Speech and Language Assessments for Toddlers and Preschoolers: An Evidence-Based Guide for SLPs
Choosing a speech and language assessment for a 2-year-old, 3-year-old, or preschool-age child involves much more than finding a standardized test that covers the child's chronological age.
Young children may communicate through words, vocalizations, gestures, eye gaze, play, signs, or augmentative and alternative communication. Their performance can also change substantially depending on the examiner, environment, familiarity of the activity, language being used, fatigue, and level of support.
For that reason, a high-quality early childhood speech-language evaluation should not depend on one test score.
The American Speech-Language-Hearing Association (ASHA) recommends that assessment of young children draw from multiple sources of information, which may include caregiver interviews, developmental observation, language sampling, standardized and nonstandardized measures, play-based assessment, speech-sound assessment, and hearing screening. Assessment findings should be interpreted within the context of the child's overall development, family, communication environments, and cultural and linguistic background.
The right assessment battery therefore depends on the clinical question:
Is the concern receptive language? Expressive language? Social communication? Speech sounds? Overall development? Motor speech? Or a combination of these areas?
This guide reviews commonly used assessment tools for toddlers and preschoolers and, more importantly, explains how they can fit into a comprehensive speech-language evaluation.
Speech and Language Assessments for Infants and Toddlers
REEL-4: Receptive–Expressive Emergent Language Test–Fourth Edition
Age range: Birth through 36 months
Approximate testing time: 20 minutes
Primary domains: Receptive language and expressive language
Administration: Individual; information is obtained through caregiver interview
The Receptive–Expressive Emergent Language Test–Fourth Edition (REEL-4) is specifically designed for infants and toddlers.
Unlike an assessment that depends primarily on a young child's performance during structured testing, the REEL-4 obtains its results through a caregiver interview. It contains Receptive Language and Expressive Language subtests that contribute to a Language Ability composite, as well as a supplementary Vocabulary Inventory.
PRO-ED reports that the REEL-4 was normed on 1,019 infants and toddlers and provides standard scores, percentile ranks, and age equivalents. The publisher also reports reliability coefficients exceeding .90 and diagnostic-accuracy studies involving children with language impairment, developmental delay, and low-functioning autism.
When might an SLP consider the REEL-4?
The REEL-4 can be particularly practical when evaluating a 2-year-old with suspected receptive or expressive language delay, especially when direct standardized testing may not fully capture the child's abilities.
Caregiver report is not simply a fallback for children who cannot participate in formal testing. ASHA specifically recognizes parent and caregiver interviews, questionnaires, developmental observations, and language sampling as important sources of assessment information for toddlers.
Important clinical consideration
The REEL-4 evaluates language development, but it should not automatically be considered a complete communication assessment.
A toddler with limited spoken language may also require evaluation of:
- gestures;
- eye gaze;
- communication functions;
- social interaction;
- symbolic play;
- speech-sound development;
- hearing;
- functional communication; and
- communication across everyday environments.
ASHA recommends evaluating preverbal communication, play, gesture, and other forms of nonverbal communication when a child has not yet developed verbal language.
PLS-5: Preschool Language Scales–Fifth Edition
Age range: Birth through 7 years, 11 months
Approximate testing time: 45–60 minutes
Primary domains: Auditory Comprehension and Expressive Communication
Administration: Interactive tasks involving objects, pictures, pointing, and verbal responses
Despite its name, the Preschool Language Scales–Fifth Edition (PLS-5) covers a much wider age range than preschool alone.
Pearson currently lists the PLS-5 for children from birth through 7:11. It produces Auditory Comprehension, Expressive Communication, and Total Language scores and includes interactive tasks involving manipulatives, pictures, and verbal or pointing responses.
For young children functioning within the infant and toddler range, the PLS-5 also includes a Home Communication Questionnaire that can provide information from caregivers about communication skills observed outside the structured evaluation.
When might the PLS-5 be useful?
The PLS-5 may be considered when an SLP wants an interactive standardized measure for both receptive and expressive language.
For a 2- or 3-year-old, areas examined may include skills related to early play, comprehension, vocabulary, emerging word combinations, grammatical development, and other receptive and expressive behaviors.
Bayley-4: Bayley Scales of Infant and Toddler Development–Fourth Edition
Age range: 16 days through 42 months
Approximate testing time: 30–70 minutes depending on age
Primary focus: Broad infant and toddler development
The Bayley-4 is designed for children from 16 days through 42 months and provides information across multiple areas of development rather than focusing exclusively on speech and language. Publisher-reported testing time ranges from approximately 30 to 70 minutes depending on the child's age.
Why is the Bayley-4 different from the REEL-4 or PLS-5?
