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About our Assessments
Teletherapy or In Person Assessments
We are able to assess most children via teletherapy OR in person at this time.
How Do I Get Started?
What Should I Expect? What Is the Process?
We Want to Get to Know Your Child
Kristen White, our Director of Clinical Services, will review your paperwork and assist the Office Manager in scheduling your child once we have an opening. Articulations assessments are done in one sitting. All others take a bit more time.
The First Visit: The first visit is scheduled with Kristen White. For elementary/auditory processing cases, Patti Hamaguchi may join. Kristen and/or Patti will talk with you, without your child there, in order to review your concerns, your child's history, etc. and to make sure we select exactly the right tests. In some sense, we are in fact "speech-language detectives" when we start this process. After this, Kristen will do some initial chit-chat/play with your child for 15-20 minutes and perhaps some simple, initial testing. The primary goal is to make your child feel comfortable and "warm up" to us. We will not generally do any challenging testing on this first visit.
Next: A testing plan is then put together and carried out by our speech pathologists, usually over 3-5 sessions. The results are scored, and a review takes place about 2-3 weeks later with the parents/clinical staff. You will be provided with a report at that time and we will discuss treatment goals, and if any other referrals (hearing, occupational therapy, etc.) are appropriate.
What Kind of Testing Do We Do?
Articulation (Pronunciation)
Articulation Assessment ($450) with oral-motor exam, formal report & review: $450 Includes the following: Review of records and previous reports, administration of informal and formal articulation measures, oral-motor exam; written report (typically about 2-3 pages) including recommended goals and therapy techniques. The reports are generally necessary for insurance reimbursement. (FYI If your child has difficulties with articulation as well as language, you will want to schedule a comprehensive speech-language assessment instead, which would also include articulation/oral-motor exam. See below.)
What do we do? We typically administer the following 2 tests:
- Goldman-Fristoe Test of Articulation (assesses speech sound errors in words and sentences)
- Hamaguchi Oral-Motor Assessment (assesses the physical strength and movement of the oral muscles needed for speech)
We also:
- Observe your child’s speech in a variety of contexts, including conversational samples
- Note and observe your child’s intonation
- Rate of speech production
- Breath support
- Ability to chew, swallow and drink correctly
- The movement of the oral muscles both during speech and at rest
- Physical features (enlarged adenoids, restricted frenulum, dental issues) that may impede normal speech
- Look for the presence of interfering hypo or hyper oral sensory issues that are present.
The other purpose of the assessment is to determine what type of speech disorder your child is demonstrating (e.g. Apraxia? Phonological processing? Developmental? Oral-motor weakness?) and develop an appropriate treatment plan for that specific speech disorder. Many times the specific diagnosis is associated with related learning or sensory delays and we will share important information about the nature of the disorder with the parent, as well as any suggestions for the parent to help the child at home.
Articulation Assessment with Phonemic Awareness Testing ($650) (how your child pronounces sounds in words, sentences and conversation, oral-motor exam) This also includes phonological awareness testing (how your child is learning sound positions, blending sounds as needed for sounding out words for reading and spelling) and possibly a hearing screening. This is generally recommended for children with multiple articulation errors ages 4 and up.
For Toddlers & Preschool-Age Children
About Our Assessments
Comprehensive Speech-Language Assessment for children Birth- 2 years: $1200
This includes everything: language comprehension and expressive language development, pronunciation, oral-motor exam, social/play and engagement, attention span, getting input from any daycare/preschool teachers. We generally administer the PLS (Preschool Language Scale) and the ELCI (Early Language Communication Instrument) as well as other inventories.
Comprehensive Speech-Language Assessment for Children Ages 3 to 4 years 11 months: $1800. This includes everything: language development, pronunciation, engagement and attention span, oral-motor exam, social/play and getting input from any daycare/preschool teachers. If the child is not yet talking and a possible candidate, we can also trial an assistive augmentative communication (AAC) device; if at least 4.5 years old and has multiple speech errors, we may also administer phonological awareness tests.
What we do: review of previous records and patient history, meeting with the child for approximately 2 hours (3 hours maximum) total over the course of about 3-4 sessions for 45 minutes or so each; administration of informal and formal tests (if the child is capable); scoring and interpretation of reports, speaking with outside professionals who work with the child if requested to a maximum of 30 minutes total; written report (typically 7--10 pages) including recommended goals and course of treatment; 45-minute review of report with parent(s).
What do we do? We use toys and “play” to observe your child’s skills in the following areas:
- How and when does the child vocalize?
- What kinds of sounds or words is the child producing and under what circumstances?
- Is the child using other means to communicate, such as signing or gesturing?
- Is there inflection to indicate differences between commenting and asking?
- What is the child’s articulation pattern?
- Are there issues that may suggest a more global delay or autism spectrum disorder?
- How is the child’s attention span and play behaviors?
- Does the child understand what is said? Can he point to things?
