When should I refer for Speech & Language Evaluation?

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