The Bayley is fundamentally a developmental assessment, not only a language test.
It is useful when communication concerns occur alongside questions about broader development.
For example, a toddler referred for limited language may also demonstrate concerns involving:
- cognitive development;
- motor development;
- adaptive functioning;
- play;
- social-emotional development; or
- broader developmental milestones.
A multidisciplinary developmental assessment can help place communication skills within this larger developmental context.
ASHA similarly recommends interpreting communication findings in relation to a child's overall development and collaborating with other professionals when broader cognitive or developmental assessment is indicated.
Important consideration for SLPs
The Bayley-4 should not be viewed as a substitute for a detailed speech-language evaluation when the referral question requires more specific analysis of communication.
A child may require both broader developmental information and an SLP-specific analysis of receptive language, expressive language, social communication, speech sounds, play, gestures, and functional communication.
DAYC-2: Developmental Assessment of Young Children–Second Edition
Age range: Birth through 5 years, 11 months
Approximate testing time: 10–20 minutes per domain
Domains: Communication, cognition, social-emotional development, physical development, and adaptive behavior
The Developmental Assessment of Young Children–Second Edition (DAYC-2) is another broad developmental assessment commonly relevant to early intervention.
The DAYC-2 contains five domains:
- Communication
- Cognition
- Social-Emotional Development
- Physical Development
- Adaptive Behavior
The domains can be administered independently, and PRO-ED reports approximately 10–20 minutes of testing per domain. Information can be obtained through direct assessment, observation, and caregiver interview.
Why might an SLP use the DAYC-2?
For an SLP, the Communication domain can provide information regarding receptive and expressive communication while allowing those skills to be viewed in the context of the child's overall development.
It can be particularly relevant within early intervention and multidisciplinary evaluations, where the team needs information across several developmental areas.
However, as with the Bayley-4, broad developmental assessment and detailed speech-language analysis serve different purposes.
If speech or language is a primary area of concern, additional assessment may be required to characterize the communication disorder adequately.
CSBS DP: Communication and Symbolic Behavior Scales Developmental Profile
Functional communication age: Approximately 6–24 months
Chronological use: Can be used with older children whose communication development falls within that range
Primary domains: Early communication, social communication, and symbolic behavior
The Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP) is especially relevant for children who have limited verbal language.
Brookes Publishing describes the CSBS DP as measuring seven predictors of language development:
- emotion and eye gaze;
- communication;
- gestures;
- sounds;
- words;
- understanding; and
- object use.
It is designed primarily around a functional communication age of 6–24 months, although it may be used with children who are chronologically older when their communication development falls within that range.
Why is this important?
A toddler's communication ability cannot always be represented by counting spoken words.
Before children develop robust spoken language, they communicate through behaviors such as:
- showing;
- giving;
- pointing;
- reaching;
- coordinating gaze;
- vocalizing;
- gesturing;
- initiating joint attention;
- responding to others; and
- using objects symbolically.
ASHA specifically recommends that comprehensive assessment of children with late language emergence consider social communication, symbolic play, gestures, nonverbal communication, and communication functions, particularly for children who have not yet developed verbal language.
For this reason, tools focused on early social communication can add information that a conventional receptive/expressive language score may not fully capture.
MacArthur-Bates Communicative Development Inventories
Type: Caregiver-report instruments
Primary areas: Vocabulary, gestures, early grammar, and language development
Relevant toddler forms: Vary according to age and version
The MacArthur-Bates Communicative Development Inventories (MB-CDIs) are parent-report instruments designed to capture early language abilities including vocabulary comprehension, vocabulary production, gestures, and grammar.
For example, the Words & Sentences form is designed for children approximately 16–30 months of age, making it highly relevant to the evaluation of many 2-year-olds.
The CDI family also includes forms for younger infants and later toddler/preschool development.
Why caregiver report matters
A 45-minute evaluation provides only a sample of a young child's communication.
A caregiver has observed that child across:
- meals;
- play;
- routines;
- interactions with siblings;
- books;
- community activities;
- familiar people; and
- different emotional states.
Structured caregiver-report tools can therefore provide information about language that may not emerge during a clinical session.
ASHA specifically recognizes parent and caregiver questionnaires and interviews as valuable components of early language assessment.
Parent-report measures also have a substantial research history in early language assessment, including studies supporting the validity of MacArthur-Bates CDI measures in young children.
Speech and Language Assessments for 3-Year-Olds and Preschoolers
At approximately age 3, assessment options begin to expand.
However, age alone should still not determine the test battery.
A 3-year-old referred because “people cannot understand her” requires a different assessment emphasis from a 3-year-old who has intelligible speech but has difficulty understanding language or making sentences.
