Excellent Toys for Teaching Cause and Effect

Spinning drum…. child reaches out and spins drum – easy to operate with a big non-electronic effect!

Piano for non-electronic effect!

Music Toy for Cause and Effect

Electronic Piano/Bongos for Cause and Effect

Pop N Pals

Easy PUSH toy for cause and effect

Stand up push toy

Ball Toys… great for teaching cause and effect

Excellent Toys for Teaching Simple Problem Solving

Tissue box…. child learns to pull and brightly colored tissues come out

Earliest puzzle… no choices –  child fits shape into opening…

Great first shape sorter… child can get shape in 2 ways

FUN shape sorter with cool sound effect

Trial and Error with Simple Problem Solving… ball vs. coin

Cool Ring Stacker

Nesting Cups

Nesting Blocks with Plastic Animals

THERAPY MANUALS

Teach Me To Talk: The Therapy Manual

Teach Me To Play WITH You

Let’s Talk About Talking

The Autism Workbook

Giggle Time… Susan Aud Sonders

More Than Words… Hanen

EXPRESSIVE LANGUAGE FOCUS

422 – 429 Teach Late Talkers to Imitate

422 Help a Nonverbal Child Find His Voice

409 Treating Expressive Language in Autism

398 – 399 Teaching Expressive Language

The post #450 and #451 Recommended Toys 12 Months appeared first on teachmetotalk.com.

I almost titled this post “Why Flashcards Don’t Work to Teach a Nonverbal Toddler to Talk,” but I opted for the one above instead. Many parents and even some therapists default to using flashcards in an effort to teach a child new words.

From a parent’s standpoint, flashcards may be a natural choice. They seem educational and after all, doesn’t everyone remember using flashcards in school to learn new information?

From a therapist’s viewpoint, I can also see why flashcards may be a preferred treatment method. When most of us attended grad school or have treated older children, we were taught to use picture cards during therapy, mostly to increase efficiency. It’s pretty easy to flip through a stack of 25 cards with an 8 or 10 year old, particularly if you’re working on getting the right sounds in the right places (or articulation, if you prefer the technical terminology.)

But here’s what happens when we try to use this same technique with younger and younger kids… it doesn’t work! Or at least not as well as we’d like and here’s why:

Many young children who are pre-verbal aren’t yet symbolic and pictures are symbols.

Flashcards show pictures of objects (and sometimes even written words!), and the child may not realize that the picture represents the real thing. In other words, just because the child sees the picture of the cup, he may not associate the picture of the cup with the one he may even be holding in his hand. Some children may not yet understand the word “cup” even when you say it.

This is important for language development because words are also symbols. If a child hasn’t yet linked the spoken word “cup” with the one he uses every day, he may not be ready to understand the picture is also called cup.

Beyond that, for many, make that for most toddlers, flashcards are just plain B.O.R.I.N.G. What’s the appeal of looking at a picture of a dump truck when you can glance out the window and spot a life-size truck or even better, you can zoom a cool toy version across the floor?

It’s true that some children do like flashcards. These are usually children with visual strengths. Kids like this may also watch movie after movie, spend lots of time exploring picture books, or require that the iPad be pried from their little hands in order to move on to something else. They may be drawn to finding shapes, colors, letters and numbers in all kinds of places. For those children, flashcards may be a natural extension of their individual learning preference. Although I detest flashcards for most of the toddlers I work with during therapy sessions, even I use them with children like this because it’s what they enjoy. Because of that, flashcards do work to teach language for these young learners. However, we must be careful, even when kids do seem to learn words by looking at the cards with you, that their language skills are generalizing to everyday life. It’s problematic when a child can say “banana” when he’s looking at a picture in his favorite book or in an app, but he can’t ask his mom for “banana” when he sees it on the counter top in the kitchen.

So if flashcards are out, what’s a desperate parent or therapist to do when we want to teach a very young child a new word?

It’s easier than you think!

Choose real life!

