You've just finished scoring an evaluation. The standard scores come back low — maybe in vocabulary, syntax, or listening comprehension — but… the child seems fine.

They're social. They're verbal. They're doing OK in class or at home. And yet the numbers suggest a language disorder.

So what now?

This is a scenario many SLPs face — and it puts you in the tricky position of interpreting data that doesn't align with real-world impressions. Should you qualify them? Should you dig deeper? Should you recommend services?

In this article, we'll unpack how to think critically when test results and functional performance don't match — and how to document your decision with confidence.

Why This Happens More Often Than You'd Think

Standardized tests are powerful tools — but they don't capture:

• Executive functioning
• Motivation and testing fatigue
• Classroom accommodations
• Cultural or linguistic differences
• Strengths in unstructured conversation

In other words, a child can score poorly without showing clinical need — and vice versa.

That's why IDEA, ASHA, and most private payers emphasize functional impact as a key part of eligibility.

Step 1: Double-Check the Context

Before jumping to conclusions, ask:

• Were the testing conditions ideal? (Quiet, breaks, good rapport?)
• Was the child sick, tired, anxious, or distracted?
• Do the subtest scores make sense together, or are they inconsistent?
• Was the test culturally and linguistically appropriate?

If red flags pop up, a rescore or alternative measure might be warranted.

Step 2: Look for Real-World Evidence

Ask teachers or caregivers:

• Does the child struggle to follow directions?
• Do they misunderstand stories, conversations, or figurative language?
• Are they behind on reading comprehension or writing?
• Do they rely on peers or visual supports to keep up?

If the answer is no, you might be looking at a student who:

• Has low test-taking endurance
• Performs better in naturalistic environments
• Relies on nonverbal reasoning or executive strategies

Step 3: Observe and Sample

Structured tests aren't the only way to gather data. You can also:

• Observe the child during group work or class discussions
• Take a language sample and analyze complexity, grammar, and coherence
• Use dynamic assessment or test–teach–retest models
• Try informal narrative retells or explaining procedures

This gives you a clearer picture of functional use, not just isolated responses.

Step 4: Don't Let the Scores Dictate the Story

You're the clinician. Your professional judgment matters — especially when the data is confusing.

If the scores are low but function is high, document it:

"Although [student] obtained standard scores below average on the CELF-5, classroom observations and teacher interviews indicate age-appropriate comprehension and verbal expression across settings. Based on triangulated data, language impairment is not suspected at this time."

If function is unclear or concerns arise during informal tasks, consider a trial period of services or reassessment in 6–12 months.

Step 5: Document Clearly (and Defensibly)

When choosing not to recommend services, include:

• The low scores and relevant subtest areas
• Functional observations (home, school, therapy)
• Caregiver/teacher input
• Any informal testing results
• Your clinical conclusion, with rationale

This protects you — and helps teams and families feel confident in the decision.

How SLP Score Supports Complex Cases

SLP Score gives you the tools to write nuanced, legally sound reports — especially when the answer isn't straightforward.

You can:

• Enter and interpret standardized scores in context
• Add functional observations right alongside data
• Auto-generate plain-language summaries to explain why a child may or may not qualify
• Export everything to Google Docs or Word for easy edits and sharing

So when you're stuck in a gray area, SLP Score helps you write your way out.