Why You Can’t Stop Evaluating your Speech Therapy Clients

Hi SLP friends!

I want to chat about why you need to continuously evaluate your clients. And no, I’m not talking about standardized tests. But before I get into that I want to also tell you how important it is to read an evaluator’s report and then just take it with a grain of salt. Especially if you weren’t involved in the evaluation.

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For example, the other day I had a parent ask me to read the report from the evaluation and just kind of tell her in laymans terms what it meant. This was for a 2 year old. And right there on the first page it said diagnois: articulation impairment characterized by substitutions. Let me say that again, articulation impairment characterized by SUBSTITUTIONS.

Well for one, if the speech sample showed these patterns of substitutions, that’s phonological, that’s not articulation. There was a whole lot of the report that I disagreed with besides the inaccuracy of that statement. I knew this because I had been working with this client for over a year. This was the evaluation to go from the early intervention program to the school system. But my point in telling you this isn’t to talk poorly about that therapist, that’s not my intention, but instead im trying to tell you, what if I didn’t know the client. What if I took the report as it was and just went with it. My approach would have been completely wrong and I would be focusing on the wrong things. This client doesn’t need an articulation approach But what if I didn’t know that? 

This is why it’s SO important for us to constantly observe during our sessions, constantly have these like informal evaluations going on in our heads to get a better picture of the whole child. I don’t really care about how a child performs on a standardized test because it’s taken out of context. I want to see how they do when we are playing, when it’s natural, when they are with their peers. These observations are going to give me the answers to my questions. It’s going to give me the information I need to choose the right approach and develop the right intervention plan.

What I used to tell parents when I did an evaluation and what I told the mom I mentioned earlier is that an evaluation is just a snapshot of a child. It’s not always a true representation of a child’s skills. because think about it, most often they are with a brand new person and asked to perform. What child is going to perform perfectly with that? Not many. So when you read an evaluation or when you do an evaluation, you need to keep that in mind.

Also, think about how quickly young children develop and change. It’s a continuum and skills are constantly evolving. As skills are achieved, other deficits pop up. I don’t want to work off this like checklist I get from a report and only focus on those skills. I’d be missing crucial information that’s needed to make a differential diagnosis. 

And don’t get me wrong, standardized tests are necessary and required and can give us good information. I just want that to be your starting point for evaluating, not your ending point. When you get a client that already has goals written based off of that report, again, take it with a grain of salt. Start there but keep observing to see what else is going on, what else you need to address in your sessions.

One last thing.

Do you ever feel ‘stuck’ with a client, or maybe you meet the goals you had and you aren’t sure where to go to next. Or maybe you’ve plateaued with a client and you aren’t sure how to continue progressing? This is where those informal evaluations, those observations come in handy. Take a step back and look at your client like it’s the first time seeing them again. Observe them. Take a language sample. Make notes about interactions or you know whatever it is at their level or what area of speech and language you’re addressing. I bet you’ll feel a lot more unstuck after you do that. 

So that is my spiel about that. I really hope it was helpful and I hope it got you thinking about one of your clients or I hope it gave you a new perspective and new way of doing things.