When language is emerging, or when a child is first beginning to learn what words mean and how to say them, teach new words by using real objects and real events, preferably as you’re going about your day. You don’t need pictures of blocks, a car, a ball, cookies, or milk to teach those kinds of familiar words. Dig through your kid’s toy box or get yourself to the kitchen and find the real one instead!

Be sure to say the word several times as you use the object in the way it’s intended – meaning that you actually play with the toy or eat the food. It will be much more relevant and much more likely to make a lasting impression for your child to help him learn to understand and use the word. Beyond that, the real thing is just plain FUN for your child and for you!

Remember…you can teach words anytime, anywhere.

Need a book full of ideas like this? If you like the idea of reading a goal and several proven activities to address that milestone, Teach Me To Talk: The Therapy Manual is written specifically for speech-language pathologists and other early intervention professionals who work with young children birth to 4 with receptive and expressive language delays and disorders. Because this project was written for professionals, it may not be as family-friendly as other teachmetotalk.com products, but many committed mothers and fathers report that this manual gave them more direction and specific instructions for what to work on at home than any other resource they’ve used. This manual is especially helpful for selecting goals and then designing corresponding fun and developmentally-appropriate treatment activities for toddlers and young children functioning from the 6-9 month developmental level up to the 48 month developmental level. It’s the ultimate “how to” tool for working with infants and toddlers with language delays.

Laura

The post The Truth about Flashcards for Toddlers Who Don’t Yet Talk appeared first on teachmetotalk.com.

“I attended your course in St. Louis… I used the strategies you taught the very next week and the sessions went very well. I just needed to drop back some levels! Thank you!” Ellen, SLP

This is the kind of email I receive almost every day at teachmetotalk.com.

In this post I want to share with you why taking a step back can be the very thing you need to do in order to help a young child learn something new.

Believe me, I know firsthand how frustrating it is when a late talker you’re working with does not seem to be making any progress. After several weeks (or months!) of getting nowhere despite your best efforts, you probably begin to question why what you’re doing isn’t working. Sometimes, instead of questioning what we can do differently, human nature seems to dictate that we double-down and try even harder without changing much of anything. Or worse, we may be tempted to give up, thinking, “This is never going to work.”

Neither one of those approaches is successful.  There is one simple lesson I’ve learned over and over again in my practice as a pediatric speech-language pathologist and, if I’m being honest, even in my role as a mother:

When a child is not making progress, back up!

We have to constantly remind ourselves when we’re in this situation that the real reason a very young child isn’t making any gains is because the goal we’re trying to get him to reach is too difficult. What we’ve chosen to focus on is somewhere beyond where a child is currently capable of functioning.

In other words, the goal is too hard.

Period.

No more analysis is needed. I firmly believe that if a child could do what we’re working on, he would.

When you find yourself in this predicament, we’ve already established that continuing to do what you’ve been doing won’t likely produce different results. And we’ve already said that quitting isn’t an option, which leads us to our default plan:  back up!

What do I mean by “back up?”

Look at the skills that come just before the one that’s eluding the child, figure out what’s missing, and begin there.

If this doesn’t make much sense to you, let me stop and share an analogy I use with the families of children I see in my practice. When a parent seems confused that what I’m working on doesn’t seem to be the end goal, I explain it this way:

Learning to communicate is a lot like learning higher level math. You’d never expect a teenager to understand algebra unless she knew how to multiply and divide. Teachers would not begin to teach long division until a child had memorized their multiplication tables. Kids aren’t ready for multiplication until they’ve had lots of practice learning to add and subtract. We wouldn’t dare think of teaching a child addition and subtraction unless they could write numbers. Children don’t learn to write numbers until they can identify numbers and have learned to count.

See?

It’s a process.

Language development is a process too, but because it happens quickly and often without much effort in toddlers and young children with typically developing skills, we often forget just how sequential the process of learning to talk really is. We become anxious to jump to the end goal (“I just want him to talk!”) rather than realizing all of the things that must come first. Our intentions and our goals can become too big and unrealistic, particularly when a young child is obviously struggling.

