What to Expect in a Pediatric Speech and Language Evaluation

The purpose of a speech and language evaluation is to determine your child’s strengths and challenges related to a variety of areas and conclude if therapy would be beneficial in further developing skills and aiding his/her ability to communicate effectively with SLPmainothers. Parents may request an evaluation if they have concerns, or children may be referred by a pediatrician, teacher, or after a developmental screening. While it may vary across settings, the following is a general outline of what you can expect from a formal speech and language evaluation.

  • Background and Developmental Information: Upon beginning the process, most facilities will request information regarding your child’s early developmental history. This will include things such as birth history, age milestones were met, and significant medical history. If your child has previously participated in therapy or related developmental/educational evaluations, providing copies of these reports to your therapist will be extremely beneficial in helping develop the whole picture of your child. In some settings, the therapist will obtain information from your child’s teacher regarding challenges specifically related to classroom learning and peer relationships.
  • Caregiver Interview: An essential portion of the evaluation will be information provided by the child’s family. The therapist will guide a discussion regarding your major concerns, what you would like to achieve by participating in the evaluation, and goals you might have for your child. The therapist may ask for specific examples of times you’ve noticed these challenges, thoughts about your child’s awareness toward the issue, and other questions to develop an overall understanding of how your child is communicating. Depending on the age of the child, he/she may participate in the interview portion to share feelings and thoughts on the area of difficulty, and what he/she would like to accomplish. Based on the background information provided and the caregiver interview, the therapist will choose assessment tool(s) to evaluate the area(s) of concern.
  • Assessment and Observation of the Child: Initially the therapist will spend time talking and/or playing with your child to develop rapport and make observations based on how he/she interacts and communicates in an unstructured setting. Then, your child will participate in assessments that may include:
    • Oral motor assessment to observe the structures of the face and mouth at rest and while speaking, as well as oral musculature and motor planning of oral movements.
    • Standardized assessment of the area(s) of concern (not an exhaustive list)
      • Expressive (what he/she produces) language and/or Receptive (what he/she understands) language
      • Speech production and fluency of speech
      • Pragmatic or social language
      • Feeding and Swallowing
      • Reading/Writing skills
  • Evaluation Report: The therapist will then compile all of the information gathered from the family, observations, and assessments and summarize it in a formal report. It will include a description of each area of assessment and its findings. Based on the results, the therapist will determine if therapy is necessary and if so, develop a plan for treatment. Specific goals to target the areas of need and a time frame for doing so will be included in the report.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Speech-Language Therapy

5 Tips to Make Speech-Language Therapy Successful

With what little time there is, it is important to maximize the efficiency of speech-language therapy, thereby increasing the chance of success. Life is busy, and children are involved in numerous after-school activities. Whether karate, dance, violin, or speech-language therapy, time after school is precious.

5 Tips to Make Speech-Language Therapy Successfulspeech-language therapy

Frequency: After completing an initial evaluation, speech-language pathologists will make recommendations for ongoing therapy services. In many instances, a child attending therapy more than once per week may progress faster toward goals than children who do not attend sessions as frequently. Increased exposure to direct (or even indirect) intervention can result in greater therapy success.

Carryover: Carryover, or the idea that skills learned in the clinic will be transferred or generalized out of the clinic, is an important aspect in a variety of therapies. In order to make therapy a success, children who receive increased practice, and more time spent focusing on a given skill, will improve in abilities and rate of mastery.

Prioritizing Therapy: While after school activities are important, parents also need to make time for speech-language therapy. In order to make therapy a success it needs to become a priority. Consistently attending sessions, whether weekly or more often, is crucial to ongoing progress. Breaks in therapy can result in a regression of newly acquired skills and may prolong the therapy progress.

Positive experience: When therapists create a positive environment for therapy, children are more likely to participate, leading to greater gains and progress. When children are enjoying their time, they are more motivated to work hard. Conversely, when children are struggling to participate, both parents and clinicians can help children see the “what’s in it for me” factor. This may be a compromise of children and clinicians taking turns picking activities, children being “rewarded” with free time at the end of a session, or even a special treat upon conclusion of the session.

