10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-10

Why do speech therapists use standardized tests at all?

A standardized test has one job. It compares your child to a large, representative group of same-age children using the same procedures, materials, and scoring rules every time. Without that comparison, a clinician can say "your two-year-old seems quiet" but can't say "your two-year-old's expressive vocabulary is at the 5th percentile for age 24 months." That specificity is what triggers eligibility for services.

The American Speech-Language-Hearing Association requires SLPs to use at least two assessment procedures for any diagnostic evaluation, and at least one has to be a validated standardized measure ^[1]. That's more than professional habit. It guards against clinician bias, and it hands you, the parent, something concrete to question, compare, and revisit at re-evaluation.

Standardized scores also travel. If your family moves from Ohio to California, a standard score from a PLS-5 means the same thing to an SLP in Sacramento that it meant to the one in Columbus. That portability matters for continuity of care.

One honest caveat: no single test captures everything. Standardized scores are one input. A good SLP pairs them with informal observation, parent interview, and language sample analysis. The tests tell you where a child lands statistically. The rest of the picture tells you why.

What are the most commonly used speech and language tests for toddlers?

Here's the honest answer: there's no single mandated list. SLPs pick tests based on the child's age, the referral concern, and which normed tools their clinic or district has already paid for. Still, a fairly consistent set of instruments shows up across private practice, early intervention, and hospital settings.

For a 12 to 36 month old with a speech delay referral, the most likely combination you'll see is the PLS-5 plus the MacArthur-Bates CDI, sometimes with the Bayley-4 language subscales if there's a broader developmental question on the table ^[2][3][5].

For a two-year-old where the worry is clarity of speech more than vocabulary size, an SLP might add the GFTA-3 or a similar articulation test. Those tests need a child who can imitate words on demand, which many toddlers won't do on a first visit with a stranger ^[4].

What does the Preschool Language Scales (PLS-5) actually test?

The PLS-5 is probably the single most widely used speech-language test for toddlers in the United States ^[2]. It covers birth through age 7 years, 11 months, so the same tool can assess a 10-month-old who isn't babbling and a 5-year-old with unclear sentences.

The test has two subscales. The Auditory Comprehension subscale asks: does the child understand what's said to them? For a one-year-old, that might be responding to their name or following a one-step command. For a three-year-old, it might be identifying objects by function or understanding basic concepts like "on top of" versus "beside."

The Expressive Communication subscale asks: what is the child producing? Gesture, vocalization, single words, two-word combinations, and eventually sentences all get tracked developmentally.

Each subscale produces a standard score (mean 100, standard deviation 15), a percentile rank, and an age equivalent. Most early intervention programs in the US use a standard score of 77 or below (more than 1.5 standard deviations under the mean) as an eligibility threshold, though the exact cutoff varies by state ^[6]. Some states use 1 standard deviation below (a score under 85), especially for children under age 3.

The PLS-5 was normed on 1,400 children across the US in a sample built to match 2010 US Census demographics ^[2]. That's a reasonable norm sample. Still, SLPs working with children from non-mainstream American English backgrounds should read those age equivalents carefully.

What is the Bayley-4, and when do SLPs use it?

The Bayley Scales of Infant and Toddler Development, 4th Edition (Bayley-4) is a broad developmental assessment, not a speech test specifically ^[3]. Psychologists and developmental pediatricians use it as often as SLPs do. Because language is one of its five domains, SLPs sometimes give the language subtests when a broader developmental picture is needed, or when the referring physician wants to rule out global developmental delay alongside a speech concern.

The Bayley-4 language domain has a receptive communication subscale and an expressive communication subscale. For a 14-month-old who isn't pointing or waving, those subscales can say a lot. The test was updated in 2019 and normed on 1,000 children from 16 days to 42 months ^[3].

A practical note: the full Bayley-4 takes 50 to 90 minutes to administer. Most SLPs running a focused speech-language evaluation will reach for the PLS-5 or REEL-4 instead and let the developmental pediatrician handle the Bayley if a full cognitive picture is needed. If your child's evaluation includes the Bayley-4, the team is usually looking at more than speech alone.