To learn how to “back up,” we begin with what’s not happening and then walk it back (by looking at the continuum of developmental milestones in reverse) to the point where the first breakdown occurs. Then we go back a step, because that’s the starting point where the child is mostly likely to be successful.

Let’s look at a common example.  Let’s say that a mom expresses her desire for her child to be able to carry on a conversation with her but that’s not happening yet, as in, it’s not even close. How can we apply the “back up” principle in this example? Start with what your goal is and walk it back.

If you want a child to participate in conversations with you, start by analyzing what comes before adult-like conversation. Examples of what you would ask yourself are…

Can the child generate a full sentence on her own? Does she understand questions well enough to respond to you, or are her answers pretty limited? Does she already talk using a wide variety of shorter phrases? Is her vocabulary fairly large with enough “words in the bank” to pull from to generate longer sentences? When she attempts to speak in sentences, is she missing the “little words” only, or does she seem to not know what she wants to say? Does she understand the concept of turn-taking, meaning you do something and then I do something? Is her attention span long enough for her to stay with you beyond a sentence or two?

Can you see how all of those smaller steps lead to participating in the overall, “big picture” goal, which was conversation?

Can you also see how a child who is not doing the things I mentioned is not really ready for such a “big” goal?

This seems like common sense, something we should all understand how to do. However, many times when we’re working on something as important as treating a problem so big it’s warranted its own word – a specific diagnosis – we seem to forget that simpler is usually better.

I see this happen over and over in therapy and in my experience, it’s the main reason toddlers don’t make more consistent progress once therapy begins. Many times the problem isn’t that the therapy isn’t good or that parents aren’t committed or that anything else is going on. The problem is that we’ve jumped too far ahead of where a child is functioning developmentally and the chasm is too wide. We’re trying to cover too much ground at once. The child needs to master several preliminary goals first.

While the example I gave you before about speaking in conversations is pretty broad, you can take this same principle and apply it to every goal we target with toddlers who are having difficulty with speech-language development  – and really every other skill too!

The key is breaking down large goals (such as “I want him to tell me what he wants” or “I want him to understand what people say to him”) into smaller, achievable steps that should lead up to the overall skill.

As a parent, unless you’re an expert in child language development, this may be well beyond your ability to do alone. AND THAT’S OKAY! Just because you’re a mom or dad, you’re not supposed to be an expert in everything! Get yourself some help!

Hopefully, your child is already in therapy and you have a great resource readily available to you – your child’s therapist. Ask him or her about the concept of “backing up.” Say something like: “I think my excitement (or anxiety, or determination, or paralyzing fear – Whatever your emotion is, name it!) for the end result has clouded my judgment and I’m not realizing all of the little things that must come first before my child will be able to _____.”

In a perfect world, your child’s therapist will grab you in sheer relief and say, “That’s what I’m here for! I can help you with that! Here’s what we should do!” If that doesn’t happen, you may have caught the therapist a little off guard. Give them a little time to catch up to your new revelation and have the conversation again in a week or two when they have had some time to process what you’ve said and make adjustments.

If your late talker isn’t in speech therapy and you’re going it alone, for whatever reason, do your best to logically think through developmental milestones.  Then determine what a realistic goal would be so that you can direct your efforts toward working on what’s more likely to be successful.  My advice is to get yourself some credible resources…and use them!

An article like this can’t possibly provide the kind of information you need in order to do this. Every child, with his or her own set of unique strengths and weaknesses, will be a little different.  There’s no way that a single post, or an entire website about language development (even this one with hundreds of articles, podcasts, and videos!) or entire books will answer every one of your questions about your own child.  The only way that a professional can truly determine what interventions are right for your child and your situation is to meet with you and your child your child.  Still, educating yourself with books, DVDs, podcasts, and website posts is better than doing nothing. You’ll find a good place to start.

