Table 3.

Evaluation of a child with language or speech delay or disorder

Component of evaluation	Critical Information
History	Age at onset, initial presentation and subsequent course Affected subcomponents Effects of previous treatments
Past medical history	Birth history Previous illness and chronic conditions
Review of systems	Associated signs and symptoms
Family history	Family members with language, reading, or intellectual disorders Other health conditions
Psychosocial factors	Primary caregivers, parent education Number in the household, financial resources, stress Nature of parent-child interactions Amount and quality of child-directed speech Out of home care, including daycare, preschool, or school
Physical exam	Growth parameters Dysmorphic features Oral-motor structure and function
Neurological exam	Structural abnormalities, such as asymmetry in tone or reflexes Functional disorders, such as seizures
Audiological assessment	Ear specific information or sound field testing
Cognitive skills	Developmental assessment or an intelligence test
Symptoms of autism	Social communication and restrictive or repetitive behaviors