I recently spoke to a private practice SLP with great insights regarding the assessment process. Due to this SLP’s extensive experience in the field prior to working in private practice (some of her previous experience includes working in the school board, at the Geneva Centre for Autism, as part of a preschool speech and language initiative, in acute and long-term care facilities, etc.), the information she shared with me was based on many years of experience working with a diverse population of clients.
Before seeing the child and parent, this SLP conducts a phone screening to gather information when she receives a new referral. This is especially helpful in cases where the child’s L1 (Native of first language) may not be English, so that she can learn about the child’s exposure to English and other language(s) as well as the child’s expression style (i.e., communicates in L2 but understands L1) prior to the assessment. She will occasionally use parents as translators (when the parents have good mastery of English, and after providing careful instruction regarding what the parent can and cannot say to the child) during the assessment of bilingual/multilingual children, but will note this in the report since there could be issues with reliability using this method. Sometimes she will conduct informal observation during language-based play for most of the first visit with the child, in order to determine which areas need to be investigated further using the appropriate standardized test(s). However, she mentioned that tests like the CELF-4 (or even using a few of the subtests of the CELF) are helpful to get an idea of a wide variety of language skills.
One important consideration which impacts this SLP’s assessment process is the family’s financial resources (i.e., if a family has limited insurance coverage for SLP services, and cannot afford to pay for more services beyond this coverage). For this reason, the SLP stated that she approaches assessment as “diagnostic therapy” – similar to what we have been discussing in class as ‘dynamic assessment’. I think this is a good strategy to ensure that too many hours and dollars aren’t spent on assessment, since many parents bring their children to my course partner’s private practice because their child is not receiving/did not receive direct intervention in the school board (the SLP mentioned that many school board SLPs in the GTA only provide consultation and Tier 1 or Tier 2 intervention).
The SLP also stressed the importance of observing children during assessment because these observations can reveal valuable information beyond raw scores. For example, if you asked a child to complete a written sample in two minutes and the child only produced two sentences, this may have been due to motivation (child quickly wrote two sentences and then was looking around and fidgeting for the rest of the time) rather than actual difficulties with production (child took two minutes to slowly write out each word in the sentences), or vice versa. Beyond observation, she mentioned that we should listen and ask children what they find difficult too, because sometimes they are able to effectively describe why they find a certain task or skill difficult.