In closing, finding the correct starting point for working with a very young child sometimes feels like a moving target, so don’t get discouraged.  You will have to tweak and adjust until you find just the right step in the process that works for your child, but it is there waiting for you. I’ve listed some ideas for you at the bottom of this post to point you in the right direction…so you can back up!

Until next time –

Laura

————————————————————————————

Resources for helping you figure out how to back up…

“I’m teaching my toddler to talk, but I know I need more direct guidance. I want to back up, but I’m not sure how.” Get my book Building Verbal Imitation Skills in Toddlers to walk you through the steps for helping a child learn to imitate new words.

“I’ve been focused on helping my child learn to say words, but now I realize that he may not understand what many words mean. He doesn’t follow directions very well.” Try Teach Me To Talk: The Therapy Manual or Teach Me To Listen and Obey 1 & 2 so you can learn about receptive language and what you can do to help your child begin to make connections and follow verbal commands.

“I am frustrated with our lack of progress in speech therapy. We’ve been going for a while, but we don’t see changes yet.” You may be working on the wrong things! This usually means there’s something missing that you’ve not yet identified. The checklist in Let’s Talk About Talking will help you determine which of the 11 prelinguistic skills a child has mastered and which ones still need more work. The best part is that the activities and strategies are right there to help you move a child foward.

For SLPs…

If you’re new to early intervention or haven’t had the success you’d like, I have fantastic resources that you can use TODAY to help you achieve the results you want.

For help with first steps establishing interaction and engagement with toddlers who don’t participate or attend – Teach Me To Play WITH You

For a comprehensive list of every receptive and expressive milestone with strategies and ideas for how to target each goal – Teach Me To Talk: The Therapy Manual

For step-by-step instructions for helping a toddler become verbal – Building Verbal Imitation Skills in Toddlers

For specific help writing treatment plans and selecting goals for children with autism or characteristics – The Autism Workbook

For specific help writing treatment plans and selecting goals for nonverbal toddlers and preschoolers – Let’s Talk About Talking

For guidance with treating speech intelligiblity and articulation issues in toddlers and young preschoolers – FUNctional Phonology

The post Not moving forward? Try taking a step back! appeared first on teachmetotalk.com.

Before I talk about my treatment philosophies, let me send out a disclaimer for all of you who are working with SLPs or other early interventionists who may be taking a different approach with your child. There may be very valid reasons she (or he) has chosen to use other specific strategies with your child. There may be reasons that the approach I take may not be the best for your child or your family, (although I can’t think of any). Ask your therapist to have a frank discussion with you about her (or his) decision-making process in choosing techniques. Most therapists welcome this kind of discussion and are happy to talk about it with you, over and over if necessary to make you feel comfortable and empowered as an important member of the team for your child.

For children who are non-verbal or minimally verbal (less than 10 words), I believe that establishing communication and improving both receptive and expressive language skills are the primary focus for treatment. Specific speech sound practice need to be worked into play as a very FUN part of therapy, and are absolutely necessary for kids with apraxia. However, I do not feel that this should be the main focus for children who are non-verbal, even when they are non-verbal because of apraxia, and especially for those who are non-communicative.

By non-communicative, I mean children who lack interaction skills. These kids do not come to you to get the things they need. They do not point or use other gestures to make you understand what they want. He or she does not initiate social games with you. Many of them appear self-absorbed. They focus on their specific likes to the exclusion of more meaningful interaction. If this is your child, it is absolutely essential that you target social interaction and being “connected” to others FIRST, or at least WHILE, you are working on expressive language. Please don’t mislead yourself. If your child has some social interaction issues (difficulty making eye contact, little social referencing which is “checking in” with you while they’re engaged in something else, poor joint attention meaning he doesn’t easily look at something you’re trying to show him, doesn’t consistently respond to his name, has a limited attention span, and doesn’t seem to listen to or understand others when they try to communicate with him, etc.), talking is not the only problem.

