A speech or language evaluation is usually recommended when an individual (child or adult) exhibits difficulties in producing speech sounds or in understanding or using language (talking). This difficulty can cover a wide range of severity and associated problems. Difficulty producing speech sounds can be associated with hearing problems, weak oral muscles, or strokes. Language difficulties can range from not talking when expected developmentally (e.g., young child) to word retrieval problems (e.g., following a stroke). A speech-language evaluation includes case history, formal and informal testing, impressions and recommendations. Case history includes determination of the complaint, identifying associated problems via general and specific background information, family history, medical history and hearing status. Formal testing includes using standardized testing instruments to determine the existence of a speech delay or disorder by assessing both speech and language skills. The speech-language pathologist (SLP) also uses informal assessment in order to provide some insight into how the individual speaks under normal, comfortable speaking situations. Following this portion of the evaluation, the SLP provides an impression and prognosis based on the obtained information and will then formulate recommendations on treatment approaches based on all the information obtained from the evaluation.