SHOULD I GET MY CHILD TESTED FOR A SPEECH DELAY OR SHOULD I WAIT?
Updated: May 12, 2021
If you are asking this question, you already have some doubts about your child’s speech and language development. The most common reason parent wait is the fear of the unknown. Early intervention gets the best results. The Ameican Speech-Language-Hearing association has resources for parents that emphasize Don't Wait. When in doubt, do something. Your child may or may not need a speech-language evaluation, but choose one of these options to help you make the decision.
Look at developmental norms. Compare what your child does to what is average for his or her age. Remember that average can vary by a few months, but children follow the same patterns as they develop communication skills. You can download this chart to see where your child’s skills are right now, and compare that to what is expected.
You can also use the chart monthly to measure your child’s progress. See if your child makes the expected amount of progress in 3 months. A slower rate of change is one indication that you should check your child’s communication skills further.
You can share the chart with your health care provider or speech-language pathologist to give them further information when you ask for their advice.
Use a standardized screener. Speech-language screeners are designed to be a fast and easy way to check for signs that an evaluation should be done. Screeners have been studied to make sure the questions are useful indicators and the results are reliable. Research is what makes screeners “standardized.”
Research on the screener tells us what scores show typical development and what scores indicate testing should be done. Screeners don’t say that there definitely is a problem and they don’t diagnose a disorder. Screeners tell us if we should get some testing done to get more answers.
Screeners identify most children that should be tested, but miss a few. If you continue to have some concerns, you can continue to monitor with the developmental chart or redo a screener in a few months.
At the end of this post you can find links to several screeners you can use at home. Share the results with your health care provider or speech-language pathologist when you talk to them about an evaluation. Be sure to put a date on the screener so they can compare your results to their observations.
NOTE: If your health care provider has advised you to “wait and see” for communication development and has NOT used a screener, that was not valid advice. Don’t wait unless you have some valid information to make that decision.
Get a professional screening. If you are not sure how to answer some of the questions on a screener, you may get more accurate results by consulting someone who screens children professionally. Many agencies provide free screening for infants, preschoolers and school-age children. Individuals who give the screening are trained to use the screener and interpret the results. They have experience that can help answer your questions about the results or your child’s development.
Go to Where Can I Get SLP Services? for information on where to find free screening in your area.
FREE, ONLINE SCREENERS
Below are some screeners that are currently available online for parent use. Choose one or more based on your child’s age.
Ages and Stages Questionnaires – 3rd Edition (ASQ-3)® Ages 2 months – 5 years The ASQ-3 screens all areas of child development, including speech-language. It is widely used by child development specialists, and its norms are well developed. This screener is currently being made available free online, paid for by Easter Seals.
Smart Early Screening for Autism and Communication Disorders (Smart ESAC) ® Ages 9 – 18 months The Smart ESAC screens for skills that develop before children learn to talk, such as gestures, sounds, and actions with objects used in play. It is currently being researched to further develop its norms. It is being developed by autism researchers to improve on the accuracy of identifying early signs of autism. By completing this screener, you will gain information about your child’s development and contribute to research that will help many parents.
Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT R/F)® Ages 16 – 30 months The M-CHAT R/F has been used for years as an early screener for autism. Some children who score low on the screener may have some reason other than autism for their communication delay. A low score does not diagnose autism –– it means you should have testing done. Recent studies have shown that the M-CHAT R/F does a good job of identifying many children who should have further testing, but it does miss some children that later are diagnosed with autism. If your child passes but you continue to have concerns, continue to monitor or use another screener.