11/2023 We are currently completely booked for individual therapy services after 2pm. We have some limited availability for group therapy in the afternoons. Our waitlist for after 3pm individual services is closed for the 2023-2024 school year but we are taking requests for morning and early afternoon (1pm) individual therapy sessions.
We are able to assess most children via teletherapy OR in person at this time.
* Stuttering or Voice: We are not currently handling these cases, but will be happy to refer you to a local specialist who does.
* Feeding: While we do including feeding/drinking in our oral-motor screen, we do not do in-depth feeding assessments or therapy for feeding issues.
* Children over the age of 12
* Children with aggressive behaviors or who are resistant to adult-directed tasks
After you have filled out this document, please email to: firstname.lastname@example.org or mail to: Hamaguchi & Associates 20111 Stevens Creek Blvd, Suite 145, Cupertino, CA. 95014. Our fax number is (408) 366-1011.
Once we receive these documents, we will be in touch within one business day to discuss scheduling options with you.
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.
Articulation Screening: (pronouncing sounds) Informal, without a report for simple cases (only 1-2 sound errors) $216 This does not include a report. FYI: If you plan to seek insurance reimbursement, you will most likely need to have a full assessment (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:
Articulation full assessment only; with oral-motor exam, formal report & review: $432 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 below.)
What do we do? We typically administer the following 2 tests:
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: $650
Comprehensive assessment for speech delays for children birth- 2 years: $1200
Children ages 3 years-4 years 11 months $1500/$1800 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:
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?
For children with significant cognitive and communication deficits:
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.
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:
Comprehensive assessment for speech/language development for children ages 5 years to 6 years 11 months $1900 (with articulation or auditory processing is $2200)
Comprehensive assessment for speech/language development for children whose primary language is Mandarin (bilingual assessment English/Mandarin) is $3200
Ages 7 and up: $2100 (with auditory processing or articulation is $2500)
Our language assessment Includes the following: review of previous records and patient history, meeting with the child for approximately 4-5 hours total over the course of about 4-6 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 8-10 pages) including recommended goals and course of treatment; 45-minute review of report with parent(s).
What kind of information are we looking for?*
* Vocabulary development
* Language processing and attention to auditory stimuli (if we see issues we may recommend doing further auditory assessment)
* Sentence construction in a variety of contexts, including retelling a story, describing, explaining, and conversational skills
* Comprehension of language at the word, sentence and story level
* Word retrieval
* Attending behaviors
* If indicated, an oral-motor assessment or screening (for articulation disorders)
* Voice & Fluency screening
* Pragmatic (social language use) including eye contact, initiation, reciprocal communication and joint attention; inference; Play and interactive skills
For children with significant cognitive and communication deficits: Use of signs, gestures or alternative communication modality
If cognitively and developmentally age-appropriate: Use of language for higher order tasks, including interpreting humor, sarcasm, inferential language, written language, and an oral reading sample.
Some tests that we select from include: The RESCA-E (Receptive, Expressive & Social Communication Assessment-Elementary) the Goldman Fristoe Test of Articulation 2, The Hamaguchi Oral-Motor Assessment, The Rapid Naming Test, and the CASL-2 (selected subtests). In addition, we supplement our findings with informal activities to see how the child functions in a more naturalist context. These include: conversational samples, written language samples, oral reading, and participating in a play activity.
Comprehensive speech-language evaluation: $2100 (ages 7 and up) Reports tend to be lengthier, typically 13-15 pages. This assessment includes all of the areas above, as well as test batteries that examine auditory skills:
Some tests that we select in addition to those listed in the language section include: The Test of Auditory Processing Skills (TAPS-4) Test of Phonological Awareness, C-TOPP2 (Comprehensive Test of Phonological Processing 2) and Phonemic Synthesis Test. When we do in-person assessment, the fee is higher and we include the SCAN-C.The report includes recommended goals and course of treatment; 45-60 minute review of report with parent(s).
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.
Q. What if I have an assessment from another practice? Can I use that?
A. Yes. But we may decide together (parent and professional) that additional supplemental testing is required. This is billed at twice the pro-rated session fee for each day of testing, plus $324 for the report. So for 2 45-minute sessions, it would be $972. For 3 45-minute sessions, it would be $1296. For 4 testing sessions, the fee is $1620. If the testing requires additional time, we bill at the full assessment rates as above.