Paediatric (child) Speech and Language Therapy Assessment

The following resources may be of assistance if you are thinking about booking an appointment for paediatric speech and/or language therapy assessment.

 **NOTE**: This page is simply a guideline and should not be used to diagnose speech/language impairment. Each child is different so a diagnosis can ONLY be confirmed by a Speech and Language Therapist.

Communication Checklist 0-4 years


Reprinted with the kind permission of Toronto Public Health.

The following is a communication checklist for children from birth to age four whose first language is English. Parents who make an initial assessment appointment with ACHIEVE Speech and Language may find it helpful to print this page as a pdf document here, complete the checklist at home and bring it to the appointment (where the checklist can be discussed in detail with your Speech and Language Therapist). 

Reprinted with the kind permission of Toronto Public Health. This checklist is available in Arabic, Bengali, Chinese, Dari, Farsi, Filipino, French, Hindi, Italian, Korean, Polish, Portuguese, Punjabi, Russian, Somali, Spanish, Tamil, Urdu and Vietnamese via the webpage 


Does the child:

  • startle in response to loud noises?
  • turn to where a sound is coming from?
  • make different cries for different needs (hungry, tired)?
  • watch your face as you talk to her/him?
  • smile/laugh in response to your smiles and laughs?
  • imitate coughs or other sounds such as ah, eh, buh?



Does the child:

  • respond to his/her name?
  • respond to the telephone ringing or a knock at the door?
  • understand being told no?
  • get what she/he wants through using gestures (reaching to be picked up)?
  • play social games with you (Peek-a-Boo)?
  • enjoy being around people?
  • babble and repeat sounds such as babababa or duhduhduh?



Does the child:

  • follow simple one-step directions (Sit down.)?
  • look across the room to a toy when adult points at it?
  • consistently use three to five words?
  • use gestures to communicate (waves hi/bye, shakes head for no)?
  • get your attention using sounds, gestures and pointing while looking at your eyes?
  • bring you toys to show you?
  • perform for social attention and praise?
  • combine lots of sounds together as though talking (abada baduh abee)?
  • show an interest in simple picture books?



Does the child:

  • understand the meaning of in and out, off and on?
  • point to more than 2 body parts when asked?
  • use at least 20 words consistently?
  • respond with words or gestures to simple questions (Where’s teddy? What’s that?)?
  • demonstrate some pretend play with toys (gives teddy bear a drink, pretends a bowl is a hat)?
  • make at least four different consonant sounds (p ,b, m, n, d, g, w, h)?
  • point to pictures using one finger?
  • enjoy being read to and sharing simple books with you?



Does the child:

  • follow two-step directions (Go find your teddy bear and show it to Grandma.)?
  • use 100 to 150 words?
  • use at least two pronouns (you, me, mine)?
  • consistently combine two to four words in short phrases (Daddy hat. Truck go down.)?
  • enjoy being around other children?
  • begin to offer toys to other children and imitate other children’s actions and words?
  • use words that are understood by others 50 to 60 per cent of the time?
  • form words or sounds easily and without effort?
  • hold books the right way up and turn the pages?
  • read to stuffed animals or toys?



Does the child:

  • understand the concepts of size (big/little) and quantity (a little/a lot, more)?
  • use some adult grammar (two cookies, bird flying, I jumped)?
  • use over 350 words?
  • use action words such as run, spill, fall?
  • participate in some turn-taking activities with peers, using both words and toys?
  • demonstrate concern when another child is hurt or sad?
  • combine several actions in play (Feeds doll and then puts her to sleep. Puts blocks in the train and drives the train, drops the blocks off.)?
  • put sounds at the beginning of most words?
  • use words with two or more syllables or beats (ba-na-na, com-pu-ter, a-pple)?
  • recognize familiar logos and signs involving print (Stop sign)?
  • remember and understand familiar stories?



Does the child:

  • understand who, what, where and why questions?
  • create long sentences using five to eight words?
  • talk about past events (trip to grandparents house, day at child care)?
  • tell simple stories?
  • show affection for favourite playmates?
  • engage in multi-step pretend play (pretending to cook a meal, repair a car)?
  • talk in a way that most people outside of the family understand what she/he is saying most of the time?
  • have an understanding of the function of print (menus, lists, signs)?
  • show interest in, and awareness of, rhyming words?



Does the child:

  • follow directions involving three or more steps (First get some paper, then draw a picture and give it to Mommy)?
  • use adult type grammar?
  • tell stories with a beginning, middle and end?
  • talk to try and solve problems with adults and with other children?
  • show increasingly complex imaginary play?
  • talk in a way that he/she is understood by strangers almost all the time?
  • generate simple rhymes (cat-bat)?
  • match some letters with their sounds (letter b says buh, letter t says tuh)?

Ages and Stages 0-17

This webpage details ages and stages of communication development for children up to the age of seventeen.