What is the MacArthur-Bates CDI, and why is it different from the other tests?

The MacArthur-Bates Communicative Development Inventories are parent-report checklists, not clinician-administered tests ^[5]. That difference is significant. Instead of watching your child perform tasks with a stranger in a clinic room, the CDI asks you to mark which words from a long list your child understands or says at home.

For toddlers, this is often the most realistic data available. A child's best language rarely shows up in a 45-minute clinic visit with an unfamiliar adult. The CDI captures what parents see across weeks and months.

There are two main forms: Words and Gestures (8 to 18 months) and Words and Sentences (16 to 30 months). Each has published norms. A child whose expressive vocabulary falls below the 10th percentile on the CDI Words and Sentences form at 24 months is a textbook late talker flag ^[5].

The CDI is free for research and clinical use through the project's website ^[5]. That's unusual in a field where most standardized tests cost hundreds of dollars. Some SLPs use it as a screening tool before a full evaluation. Others run it alongside the PLS-5 to triangulate what the formal test may have missed because the child was nervous or refused items.

One limitation: CDI scores depend on parent perception and memory. Parents sometimes over-report or under-report, particularly first-time parents who aren't sure what words "count" (approximations, consistent use, and so on). A skilled SLP will probe your answers.

How is speech sound production tested in toddlers?

For most children under age 3, formal articulation testing is limited. The GFTA-3 (Goldman-Fristoe Test of Articulation, 3rd Edition) is the standard for articulation assessment in English and covers ages 2;0 through 21;11 ^[4]. It asks the child to name or imitate pictures, which many two-year-olds won't do reliably with a stranger.

What SLPs more often do with toddlers is take a speech sample, either from spontaneous play or picture naming, and analyze it against developmental norms. By age 2, most children are expected to produce p, b, m, n, d, t, h, and w correctly ^[7]. By age 3, k, g, f, and y are added. The GFTA-3 gives standard scores, percentile ranks, and a sound-by-sound error breakdown ^[4].

For children where childhood apraxia of speech is suspected, the GFTA-3 alone isn't enough. Apraxia needs specialized assessment including syllable sequencing tasks. You can read more about that distinction in the article on childhood apraxia of speech.

If your child is under 2;6 and the concern is overall clarity rather than specific sound errors, the SLP may skip formal articulation testing entirely at the first evaluation and instead calculate a percentage of intelligible utterances from a play-based language sample.

What do speech therapy test scores actually mean for parents?

Most standardized speech-language tests produce three kinds of scores, and they can feel confusing when nobody explains them.

Standard scores compare your child to the norm sample. The average is 100, and one standard deviation is 15 points in each direction. A score of 85 puts a child at the 16th percentile, which some states treat as the eligibility cutoff. A score of 70 puts a child at the 2nd percentile, two standard deviations below the mean, which meets eligibility criteria in nearly every US state.

Percentile ranks tell you what percent of same-age children scored lower. The 25th percentile means 75% of age-matched peers scored higher. Parents often find percentiles easier to grasp than standard scores.

Age equivalents are the tricky one. An age equivalent of "18 months" for a 30-month-old sounds alarming and precise, but age equivalents carry large measurement error and can mislead. ASHA and most test publishers warn against using age equivalents as the main basis for eligibility decisions ^[1]. The standard score and percentile are steadier anchors.

One thing worth knowing: a score that doesn't qualify for services today doesn't mean nothing is going on. A child who scores at the 15th percentile now but sat at the 50th percentile six months ago shows a trajectory that matters even if today's number clears the cutoff. Ask the SLP about score change over time, more than the current snapshot.

How does testing connect to early intervention eligibility?

In the United States, children under age 3 can get free speech therapy through Part C of the Individuals with Disabilities Education Act (IDEA) ^[6]. Each state runs its own early intervention program and sets its own eligibility criteria, but they all use standardized test scores as one piece of evidence.

IDEA Part C makes children eligible if they have a "diagnosed physical or mental condition that has a high probability of resulting in developmental delay" or if they show a "measurable developmental delay" as defined by the state ^[6]. That measurable delay is typically documented with a standardized score.

