Behaviors that should trigger an SLP referral

Difficulty functioning independently due to:

• unresponsiveness to all external stimuli
• may open eyes, suck, and/or yawn
• does not attend to others
• no purposeful speech
• extremely impaired attention and memory with impulsivity
• extremely limited communication:
• difficulty responding to and/or saying name
• difficulty expressing basic needs to others using simple words and/or gestures (i.e., yes/no, head nod)
• difficulty saying greetings (i.e., “hi” and “bye”) on own
• difficulty remembering spouse/caregiver’s name
• difficulty counting to 10
• becomes agitated when needs are not met
• limited eye contact
• limited social behaviors (i.e., expressions of courtesy and facial expressions)
• very limited communication:
• difficulty paying attention while speaking (i.e., does not complete sentences or take turns
• speaking during conversation)
• difficulty responding appropriately to message of other individual (i.e., delayed, perseverative, or off-topic responses, including inappropriate words)
• limited ability to provide biographical information
• difficulty understanding abstract information; very concrete responses

Difficulty functioning independently due to:

• difficulty anticipating consequences of own actions
• poor organization, with limited problem solving and judgment
• limited awareness of extent of difficulties; exhibits socially inappropriate behavior
• difficulty with concepts of time and money
• difficulty self-disciplining and self-monitoring to follow rules
• difficulty changing routine or schedule; difficulty learning new rules
• limited communication:
• difficulty selecting appropriate words and remembering names
• limited memory and/or knowledge of current events and/or personal history
• responses in conversation may be verbose, redundant, or tangential
• elaborates on information provided from questions, but cannot appropriately change topic, initiate, or end a conversation
• missing or misunderstanding humor
• difficulty understanding nonverbal communication (i.e., facial expressions and/or body language)
• difficulty understanding abstract information

Difficulty managing home or maintaining a job or business due to:

• difficulty planning and completing necessary daily activities
• difficulty following directions
• difficulty comprehending or applying abstract written information
• difficulty analyzing personal and/or business problems, identifying and applying solutions
• difficulty assessing own strengths and weaknesses, developing effective plans to improve weaknesses
• difficulty managing multiple responsibilities simultaneously
• difficulty managing emotions (especially anxiety, frustration, or anger) related to performance difficulties
• difficulty making, following, and modifying plans as needed
• difficulty understanding and managing personal legal or financial matters (i.e., taxes, buying or refinancing a home, etc.)
• difficulty effectively communicating with colleagues and/or customers, especially initiating effective responses, interpreting combined verbal and nonverbal responses during conversations to determine strategic communication action; modifying responses when feedback indicates it has not been successful

Does Your Child Need Speech Therapy?

Potential Consequences/Impact of Speech Impairment Can Include

• Difficulty expressing need or routine information intelligibly
• Difficulty communicating intelligibly in order to function at level of independence expected for age
• Difficulty expressing feelings intelligibly; may be at risk for frustration or depression
• Difficulty engaging successfully in social and/or classroom situations that require intelligible speech
• Difficulty achieving adequate intelligible speech to reach educational potential
• At risk for personal injury due to difficulty communicating intelligibly about a dangerous situation or calling for help

Behaviors that should trigger an SLP referral

By age 3 years cannot:

• be understood by family and/or caregivers
• correctly produce vowels and such sounds as p, b, m, w in words
• repeat when not understood without becoming frustrated

By age 4 years cannot:

• be understood by individuals with whom they do not associate regularly
• be understood by family and/or caregivers
• correctly produce t, d, k, g, f
• be asked to repeat without becoming sensitive

By age 5 years cannot:

• be understood in all situations by most listeners
• correctly produce most speech sounds
• be asked to repeat without exhibiting frustration
• Disturbance in neuromuscular control causes difficulty learning to produce sounds appropriately
  speech is usually slurred; difficulty controlling respiration for speech; abnormal loudness, rhythm, or vocal quality
  exhibits difficulty learning sounds to form words; may sound nasal, strangled and/or breathy

exhibits frustration and/or avoidance of speech due to extreme difficulty forming sounds or difficulty being understood