In order to determine the right treatment for you or your child’s speech or swallowing problems, the speech-language pathologist must first determine the cause of the symptoms. To do so, they will complete a series of tests.
After reviewing your medical history, your doctor will complete a physical exam. They will then watch you eat, paying close attention to how you sit and feed yourself as well as what happens when you swallow.
They may also need to complete a few tests.
A barium swallow requires you to ingest prepared food or liquid that contains barium. The barium shows up on an X-ray, giving your doctor the ability to see how it moves through your esophagus.
An upper endoscopy involves the use of a narrow, flexible tube (endoscope) with a light and camera on the end. The endoscope is passed through your nose into your esophagus. The images are projected on a screen so your doctor can watch what happens within your esophagus when you swallow.
An esophageal manometry test measures the strength and muscle coordination of your esophagus. A tube is passed through the nose, down the esophagus and into the stomach. You will be asked to swallow water and the sensor on the tube will record the results.
A pH impedance test is used to measure how much acid leaves your esophagus and goes into your stomach and if this acid is related to your symptoms. A thin, flexible catheter with an acid-sensitive tip is inserted through your nose into your esophagus; the test requires the sensor to stay in your nose for 24 hours. At the end of this test, your doctor is able to determine if you have gastroesophageal reflux disorder (GERD), which is necessary information when creating a treatment plan.
A quick screening is typically conducted in order to determine the assessments that must be performed. This will include speaking with the parents or teachers about their concerns over the child’s language skills as well as conducting a hearing screening to rule out hearing loss as a cause for their symptoms.
An evaluation will then be performed with a speech-language pathologist. The goal of this evaluation is to determine your child’s strengths and weaknesses in communication through the use of formal assessments, behavioral observations, parental report and background information about the child.
You will be asked to complete a Case History form. This will include questions about your child’s medical, developmental and family history.
During the speech evaluation, the speech-language pathologist will compare your child’s skills with those of other children the same age. The tests will be matched to the child’s age. Play-based and interactive assessments are used for testing toddlers, while school age children will be given more formal tests. The tests given by the speech-language pathologist will measure your child’s:
- Receptive vocabulary
- Understanding of grammar and syntax
- Understanding of directions and information
- Auditory skills
- Expressive vocabulary
- Word retrieval
- Voice quality
- Social use of language
The results of these tests will then be used to create an individualized treatment plan.