About our Assessments
Teletherapy or In Person Assessments
We are able to assess most children via teletherapy OR in person at this time.
How Do I Get Started?
4. Email, Fax or Mail This Document to Us
After you have filled out this document, please email to: frontoffice.hamaguchi@gmail.com or mail to: Hamaguchi & Associates 20111 Stevens Creek Blvd, Suite 145, Cupertino, CA. 95014. Our fax number is (408) 366-1011.
5. We Will Be in Touch!
Once we receive these documents, we will be in touch within one business day to discuss scheduling options with you.
What Should I Expect? What Is the Process?
We Want to Get to Know Your Child
Kristen White, our Director of Clinical Services, will review your paperwork and assist the Office Manager in scheduling your child once we have an opening. Articulations assessments are done in one sitting. All others take a bit more time.
The First Visit: The first visit is scheduled with Kristen White. For elementary/auditory processing cases, Patti Hamaguchi may join. Kristen and/or Patti will talk with you, without your child there, in order to review your concerns, your child's history, etc. and to make sure we select exactly the right tests. In some sense, we are in fact "speech-language detectives" when we start this process. After this, Kristen will do some initial chit-chat/play with your child for 15-20 minutes and perhaps some simple, initial testing. The primary goal is to make your child feel comfortable and "warm up" to us. We will not generally do any challenging testing on this first visit.
Next: A testing plan is then put together and carried out by our speech pathologists, usually over 3-5 sessions. The results are scored, and a review takes place about 2-3 weeks later with the parents/clinical staff. You will be provided with a report at that time and we will discuss treatment goals, and if any other referrals (hearing, occupational therapy, etc.) are appropriate.
What Kind of Testing Do We Do?
Articulation (Pronunciation)
Articulation Screening: (pronouncing sounds) Informal, without a report for simple cases (only a few sound errors): prorated at the current therapy rate, typically 45-60 minutes ($162-216) FYI: If you plan to seek insurance reimbursement, you will most likely need to have a formal evaluation (#4 below) completed instead of a simple screening.This articulation screening does not provide a report you would need to submit to your insurance company.
What do we do as part of an articulation screening? We typically play and talk with your child so that we may observe the following:
- How your child produces speech during normal conversation and play
- How your child’s mouth is functioning during the speech process, being careful to note any physical impediments to producing normal speech
- Make decisions as to whether or not your child is a good candidate for therapy or should wait until older
Articulation full assessment only; with oral-motor exam, formal report & review: $325 Includes the following: Review of records and previous reports, administration of informal and formal articulation measures, oral-motor exam; written report (typically about 2-3 pages) including recommended goals and therapy techniques. The reports are generally necessary for insurance reimbursement. (FYI If your child has difficulties with articulation as well as language, you will want to schedule a comprehensive speech-language assessment instead, which would also include articulation/oral-motor exam. See #5-7 below.) $275 without report.
What do we do? We typically administer the following 2 tests:
- Goldman-Fristoe Test of Articulation (assesses speech sound errors in words and sentences)
- Hamaguchi Oral-Motor Assessment (assesses the physical strength and movement of the oral muscles needed for speech)
We also:
- Observe your child’s speech in a variety of contexts
- Note and observe your child’s intonation
- Rate of speech production
- Breath support
- Ability to chew, swallow and drink correctly
- The movement of the oral muscles both during speech and at rest
- Physical features (enlarged adenoids, restricted frenulum, dental issues) that may impede normal speech
- Look for the presence of interfering hypo or hyper oral sensory issues that are present.
The other purpose of the assessment is to determine what type of speech disorder your child is demonstrating (e.g. Apraxia? Phonological processing? Developmental? Oral-motor weakness?) and develop an appropriate treatment plan for that specific speech disorder. Many times the specific diagnosis is associated with related learning or sensory delays and we will share important information about the nature of the disorder with the parent, as well as any suggestions for the parent to help the child at home.
Articulation Assessment for ages 5 and up that include additional phonological awareness assessment or hearing screening if needed: $450
For Toddlers & Preschool-Age Children
About Our Assessment
Comprehensive assessment for speech delays for children birth- 2 years: $900
Children ages 3 years-4 years 11 months $1200/$1375 with articulation assessment (due to longer/additional tests)
Includes the following: review of previous records and patient history, meeting with the child for approximately 2 hours (3 hours maximum) total over the course of about 3-4 sessions for 45 minutes or so each; administration of informal and formal tests (if the child is capable); scoring and interpretation of reports, speaking with outside professionals who work with the child if requested to a maximum of 30 minutes total; written report (typically 7--10 pages) including recommended goals and course of treatment; 45-minute review of report with parent(s).
What do we do? We use toys and “play” to observe your child’s skills in the following areas:
- How and when does the child vocalize?
- What kinds of sounds or words is the child producing and under what circumstances?
- Is the child using other means to communicate, such as signing or gesturing?
- Is there inflection to indicate differences between commenting and asking?
- What is the child’s articulation pattern?
- Are there issues that may suggest a more global delay or autism spectrum disorder?
- How is the child’s attention span and play behaviors?
- Does the child understand what is said? Can he point to things?
