The assessments we ask for, and the diagnoses we work with

Almost every conversation with parents opens with the same question: what should we bring? This page answers it in advance — so that you do not gather paperwork at random, do not do more than is needed, and do not spend months on assessments that will not change the program of sessions.

One reassurance first: having no assessments is not a reason to postpone the consultation. Some of them are ordered as a result of it. But there are things worth knowing before sessions begin, because without them speech work can run empty for months.

The basic set: needed in almost every case

These four come up in practically every referral, whatever is written in the child's file.

Assessment	Why it is needed	When it matters most
Hearing, objectively otoacoustic emission, ABR if in doubt	Hearing loss produces a picture indistinguishable from alalia and from autism: the child does not respond, speech goes past them. Until hearing is tested, nothing can be concluded about speech at all.	Always. Especially after repeated ear infections, and if the child seems "not to hear".
EEG with a sleep recording where needed	Epileptic activity gets in the way of any work until it is accounted for — and it often runs without seizures, showing only as brief absences.	If speech was there and was lost, if there are staring spells, night seizures, loss of skills.
Neurological examination	Muscle tone, reflexes, the pace of motor development, seizure threshold — what determines the load a child can take.	Always.
Speech pathologist's assessment	Comprehension of speech, play, communication and oral praxis. This is what separates a delay from alalia, and alalia from autism spectrum disorders.	Always. This is the part we do ourselves at the consultation.

We will also ask for something no test contains — the history. The course of the pregnancy, the delivery, the Apgar score, weight and term, the first day of life, infections and injuries. The maternity discharge summary and the records of the first year explain the picture more often than any single investigation.

What is added for particular diagnoses

Beyond the basic set, the list diverges. Below is what we ask for in addition and, more importantly, why — an assessment whose purpose is unclear usually never gets done.

Diagnosis or complaint	What we ask for in addition	Why
Alalia	Objective hearing test; EEG if speech was there and was lost	Sensory alalia and hearing loss look the same from outside. The whole program depends on which form it is.
Speech development delay, general speech underdevelopment	Hearing, neurologist, speech pathologist's report	Underdevelopment is a consequence, not a cause. The point is to find out what it is a consequence of.
Dysarthria	Neurological examination, assessment of oral praxis	The form of dysarthria is established neurologically, and it determines where to start.
Autism spectrum disorders, autism	EEG including sleep; genetic testing; hearing	Epileptic activity is present in a noticeable share of children on the spectrum. Part of what reads as "autistic" behaviour is a child who does not hear or does not understand speech.
ADHD	Sleep (including snoring and apnoea), hearing, iron, thyroid hormones, EEG	Sleep deprivation, mild hearing loss, iron deficiency, hypothyroidism and absence seizures all masquerade as inattention. They often account for half the picture.
Down syndrome	Hearing on a regular basis, thyroid, heart, vision, cervical spine, sleep	These affect development more than any amount of therapy: without them in order, sessions do not work.
Chromosomal disorders	The geneticist's report, naming the test used and the result	What matters to us is not that "there is a syndrome" but which one, and what it means for speech and learning.
Cerebral palsy	Neurologist, cranial ultrasound or MRI, the form and the GMFCS level if it has been assigned	Speech in cerebral palsy is a separate task, and the approach depends on the form and on muscle tone.
Organic CNS damage (G93.9, G93.4)	Cranial ultrasound or MRI, EEG, hearing and vision, genetics where indicated	Anything at all can sit behind that entry. Clarifying it takes several sources — no single one gives the picture.

The diagnoses we work with

We work with a child, not with a diagnosis: two children with the same entry in their files get different programs. Still, here is what people most often come to us with:

• Alalia — motor, sensory, mixed
• Speech development delay
• General speech underdevelopment, at every level
• Dysarthria, including mild forms
• Early childhood autism and autism spectrum disorders
• ADHD — attention deficit hyperactivity disorder
• Down syndrome
• Chromosomal and genetic disorders
• Cerebral palsy
• Organic CNS damage and the consequences of perinatal injury
• Developmental delay with no established diagnosis

There is another side to this, and it is fairer to say it plainly. We do not treat epilepsy, we do not adjust hormones, we do not operate, and we do not replace a neurologist, a geneticist or an audiologist. Our part of the work is speech, comprehension, attention and the ability to learn. Everything else has to be under the care of the relevant doctors, or our work will not produce a result.

If there are no assessments at all

The order of steps that saves the most time:

• Book the consultation straight away — the waiting list usually runs a month or two ahead, and that is exactly the time the assessments take;
• use that time for hearing — it is quick, inexpensive, and more often than not it changes the picture more than anything else;
• film the child to our instructions if the consultation is remote — how to do it is described on the remote assessment page;
• gather what you already have, even if it looks old or beside the point: discharge summaries, reports, EEG recordings, scans;
• leave the rest until after the consultation. The list will be shorter and more precise than anything assembled in advance.

Document review at a distance

For families outside Ukraine, reviewing the documents you send is a separate remote service: Interpretation of test results and recommendations. Its price is listed in the price table. For those living in Ukraine there is no separate service — documents are gone through as part of the consultation.

What the review covers:

• what in your reports matters for speech work and what has no bearing on it;
• what is missing from the set and what is worth investigating further — with the reason for each;
• what needs to be brought under a specialist's care before sessions begin;
• whether any of our programs suits the child, and in what order to proceed.

What to send: reports and discharge summaries (photographs are fine as long as the text is legible), EEG and hearing test protocols, scans and the reports that go with them, and the genetic report if there is one. You can send documents via Viber, Telegram or WhatsApp to +38 (050) 738-78-58, or, if the files are large, upload them to our server.

Frequently asked questions

Do we have to complete every assessment before the consultation?

No, and there is no reason to postpone the consultation because of it — some of these assessments are ordered as a result of it. There is one exception: hearing. Until we know how the child hears, any conclusion about speech rests on sand, and sessions can run empty for months. If you only manage one item on this list, make it an objective hearing test.

Why is "turns towards a sound" not a hearing test?

Because a child turns towards a clap, a vibration in the floor, a movement of air, and the fact that a parent has left the room. None of these tells you whether the child hears quiet speech in the frequency range that words are made of. That needs an objective method: otoacoustic emission, and if there is any doubt, ABR. Neither hurts, and neither requires the child to cooperate.

Our child will not sit still for an EEG. What now?

This comes up constantly, and it has a solution: the EEG is recorded during sleep, daytime or night. In fact, where epileptic activity is suspected, a sleep recording tells you more than a waking one — some changes only show up in sleep. If you were turned away because "the child will not sit", look for a center that records sleep EEG.

Do you make a diagnosis from the documents we send?

No. A diagnosis is made by a doctor, in person, not from paperwork at a distance. What we do is different: we look at what in your reports stands in the way of starting speech work, what is missing from them, what is worth clarifying and in what order. It is a review of documents, not a diagnosis, and not a substitute for an examination.

How is a document review different from an online consultation?

A document review is work with paperwork: reports, test recordings, discharge summaries. An online consultation is work with the child: we watch video filmed to our instructions and talk to the parents over a video call. Neither replaces the other, and most often they go together.

See also

• Prices and payment methods
• Remote assessment and online consultation
• Child development milestones by age: markers and red flags
• Contacts and booking

This material was prepared by the specialists of the Vlada Tarasenko Speech Restoration Centers. This material is for information only and does not replace an in-person consultation with a doctor or a speech pathologist. Only a doctor can make a diagnosis.