What to expect at an evaluation, and how early intervention works

An evaluation can sound clinical and intimidating. In practice it is closer to a careful getting-to-know-you. A speech-language pathologist talks with you about your concerns and looks at how well your child understands language, talks, and uses gestures. For older children they may look at early literacy too.

The most important thing to know is that an evaluation is a separate step from treatment. It is not a commitment. In the systems below, you give written consent for the evaluation, and consent for any services is a distinct decision that comes later, only if your child is eligible and you agree to a plan.

For children under three, the route is early intervention, run by your state under a federal law called IDEA Part C. The evaluation is free of charge, and you do not need a doctor's referral; you can contact your local program directly and ask for one. Within 45 days of your referral, the program completes the evaluation and, if your child is eligible, builds an Individualized Family Service Plan, or IFSP, that lays out the support your child and family will receive.

For children three and older, the public school system handles it under IDEA Part B. You can request an initial evaluation in writing, usually from the principal or the special education director. The evaluation is free, requires your written consent, and, if your child qualifies, leads to an Individualized Education Program, or IEP, which can include speech-language services.

You can also go the private route and see an SLP directly; ASHA's ProFind directory lists therapists nationwide. Insurance coverage for private services varies a lot by plan and state, so it is worth asking the office to check your benefits before you start. The public Part C and Part B routes are the free or low-cost options that do not depend on insurance.

Whichever path you choose, you leave that first visit with something useful: a clear read on whether your child is on track, and if not, what would actually help.