Parent Education: Providing information to parents about why speech-language therapy is important can help to justify the reason for ongoing therapy services. When parents are incorporated into the therapy progress, they are more likely to work on therapy goals outside of the clinic environment. Educating and including parents into the therapeutic progress can help to make therapy a success.

The therapeutic process may be difficult for children and families, however following these tips for success can help children to reach their potential, keep families engaged, as well improve speech-language skills!

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Baby speaking on phone

How To Expand Your Child’s Utterances




Once your child develops an assortment of single words, his next step is to start combining those single words into two word utterances. It can be difficult for little ones to make the jump from one to two words. Here are a few tips to help him through the transition:

  • Baby speaking on phoneSyllable repetitions such as “bye-bye” “beep-beep” and “pop-pop” are a great place to start. When syllables are mastered, two syllable words are often attempted.
  • Functional phrases such as “uh-oh, all gone, my turn, all done, I do” occur frequently. Because they are so frequent, they often occur multiple times throughout the day, offering lots and lots of opportunities to practice.
  • Pivot words are words similar to functional phrases in that they occur frequently throughout your child’s day. These include words such as hi, bye, more, in, out, and want. Combining simple words that your child already has in their vocabulary with pivot words can give your child an opportunity to use expanded utterances to communicate their wants, needs and ideas. Some examples of pivot words in two word phrases are:

o   “Hi baby/mama/bear”

o  ” Bye baby/mama/bear”

o   “Ball in”

o   “In cup”

o   “Want cookie”

o   “More cookie”

o   “Cookie out”

  • After your child starts to combine simple words with pivot words, you can start to introduce simple noun-verb or verb-noun combinations. Some examples of these noun and verb combinations are:

o   “Eat cookie”

o   “Bunny hop”

o   “Go car”

o   “Puppy eat”

  • Once the noun and verb combos are achieved, you will quickly see your child producing three or even four word combinations. You will see “car go” turn into “car go fast!”

It’s important to remember to model short combinations for your child in your own speech. Your child is much more likely to attempt a 2 or 3 word phrase they hear you say than a 4 or 5 word sentence. Keep the important or meaningful words in the sentence and leave out articles such a a, then, with, to, etc.  Also, narrate, narrate, narrate. Talk about what your child is playing with and keep it fun and silly!  Those single words will turn into two and three word utterances in no time!

Child with speech bubble

How To Improve Speech Intelligibility

It can be frustrating for both parents and child when a child’s language is difficult to understand! During preschool and school-age years, a child’s language is expanding and he is using more words to request, exclaim, and to label. Parents will often guess at what their child is saying, and unfamiliar adults may rely on parents to decipher their child’s speech. Many times children will throw tantrums or give up when trying to communicate. See below for some helpful tips to improve your child’s intelligibility and your understanding!

Rate: An increased rate of speech leads to more words blending together and doesn’t always give the listener enough processing time to take in all of the information. If your child has an increased rate of speech, encourage him to slow down and try again. Multisyllabic words may get simplified (e.g., “tephone” for “telephone”), leading to further difficulty for the listener. Modeling your own slow rate will allow your child to match your speech.

Volume: Using appropriate volume depending on a situation may help to improve intelligibility. Oftentimes children’s voices will be too loud or too soft, making them difficult to understand. Contrast different volumes with your own voice (no voice, whisper voice, inside voice, outside voice), and allow your child to pick the appropriate volume based on a situation.

Speech sound substitutions and errors: Sound substitutions, omissions and errors frequently impact a child’s intelligibility. There are set milestones for speech sound acquisition, however substituting one sound for another (e.g., saying “wing” for “ring” or “fumb” for “thumb”) can leave parents guessing at what their child is saying. In these cases, parents can model accurate sound production (based on age), and overcorrect, or emphasize target sounds.

If a child continues to struggle with speech intelligibility and either child or parent is getting frustrated, a licensed speech-language pathologist can help!


3 Tips for Promoting Speech and Language Development in Children: Ages 0-3

Ages 0-3 are critical for learning and mastering speech and language. Some babies and toddlers initiate talking earlier speech and language developmentthan others.  If you are looking to encourage speech and language in your little one, read on for easy guidelines to help promote speech and language for young children.

