Question 1

Q: What is a Comprehensive Speech, Language, & Literacy Evaluation?

Accepted Answer

A: A Comprehensive Speech, Language, & Literacy Evaluation at Holding Hands Speech is a thorough assessment designed to identify and understand an individual’s communication strengths and challenges across speech, language, and literacy skills. This evaluation includes standardized testing, informal procedures, extension testing, observation, performance analysis across tasks, and a case history review to assess a student's articulation, receptive and expressive language abilities, phonological processing, reading, and writing skills. This holistic approach ensures that all related factors impacting communication and literacy development are considered in the development of a tailored treatment plan that addresses specific needs, supports academic success, and enhances effective communication. The detailed final report serves as roadmap for all those who work with the student, providing a clear plan for targeted intervention and academic support.

Question 2

Q: What specific skills are assessed in a language and literacy evaluation?

Accepted Answer

A: A comprehensive evaluation at Holding Hands Speech reflects a deep-dive into a student’s linguistic system across the five domains -- phonology, morphology, syntax, semantics, and pragmatics -- and the four modalities -- listening, speaking, reading and writing -- of language. Skills that are evaluated include:Listening: Phonological awareness and processing, understanding vocabulary and concepts, following directions, auditory memory, understanding stories, comprehending grammatical structures, making inferences, determining the main idea, and understanding conversational interactions.Speaking - Articulation, speech rate, fluency, and clarity, vocabulary usage, word retrieval, morphology use, generating meaningful sentences that are grammatically correct, explaining relationships, answering questions, storytelling, the organization of ideas when relaying information, and participating in everyday conversations.Reading -  Decoding words in isolation and in context, reading fluency (speed, accuracy, and ease -- rhythm, pacing, and intonation), reading comprehension (e.g., understanding vocabulary and grammatical structure, answering detail questions, making inferences, making predictions, determining the main idea), and discerning the meaning of unfamiliar words in context.Writing - Spelling, vocabulary usage, generating grammatically correct and meaningful sentences, summarizing text, narrative and expository writing in response to a prompt, the sequencing and ordering of ideas when relaying information, and responding to questions about a presented passage.Memory -  Short-term auditory memory, working memory, and longer-term auditory memory.Each evaluation begins with a comprehensive language battery, reviewed background information, and language-impact surveys from parents and teachers. Based on the student's performance on the standardized assessment, areas of difficulty are explored in greater depth with an effort to determine the underlying source of those challenges.

Question 3

Q: What is included in a Comprehensive Assessment?

Accepted Answer

A: What is included:Approximately 6-7 hours of direct testing in the Holding Hands Speech office, typically split over two to three sessions, depending upon the student’s age and ability.Review of previous assessments, birth and health records, and educational history.Administration of a complete language battery in addition to further in-depth assessment, both formal and informal, into areas of difficulty, either proven or suspected.Extension testing to determine potential underlying causes of presenting difficulties. For example, if a child cannot follow directions, extension testing seeks to determine what supports are necessary for the child to complete the task successfully - repetition, chunking, concept development - which helps to differentiate between attention and language disorder. Parent and teacher impact rating forms, as desired.Observation in the child's school, as deemed necessary and appropriate.Detailed written report, averaging 25-30 pages, including descriptions of each task, results, and an analysis of performance.Diagnoses, as appropriate.Child-specific recommendations for accommodations and modifications for school, as appropriate.Measurable and individualized therapy goals, as appropriate.Provider referrals for suspected concomitant difficulties.

Question 4

Q: How does a neuropsychological evaluation differ from language and literacy testing?

