standardized tests, informal tests can be proposed to explore specific aspects or to adapt the evaluation to the patient.
- Free play to observe spontaneous language in children
- Picture storytelling to evaluate narrative abilities
- Dictation of invented words to analyze transcription procedures
- Reading aloud a text adapted to the level
- Ecological tests reproducing everyday life situations
💡 Complementarity
Clinical observation and informal tests do not replace standardized tests but complement them. Normed data are essential to objectify disorders, while qualitative observation helps to understand their functional impact.
📊 Standardized tests: choosing and using
Standardized tests are essential tools in the speech therapy assessment. They allow for comparing the patient's performance to a norm and reliably and reproducibly objectifying disorders.
Criteria for choosing a test
Validity
Does the test accurately measure what it claims to measure? Has it been scientifically validated?
Reliability
Are the results reproducible from one administration to another, from one examiner to another?
Standardization
Is the standardization recent and representative of the current French population?
Sensitivity
Does the test allow for detecting disorders, even mild ones, in the evaluated area?
Main test batteries
The range of tests available to the speech therapist is vast. Here are the main categories to know:
- Oral language: EVALO, ELO, N-EEL, EXALANG, specific batteries by age
- Written language: EVALEO, ODEDYS, BALE, Alouette, fluency tests
- Mathematical cognition: ZAREKI, TEDI-MATH, UDN-II
- Cognitive functions: TEA-Ch, NEPSY, memory tests
- Adult neurology: BDAE, MT86, LEXIS, naming tests
- Voice: VHI, acoustic analysis protocols
⚠️ Adherence to administration instructions
A standardized test has value only if it is administered exactly according to the instructions defined by the authors. Any modification (reformulation, additional help, different timing) invalidates the norms and makes the results non-interpretable in relation to the standardization.
Building your test battery
The choice of tests to administer depends on the reason for consultation, the patient's age, and the diagnostic hypotheses formulated following the anamnesis.
💡 Evaluation strategy
Start with global tests that help identify deficient areas, then delve deeper with more specific tests. Adapt your battery during the assessment based on the results obtained. An assessment is not a checklist of tests to be administered at all costs.
🧠 Analysis and interpretation of results
The analysis of results is the crucial step that transforms raw data into a speech therapy diagnosis. It requires rigor, synthesis skills, and clinical perspective.
Steps of the analysis
Scoring
Calculate raw scores and convert them into standardized scores (percentiles, standard deviations, standard scores)
Comparison to norms
Position the performances relative to the reference population and identify deficient areas
Consistency
Cross-reference quantitative results with qualitative observations and the anamnesis
Diagnosis
Formulate an accurate speech therapy diagnosis and assess the functional impact
Interpreting scores
Standardized scores allow for positioning the patient relative to their age group. Here are the most common interpretation benchmarks:
- Percentile < 10 or SD < -1.5: Significant deficient performance
- Percentile 10-25 or SD between -1.5 and -1: Low performance, to be monitored
- Percentile 25-75 or SD between -1 and +1: Performance within the norm
- Percentile > 75 or SD > +1: Above-average performance
⚠️ Beyond the numbers
Scores are not everything. A score within the norm may mask significant qualitative difficulties. Conversely, a low score should be interpreted in light of the context (fatigue, anxiety, bilingualism, socio-cultural level...). The speech therapy diagnosis is a clinical synthesis, not a simple addition of scores.
🎓 Perfect your assessment practice
DYNSEO offers training to enrich your evaluation with innovative digital tools that complement traditional tests.
Discover our training →📝 The assessment report: writing effectively
The assessment report is an essential professional document. It synthesizes the evaluation, establishes the diagnosis, and formulates recommendations. It is also a medico-legal document that engages your responsibility.
The structure of the report
Header
Patient's contact details, date of assessment, prescriber, reason for consultation
Anamnesis
Synthesis of relevant historical elements for understanding the disorders
Results
Presentation of the tests administered and the scores obtained with their interpretation
Conclusion
Speech therapy diagnosis, indication for rehabilitation, proposed therapeutic goals
Qualities of a good report
- Clarity: Accessible language, avoid excessive jargon, explain technical terms
- Objectivity: Rely on observable facts and quantified data
- Conciseness: Get to the point without omitting important information
- Structure: Logical organization facilitating reading
- Professionalism: Impeccable spelling, neat formatting
💡 Writing advice
Write your report promptly after the assessment, while the observations are fresh in your memory. Use a personalized template that saves you time while ensuring the completeness of the document. Always proofread before sending.
🗣️ Feedback to the patient and family
The assessment does not end with the writing of the report. Providing feedback on the results to the patient and/or their family is an essential step that conditions adherence to the therapeutic project.
Objectives of the feedback
Inform
Explain the results of the assessment in an understandable and accessible manner
Reassure
Welcome emotions, address concerns, provide a positive perspective
Involve
Make the patient an active participant in their care, build a shared project
How to announce a diagnosis
Announcing a disorder can be a difficult moment for the patient and their family. Here are some principles for a compassionate announcement:
- Start with the observed strengths before addressing the difficulties
- Use vocabulary appropriate to the interlocutor's level of understanding
- Allow time to assimilate the information and ask questions
- Explain what the diagnosis concretely implies in daily life
- Present the perspectives for care in a positive and realistic manner
- Offer resources (associations, readings, useful contacts)
"A good assessment is one that allows the patient to leave with a clear understanding of their difficulties and a perspective for improvement. The diagnosis should open doors, not close them."
— Claire M., speech therapist for 20 years
🎯 Conclusion
The speech therapy assessment is a complex act that mobilizes technical, clinical, and relational skills. Mastery of it is the foundation of quality speech therapy practice. With experience, you will develop your own style while respecting the demands of rigor and ethics in the profession.
Do not hesitate to continuously train on new evaluation tools, exchange with your peers, and question your practices. The perfect assessment does not exist, but the pursuit of excellence is what enriches our profession.
Each assessment is a unique encounter with a patient who entrusts you with their difficulties. It is a responsibility but also a privilege to accompany them towards better communication.
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