3 Tips for promoting Speech and Language Development in children 0-3 years of age:

1. Use Simple Language:

  • Short sentences are easier to understand and allow your child to pick up the important pieces of the message.
  • Talk about what you are doing as you go about your day. It is easier for a child to pick up new language if he can see or hear the object or action as he is exposed to the vocabulary. Read more

May is Better Hearing and Speech Month

May is Better Speech and Hearing Month! Many children may have difficulties with one or more aspect of speech and/or language, andBHSM according to the American Speech-Language-Hearing Association (ASHA), early detection and intervention can often be the most effective.

Below are some helpful tips parents can use to promote speech and language skills at home:

  • Communicative temptation: create situations where a child needs to gesture, vocalize, or verbalize to have his or her needs met before giving desired object (e.g., puzzle pieces)
  • Imitation: having a child imitate you helps him or her to produce words and sounds at appropriate times (e.g., saying “hi” to animal toys as you take them out of the box)
  • Expanding: using a child’s language and expanding it to make it more complex (e.g., child says “ball,” adult can say, “that is your ball!”)
  • Build vocabulary: target and explain relevant new words (e.g., seasonal words ) to help build vocabulary Read more

Phonics versus Phonemic Awareness ~ What’s the Difference?

Phonics involves seeing letters individually and connecting each one to a specific sound. Letters are broken down into consonants and Child Alphabetvowels. Vowels are broken down into long and short sounds and words are taught by beginning and ending sounds. The order in which letters are taught is in conjunction with typical child development.

What is Phonemic Awareness?

Phonemic Awareness involves the understanding that spoken words are made up of individual sounds; these are known as phonemes. A child who is phonemically aware is able to isolate sounds, manipulate sounds, blend and segment sounds orally and in written words. Essentially, it is the ability to hear the different sounds in speech. Students may not recognize the written letter that accompanies the sounds, but he or she will recognize it in speech. Therefore, phonological awareness comes before phonetic skills.

The following is a simple separation of these two important pre-reading skills:

Phonemic Awareness

  • Main focus is on sounds, or phonemes
  • Deals with spoken language
  • Primarily auditory
  • Students work with manipulating the sounds within words


  • Main focus is on graphemes/letters and corresponding sounds
  • Deals with written language, or print
  • Both visual and auditory
  • Students work with reading and writing letters based on their sounds and spelling patterns

Phonics and Phonemic Awareness are similar; however, they serve two distinctive purposes. Proficient use of both skills is the first step in the journey of becoming literate. Despite the many studies and educational debates on teaching these reading skills and others, one thing has remained certain. The more a child is read to the better his or her reading skills will be.

Language Milestones for Preschool-Aged Children

Language encompasses the way in which we produce ideas (expression), understand concepts (comprehension) and use the social 3 year old boyrules for communication (pragmatics). Preschool years are a critical time for a child’s speech and language development. Children are rapidly acquiring new skills, therefore, parents may start to wonder if their child is meeting developmental milestones. Difficulties in language skills and concepts can have long-term implications of a child’s ability to succeed during school-age years. The milestones listed below are intended as a general trajectory that many children tend to follow; however, many will find that there is some variability between stages.

Language Milestones

Two to Three Years Old:

  • Opposites: children will begin to understand differences between words such as “go/stop”, “big/little” and “up/down”
  • Directions: children will begin to follow simple two-step requests (e.g., “get your shoes and put them on”)
  • Stories: children will want to hear more stories and may make ask parents to read books to them
  • Requests: children may begin to name objects when requesting (e.g., “I want juice”)

Three to Four Years Old:

  • Story-telling: children will start to tell more stories, often explaining what happened at school
  • Questions: children will begin to answer simple “wh” questions, including: “who”, “what” and “where”
  • Sentences: children may start to string 4 or more words together, creating more complex sentences

Four to Five Years Old:

  • Understanding: children can be expected to understand most requests made by
    parents (e.g., “clean your room”)
  • Reading: children may answer questions posed by parents during book reading (e.g., “what did the caterpillar eat on Monday?”)
  • Identification: children may start to recognize letters and numbers
  • Grammar: children will start to use age-appropriate grammar (e.g., plurals, past tense, pronouns)
  • Describes: children will begin to use more descriptive words when speaking (e.g., “the smaller shoes are mine”)

Preschool years are such an exciting time for children’s development. Children begin to blossom academically, socially and emotionally. If you have questions, concerns or suspect that your child may not meet all of these milestones, a licensed speech-language pathologist may be able to help!