GFTA-3: Goldman-Fristoe Test of Articulation–Third Edition
Age range: 2 years through 21 years, 11 months
Approximate testing time: 5–15 minutes for Sounds-in-Words
Primary domain: Speech-sound production
The Goldman-Fristoe Test of Articulation–Third Edition (GFTA-3) is a norm-referenced measure of speech-sound production.
Although frequently associated with preschool and school-age children, the GFTA-3 begins at age 2:0, so it can be used with appropriately selected 2- and 3-year-olds. Pearson reports that the Sounds-in-Words portion generally takes approximately 5–15 minutes.
The assessment includes opportunities to examine production in different contexts, including single words and sentence-level production where appropriate.
What the GFTA-3 can tell you
The GFTA-3 can contribute information about which consonants a child produces accurately or inaccurately and how speech-sound performance compares with normative expectations.
But a standardized articulation score is only one component of a comprehensive speech-sound evaluation.
ASHA recommends that speech-sound assessment include information from both single-word production and connected speech, because a child's performance in isolated words may differ from production during natural communication.
A comprehensive assessment may also evaluate:
- error types;
- phonological patterns;
- sound position;
- consonant clusters;
- syllable shapes;
- consistency of errors;
- stimulability;
- intelligibility;
- connected speech;
- oral structures and function; and
- hearing.
A GFTA-3 score alone does not characterize every speech disorder
This is particularly important when the clinician suspects:
- a phonological disorder;
- inconsistent speech production;
- childhood apraxia of speech;
- dysarthria;
- structural differences;
- hearing-related speech differences; or
- speech differences related to another language or dialect.
The diagnostic question should determine what additional measures and analyses are required.
CELF Preschool-3: Clinical Evaluation of Language Fundamentals Preschool–Third Edition
Age range: 3:0–6:11
Approximate completion time: 15–20 minutes for Level 1; full administration varies
Primary focus: Preschool language
For children beginning at age 3, another option is the Preschool–Third Edition (CELF Preschool-3).
Pearson lists the current edition as published in 2020 for children ages 3:0 through 6:11. It can provide a Core Language Score as well as receptive, expressive, language content, language structure, and other index scores depending on the subtests administered.
The current edition also includes connected-speech and pragmatics-related components and updated norms compared with the previous edition.
When might the CELF Preschool-3 be useful?
It can be considered when a preschooler's referral question requires more detailed examination of areas such as:
- receptive language;
- expressive language;
- vocabulary;
- morphology;
- syntax;
- sentence formulation;
- language concepts; and
- emerging classroom-related language abilities.
It begins at age 3, so it is not an option for a 2-year-old.
Which Speech Assessment Should I Use for a 2-Year-Old?
There is no universal “best speech assessment for a 2-year-old.”
A better question is:
What am I trying to determine about this particular 2-year-old?
If the primary concern is emerging receptive and expressive language
Possible tools may include:
- REEL-4;
- PLS-5;
- MB-CDI; or
- DAYC-2 Communication Domain.
If the child uses very few spoken words
Consider adding measures that examine:
- gestures;
- joint attention;
- communication functions;
- symbolic play;
- social communication;
- vocalizations; and
- early word use.
The CSBS DP may be particularly useful when these early communication behaviors are central to the referral question.
If there are broader developmental concerns
A broader developmental assessment such as the:
- Bayley-4; or
- DAYC-2
may contribute important information alongside an SLP-specific communication evaluation.
If speech intelligibility or speech sounds are the primary concern
The GFTA-3 can be administered beginning at age 2, but the child's developmental level and ability to participate must be considered. A naturalistic speech sample may be especially informative at this age.
Which Speech and Language Assessment Should I Use for a 3-Year-Old?
At age 3, clinicians have more options.
For a 3-year-old with suspected language disorder, possible standardized measures include:
- PLS-5;
- CELF Preschool-3;
- DAYC-2 Communication Domain; and
- other measures selected according to the referral question and the child's linguistic background.
For speech-sound concerns, the GFTA-3 can contribute standardized information, but it should be supplemented with appropriate connected-speech and phonological analysis.
For a child with significant developmental or social communication differences, the evaluation may require broader measures of development, play, interaction, and functional communication.
Screening Is Not the Same as a Comprehensive Speech-Language Evaluation
A screening is designed to identify whether further evaluation may be necessary.
It does not establish a diagnosis.
ASHA states that screening may include caregiver concerns, hearing screening, formal screening tools, observations, questionnaires, play-based observation, and preliminary information about speech-sound development.
If concerns persist, a comprehensive evaluation investigates the child's communication abilities in considerably greater depth.
What Should a Comprehensive Toddler Speech and Language Assessment Include?