Accepted Answer

A: While both assessments seek to help struggling learners, they look through different lenses and serve different purposes.Neuropsychological EvaluationThe Specialist: Conducted by a Licensed Neuropsychologist.The Core Focus: To determine the connection between brain function and behavior by generating a profile of cognitive strengths and weaknesses. This evaluation often covers the areas of attention, processing, memory and learning, executive functioning, reasoning, basic language skills, visual-spatial skills, intellectual abilities, and overall mental health. The Blueprint: Focuses on providing broad diagnoses (e.g., ADHD, Autism, Learning Disabilities, Anxiety), recommendations for school accommodations and modifications, special education services and placements, and referrals to other professionals for more in-depth testing.The Depth: Broadly measures domains like IQ, memory, executive functioning, emotional regulation, and when conducted as a neuropsychoeducational evaluation, academic performance. Comprehensive Speech, Language & Literacy EvaluationThe Specialist: Conducted by a Licensed Speech-Language Pathologist (SLP).The Core Focus: To identify the root causes of communication and learning difficulties and, most importantly, their impact on academic success. This is done by analyzing how a student understands and uses both spoken and written language.The Blueprint: Generates a profile of linguistic strengths and needs that directly informs educational needs with respect to placement, student-specific accommodations and modifications, and most importantly, detailed goals for therapeutic intervention across all four modalities of language - listening, speaking, reading, and writing.The Depth: Drills down deep into the specific sub-skills of language and literacy.

Question 5

Q: Why would a student need BOTH a neuropsychological eval and language & literacy testing?

Accepted Answer

A: Students with obvious language difficulties as well as those with more subtle linguistic challenges can benefit from both types of evaluations. Both evaluations will generate recommendations on school placement, provide a list of appropriate evidence-based interventions, and provide a list of accommodations and modifications, either specific to the student's diagnosis (neuropsychologists) or the student's performance (speech-language pathologist). Perhaps the greatest difference between the two evaluations comes down to the SLP's provision of a detailed and actionable roadmap for therapeutic intervention with individualized and measurable goal recommendations. For children with language difficulties, this roadmap is essential for academic success.

Children with subtle language weaknesses perhaps benefit the most from comprehensive language and literacy testing. These children tend to be those whose parents feel that something is amiss despite assurances from the school that the student is doing well, given their good grades and work ethic. While attention, processing speed, and memory can be quite impactful to learning, many children struggling in school present with undiagnosed Developmental Language Disorder (DLD), affecting on average two children in every classroom (about 7-8%). Without a comprehensive language and literacy assessment, the child with DLD will continue to be underserved and ultimately struggle, especially as they reach their late elementary school years and beyond.

Question 6

Q: What does a Comprehensive Speech, Language, & Literacy Assessment cost?

Accepted Answer

A: A Comprehensive Speech, Language, & Literacy Assessment at Holding Hands Speech costs $2000. While some families have insurance that will cover a small portion of the assessment cost, most families must pay out-of-pocket for this assessment.The American Speech-Language-Hearing Association (ASHA) has information for families on health insurance and coverage for speech/language needs, as well as action steps to assist parents and legal guardians in obtaining coverage. https://www.asha.org/public/coverage/

The Maryland Insurance Administration offers a Parent's Guide to Habilitative Services that reviews what must be covered under Maryland law, as well as what steps to take when coverage is denied.https://insurance.maryland.gov/Consumer/pages/habilitativeservices.aspx

Question 7

Q: What is an Independent Educational Evaluation (IEE)?

Accepted Answer

A: An Independent Educational Evaluation (IEE) is an assessment conducted by a qualified evaluator, outside of the school system and selected by the parents, to provide a second opinion regarding a student’s speech, language, and/or literacy needs. IEEs are directly paid for by the student's school district, who enters into an agreement with the evaluator. The school district often imposes certain minimum requirements for the evaluation, such as which areas (e.g., expressive language, pragmatics) are to be assessed and what forms of assessment (i.e., standardized assessment, observation, teacher impact forms) must be included. It is then up to the parents and the evaluator to determine further depth and method of assessment.

Holding Hands Speech has partnered with several local school districts to complete IEEs. If Holding Hands Speech is not listed on your local district's IEE provider list, you may still request that an IEE for your child be completed at Holding Hands Speech. Families seeking an objective evaluation for educational planning and intervention purposes will be pleased with the thorough and individualized assessments for which the practice is highly regarded.

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