Late Talkers

This webpage explains the four stages of early communication development and is helpful for parents of late talkers.

CBeebies Grown ups

Helpful article with information on the areas of paediatric speech and language.

The Speech and Language Therapy
Assessment Process

Often, parents would like to know in advance what Speech and Language Therapy assessment will entail. This can help you to prepare your child (and yourself!) for this new experience. Here is some general advice on the assessment process in ACHIEVE Speech and Language Therapy:


The Assessment Environment

Assessment usually takes place in different parts. It usually entails:

  • parents completing and submitting a short new client information form (online);
  • Louise sending you any baseline checklists to complete (for example, a checklist for 3 year olds);
  • case history and background information discussion with parents (typically by Zoom or telephone call) in advance of the face-to-face session; and
  • the face-to-face assessment session with you and your child in the clinic. 

The Case History

It is important for Louise to gather all the relevant information on your child's development to date. This usually involves finding out about your child's medical and developmental history. Louise may ask about when your child started crawling, walking, dressing / feeding / using the toilet independently etc.. We also discuss your child's current communication profile at home (and at playschool / school). Louise may ask about when your child started babbling, using first words, combining two words together etc. and ask you about how many words your child is currently using. 

Some parents find it helpful to start keeping a Communication Diary before the assessment appointment and to use this notebook to write down every different word / phrase you hear your child using. Using a Communication Diary -and bringing it with you to your child's assessment appointment- means that you can easily add up all the words that your child is using and have communication examples for Louise to read about.

If you've been asked to complete any baseline checklists, Louise will use the information you've provided to tailor assessment. 


Face-to-face Assessment

The way in which your child's speech, language and / or communication is assessed depends on your child's age and individual profile (for example, levels of attention). Generally, the younger the child, the more the assessment will be done through playing with him / her. Speech and Language Therapists use toys in lots of different ways when assessing children. For example, a Mr. Potato Head® toy can give us lots of information: on how long your child can pay attention when playing a game; on whether or not your child knows colours and body parts; on how your child asks for items / makes requests; on whether he / she can understand simple and more complex instructions. Sometimes Louise will also use a parent questionnaire assessment to learn more about your child's abilities; after all, whilst Speech and Language Therapists are experts in the field of child communication, you are the expert on your own child!


For older children, assessment may involve standardised assessments. These picture and word books are used to assess various aspects of communication, for example your child's knowledge of the names of actions / animals, the structure of your child's sentences and how well they remember spoken instructions. Standardised assessments must be carried out in a certain way i.e. Louise may need to use particular sentences when giving the test instructions or may only be allowed to give an instruction once (with no repetitions). Standardised assessments allow Speech and Language Therapists to compare your child's speech, language and communication with other children of the same age.


Louise may assess your child's:

  • speech sounds (how easy your child is to understand when he / she is talking);
  • oral-motor skills (how your child moves their articulators -teeth, lips, tongue, soft palate, jaw etc.- to make speech sounds);
  • receptive language skills (how well your child understands language spoken to them);
  • expressive language skills (how your child uses words / sentences to express him- or herself verbally);
  • speech fluency (whether or not your child is stuttering / stammering);
  • social-communication skills (how your child interacts with others socially).


Feedback on Assessment Results

Assessment is usually completed during this face-to-face session, although in some cases a second session is scheduled to finish the assessment (at no extra cost). Once the assessment is completed, Louise will give you verbal feedback on the results. This will outline your child's communication strengths and any areas of need that were identified during assessment. You will have the opportunity to ask any questions you might have about the assessment process and results and any treatment plan required. Parents often find it helpful to take notes when they are getting verbal feedback as there is often a lot of information about your child's communication profile delivered to you in a short period of time. Note-taking is a good way of highlighting the key points for you to think about at home after the assessment has ended. In addition, notes are helpful for discussing the results with your partner later if you were not both able to attend assessment.


Going forward from Assessment

Assessment is the first step in helping your child to achieve his / her communication potential. If therapy is indicated from assessment findings, an appointment for further therapy may be arranged. If it will not be possible to offer therapy post-assessment, due to scheduling constraints, you will be advised in advance of the assessment appointment and a list of other private Speech and Language Therapists working in Donegal and offering therapy sessions will be provided to you. Please see Fees Schedule - Cancellation Policy page for details of the cost of Assessment and Therapy sessions. Sometimes referral to other professionals (for example, an Educational Psychologist) is indicated following assessment; Louise will talk you through the steps that will need to be taken to help your child achieve his / her communication goals. If a formal report is required for school or medical purposes, one can be devised (this may incur an extra charge if report has not been booked in advance - please see Fees Schedule - Cancellation Policy page for further information).


If you have any questions regarding assessment, please call Louise at 086 1246 596 for an informal, obligation-free chat about your child's needs.