The speech language pathologist (SLP) will begin by asking about your medical history, education, and employment, and cultural and linguistic background. The SLP will seek to understand your concerns, how your communication difficulties are impacting your life every day, as well as what goals and hopes you have for the evaluation and therapy.

A comprehensive assessment covers all aspects of communication to get a full picture of skills and challenges. At the end of the evaluation, the SLP will discuss their findings and observations and make recommendations. The evaluation will consist of the following:

The SLP will ask you to do tasks that allow them to assess the structure and function of the parts of the oral mechanism. This includes the lips, teeth, and hard and soft palate. The SLP is looking at strength, coordination, range of motion, and other aspects of the oral mechanism.

The SLP will obtain a speech sample during conversation, as well as administer standardized tests that’s ask you to name pictures and objects, repeat words and phrases of varying lengths and complexities, and perform different actions with your mouth. The purpose of this assessment is to determine what sounds you have difficulty saying, and if there is a pattern to your difficulties. Apraxia is an acquired speech impairment that is characterized by difficulty pronouncing words often exhibiting speech sound errors/ inconsistencies and groping for the right words. Apraxia impairs the muscles’ ability to receive message from the brain to make them move. Dysarthria is a motor speech disorder where the muscles used for speech have been weakened or aren’t receiving message properly from the brain due to brain damage. Signs of dysarthria include slurred or “mumbled” speech that is difficult to understand. Speech could sound choppy or robotic or sound like it is coming out too fast or too slow. It may cause the voice to sound breathy and hoarse. The SLP can help you learn ways to speak that help you to be better understood, as well as ways to help listeners participate in good communication with people with apraxia or dysarthria.

The SLP will assess the quality, loudness, pitch, resonance, and prosody of your speech through informal assessment or possibly using computer software. Neurological conditions or vocal pathologies such as polyps or nodules can impact the voice. Typically, if vocal symptoms are present, a prior evaluation by and otolaryngologist (ENT) is required to determine the underlying cause of the symptoms, or referral to an ENT may be made by the SLP before therapy can begin. Different etiologies will call for different treatments.

People who stutter often repeat parts of words, stretch sounds out for a prolonged period, or have a hard time getting a word out. The SLP will look at the types and numbers of disfluencies, as well as the impact of stuttering on interactions and everyday life. For adults, treatment focuses on managing stuttering by practicing methods to minimize disfluencies and feelings of tension and anxiety that impact different speaking situations.

The ability to understand language(receptive) and use language (expressive) encompasses the spoken and written word, as well as gestures and facial expressions. The SLP will obtain language samples, as well as conduct standardized tests that will ask questions about pictures, words, objects, stories, and concepts to determine if there is any loss of the ability to produce and or process language. This is also known as aphasia and can impact reading and writing in addition to speaking and understanding language. Aphasia can also impact cognitive skills such as attention, problem solving, memory, executive function, reasoning, planning, and organization.

Neurological disease, stroke, and cancers among other things, can impact the ability of adults to safely eat and drink. The SLP will determine if you have difficulties swallowing at any stage, and with what food types and consistencies. Therapy techniques, diet modifications, and adaptive equipment such as special utensils and cups can improve function and safety of eating and drinking for adults with dysphagia.