Click here to download a free copy of the 3 Year Old Milestone Guide covering Speech, Fine and gross Motor, Behavior, Social/emotional and more!

How to Elicit the “B” and “P” Sounds in Your Child’s Speech

Every speech sound has a place of production, manner of production and can either be voiced or voiceless sounds. Place of production is the girl talkingaccurate placement of articulators. Manner of production is the restriction of airflow in the oral cavity. A voiced sound has our voice box on versus a voiceless sound when our voice box is off. The phonemes /p/ and /b/ are similar in the place of production and the manner of production. The difference is the /b/ phoneme is voiced and the /p/ phoneme is voiceless. Place your hand over your throat and say “puh” followed by “buh”. You should not notice any difference in lip position and you should have a small burst of air with during both sounds. The only difference you should feel is when during the pronunciation of “buh”. In this case,you should feel vibrations.

Ways to elicit /p/ and /b/

Place of Production:

  1. Draw attention to pressing the lips together.
  2. Use a touch cue by lightly touching the child’s upper lip with the back side of your pointer finger. You should notice the upper lip curl down a bit. You can also use a little hint of flavor as a touch cue by placing frosting or peanut butter on the upper and lower lip and ask the child to bring the lips together to touch the spot you put the flavor on.
  3. Ask the child to make kissing noises.

Manner of Production:

  1. Place a feather, half of a tissue (so the pieces are thin) or the back of the child’s hand in front of the child’s mouth while you produce a series of “puh” and “buh”sounds to demonstrate the explosive release of air. Encourage the child to move the feather or tissue in the same way.
  2. To demonstrate the difference in voiced versus voiceless,draw attention to the “buzzing” voice box during “buh” by placing the child’s hand on your throat.

If you have concerns regarding your child’s speech production, please consult a licensed speech-language pathologist to complete a full evaluation of skills.

7 Ways to Increase Phonological Awareness

Identifying different sounds that make words and associating these sounds within written words are an essential foundational child and mother speakingcomponent for early literacy skills.  There are forty-four phonemes (sounds) in the English language; this includes letter combinations such as /th/. In addition to identifying these sounds, one must be able to manipulate the sounds. This is often referred to as phonemic awareness. There are five levels of phonological awareness, ranging from rhyme to being able to switch or substitute the components in a single word. Phonological awareness affects early reading ability as well as strengthens  emerging reading skills.

How To Teach Phonological Awareness:

To teach phonological awareness, begin by demonstrating the relationship between parts to wholes. Start at sentence level; segment short sentences into individual words in order to show how the sentence is made up of words. This can be done by using chips to represent the different words in the sentence. Once this relationship is understood at the sentence level, you can then move on to word level. Begin by segmenting multi-syllabic words into two syllables, eventually moving to segmenting words into individual sounds. This will increase  phonemic awareness.  This can be achieved by asking the students to produce that sound, both in isolation as well as in a variety of words and syllables. It is best to begin with easy words and gradually progress to more challenging words.

7 Phonological Awareness Example Exercises:

  1. Rhyming (e.g., tell me all the words that rhyme with mop)
  2. Identifying initial sounds in words (e.g., does mop begin with the /m/?)
  3. Word to word matching (e.g., do pen and pipe begin with the same letter?)
  4. Phoneme deletion (e.g., what word would be left if the /k/ sound were taken away from cat?)
  5. Phoneme counting (e.g., how many sounds do you hear in the word “cake”?)
  6. Blending (e.g., what word would we have if we blended these sounds together: /m/ /o/ /p/.)
  7. Phoneme segmentation (e.g., what sounds do you hear in the word cat?)

Children should be demonstrating these skills by the end of their first year in grade school. By practicing these skills, you will be providing your child with greater success, therefore, increased confidence. Try one of these exercises today and watch your child blossom!