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Infant-Toddler Communication



Assessment is generally prompted by referral for concerns by pediatricians, caregivers, or other service providers. These concerns may be identified by failing a speech-language or hearing screening or when other evidence suggests that the infant's/toddler's ability to communicate is impaired, or likely to be impaired, because of identified biological or other developmental risks involving their body structure/function and/or activities/participation. An infant-toddler assessment is conducted to evaluate strengths and weaknesses of early communication interactions and prespeech-language functioning in infants and toddlers

They is conducted to identify and describe —

  • underlying strengths and weaknesses related to factors that affect communication performance such as play, prespeech, babbling, jargon, early words and sentences, and communicative intent;

  • effects of preschool communication impairments on the infant's/toddler's activities (capacity and performance in everyday communication contexts) and participation; such as day care and family/caretaker interaction;

  • contextual factors that serve as barriers to or facilitators of successful communication and participation for infants/toddlers with communication development risks.

An assessment may result in the following:

  • Diagnosis of a communication disorder or high risk of developmental difficulties.

  • Identification of a communication difference.

  • Clinical description of the characteristics of the current level of communication development and/or impairment.

  • Prognosis for change (in the infant/toddler and/or relevant contexts).

  • Recommendations for intervention and support.

  • Identification of the effectiveness of intervention and supports.

  • Referral for other assessments (e.g., swallowing and feeding) or services.


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  6. Relevant case history, including medical status, and socioeconomic, cultural, and linguistic backgrounds.

  7. Review of auditory, visual, motor, and cognitive status.

  8. Standardized and/or nonstandardized methods selected with consideration for ecological validity, such as —

    • parent's response instruments and observational instruments that examine early communication, prespeech-language, and early speech-language behaviors;

    • criterion-referenced developmental scales;

    • description of samples of play behavior and nonverbal and early speech-language interactions with caregivers and others;

    • caregiver interviews;

    • contextualized behavioral and functional-communication observations.

  9. Follow-up services to monitor cognitive-communication-motor status and ensure appropriate intervention and support for infants/toddlers with identified communication impairments or high risks of communication developmental difficulties.


Results of the assessment are provided to the family/caregivers, as appropriate. Written reports are distributed to the referral source and other professionals when appropriate and with written consent.

Documentation addresses the type and severity of the communication impairment, or risks of impaired communication development, and associated conditions (e.g., medical diagnoses). When intervention services are recommended, information is provided concerning frequency, estimated duration, and type of service (e.g., individual, group, home program).

The privacy and security of documentation are maintained in compliance with the regulations of the Health Insurance Portability and Accountability Act (HIPAA), the Family Educational Rights and Privacy Act (FERPA), and other state and federal laws.


Early Intervention (Treatment, Therapy)

Family-centered intervention and developmentally supportive services are provided for infants and toddlers with identified communication disorders or with high risks for delayed development of receptive and expressive language skills.  Communication intervention for infants and toddlers is prompted by referral and/or by the results of an early communication, and prespeech-language assessment. Infants and toddlers and their families receive intervention and/or consultation services when there is a reasonable expectation of benefit to the infant/toddler in body structure/function and/or activity/participation. Interventions that enhance activity and participation through modification of contextual factors may be warranted even if the prognosis for improved body structure/function is limited.

Depending on assessment results and the age of the infant/toddler, intervention addresses the following:

  • Preverbal communication (e.g., helping the family/caregiver be sensitive to the infant's or toddler's physical states and needs, gestural and other means of conveying them, and helping them learn to foster the development of preverbal expressions of communicative intentions and turn-taking).

  • Early receptive language skills (e.g., understanding words, sentences, and communicative intentions with and without nonverbal supports).

  • Early expressive language skills (e.g., babbling, producing early words and sentences; expressing a variety of communicative functions verbally and nonverbally).

  • Social interaction, play, and emergent literacy skills (e.g., engaging in joint action routines; interacting with family/caregivers using toys, baby books and other age-appropriate literacy materials).

Intervention extends long enough to accomplish stated objectives/predicted outcomes. The intervention period ends when there is no longer any expectation for further benefit at this particular developmental stage.