Evaluating Speech After Traumatic Brain Injuries

by Jacky G.

A traumatic brain injury (TBI) typically results in a wide range of physical and cognitive effects. Recovery is gradual and many children only partially recover from their injuries. Before developing his treatment plan, your child’s speech-language pathologist (SLP) will conduct a thorough evaluation of the changes in his speech and language skills. She will also determine the impact of those changes on his day-to-day routine. The SLP will use a formal and an informal assessment to evaluate your child.

Formal Assessment

A formal assessment refers to the use of standardized tests. The SLP will administer these tests in order to determine your child’s strengths and weaknesses. They will help the SLP compare your child’s abilities before the injury to his abilities after the injury. The results of these tests will be based on percentile ranks, standard scores, and age equivalent scores.

These standardized tests will assess your child’s conversational skills, or pragmatic language skills, his word finding abilities, his speech, and his language. Your child’s speech refers to his articulation, rate of speech, tone of voice, and fluency. His language skills refers to his listening, reading, speaking, and writing abilities.

Modifications to Formal Assessments

The SLP can make a few modifications to the standardized tests if the child requires it. While she cannot change the instructions or the allotted time for each test (this would make the results less accurate), she may administer the tests in shorter sessions. If your child experiences vision problems because of the TBI, she may enlarge the material. She may also provide verbal prompts to aid with word retrieval.

Informal Assessment

An informal assessment does not consist of standardized tests. It refers to the evaluation of the child’s abilities in his natural environment. The SLP may talk to his teachers to learn about his communication issues. She may interview them or use questionnaires, or she may use a combination of both. She will ask the child’s parents and caregivers about his ability to communicate his needs and wants, and whether he can hold a conversation. The SLP will likely observe the child in a variety of settings to assess his interactions, such as the classroom, the playground, or a playgroup outside of school.

Narrative Language Samples

Your child’s speech therapist might also use narrative language samples to assess his speech and language skills. She might ask your child to tell her a story, whether fabricated or from personal experience. She might also tell your child a story and ask him to retell it. A story could be something as simple as discussing the routine he uses to get ready for bedtime. The SLP will evaluate your child’s narrative language abilities based on whether the story makes sense, flows logically, and has a beginning, middle, and end. She will also analyze his word choice.

Curriculum Based Language Assessment (CBLA)

A curriculum based language assessment is a type of informal assessment that refers specifically to evaluating your child’s language skills as they apply to his school’s curriculum. The SLP will review the strategies your child uses to process the material and determines what resources he needs. She might suggest modifications to the curriculum itself or the way in which it is presented. For example, the teacher might provide oral instructions, but your child might also benefit from written instructions.

Your child’s speech therapist will evaluate her findings and use them to develop a comprehensive treatment plan to help your child improve his communication skills.

Speech Therapy Techniques