One of the most common questions I am asked is whether or not a child
should be formally evaluated. It's a complicated question, and is
usually unfamiliar territory for parents. There are a lot of factors to
consider, so lets talk through it. Or type through it. Whatever.
If
you are having concerns about your child's speech or language and you
are asking this question, you have achieved the first step of the
intervention process: admitting there is a
problem. Like Alcoholics Anonymous without the alcohol.
Sometimes you know exactly what the problem is ("My kid is two and only
says 'baba'," "Other people can't understand what my child is saying")
and sometimes you can't quite put your finger on it. Either way, the
idea of testing your child or getting them some sort of services has
crossed your mind, if not consumed your every waking thought. There are
lots of reasons to be apprehensive about testing that I didn't really
understand for a while.
My thought was always "Speech testing has yet
to cause injury or sudden death. If you have concerns, why
not test?" Then I realized that speech testing
from a clinic or hospital runs somewhere in the $400 range. Owchie.
Sometimes it's covered by insurance, lots of times it's not. Parents
are concerned about "labels" that could follow them their whole life.
Sometimes, it's hard to admit that there may be something different
about the way your child is developing. Testing can also be an intense and taxing process for a young child. All of these things are real
concerns, and they are valid.
The following questions can help you
decided what the best direction is for you and your child.
1. Do I already know what my concern is?
If you know that your child isn't using pronouns correctly, you
probably don't need a standardized test to tell you what is wrong or how
to direct treatment. On the other hand, if your child has different
"gaps" in their language that are difficult to describe, or if you have
more than a few concerns with their language (they don't understand
basic directions and don't understand "who" questions, but they can talk
in full sentences), you might need a standardized test that looks at a
variety of language skills to find all the holes. Think about what new
information formal testing would provide. Is that information
necessary? Sometimes it is, sometimes it isn't. You can ask a speech
therapist about it! Don't be afraid to call someone up and ask them
what they would recommend.
2. Do I need a formal
diagnosis? When trying to get speech services for your
child, you may need a diagnosis, or a "label." For services in schools,
your child needs to have a primary diagnosis or classification to
receive those services. You may need a formal assessment and diagnosis to have
insurance cover your therapy treatment. Maybe you just want a name for
what is going on for your own peace of mind.
Lets go back to the "label following my child"
idea. This is a common concern with parents. Let me tell you exactly
how that label follows your child. They qualify for special education
services under a certain classification. This classification describes
the primary reason your child needs services. Some common
classifications are Autism, Other Health Impairment (like ADD or medical
diagnosis), Speech/Language Impairment, or Specific Learning
Disability. Your school can then provide services to help your child
progress in their education because they determined that their
classification is affecting the way they learn.
As they move from grade
to grade, they have a special education file that "follows" them (meaning it is kept in the school they are attending). The
only people who have access to that file are the people providing
services to the child, and the parent. Anyone else has to have a pretty
darn good reason to look inside, and has to have permission first.
Teachers are made aware of students in their class that will be
receiving services by the special education teachers and/or speech
therapist at the beginning of the year so they can be pulled from class and so teachers can collaborate with the special education staff.
If your child is ever exited
from services, be it speech, academics, or otherwise, your school
district hangs on to that file. It's in a special cabinet in case there
are ever new concerns or if you ever wanted a copy of something in that
file later on. After your child is exited or released from services, a
general education teacher will not know that they received those
services unless they have academic concerns and want to make a referral
for the child to be in special education. Then, the team would find
their inactive file, review the testing and data in it, and get an idea
about the child's educational history.
That's it! Hopefully, that
eases some concern about labeling kids and their file that "follows"
them. It's not like the whole world know they have a diagnosis. The
file doesn't haunt them throughout their educational career. It's just a
quick and easy way to communicate why a child is receiving services.
3. Will testing give me a better picture of what my
child's needs are? Sometimes kids are puzzling. They
have multiple areas of concern. They do things that seem just plain
weird. It's totally OK. I love puzzle kids because they are challenging and
fun and when you make a breakthrough you get to celebrate like crazy. There
are cases where speech isn't the only concern or the primary concern,
and there are a variety of issues going on. That could be motor
development, facial deformities, syndromes, behavior, and the list goes
on. There are times when you might want to rule out any speech and
language issues, investigate a certain aspect of language that they
might be at risk for, maybe their diagnosis has changed or their
language skills have changed drastically for an unknown reason. It can
be worthwhile to have that speech/language piece so you can make more
informed decisions for your child.
After discussing these questions with
your spouse, doctor, therapist, educators, or anyone else who may have a
valuable opinion, you can hopefully feel more confident in your
decision.
What are your testing concerns? What helped you decide
whether or not to have a formal evaluation?