A comprehensive evaluation is more than a standardized test protocol.
Based on ASHA's guidance for late language emergence and pediatric language and speech-sound disorders, clinicians should consider several sources of evidence.
Case History
Relevant information may include:
- pregnancy and birth history;
- developmental milestones;
- medical history;
- hearing history;
- history of middle-ear infections;
- family history of speech, language, or literacy difficulties;
- developmental diagnoses or concerns;
- current services;
- caregiver concerns;
- languages and dialects used by the child;
- amount and context of exposure to each language; and
- family priorities.
For multilingual children, language history is essential because communication abilities need to be understood across the child's linguistic environments.
Hearing Screening or Audiologic Information
Hearing should not be overlooked simply because the referral is for language.
ASHA includes hearing screening within comprehensive language and speech-sound assessment when it has not already been completed.
A child may respond to environmental sounds and still require formal assessment of hearing when clinically indicated.
Caregiver Interview and Parent Report
Caregiver information is particularly important for toddlers because young children's behavior during an evaluation may not reflect what they routinely do at home.
Ask about communication across ordinary activities:
- What does the child request?
- How do they protest?
- What words do they use spontaneously?
- Do they imitate?
- Do they combine words?
- How well do they follow familiar versus unfamiliar directions?
- How do they communicate when a listener does not understand?
- What gestures do they use?
- What does communication look like with siblings or peers?
ASHA recognizes caregiver interviews, questionnaires, and reports as important components of early communication assessment.
Receptive Language
Assessment of receptive language may examine skills such as:
- response to names and familiar words;
- receptive vocabulary;
- understanding of actions;
- comprehension of simple directions;
- concepts;
- grammatical relationships;
- increasingly complex instructions; and
- comprehension within natural routines.
For toddlers, comprehension should not be judged exclusively by whether a child points correctly to pictures in standardized testing.
Observing comprehension during familiar, meaningful interactions can provide additional evidence about functional language ability.
Expressive Language
Depending on developmental level, examine:
- vocalizations;
- word approximations;
- spoken vocabulary;
- vocabulary diversity;
- word combinations;
- mean or typical utterance length;
- morphology;
- syntax;
- communication functions; and
- spontaneous versus imitated communication.
ASHA specifically identifies vocabulary, word combinations, early grammar, communication forms, and communication functions as relevant components of assessment for late language emergence.
Play and Social Communication
For very young children, play is not simply something used to keep the child engaged while testing.
It provides clinically important information.
An assessment may examine:
- functional play;
- relational play;
- symbolic or pretend play;
- joint attention;
- reciprocity;
- eye gaze;
- initiation;
- response to communication partners;
- gesture use;
- turn-taking; and
- communication for different purposes.
ASHA explicitly recommends assessment of symbolic play, social communication, gestures, and other preverbal communication behaviors when appropriate.
Language Sample
A standardized language test tells us how a child performs under standardized conditions.
A language sample helps show how the child communicates.
Depending on age and developmental level, the clinician may observe communication during:
- free play;
- shared book reading;
- parent-child interaction;
- conversation;
- picture description;
- storytelling; or
- familiar routines.
ASHA identifies language sampling and developmental observation as important components of early language assessment.
For multilingual children, speech and language samples can be especially valuable because they allow clinicians to examine functional communication across the languages and dialects the child actually uses.
Speech-Sound Assessment
If speech production is a concern, examine more than the number of errors on an articulation test.
ASHA recommends consideration of both single words and connected speech as well as:
- consonant inventory;
- vowel production when relevant;
- syllable structures;
- phonological patterns;
- error consistency;
- sound position;
- stimulability;
- intelligibility; and
- contextual variation.
For toddlers with limited expressive vocabulary, speech-sound information may need to come primarily from spontaneous vocalizations and words produced during play.
Oral Mechanism Examination
When appropriate, the SLP examines the structure and function of the speech mechanism.
ASHA identifies components such as oral structures, dental occlusion, hard and soft palate, and movement of the lips, jaw, tongue, and velum as relevant to speech assessment.
Findings should be interpreted in relation to the referral question rather than treating the oral mechanism examination as an isolated checklist.
Functional Impact
One of the most important questions is also one of the easiest to overlook:
How are the child's communication difficulties affecting everyday participation?
A comprehensive assessment should help determine whether communication differences interfere with:
- interacting with caregivers;
- playing with peers;
- participating in preschool;
- expressing needs;
- repairing communication breakdowns;
- learning;
- participating in routines; or
- developing relationships.
ASHA's assessment framework explicitly considers activity, participation, environmental factors, and the impact of communication difficulties on the child and family—not only impairment-level test scores.
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