Most states require a delay of at least 25% (roughly 1.5 standard deviations) in one or more developmental areas. Some require delays in two or more areas. A few states use a more generous 20% threshold. The CDC's Act Early initiative keeps a state-by-state eligibility guide worth checking for your specific state ^[8].

For children ages 3 to 5, services move to Part B of IDEA, run through the public school system. Eligibility at that age usually needs either an educational disability category (like "speech-language impairment") or documented developmental delay, again backed by standardized scores ^[6].

If you're just starting this process, the article on early intervention has a plain-language walkthrough of how to request an evaluation.

Are there screening tools that come before the full standardized tests?

Yes, and they're worth knowing about because screening usually happens before a formal SLP evaluation.

Pediatricians are supposed to do developmental surveillance at every well-child visit and standardized developmental screening at 9, 18, and 30 months, per American Academy of Pediatrics guidelines ^[9]. The most common screener in primary care is the M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up) at 18 and 24 months, which flags autism-related communication concerns specifically ^[10].

Other screeners SLPs or early interventionists use before the full diagnostic battery include the Ages and Stages Questionnaire (ASQ-3), the Communication and Symbolic Behavior Scales (CSBS-DP), and the PEDS (Parents' Evaluation of Developmental Status). These produce pass, monitor, or refer results, not standard scores. They aren't diagnostic.

If a screening says "refer," the next step is a full evaluation using the standardized tests described above. Screening results by themselves don't decide eligibility. A child can fail a screening and then score within normal limits on formal testing, or pass a screening and still show clinically significant differences on a full evaluation.

How is testing different for bilingual or multilingual toddlers?

This is one of the most consistently mishandled areas in pediatric speech-language assessment, and it matters a lot.

All the major tests described here were normed mainly on English-speaking children. Using English-only scores to evaluate a child who hears two languages at home will systematically underestimate their total language knowledge. A two-year-old who knows the word for "dog" in Spanish but not in English is not language delayed. An English-only test marks that as a missing word.

ASHA is clear that bilingual children should be assessed in both languages whenever possible, using clinicians or trained interpreters with real competence in the language ^[1]. A vocabulary score should ideally reflect total conceptual vocabulary across both languages, more than English.

For Spanish-English children, there are Spanish-normed alternatives to some major tests. The Preschool Language Scale, 5th Edition Spanish (PLS-5 Spanish) has its own Spanish norms, not a translation of the English norms ^[2]. That distinction matters enormously.

If your child is being evaluated by an SLP who speaks only English and your child's primary home language is not English, you have the right to request a bilingual evaluation or to have a trained interpreter present. Under IDEA, evaluations must be conducted in the child's native language or other mode of communication ^[6].

What happens after the standardized tests are done?

The SLP writes an evaluation report pulling together test scores, observations, language sample analysis, and parent interview findings. That report should explain each score in plain language, more than list numbers.

If the scores and clinical judgment support a diagnosis or eligibility finding, the report recommends a course of action. For children under 3, that usually means referral to early intervention for an IFSP (Individualized Family Service Plan). For children 3 to 5, it means an IEP (Individualized Education Program) through the school district ^[6].

Re-evaluation typically happens every 1 to 3 years for children receiving services, or whenever there's a significant change in how a child presents. Scores from the same test aren't directly comparable across editions (PLS-4 and PLS-5 use different norms, for example), so the SLP should note which edition was used every time.

Wondering what home practice looks like between therapy sessions? Some families find structured daily language routines help reinforce what the SLP is working on in clinic. Apps like Little Words use evidence-based prompting strategies to help parents build those routines around a child's actual current level, based on the kind of profile a standardized evaluation produces.

The article on speech therapy covers what to expect in the therapy itself once the evaluation is done.

How much does a speech-language evaluation cost, and who pays?

Cost swings widely by setting.

For children under age 3, a Part C early intervention evaluation must be provided at no cost to the family under federal law, regardless of income or insurance ^[6]. That's the law, not a program perk. If someone tells you there's a fee for an EI evaluation, push back or contact your state's lead agency.

