Early Intervention Speech Therapy Evaluation: What to Expect and How to Prepare

Written by: Michelle Altamura, M.S. CCC-SLP TSSLD CAS

When a toddler isn’t meeting speech or language milestones, it is natural for caregivers to wonder: “Should I be worried?”  and “Is my child developing like his/her peers?” As these questions arise, a solution could be in the form of an early intervention of speech therapy evaluation. These assessments are designed to identify communication delays or disorders in young children between birth to age three so they can receive support during the most critical period of brain development.

Speech Therapy Evaluation​ Timing Matters

The first three years of life are a window of rapid brain development. Delays in this window can have a domino effect on social interaction, behavior, and learning. Intervention during this time can significantly improve outcomes. While some developmental concerns may be resolved over time, research increasingly supports moving away from the “wait and see” approach, especially communication delays. A systematic review by Wallace et al. (2021) found that children with untreated language delays are at greater risk for long-term academic and social difficulties. Early identification and intervention, even before a formal diagnosis, lead to better language outcomes and reduce the need for services later in life. Acting early gives children the best chance to build strong communication foundations.

What to Expect During the Speech Therapy Evaluation

The thought of an evaluation can feel overwhelming, but it’s often a play-based process designed to help everyone understand how your child communicates. A licensed speech-language pathologist (SLP) will guide the evaluation and make sure your child feels safe and comfortable throughout. There are several key areas of early intervention speech therapy evaluation:

Caregiver Interview

The SLP will begin by learning about your child’s medical and developmental history, as well as your observations and concerns. You’ll be asked about milestones like first words, play habits, feeding challenges, and any changes you’ve noticed in your child’s communication.

Play-Based Observation

Much of the evaluation will feel like play! The SLP will interact with your child using toys, books, or games to see how they communicate during natural activities. They’ll look for how your child uses gestures, sounds, eye contact, words, or actions to get their needs met.

Standardized Testing

The SLP will use formal assessments to measure expressive language (what your child says), receptive language (what your child understands), and pragmatic language (how your child interacts). These tools help compare your child’s skills to typical developmental milestones. In addition, the SLP will observe how communication connects to other developmental areas, since speech and language are deeply linked to: Cognitive development (how your child thinks, solves problems, and understands the world), Motor development (how your child uses their body to interact with the world), and Social-emotional development (how your child interacts with others and manages emotions.

Oral Motor Assessment

The SLP might gently look at how your child’s lips, jaw, and tongue move, especially if there are concerns about feeding, drooling, or articulation. This helps determine whether physical structures are impacting speech development.

Cursory auditory assessment

The SLPs will make notice of how your child responds to sounds in their environment, to rule out hearing concerns that may impact speech and language development.

How to Prepare

You don’t need to do much to prepare for a speech therapy evaluation, but a few thoughtful steps can help the experience feel smooth and comfortable for both you and your child.

Start by making sure your child is well-rested and has had a snack before the appointment. When the evaluator calls, make them aware of any important routines that they should schedule around to set your child up for success. It’s also a great idea to have familiar items out, like a favorite toy, book, or comfort item. These familiar pieces can help your child feel more at ease when interacting with a new person.

Before the evaluation begins, let the speech-language pathologist know about anything that helps your child feel safe, calm, or engaged, whether it’s a particular routine, song, or sensitivity to new people or environments. Don’t hold back on sharing your observations! You are an important part of the team and know your child best. The more insight you provide, the better the SLP can understand your child’s unique communication style and needs. There’s truly no such thing as too much information when it comes to supporting your child’s development.

Communication Skills Assessed During the Speech Therapy Evaluation

Each of these areas is considered in relation to age-based developmental milestones to determine whether your child is on track, showing emerging skills, or may benefit from support.

• Pre-linguistic skills- eye contact, turn-taking, imitation, joint attention, early play, and gesture use.
• Receptive language- understanding words, following directions, identifying objects or pictures, responding to questions.
• Expressive language- use of sounds, words, phrases, sentence structure, vocabulary size, and clarity of spoken language
• Speech sound development- clarity of speech; ability to produce age-appropriate sounds and patterns.
• Social communication (pragmatics)- using language to greet, request, comment, take turns, maintain interactions.
• Play and interaction skills- engagement in symbolic play, pretend play, functional use of toys and materials.

What Happens After the Evaluation

If the evaluation shows a communication delay, the next step is creating a support plan tailored to your child’s needs. In early intervention programs, this plan is called an Individualized Family Service Plan (IFSP). It outlines:

• Your child’s current levels of development
• Specific goals for communication growth
• The types and frequency of services recommended (like speech therapy)
• Strategies you can use at home to support progress.

Therapy often happens in familiar environments, like your home or daycare, where your child spends most of their time. This occurs so that your child can learn in the context of everyday routines. Sessions may involve play-based activities, coaching caregivers, or interactive games that target speech and language goals.

Even small steps forward can lead to big changes. With the right support in place, many children make considerable progress in a short time.

Tying it all Together

A speech therapy evaluation isn’t something to fear. It is meant to support you and your child in all the ways you need to make sure your child has the tools they need to participate in their daily routines. If you have concerns about your child’s communication, don’t wait. You don’t need a doctor’s referral or a formal diagnosis to seek help. Trust your instincts and start the conversation. Early support builds strong futures, and your voice matters in the process.

Contact us today for personalized speech therapy!