The purpose and nature of a speech and language therapy assessment
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The purpose and nature of a speech and language therapy assessment

If you have ever wondered what happens when you bring your child to a speech and language therapy assessment, then this blog will shed light on the ins and outs of it for you.

At its heart, a speech and language therapy assessment is a systematic and thorough evaluation of your child’s communication or eating/swallowing abilities. It’s more than just asking a few questions. It is a carefully constructed process designed to identify strengths, pinpoint challenges, and ultimately pave the way for effective intervention.

Establishing a detailed profile – a few bullet points:

  • Identification of communication and swallowing difficulties: I aim to determine if a communication or swallowing disorder exists. I will establish if the difficulty is a delay or a more complex disorder.
  • Diagnosis of the specific disorder/autism: The assessment delves deeper to pinpoint the specific type and nature of the difficulty. For instance, is your child’s language delay due to a specific learning disability, a developmental delay, or another underlying condition?
  • Knowing the aetiology or what is causing a difficulty is crucial for targeted intervention. And whilst we are on the topic let’s talk about an autism assessment: I am trained and experienced in assessing and diagnosing autism. However, when it comes to the diagnosis of autism I provide a preliminary ‘working hypothesis’ rather than giving a definite final diagnosis. The reason for this is that it is considered the ‘gold standard’ and ‘best practice’ to diagnose autism in a multi-disciplinary setting and context. Since I work on my own, I always refer to highly recommended multi-disciplinary clinics for the ultimate diagnostic assessment.
  • Determination of severity: Understanding the severity of the difficulty is essential for prioritising intervention and measuring progress. Is your child’s difficulty mild, moderate, or severe? This helps me choose a particular approach and then tailor it to suit each individual child.
  • Identification of underlying strengths and weaknesses: An assessment doesn’t just focus on what’s wrong. It also highlights your child’s strengths and areas of relative ease. This information is invaluable for building upon existing skills during therapy. Understanding weaknesses provides specific targets for intervention.
  • Guiding intervention planning: The assessment provides the crucial information I need to develop an individualised intervention plan. The findings directly inform the selection of therapy goals, strategies, and techniques. Without a thorough assessment, therapy would be a shot in the dark.

A multi-faceted approach

A speech and language therapy assessment is not a ‘one-size-fits-all’ procedure. The specific tools and techniques used will vary depending on a child’s age, the nature of the suspected difficulty, and other relevant factors. However, most comprehensive assessments incorporate several key components:

  • Case history: This involves gathering information about your child’s developmental, medical, social, and educational background. We will go through all the relevant milestones and throughout the process I will make notes which will help bring all the puzzle pieces together.
  • Observation: I will observe how parent and child play together and we also look at how the child plays by themselves. Additionally of interest is how a child plays with me, the therapist. Through discussion I will also endeavour to find out how your child plays with other children, be it at the nursery or within the family.
  • Standardised assessments: These are commercially available tests with specific administration and scoring procedures. They provide norm-referenced data, allowing to compare the individual child’s performance to that of his or her peers. Examples include articulation tests, language comprehension and production tests, and fluency assessments. I tend not to use these assessments a lot.
  • Instead, I use non-standardised assessments: These are more flexible and allow to probe specific areas of concern in more detail. This might include language samples (analysing spontaneous speech), dynamic assessment (testing and teaching to identify learning potential), and informal observation of play or interaction.
  • Immediate feedback and report writing: During and thenfollowing the assessment, I will bring all the gathered information together and I will discuss with the parents what my findings are and what my recommendations in the short term are. Parents always go home with a good handful of useful strategies that they can implement at home right away. In addition, I provide a comprehensive report outlining the findings, diagnosis (if applicable), severity, strengths and weaknesses, and recommendations for intervention.

In conclusion, a speech and language therapy assessment is a dynamic and essential process. It is a journey of discovery, aiming to understand a child and the child’s family and his or her unique communication or feeding profile. The assessment is usually the start of our wonderful learning journey together.

Below is a short video clip of an assessment where you see me in action explaining a particular therapy approach to a set of parents. It perhaps shows a tiny bit of how relaxed we are in our sessions and that assessment is not at all daunting, but a hugely informative event overall which will leave you feeling empowered and hopeful.

What happens after an assessment?

Please feel free to get in touch with me via my contact form if you wish to have an assessment for your child’s communication difficulties or feeding difficulties.

An assessment is always a stand-alone event and does not mean you need to automatically book follow up sessions at all. It will give a lot of information and based on this you can decide if you would like more therapy or follow up for you and your child. Many times ongoing therapy is not needed! I only recommend a course of therapy if it is really needed and where it would be immediately beneficial for your child.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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A woman on the left is pointing to her open mouth. A girl on the right is looking at her and copying the mouth shape.

My child is very hard to understand! How can Speech Therapy help?

Kids Speech Therapist London

There are many reasons for speech sound delay or disorders and the first step is a thorough assessment.

What does a Speech Assessment look like?

With younger children, around 2 – 2.5 years we often start by collecting a good speech sample during play or general chatting. Sometimes we do this with an audiotape so that we are able to listen to your child’s speech sounds repeatedly in order to determine any speech error patterns. A good way to get a speech sample is looking at a favourite book together and trying to get your child to name as many items, animals or characters as possible in the book. For older children, 4.5 years plus we do more formal speech sound assessments where we show your child a series of pictures which focus on varying sounds or sound patterns, for example:

  • Are the end sounds present or left off, does your child say BE_ instead of BED for example?
  • Are the back sounds produced at the front of the mouth, is a digger a DIDDER or a pig a PID?
  • Are sound blends reduced, for instances a snake becomes a NAKE ?
  • Or do many phonemes (single speech sounds) collapse all into one error sound? Like all F , R or L become a B?

Once we have discovered the error pattern we can then unravel the problem and work on solutions. We make a plan and prioritise which of the patterns we can target first, second and next. There are several approaches that can be used to tackle speech sound errors and most therapist have two or three favourite approaches as their go-to. I will fill you in on my favourite ones in future blogs.

What does a Speech Therapy session look like?

These days we have two options: on-line via zoom and face to face in the clinic setting.

Both are great options!

For all clients who live far away a zoom session will be the option to go for. But zoom sessions also work really well for the older child as, let’s face it, are there any kids out there who do not like a bit of screen time?

I find that children around 5 years old really love the on-line games and sessions are fun and very effective. We usually start off with a quick game to warm up and then we go into the speech sound patterns we need to improve and work on. There are 100s of tried and tested on-line games and game decks which can be hugely entertaining and really nice to work with.

In clinic, we also often start with a short game to settle in and then we target the various sound patterns we are working on within table top games, or arts and crafts activities. We aim to get up to 100 speech sound trials per session, using a variety of motivating games to keep our little ones going and focused.

Both, face to face and on-line sessions are between 40-45 minutes long – time usually flies by! – and then parents get to practise home exercises to make sure that the new speech sounds are being practised every day.

Over the coming weeks I shall do blogs on great games and home exercises that I give the parents and I will talk about games we do in the session that are fun and can be copied for home use. Watch this space!


Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.