For school-age children (3 and older) with educational eligibility, evaluations through the public school are also free under IDEA Part B ^[6].

Private SLP evaluations outside the school system usually run $200 to $600, though prices in major metro areas and specialized practices can climb higher. Some private evaluations, especially from hospital outpatient clinics, are covered by health insurance. The Affordable Care Act requires pediatric oral health and habilitative services to be included as essential health benefits in many marketplace plans, though coverage for speech evaluations varies by state and plan ^[11].

Medicaid covers speech-language evaluations and treatment for children who qualify. The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit under Medicaid requires coverage of medically necessary speech-language services for children under 21 ^[12].

If your child receives autism services through insurance, the autism spectrum speech therapy article covers how that pathway works separately.

Frequently asked questions

At what age can a speech-language pathologist start using standardized tests?

Several standardized tools cover children from birth, including the PLS-5 (birth to 7;11) and the Bayley-4 (16 days to 42 months). For very young infants, parent-report tools like the MacArthur-Bates CDI Words and Gestures form (8 to 18 months) are most practical. Formal testing with direct child interaction becomes more feasible and reliable around 12 to 18 months, when children start responding to structured prompts.

Can my child fail a speech test?

There's no pass or fail in standardized speech testing. Tests produce scores that describe where a child lands relative to age peers. A low score isn't failure. It's information that helps determine whether a child needs support. What matters is whether the scores, combined with clinical observation, point to a delay significant enough to affect development or qualify for services under IDEA.

What's the difference between a speech delay and a language delay, and do the tests measure them separately?

Speech is the physical production of sounds. A speech delay means sounds are unclear or missing. Language is understanding and using words, grammar, and meaning. The GFTA-3 measures speech (articulation). The PLS-5 and REEL-4 measure language (comprehension and expression). A child can have one without the other, which is why a full evaluation usually includes tests from both domains.

How long does a speech-language evaluation for a toddler take?

Most toddler evaluations take 60 to 90 minutes, sometimes split across two visits if the child tires quickly or won't cooperate. That time covers the parent interview, standardized testing, informal observation, and a language sample. A full written report usually follows within 5 to 10 business days, though timelines vary by setting.

Can I request specific tests, or does the SLP decide?

The SLP picks the assessment battery based on clinical judgment, the referral question, and what tools the practice has. You can ask why specific tests were chosen and whether tests in your child's home language are available. Under IDEA, you also have the right to request an Independent Educational Evaluation (IEE) at public expense if you disagree with the school district's evaluation.

What if my toddler refuses to do the test tasks?

This is common, and good SLPs expect it. If a child won't complete enough items for a valid standard score, the SLP notes an "invalid" or "unable to obtain" result and leans more on parent report, observation, and informal sampling. An uncooperative child is not a failed evaluation. The clinician may also recommend a second session when the child is rested and more familiar with the room.

Do standardized tests work the same way for autistic toddlers?

Standard scores from normed tests still get used, but interpretation needs more care. Autistic children may have scattered skill profiles where receptive and expressive scores diverge sharply, or where the motor demands of a task hide actual language knowledge. SLPs should add autism-specific communication assessments and avoid assuming a low score means a child understands nothing. The article on autism spectrum speech therapy covers this in more depth.

How often should a toddler be re-tested?

Under IDEA, children in early intervention are typically re-evaluated before transitioning to preschool services at age 3, then on a schedule set by the IEP team, usually every 3 years unless parents or the team request more frequent evaluation. Clinically, if there's a significant change in a child's communication, a re-evaluation can be requested at any time regardless of the standard schedule.

What's an age equivalent score, and should I trust it?

An age equivalent says your child performed like a typical child of a given age. A 30-month-old with an age equivalent of 18 months sounds precise, but age equivalents carry wide measurement error, and ASHA specifically discourages using them as the main basis for eligibility decisions. Standard scores and percentile ranks are more stable and should be the main numbers you discuss with the SLP.

Are there tests that specifically screen for childhood apraxia of speech?