- Does the child have oral weaknesses, physical impediments or difficulty with motor planning that may be inhibiting speech development? (Usually done with the Hamaguchi Oral Motor Assessment if the child is cooperative)
- How does the child interact with the parent and the examiner?
When possible, we do like to attempt some formal testing measures as well, once the child is more comfortable with the environment. We select the tests based on the child’s needs and skill level, but these are a few of the tests we use with this age group: Preschool Language Scale-5 (“PLS”) Goldman-Fristoe Test of Articulation 2, Peabody Picture Vocabulary Test-4, Expressive One-Word Picture Vocabulary Test -2, REEL-5, Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and the ELCI (Early Language Communication Instrument)
Bilingual Assessment for Toddlers/Preschoolers up to Age 3 years 11 months (Mandarin/English or Cantonese/English) $2300 This includes everything: language comprehension and expressive language development in both languages, pronunciation analysis in both languages, engagement and attention span, oral-motor exam, social/play and getting input from any daycare/preschool teachers. If the child is not yet talking and a possible candidate, we can also trial an assistive augmentative communication (AAC) device.
Bilingual Assessment for Children ages 4 up to 5 years 11 months (Mandarin/English or Cantonese/English) $3300 This includes everything: language comprehension for questions, conversation and stories and expressive language development in both languages, pronunciation analysis in both languages, engagement and attention span, oral-motor exam, social/play and getting input from any daycare/school teachers. If the child is not yet talking and a possible candidate, we can also trial an assistive augmentative communication (AAC) device. If at least 4.5 years old and has multiple speech errors, we may also administer phonological awareness tests.
What kind of information are we looking for when testing young bilingual children?
- Vocabulary development--comparing both languages
- Comprehension of language at the word, sentence and story level; Can the child point to objects or pictures? Attend to an adult? For how long? How does their language compare across both languages?
- Use of language: How is the child using language and when? Phrases or sentences? Does the child use age-expected grammar?
- Articulation features of both languages
- If indicated, an oral-motor assessment (for articulation disorders)
- Voice & Fluency screen
- Pragmatic (social language use) including eye contact, initiation, reciprocal communication and joint attention
- Play and interactive skills
For children with significant cognitive and communication deficits:
- Use of signs, gestures or alternative communication modality
Augmentative and Assistive Communication System Assessments
About Our AAC Assessment Process
We provide Augmentative and Assistive Communication Systems (AAC) assessments as part of our comprehensive assessments for new clients if it is indicated (and the parent is interested) OR for current clients or new clients who come to our practice with previous assessments. In those cases, it is done as part of the Supplemental Testing process described below.
For Elementary Age Children
Q & A's
Answers to Questions You May Have About the Assessment Process
Q. What if my child screams and cries and won’t do anything the speech pathologist asks him to do?
A. Although rare, this does occasionally happen. We do attempt to establish a rapport with your child and make her comfortable. Usually by the second or third session, the child is more comfortable and less apprehensive about the sessions. Sometimes the child needs a “snack break” to break up the sessions and regroup. However, there are times where a child is simply inconsolable. As stated in the previous section, there is a “maximum” number of hours of scheduled direct time with your child that is included with the assessment fee. All scheduled sessions are counted in this total, regardless of your child’s level of cooperation or speed in responding. We may decide to simply do more informal kinds of assessment early on and save the formal assessment process until your child has settled into the routine and developed a rapport with the therapist. There are also parent rating scales like the ELCI (Early Language Communication Inventory) that will give us much information, in addition to our own observations which will at least give us an idea of where your child is, and what kinds of help they may need and will suffice for insurance requirements.
Q. What if I need to cancel the assessment after I have started the process?
A. Again, this is extremely rare but occasionally parents have family emergencies, unexpected job transfers, or simply decide their child is too fussy to continue. In these cases, you will be charged for the scheduled assessment time up to that point at our usual therapy rate ($226 an hour) and no report will be provided, if we are given at least three days’ notice before the upcoming appointment.
Q. What if I plan to apply for insurance reimbursement?
A. If you plan to seek reimbursement from your health insurance company for an evaluation, you usually must have a written referral from your child’s primary physician before the evaluation. Please be aware that we are not affiliated with any HMO or PPO groups, although many clients receive out-of-network PPO reimbursement or use their company's HSA. Please read our flyer, “If You Intend to Seek Insurance Reimbursement” form.
Q. What if my child is developmentally functioning on a much younger level and is age 5? I don't think he will be able to do all that testing.
A. If your child is not able to participate in the typical assessment process, we do consider this on a case-by-case basis. In some situations, if the child is performing at a much younger age we will consider dropping the fee to be comparable to the testing we do for younger child as the sessions will be fewer and shorter.
Q. What if I have an assessment from another practice? Can I use that?
A. Yes. But we may decide together (parent and professional) that additional supplemental testing is required. This is billed at twice the pro-rated session fee for each day of testing, plus $340 for the report.