Getting a Speech Evaluation

A speech evaluation for a child under three usually begins with one phone call to your state’s early intervention program, which a parent can make without a pediatrician’s referral. The evaluation is free under federal law, usually happens at home through play, and must be completed within 45 days of your call.

What you’ll learn

• Who to call, and what to say when you do
• What happens at the visit, and how long it takes
• What the evaluation and any therapy afterward cost
• What you can turn down, and what changes at the third birthday

How Do You Get a Speech Evaluation?

For a child under three, the place to ask for a speech evaluation is your state’s early intervention program, and you can refer your own child. No pediatrician has to agree with you, no diagnosis is needed, and there is nothing to sign before you call. Early intervention is the everyday name for Part C of the Individuals with Disabilities Education Act, the part of that federal law covering children from birth to their third birthday. Every state has a Part C program, each under its own name.

Under a federal requirement called Child Find (34 CFR 303.301), every state must identify, locate and evaluate children who may need early intervention services, so a parent who calls is not asking for a favor. For most families, early intervention is the first door into the professional system, and the steps from first call to written plan run in this order:

1. Find your state’s program. Search your state’s name with the words early intervention, or use the Centers for Disease Control and Prevention’s directory of state programs.
2. Make the referral. Give your child’s name, date of birth, your address and one sentence about what worries you.
3. Take the intake call. A service coordinator is assigned and calls you back to arrange the visit.
4. Have the evaluation. The visit usually happens at home.
5. Get the result in writing. The finding, eligible or not eligible, comes to you on paper.
6. Write the plan, if your child qualifies. Federal rule (34 CFR 303.310) gives the state 45 days from the referral to complete the evaluation and hold the first plan meeting.

What to Say When You Call for an Evaluation

When you call early intervention, the person who answers is usually an intake coordinator working through a form, not a clinician. A coordinator is not there to judge your concern and needs only your child’s details and one plain sentence about what you are seeing at home.

A sentence like this one is enough: “My son is twenty-six months old, he uses about fifteen words, and I would like to request an evaluation to get a baseline.” The word baseline helps, because it makes the call a request for information rather than for services, and that is hard to argue with. Have these within reach before you call:

• Your child’s date of birth and your address, so the coordinator can route you to your local office.
• A rough count of the words your child uses without being prompted.
• Anything a pediatrician has said, though you need no one’s permission to call.
• The times of day that suit your family, because most evaluations happen at home.

Before you hang up, ask whether your state charges a fee for any services after the evaluation and, if your child is nearly three, when planning starts for the handover to the school district. Then write down the date of the call, since the 45 days are counted from the referral.

If Someone Suggests Waiting

You can still ask for an evaluation when someone suggests waiting, because a referral is a request for a look and not a claim that something is wrong. If a pediatrician advises giving it more time and your gut disagrees, you can thank the pediatrician and still call the program yourself.

What Happens During a Speech Evaluation?

A speech evaluation through early intervention usually means two people coming to your home for an hour or two. Nobody sits your child at a desk: the two of them get down on the floor with a bag of toys and join in, watching how your child plays, what your child does to get their attention and how much your child understands.

How much a child understands, which clinicians call comprehension, carries a lot of weight in that hour, because comprehension is the line between a late talker and a broader delay. Expect plenty of questions for you as well, since you see your child every day and Part C treats a parent as part of the team. Any notes you have kept on your phone are worth bringing.

Hearing is usually checked or asked about early on. The American Academy of Pediatrics puts a hearing check first in any speech concern, because hearing and speech are closely linked, and settling the hearing question changes what everything else means. The team also looks at communication beyond speech, since autism, ADHD and sensory differences all show up in how a child plays and shares attention.

If you are also carrying the question of whether anything you did caused a speech delay, the answer is almost certainly no, and that question does not need to come into the room with you.

From clinical practice

Some families call a year after they meant to, not for lack of caring but because the call felt like a big, formal step and kept sliding down the list. Parents rarely regret having called early.

Afterward, parents often say they had dreaded the appointment and found two people on the living room rug with a bag of blocks, and a child with no idea anyone was watching. A finding that a child is not eligible still makes the morning worthwhile, because it is an answer in writing from someone qualified to give it.

Does a Speech Evaluation Cost Anything?

An early intervention speech evaluation costs your family nothing, in every state, because federal regulation 34 CFR 303.521(b) requires Part C evaluations to be carried out at public expense.

Services after the evaluation are a separate question. When a child is found eligible and a plan is written, some states charge a sliding-scale fee for ongoing therapy, meaning the amount depends on family income, while other states charge nothing, so ask the coordinator how your state handles it.

Can You Turn Down Early Intervention Services?

If your child qualifies for early intervention, the plan that gets written is an IFSP, short for Individualized Family Service Plan. The word in the middle is family, because an IFSP is built around your household and you help write it, so what you see at home belongs in the plan.

You do not have to accept any part of the plan. Parents can decline any service, take some services and refuse others, or disagree with what the evaluation found, because consent is yours to give and yours to withdraw. If you disagree with the eligibility decision itself, ask your service coordinator about the dispute process in your state.

What Changes When Early Intervention Ends at Three?

Early intervention under Part C ends at the third birthday, and the handover is rarely explained ahead of time. From then on, your local school district is responsible, under Part B of the same federal law, which covers special education.

The school district decides eligibility by its own criteria, so a child found eligible under Part C is not automatically eligible under Part B. Your early intervention team should start transition planning, meaning preparation for that handover, before the third birthday, and it is worth asking about early. For a child who has already turned three, the place to call is the local school district.

Common Questions From Parents

Do I Need a Referral From My Pediatrician?

No. A parent can refer a child directly, and every state has to accept a referral that comes from a parent. Pediatricians can make referrals as well, and many do, but the process does not wait for a pediatrician to agree.

How Much Does the Evaluation Cost?

Nothing, wherever you live. Under 34 CFR 303.521(b), the state pays for a Part C evaluation, not the family. Therapy afterward is separate: some states use an income-based sliding-scale fee and some charge nothing, so ask when you call.

How Long Does It Take to Get an Evaluation?

The state has 45 days from your referral, under federal rule, to finish the evaluation and, for a child who qualifies, hold the first plan meeting. The call back to arrange a visit usually comes a good deal sooner.

What If My Child Is Almost Three?

Call anyway. Part C covers children up to the third birthday, and the early intervention team is the one that starts the move to the school district. If your child has turned three already, contact the school district instead.

What Is an IFSP?

IFSP stands for Individualized Family Service Plan, the written plan for a child found eligible under Part C. The plan is shaped around your family, you help write it, and you can turn down any part of it.

What If My Child Doesn’t Qualify?

You still have a written record of where your child was on the day of the evaluation, and a professional you can go back to if nothing changes. If you disagree with the finding, ask the coordinator about your state’s dispute process.

Reviewed by Monica d’Errico-Franklin, M.S., CCC-SLP

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