The GFTA-3 can spot articulation errors but wasn't designed to diagnose apraxia. Tools built for apraxia screening in young children include the Kaufman Speech Praxis Test (KSPT) and the DIVA (Dynamic Indices of Vowel Accuracy). Formal apraxia diagnosis needs a skilled clinical exam of motor speech patterns, not a single test score. See the article on childhood apraxia of speech for details on that process.

What is the M-CHAT, and is it a speech test?

The M-CHAT-R/F (Modified Checklist for Autism in Toddlers) is a developmental screener for autism risk, not a speech test. It covers communication, social engagement, and play behaviors at 18 and 24 months. A positive result doesn't diagnose autism. It means the child should have a full evaluation. The American Academy of Pediatrics recommends it at those two well-child visits as part of routine developmental surveillance.

Can a preschool teacher or pediatrician administer these standardized speech tests?

No. Standardized speech-language tests must be administered and interpreted by a licensed speech-language pathologist. Pediatricians use developmental screeners (like the ASQ or M-CHAT) designed for non-specialist use. Teachers may complete rating scales as informants. But the standardized tests that produce the scores used for diagnosis and eligibility require an SLP with the specific training and scope of practice those tools demand.

What's the difference between a screening and a full evaluation?

A screening is brief (5 to 15 minutes) and produces a pass, monitor, or refer result. It identifies who needs a closer look. A full evaluation uses multiple standardized tests, parent interview, observation, and language sampling to build a detailed profile with standard scores. Screenings don't decide eligibility. Only a full evaluation can. If a screening flags a concern, the next step is always a full evaluation.

Sources

1. ASHA - Spoken Language Disorders: Assessment: ASHA requires SLPs to use at least two assessment procedures, including a validated standardized measure, for diagnostic evaluations; cautions against using age equivalents as primary basis for eligibility
2. Pearson - Preschool Language Scales 5th Edition (PLS-5): PLS-5 covers birth to 7;11, has two subscales (Auditory Comprehension and Expressive Communication), was normed on 1,400 children matched to 2010 US Census; Spanish edition has independent Spanish norms
3. Pearson - Bayley Scales of Infant and Toddler Development 4th Edition (Bayley-4): Bayley-4 updated in 2019, normed on 1,000 children from 16 days to 42 months, includes language domain with receptive and expressive subscales
4. Pearson - Goldman-Fristoe Test of Articulation 3rd Edition (GFTA-3): GFTA-3 is a standardized articulation test covering ages 2;0 to 21;11 that produces standard scores, percentile ranks, and sound-by-sound error analysis
5. MacArthur-Bates CDI Project: MacArthur-Bates CDI is a free parent-report vocabulary checklist normed for 8 to 37 months; a child below the 10th percentile on Words and Sentences at 24 months is a late talker flag
6. U.S. Department of Education - IDEA Part C and Part B: IDEA Part C provides free early intervention evaluations and services for children under 3 with developmental delay; Part B covers ages 3-5 through public schools; evaluations must be in the child's native language
7. ASHA - Speech Sound Development: By age 2, most children correctly produce p, b, m, n, d, t, h, and w; by age 3, k, g, f, and y are added
8. CDC - Learn the Signs Act Early: CDC Act Early provides state-by-state early intervention eligibility information and developmental milestone resources
9. American Academy of Pediatrics - Developmental Surveillance and Screening: AAP recommends standardized developmental screening at 9, 18, and 30 months during well-child visits; M-CHAT-R/F is recommended at 18 and 24 months
10. M-CHAT Research - Modified Checklist for Autism in Toddlers: M-CHAT-R/F is a validated autism screener for 16 to 30 months used in primary care settings; a positive screen indicates need for full evaluation, not a diagnosis
11. HealthCare.gov - Essential Health Benefits: ACA marketplace plans must cover pediatric oral health and habilitative services as essential health benefits; speech evaluation coverage varies by state and plan
12. CMS - Medicaid EPSDT: Medicaid EPSDT requires coverage of medically necessary speech-language evaluations and treatment for children under age 21