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When should I refer for Speech & Language Evaluation?

Updated: Feb 10


Infants:

  • Lack of eye contact or gaze

  • Difficulty feeding or swallowing

  • Difficulty with head control or other motor movements

  • Extremely fussy or very quiet baby

  • Difficulty regulating sleep patterns

  • Medical issues such as reflux, prematurity, asthma, ear infections

Toddlers and Preschoolers:

Articulation

  • Excessive drooling

  • Highly unintelligible

  • Starts to talk and then stops

  • Child omits the end sounds of words

  • Is not producing /m, p, b, t, d/ - 2 year olds

  • Is not producing /k, g, f, n/ - 3 year olds

  • Is not producing /sh, ch, j, v/ - 4-5 year olds

Receptive Language:

  • Child seems to not hear you

  • Child will only respond to things phrased in a certain way (ex., “juice” but not “drink”)

  • Little affect or understanding of feelings

  • Responds very well to visual cues or gestures, rather than speech

  • Echoes what they hear but are not spontaneous in productions

  • Trouble with following directions

  • Trouble in new situations (daycare, preschool)

  • May have behavior problems (frustrations, trouble with transitions)

Expressive Language:

  • Lack of true words to communicate

  • Lots of pointing, grunting, or crying when attempting to communicate what they want

  • Child echoes but is not spontaneous with words

  • Cannot maintain topic at hand for any period of time

  • Child will start to play with a toy, but is not able to expand the play or move to anything new (e.g., performs the same action over and over)

  • Difficulty coming up with names of items or people (word retrieval)

Sensory Integration Issues:

  • Child may avoid touch or being touched

  • Picky about food, texture, and touch

  • Stuffing food in pockets of cheeks

  • Difficulty drinking from a straw

  • Child may bump into things often or seems not notice where he is walking

  • Under reactive to environment

  • Often looks like attentional or behavior issues



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