- Does the child have oral weaknesses, physical impediments or difficulty with motor planning that may be inhibiting speech development? (Usually done with the Hamaguchi Oral Motor Assessment if the child is cooperative)
- How does the child interact with the parent and the examiner?
When possible, we do like to attempt some formal testing measures as well, once the child is more comfortable with the environment. We select the tests based on the child’s needs and skill level, but these are a few of the tests we use with this age group: Preschool Language Scale-5 (“PLS”) Goldman-Fristoe Test of Articulation 2, Peabody Picture Vocabulary Test-4, Expressive One-Word Picture Vocabulary Test -2, REEL-5, Clinical Evaluation of Language Fundamentals-Preschool (CELF-P).
Birth-Age 5: Comprehensive Assessment with Bilingual Input (Mandarin/Cantonese/only) - $1500
What kind of information are we looking for when testing young children?
- Vocabulary development
- Comprehension of language at the word, sentence and story level; Can the child point to objects or pictures? Attend to an adult? For how long?
- Use of language: How is the child using language and when? Phrases or sentences? Does the child use age-expected grammar?
- Articulation
- If indicated, an oral-motor assessment (for articulation disorders)
- Voice & Fluency screen
- Pragmatic (social language use) including eye contact, initiation, reciprocal communication and joint attention
- Play and interactive skills
For children with significant cognitive and communication deficits:
- Use of signs, gestures or alternative communication modality
Some tests that we select from include: The Peabody Picture Vocabulary Test, The Expressive One Word Picture Vocabulary Test, The Preschool Language Scale-5, the Goldman Fristoe Test of Articulation 2, The Hamaguchi Oral-Motor Assessment. In addition, we supplement our findings with informal activities to see how the child functions in a more naturalist context. These include conversational samples and participating in a play activities.
Augmentative and Assistive Communication System Assessments
About Our Assessment
How much are AAC assessments at your practice and what does that include?
The fee for the assessment is $800. The cost of the app can be added so that it can be included in the assessment fee and eligible for insurance reimbursement, which would range from $200-300, depending on the app that is selected (assuming one is) making the total $1000-1100 if it is rolled into the assessment fee. When combined with a comprehensive speech-language assessment, the total is $2200
An assessment for an AAC system includes the following:
- Intake/initial discussion about how AAC might benefit the child, what you want from an AAC system for your child, etc.
- Input from the child’s teacher and/or school SLP
- The Communication Matrix – a questionnaire that allows us to get an understanding as to how and why your child is currently communicating
- The SETT Framework (takes into account the student’s current strengths and needs, the environment in which the child would be using the device, the tasks in which a child would benefit from having the device and thinking of vocabulary needed, and the tools available to the child – deciding what device would be best for the child.)
- Collaboration with other professionals who will be heltful with carryover when using the device
- A standardized assessment to figure out what device may be best for the child as well as feature-matching
- Initial acclimation with the child to see how the child responds to various configurations/apps
- Initial programming of the device for the first group of core and fringe words
- Orientation session with the parent and child on the device, up to 45 minutes
- A written report and review that can be shared with the school or insurance company
For Elementary Age Children
Q & A's
Answers to Questions You May Have About the Assessment Process
Q. What if my child screams and cries and won’t do anything the speech pathologist asks him to do?
A. Although rare, this does occasionally happen. We do attempt to establish a rapport with your child and make her comfortable. Usually by the second or third session, the child is more comfortable and less apprehensive about the sessions. Sometimes the child needs a “snack break” to break up the sessions and regroup. However, there are times where a child is simply inconsolable. As stated in the previous section, there is a “maximum” number of hours of scheduled direct time with your child that is included with the assessment fee. All scheduled sessions are counted in this total, regardless of your child’s level of cooperation or speed in responding. We may decide to simply do more informal kinds of assessment early on and save the formal assessment process until your child has settled into the routine and developed a rapport with the therapist. In addition, this might also signal that your child is not ready for the kind of adult-directed therapy that we do, and so we may consider referring out to other professionals for alternative kinds of intervention.
Q. What if I need to cancel the assessment after I have started the process?
A. Again, this is extremely rare but occasionally parents have family emergencies, unexpected job transfers, or simply decide their child is too fussy to continue. In these cases, you will be charged for the scheduled assessment time up to that point at our usual therapy rate ($216 an hour) and no report will be provided, if we are given at least three days’ notice before the upcoming appointment.
Q. What if I plan to apply for insurance reimbursement?
A. If you plan to seek reimbursement from your health insurance company for an evaluation, you usually must have a written referral from your child’s primary physician before the evaluation. Please be aware that we are not affiliated with any HMO or PPO groups, although many clients receive out-of-network PPO reimbursement or use their company's HSA. Please read our flyer, “If You Intend to Seek Insurance Reimbursement” form.
Q. What if my child is developmentally functioning on a much younger level and is age 5? I don't think he will be able to do all that testing.
A. If your child is not able to participate in the typical assessment process, we do consider this on a case-by-case basis. In some situations, if the child is performing at a much younger age we will consider dropping the fee to be comparable to the testing we do for younger child as the sessions will be fewer and shorter.