The typical procedure for the assessment is as follows:
1) Fill out a Waitlist Form if your child can only attend in the afternoons. (We are currently not accepting new afternoon clients, only clients who can attend services in the morning or very early afternoon.) If your child can attend services in the mornings, please fill out this form: Request for Morning Services. Once your child is able to be scheduled, these are the next steps:
2) Mail it, scan/email, fax or bring it to our office. Patti Hamaguchi will review it and direct us to the next steps with your child's case.
3) First Visit: The first visit is scheduled with Patti Hamaguchi, which is a morning appointment, on a Monday or Friday. We will need all previous reports and patient history filled out and delivered to our office no later than 3 business days prior, in order to have sufficient time to review them. Patti will meet with one or both of the parents, while the child waits in the waiting room with the other parent or responsible adult that you bring with you. After the meeting (usually about 10-15 minutes), the child is brought in and Patti will do informal and formal testing tasks at that time. On the first visit, 1/2 of the total assessment fee is due.
3) After the initial meeting, Patti Hamaguchi will formulate an assessment "plan" for the SLP team. The actual administration of the tests is typically carried out by other SLPs on staff and entails several appointments.
4) Patti Hamaguchi will contact a classroom teacher or other professional you desire as specified on your exchange of information, in order to gain additional information about your child's communication skills in other settings.
5) Two-three weeks after your child's last assessment appointment, we will have a meeting (adults only) to review the results, and will provide you with two copies of the report.
1. Screenings for articulation and children under the age of 2: A screening is an informal observation of your child that helps us determine if a more comprehensive evaluation is necessary. There are no written reports provided with a screening. The fee is prorated for our time spent with your child and speaking with you afterward. ($188 for a typical 60-minute screening). If a full evaluation is then scheduled, your screening fee will be deducted from the evaluation fee. If the time spent is less, we will pro-rate your fee accordingly. We will generally only perform screenings in lieu of an actual assessment for articulation errors or children under the age of 2.
2. Consultations: A consultation refers to a review of your child's previous reports, informal observation of your child, talking with you about your concerns, and providing input as to the next best course of action. There are no reports provided with a consultative appointment. Please understand that this is NOT an assessment so we cannot give you information about your child's percentiles, levels, or even put together a complete treatment plan as a result of a consultative appointment. Your child will still need an actual assessment for us to answer those kinds of questions if there has not been one already. Should you schedule a full (comprehensive) assessment with our office in the 60 days following the consultation, we will deduct the consultation fee from the total fee for the assessment. You should expect that this would take 60 minutes, depending upon the presenting issues and the number of questions you may have. Fees are $188 (60 minutes).
3. Articulation Screening: (pronouncing sounds) Informal, without a report for simple cases (only a few sound errors): prorated at the current therapy rate, typically 45-60 minutes ($142-$188) FYI: If you plan to seek insurance reimbursement, you will most likely need to have a formal evaluation (#4 below) completed instead of a simple screening. This articulation screening does not provide a report you would need to submit to your insurance company.
What do we do as part of an articulation screening? We typically play and talk with your child so that we may observe the following:
4. Articulation assessment only; with oral-motor exam, formal report & review: $299 Includes the following: Review of records and previous reports, administration of informal and formal articulation measures, oral-motor exam; written report (typically about 3 pages) including recommended goals and therapy techniques. Additionally, Patti Hamaguchi reviews each case and report with the treating speech pathologist. The reports are generally necessary for insurance reimbursement. (FYI If your child has difficulties with articulation as well as language, you will want to schedule a comprehensive speech-language assessment instead, which would also include articulation/oral-motor exam. See #5-7 below.)
What do we do? We typically administer the following 2 tests:
The other purpose of the assessment is to determine what type of speech disorder your child is demonstrating (e.g. Apraxia? Phonological processing? Developmental? Oral-motor weakness?) and develop an appropriate treatment plan for that specific speech disorder. Many times the specific diagnosis is associated with related learning or sensory delays and we will share important information about the nature of the disorder with the parent, as well as any suggestions for the parent to help the child at home.
5. Comprehensive assessment for speech delays for children birth- 4 years: * $750
Includes the following: review of previous records and patient history, meeting with the child for approximately 2 hours (3 hours maximum) total over the course of about 3-4 sessions for 45 minutes or so each; administration of informal and formal tests (if the child is capable); scoring and interpretation of reports, speaking with outside professionals who work with the child if requested to a maximum of 30 minutes total; written report (typically 5-7 pages) including recommended goals and course of treatment; 45-minute review of report with parent(s).
What do we do? We use toys and “play” to observe your child’s skills in the following areas:
When possible, we do like to attempt some formal testing measures as well, once the child is more comfortable with the environment. We select the tests based on the child’s needs and skill level, but these are a few of the tests we use with this age group: Preschool Language Scale-4 (“PLS”) Goldman-Fristoe Test of Articulation, Peabody Picture Vocabulary Test, Expressive One-Word Picture Vocabulary Test, Rossetti Scale
What kind of information are we looking for?
