Speech and language assessment for children, teens and adults

An assessment answers a simple question that often feels anything but simple: can you or your child benefit from speech-language therapy, and if so, what kind? Our speech-language pathologists look at overall speech and language skills using a combination of a parent or client interview, play-based informal assessment and formal standardized testing. You leave with clear answers, a written report and a plan.

Assessments can look at speech sounds, language understanding and expression, voice, fluency (stuttering) and swallowing. The most common are speech and language assessments for children, but we see teens and adults too.

When to consider an assessment

Children develop at different rates, and a wide range of timing is typical. Still, some signs are worth a conversation with a speech-language pathologist. You do not need to be certain something is wrong to book. Many families come in simply to find out.

Toddlers (12 months to 3 years)

• Little babbling or few gestures (pointing, waving) by around 12 months
• Few or no single words by around 18 months
• Not yet combining two words (“more milk”, “daddy go”) by around 2 years
• Difficulty following simple directions or understanding familiar words
• Frustration or tantrums that seem linked to not being understood

Preschoolers (3 to 5 years)

• Speech that unfamiliar listeners find hard to understand by around age 3 to 4
• Short or simple sentences compared with children of the same age
• Difficulty answering questions, telling what happened, or playing with words and rhymes
• Repeating sounds or words, stretching sounds, or getting “stuck” when starting to speak

School-age children and teens

• Difficulty learning to read and spell, or with phonological awareness
• Trouble understanding instructions, following lessons or organizing ideas when writing
• Difficulty with conversation, making inferences or reading social situations
• Speech errors that continue past the early school years, or ongoing stuttering

Adults

• Changes in speech, language, voice or swallowing after a stroke, head injury or neurological diagnosis
• Hoarseness or vocal fatigue that lasts, especially for people who use their voice at work
• Stuttering that affects work, school or daily life
• A wish to modify an accent for personal or professional reasons

If you notice any of these, or if a doctor, teacher or educator has raised a concern, an assessment is a reasonable next step.

Screening or full assessment

A screening lasts about one hour. It gives a quick picture of current skills and tells us whether a full assessment is needed. It is a good option when you are unsure whether there is a concern at all.

A full assessment goes further. It combines the interview, informal assessment and formal testing described below, and it leads to a written report with recommendations. Its length varies according to age, the history of previous assessments, the severity of the difficulty, and the person’s collaboration and attention on the day.

When you call, our team will ask a few questions and help you choose the option that fits.

How the assessment works

1. Parent or client interview

We start by listening. We discuss your concerns, as well as any concerns raised by a physician or teacher. We also review medical history, developmental milestones, language acquisition (especially for bilingual and multilingual clients), educational history and family history. For adults, we talk about work, daily communication and what you would like to change.

2. Play-based informal assessment

For children, this part looks like play. We use toys, books or short videos to collect a spontaneous speech and language sample. We then transcribe and analyze it. For example, we check whether a child’s language includes the grammatical forms expected for their age.

We also collect a narrative sample, such as retelling a story, to look at higher-level language skills like sequencing, reasoning and perspective taking. With teens and adults, this part is a conversation and a set of everyday communication tasks.

3. Formal standardized testing

Formal assessment can cover speech, language, voice, fluency and swallowing. In a speech or language assessment, we look at:

• Which sounds are produced in error, and how they are produced
• Where speech errors occur in words
• How speech compares with that of peers with typically developing speech
• The concepts, vocabulary and grammar you or your child understands
• The ability to express those concepts, vocabulary and grammar in different situations
• How receptive and expressive language compares with that of same-age peers

We choose tests that suit the person’s age and language background, and we interpret scores with that background in mind.

4. Written report

After the assessment, your clinician analyzes the results and writes a report. Your clinician will tell you when to expect it.

5. Debrief

We go through the results with you in plain language. You can ask questions, and we discuss recommendations and next steps together. This conversation matters as much as the report itself.

Assessing bilingual and multilingual children

Montréal families often speak two, three or more languages at home, and that is a strength. It also means assessment has to be done thoughtfully.

A child learning two languages may mix them, have a smaller vocabulary in each language taken separately, or go through a quiet period in a new language. These are typical patterns, not signs of a disorder. Comparing a bilingual child with monolingual norms in only one language can make a typical child look delayed, or hide a real difficulty.

Whenever possible, we look at both languages. We ask about when and how each language was learned and how much your child hears and uses each one. A true language disorder shows up across all of a child’s languages, while a language difference reflects exposure. Our clinicians speak English, French, Spanish, Portuguese, Arabic, Greek and Armenian. Availability varies, so we match you with the clinician best suited to your family. Research does not support dropping a home language because of a speech or language difficulty, and we will never ask you to.

Preparing for the appointment

What to bring

• Any previous speech-language, psychology, occupational therapy or hearing reports
• Report cards, school plans or notes from the daycare or teacher
• A list of questions and examples of what concerns you (a short video of your child talking at home can be very helpful)
• For adults: relevant medical reports and a list of medications
• Glasses or hearing aids, if used

How to prepare your child

Keep it simple and positive. You might say, “We are going to meet someone who plays games and looks at books with kids, to see how you talk and understand.” Avoid calling it a test. Make sure your child is rested and has had a snack, and bring a favourite comfort object if it helps.

It is normal for a child to be shy or to talk less than usual. Tell us what is typical at home. We expect it, and we adapt.

What the report contains

Your written report usually includes:

• The reason for the assessment and relevant history
• Observations from the session and the language sample
• Results of any standardized tests, explained in plain language
• Clinical impressions, including a diagnosis when appropriate
• How the difficulty affects daily life, school or work
• Recommendations: therapy, home strategies, school accommodations, referrals or monitoring

How families use it

Many families share the report with their child’s school or daycare to support planning and accommodations. Some share it with a doctor or another professional. We provide receipts that you can submit to your private insurance plan; coverage varies, so check with your insurer. The report belongs to you, and we share it only with your consent.

After the assessment

Not every assessment leads to therapy. Sometimes the right recommendation is home strategies and a check-in a few months later. When therapy is recommended, we set goals with you and discuss session frequency and the expected length of treatment. You can learn more about individual treatment, telepractice and our group programs.

Getting started

Assessments are available in person at our Marché Central clinic in Montréal, or by telepractice anywhere in Quebec and Ontario.

To book, call our Marché Central clinic at 514-467-9132 (Monday to Saturday, 8:00 to 19:00), or request an appointment through our contact form. We will answer your questions and match you with the right clinician.