It's not uncommon for speech-language pathologists (SLPs) to walk into a new evaluation and find that the patient denies having any problems. That can happen for many reasons, such as:
"I talk fine."
Reluctance to admit having a problem, especially a cognitive problem.
Falsely believing that their trouble is "just part of getting older."
Lack of awareness of the symptoms they are having.
Forgetting that they are having symptoms.
This is the time to use motivational interviewing and attentive listening to uncover any problems related to speech-language pathology.
Here are examples of what you could say in this type of situation, or download for easy reference:
First, introduce yourself and open the floor to your patient sharing any concerns:
“Hi, my name is __. I’m a speech-language pathologist. I help people who have trouble with swallowing, communication, or cognition, like memory. I’ve read your chart, so I already have some ideas about how I might be able to help you. But first, I’d like to hear what’s important to you. What would you like to talk about?”
If they deny any concerns:
“I hear what you’re saying. I just want to make sure I don’t miss anything. When I read your chart, I saw that you were having trouble with __. Do you notice having any trouble in that area now?”
If they still deny concerns, but you suspect they are having symptoms:
“That’s great that you’re no longer having any trouble with __. Is it okay if I ask your spouse to see if they’ve noticed anything?”
It’s great that you’re no longer having trouble with __. Is it okay if we do the evaluation so I can document that for your doctor?”
If they have concerns, but they're too vague to be helpful in narrowing down your assessment or goals:
“What I’m hearing is that you’re having trouble with __. Could you tell me more about that?”
“Can you describe for me what happens when you __?”
“If we could fix that in therapy, how would you know __ is better?”
“Do you notice any trouble with __, __, or __?”
Finally, you can show your patient or their spouse EST's checklist of 54 daily activities that SLPs can help with!