Speech and language therapy assessment for dysorthographia

The speech and language therapy assessment is the key step in finding out whether your child has dysorthographia. It is the assessment that makes the diagnosis, specifies the child’s profile and opens the way to remedial therapy and school adjustments. Here is how to obtain it, how it unfolds and what you will concretely take away from it. You will also learn how to prepare your child so that everything goes as smoothly as possible.

What the speech and language therapy assessment is for

The speech and language therapy assessment answers a simple question: are your child’s spelling difficulties due to a disorder, or to something else? The speech and language therapist compares their results with those of children of the same age and school year. It is not about judging your child, but about understanding precisely how they function.

If it is indeed dysorthographia, the assessment specifies its form: difficulty with sounds, with word memory, with grammar, or a mixture of all three. It also identifies strengths on which remedial therapy can build. This information is valuable for tailoring the therapy to your child’s profile, rather than applying a single method. The assessment also serves to reassure: putting a name to the difficulties often helps the whole family move forward.

Finally, the assessment report serves as the basis for what comes next: setting up a PAP at school, a possible MDPH file, and of course the remedial therapy plan. It is therefore an important document, to be kept and passed on to the right contacts.

How to obtain an assessment

The speech and language therapy assessment is carried out on medical prescription. Your GP, your child’s paediatrician or the school doctor can write it, usually with the wording « speech and language therapy assessment with remedial therapy if necessary ». Explain the difficulties you have observed to the doctor, with examples, so that they understand the situation.

With this prescription, you contact a speech and language therapist. Waiting times are often long, from several weeks to several months depending on the region. Do not hesitate to register on several waiting lists and to ask whether any cancellations are likely. Some practices offer an initial phone call to assess how urgent the request is. Keep a copy of the prescription, as you will be asked for it at the first appointment and for reimbursement.

To find a professional near you, consult the ProfessionnelsDys directory. The school doctor or the teacher also often know the professionals in the area. See also waiting times for an assessment.

How the assessment proceeds

The assessment begins with an interview with you. The speech and language therapist asks about your child’s development, schooling, difficulties, habits and any family history. Remember to bring exercise books and school reports. This information helps the therapist interpret the results and choose the tests.

Next come the tests with the child, presented as small exercises or games. They usually last between one and two hours, sometimes split over two sessions to avoid tiredness. The child is put at ease: there are no right or wrong marks, only observations. Some therapists also offer a questionnaire to complete in advance, to save time on the day of the assessment.

You do not always attend the whole session. This is normal: your child concentrates better on their own. Where possible, avoid scheduling the assessment after a long school day, when your child is tired. To prepare them well for it, read preparing your child for the assessment.

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The tests used

For spelling, the speech and language therapist has the child write words and sentences from dictation: regular words, irregular words and invented words, which show how the child transcribes sounds. They also analyse grammar in sentences and sometimes in a short text. The analysis looks not only at the number of errors, but also at their type.

The assessment also evaluates reading, as dysorthographia and dyslexia often go together. It tests phonological awareness, that is, the ability to manipulate sounds, as well as working memory and oral language. These skills are often linked to spelling difficulties and guide the remedial therapy. Errors are classified by type, which makes it possible to see whether the child mainly struggles with sounds, with word memory or with grammar.

These tests are standardised: the results are compared with those of a large number of children of the same age. This is what makes it possible to say whether the difficulties are truly outside the norm for their age. More details in the tests used in the assessment.

The assessment report

A few days or weeks later, the speech and language therapist gives you a written report and sends it to the prescribing doctor. It presents the results of each test, an analysis of the errors and a conclusion. It often includes graphs or tables, which place your child in relation to the average.

The conclusion states whether there is a disorder, its form and its severity, using either the term dysorthographia or the term specific disorder of written language. It specifies whether remedial therapy is needed and at what frequency. It may also recommend further assessments if an associated disorder is suspected. It also indicates whether school adjustments are recommended, which then makes the steps with the school easier.

The vocabulary is sometimes technical. Do not hesitate to ask for a feedback appointment to put your questions to the therapist. It is an opportunity to fully understand the situation and the next steps. See understanding the report.

Reimbursement and cost

The speech and language therapy assessment is covered by the Assurance maladie (national health insurance) at 60% of the agreed fee, the remainder usually being covered by the mutuelle (supplementary health insurance). Most speech and language therapists are contracted and do not charge excess fees. The amount you pay out of pocket is therefore often nil or low, depending on your contract.

The fee depends on the type of assessment provided for under the fee schedule. Your speech and language therapist can tell you the exact amount before the appointment. It varies depending on whether the assessment covers only written language or several areas. If in doubt, ask for an estimate when booking the appointment.

If the speech and language therapist requests other assessments (neuropsychological, occupational therapy), these are not always reimbursed. Check with your mutuelle. If your child receives the AEEH (disability allowance for children), these costs may be partly covered. See the cost of an assessment.

What happens after the assessment

If dysorthographia is confirmed, remedial therapy can begin, often with the same speech and language therapist. It usually takes place once or twice a week, in sessions of about 30 to 45 minutes. Regular sessions are important for the therapy to bear fruit.

Pass the report on to the school, or at the very least its conclusion. It makes it possible to request a PAP (individualised support plan), with adjustments suited to the classroom and to assessments. You are not obliged to pass on the whole report: the conclusion is often sufficient. Keep in touch with the doctor who prescribed the assessment; they remain a useful contact for coordinating follow-up.

Follow-up assessments are carried out regularly to measure progress and adjust the remedial therapy. These assessments also make it possible to decide, when the time comes, to end the course of therapy. All the stages are detailed in after the diagnosis: the stages.

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Questions that keep coming up

How long a speech and language therapy assessment lasts ?

Allow between one and two hours for the tests, sometimes over two sessions, plus the time for the interview with the parents. Writing the report then takes a few days to a few weeks. Plan for a calm moment, when your child is not tired.

Is a prescription needed for a speech and language therapy assessment ?

Yes, for it to be reimbursed. Your GP, the paediatrician or the school doctor can prescribe a speech and language therapy assessment, usually with the wording « with remedial therapy if necessary ». Without a prescription, the assessment is still possible but it will not be reimbursed.

At what age should an assessment for dysorthographia be done ?

Most often from CE1 or CE2 (Years 2 or 3), when spelling becomes a real school expectation. An earlier assessment is possible if the difficulties are significant, particularly to identify an associated dyslexia. Do not wait too long either: waiting times are often long.