For children with significant cognitive and communication deficits:
Some tests that we select from include: The Peabody Picture Vocabulary Test, The Expressive One Word Picture Vocabulary Test, The Preschool Language Scale-5, the Goldman Fristoe Test of Articulation 2, The Hamaguchi Oral-Motor Assessment. In addition, we supplement our findings with informal activities to see how the child functions in a more naturalist context. These include conversational samples and participating in a play activities.
6. Comprehensive assessment for speech/language development for children ages 5-12 years without auditory processing component: * $1275
Includes the following: review of previous records and patient history, meeting with the child for approximately 4-5 hours total over the course of about 4-6 sessions for 45 minutes or so each; administration of informal and formal tests (if the child is capable); scoring and interpretation of reports, speaking with outside professionals who work with the child if requested to a maximum of 30 minutes total; written report (typically 8-10 pages) including recommended goals and course of treatment; 45-minute review of report with parent(s).
What kind of information are we looking for?
* Vocabulary development
*Language processing and attention to auditory stimuli (if we see issues we may recommend doing further auditory assessment)
* Sentence construction in a variety of contexts, including retelling a story, describing, explaining, and conversational skills
* Comprehension of language at the word, sentence and story level
* Word retrieval
If indicated, an oral-motor assessment or screening (for articulation disorders)
Voice & Fluency screen
Pragmatic (social language use) including eye contact, initiation, reciprocal communication and joint attention; inference;
Play and interactive skills
For children with significant cognitive and communication deficits:
Use of signs, gestures or alternative communication modality
If cognitively and developmentally age-appropriate:
Use of language for higher order tasks, including interpreting humor, sarcasm, inferential language
Written language and an oral reading sample
Some tests that we select from include: The RESCA-E (Receptive, Expressive & Social Communication Assessment-Elementary) The Preschool Language Scale-5, the Goldman Fristoe Test of Articulation 2, The Hamaguchi Oral-Motor Assessment, The Rapid Naming Test, and the CASL-2 (selected subtests). In addition, we supplement our findings with informal activities to see how the child functions in a more naturalist context. These include: conversational samples, written language samples, oral reading, and participating in a play activity.
7. Comprehensive speech-language evaluation with auditory skills battery: $1575 (ages 6 and up) Reports tend to be lengthier, typically 1-12 pages. This assessment includes all of the areas above, as well as test batteries that examine auditory skills:
Some tests that we select from include in addition to those listed in the language section include: hearing screening with tympanometry, The Test of Auditory Processing Skills (TAPS-3) Auditory Processing Abilities Test (APAT), SCAN-C-3 (Auditory Processing Screening Test) Test of Phonological Awareness, Goldman-Fristoe Test of Auditory Discrimination, C-TOPP2 (Comprehensive Test of Phonological Processing 2) and Phonemic Synthesis Test.
8. Stuttering: We are not currently doing stuttering assessments but will be happy to refer you to a local specialist who does.
9. Supplemental Testing: Many children come to our practice with speech-language evaluations from other speech-language pathologists. In most cases, the information from these evaluations is adequate to begin therapy. However, there are times when other information is needed (such as an in-depth oral-motor evaluation, auditory processing testing, etc.). We will conduct these supplementary tests during your child’s regular therapy session.
Answers to Questions You May Have About the Assessment Process
Q. What if my child screams and cries and won’t do anything the speech pathologist asks him to do?
A. Although rare, this does occasionally happen. We do attempt to establish a rapport with your child and make her comfortable. Usually by the second or third session, the child is more comfortable and less apprehensive about the sessions. Sometimes the child needs a “snack break” to break up the sessions and regroup. However, there are times where a child is simply inconsolable. As stated in the previous section, there is a “maximum” number of hours of scheduled direct time with your child that is included with the assessment fee. All scheduled sessions are counted in this total, regardless of your child’s level of cooperation or speed in responding. We may decide to simply do more informal kinds of assessment early on and save the formal assessment process until your child has settled into the routine and developed a rapport with the therapist. In addition, this might also signal that your child is not ready for the kind of adult-directed therapy that we do, and so we may consider referring out to other professionals for alternative kinds of intervention.
Q. What if I need to cancel the assessment after I have started the process?
A. Again, this is extremely rare but occasionally parents have family emergencies, unexpected job transfers, or simply decide their child is too fussy to continue. In these cases, you will be charged for the scheduled assessment time up to that point at our usual therapy rate ($188 an hour) and no report will be provided, if we are given at least three days’ notice before the upcoming appointment.
Q. What if I plan to apply for insurance reimbursement?
A. If you plan to seek reimbursement from your health insurance company for an evaluation, you usually must have a written referral from your child’s primary physician before the evaluation. Please be aware that we are not affiliated with any HMO or PPO groups, although many clients receive out-of-network PPO reimbursement or use their company's HSA. Please read our flyer, “If You Intend to Seek Insurance Reimbursement” form.
Q. What if my child is developmentally functioning on a much younger level and is age 5? I don't think he will be able to do all that testing.
A. If your child is not able to participate in the typical assessment process, we do consider this on a case-by-case basis. In some situations, if the child is performing at a much younger age we will consider dropping the fee to be comparable to the testing we do for younger child as the sessions will be fewer and shorter.