When should I be concerned about my child’s speech or language skills?

A speech-language evaluation is recommended if your child is not:
– Talking or has few spoken words
– Does not initiate play/interact or make eye contact with others
– Does not point to picture or objects when named
– Whines/cries or gestures to request things instead of speaking
– Has difficulty following spoken directions
– Has difficulty understanding you when you talk
– Is unable to engage in back-and-forth conversation
– Gets “stuck” when speaking or repeats sounds or words excessively (“Stuttering”)
– Has difficulty answering questions (such as: “Who,” “What”, “Where”)
– Has difficulty coming up with a word or putting sentences together
– Pronounces sounds incorrectly that most children have mastered for his/her age
– Is difficult to understand
– Sticks his/her tongue out when speaking or swallowing
– Shows frustration related to his/her communication skills
– Is having difficulty in school related to his/her communication skills such as with reading, spelling, written language, following directions, etc.

To read more detail about the speech development of your child please visit: Does My Child Need Therapy?

When should I be concerned about my child’s or my ability to eat or drink?

It is recommended that swallowing should be assessed if you or your child is coughing or choking frequently after eating or drinking, if sensory or food aversions are a concern, or if there is a known medical diagnosis of dysphagia (swallowing disorder).

What happens during the evaluation?

Our speech pathologist will obtain information regarding relavent medical history and, if it’s in regards to a child, developmental milestones. They will evaluate your child’s ability to talk, speak clearly, express their thoughts, follow directions, interact with others and understand statements. The therapist will typically use various standardized “tests”, to see how your child compares to other children who are the same age.
For Adult clients, we would follow these same assessment guidelines and would need all relevant information from your doctor about the concerns.

How long will the evaluation take?

Depending on the client’s age and the type of tests given, the evaluation will take thirty minutes to two hours on average.

Will I get a written report of the evaluation?

You will receive a written report describing the outcome of the evaluation. The speech pathologist will prepare this report after the evaluation / testing is completed.

Will commercial insurance pay for speech or language therapy services?

We are glad to check on benefits by calling your commercial insurance company but many companies, including BCBS of Tennessee, typically do not pay for children’s speech/language therapy without a “medical diagnosis” such as Down syndrome, Autism, apraxia, cerebral palsy, cleft palate, etc. Developmental delay, though a medical diagnosis, is oftentimes excluded. Evaluations may or may not be covered but typically are. If insurance does not cover speech and language services, please ask us about our out-of-pocket rates.
If your child has TennCare, however, therapy services are covered, including the evaluation.
We do require a doctor order to bill insurance.

Does TennCare Cover speech or language therapy services for my child?

Tenncare DOES cover speech and language services with a doctor order up until the age of 21 years old. Your child must have been seen for their annual and required “well visit” for the doctor to write the order.
However, we will need to conduct an evaluation (testing) of your child to be sure that therapy is necessary. TennCare will usually pay for this evaluation.

How long can my child receive services?

Availability of services is determined by your insurance carrier.
However, when services are approved, the insurance company (including TennCare) can allow services to continue until your child is re-evaluated and shows language / communications skills that are appropriate for his/her age level.

How can I learn more information about when to be concerned about speech, language, feeding, and fluency?

You can contact the American Speech-Language-Hearing Association at http://www.asha.org where they have a multitude of resources and detailed information online about all communication disorders, norms, etc.

If you are interested in learning more about stuttering, the Stuttering Foundation of American has information on their website about that at http://www.stutteringhelp.org.

What are the “red flags” that my child may have Autism?

According to the American Speech-Language-Hearing Association (ASHA), Autism Spectrum Disorders is a neurodevelopmental disorder characterized by deficits in social communication and social interaction and the presence of restricted, repetitive behaviors. A child that may have Autism will have difficulty in the areas of communication, social skills, and behavior. Some of the red flags for a child with Autism are listed below:

  • Difficulty responding to their name or following directions
  • Difficulty understanding and using gestures (pointing, waving, etc)
  • Not learning new words or a sudden loss of words
  • Child stops talking all together
  • Child repeats words they just heard (echolalia)
  • Speaking in a sing-song voice
  • Issues with behavior (tantrums/meltdowns)
  • Not wanting to play with others/difficulty making friends
  • Unable to make eye contact or smile socially
  • Difficulty making transitions
  • Hand-flapping, rocking, spinning
  • Hyper-focused on particular items (bubbles, tv show, favorite toy)
  • Get upset by certain sounds

If you suspect that your child is displaying warning signs of Autism, you should speak with your pediatrician and discuss options for your family. A Speech Language Pathologist is able to evaluate your child’s social and communication skills related to Autism, as well as provide therapy for your child.

For more information, please see the following websites:



What locations does Sidekick serve?

We serve clients in their homes, preschools, and daycares in the Knoxville and surrounding areas as well as Johnson City, Morristown, Lenoir City, Maynardville, and Dandridge. We also serve Tenncare children in the following school systems:
Carter County, Cocke County, Etowah City, Greene County, Grainger County, Hamblen County, Hancock County, Johnson City Schools, Lenoir City, Rogersville City Schools, Scott County, Union County, Norris Academy.