If a child is interacting with you socially, but is not yet using gestures consistently to indicate wants and needs, and/or is not initiating interaction with you, this should also be a focus. Children who are social responders, but not social initiators, can be taught to do this. I might use another adult or older sibling to help model these kinds of things. For example, an older sibling can initiate jumping off the couch into my arms by climbing onto the couch and holding out his hands for me to begin the routine. Or I might take the child’s hand and place it on Mommy’s to help pull Mommy over to the counter to get a drink. I might sit behind the child and help him lean into take Mommy’s hands to initiate Peek-A-Boo or Row Row Your Boat.

I model pointing constantly with a child who can’t do this yet. Point to pictures in books, choices in play, clothing items, body parts, everything. I make it a big gesture. I work on pointing by making sure kids reach for things. If he’s not reaching, I hold toys he wants just in front of him to make him lean in. Sometimes I ask Mom to help him reach with hand-over-hand assistance. In play with toys and in books I also have kids pat, tickle, feed, and any other action I can think of to have them touch specific items. If this doesn’t work, I rely on a couple of oldie but goodie OT tricks. Have her practice touching a dot on a cup with her index finger with hand-over-hand assistance. When she perfects this and can do it on her own, pull the cup back just as she is about to touch it. Or practice stuffing a scarf through a hole with your finger. If this doesn’t work, talk to an OT!

Don’t get me wrong. A toddler with apraxia can still have issues with social communication, interacting, and even gesturing. However, in this kind of case, in my opinion, apraxia is not the main reason he’s not talking or communicating. More importantly, if he’s not following directions or doing other kinds of things to indicate that he understands language, direct lots of your efforts to improving language comprehension. Start by teaching him to Do His/Her Part in daily activities. For example, you’ll give him a “job” during each big part of his day like meals, bathtime, playtime, etc.

The thing I do with all kids I see for therapy, and especially those with apraxia is absolutely, in the most fun way possible, REQUIRE them interact and respond. Children do not get to veg out in their own worlds, or direct all the play. (If this sounds like your child, please carefully read the next paragraph.) I do not follow children around simply narrating what they do “hoping” that they may imitate what I say. This kind of language stimulation approach is not successful for children with apraxia. If it were, these children would already be talking, because most good parents talk to their children in this way already. If you are using this approach, or (gasp) you have a therapist using this approach, please read on for what I believe is a better way to do things.

For children with limited social interaction skills or lower functioning cognitive skills, this “requiring a response” may not be achievable for a long time. For those kids we work on interacting during social games and participating with very basic cause/effect toys or foundational cognitive skills like object permanence. I also use Floortime techniques for at least part of the session to be sure we’re working on engaging at whatever level they can achieve. For more information on this technique, read anything by Dr. Stanley Greenspan. This approach is at the core of anything he’s written.

Back to the premise of my treatment philosophy – I require the child to respond. Their attempts can be off-target. If they can’t talk, they can sign, or use any other mode (such as gestures or pictures) they can. But they absolutely, positively MUST communicate. I don’t give any kid who can initiate or respond a turn with any toy, a piece of any snack, or let them do anything else, until he at least tries to ask for it using the highest level of communication he can. I’m not mean about it. In fact, I could possibly the most fun adult many of my little clients know, but I am VERY insistent that they respond.

Like I’ve posted on other sections (What Works / What Doesn’t Work), I play for most of my therapy sessions. For most toddlers I see over 15 months old or so, play means using toys. I like to use a combination of things we sit down to do and alternate them with movement activities.

Strategies for Toddlers with Apraxia

For example, we might start the session with a favorite toy that I know a kid likes. Initially, most children are generally pretty eager to attend and play when I first arrive. I try to make this as upbeat and as fun as possible. You do this with your tone of voice (very animated and bubbly) and your facial expressions. Smile! Laugh! Act like you are having the time of your life!

For parents, this is essential. Begin your own play sessions with toys you know that he or she likes. Then move on to new things or things that are difficult. Lavish your child with affection and attention during this special play time. Let her know how crazy you are about her by how totally focused you can be during play. Don’t answer your ringing phone. Don’t constantly look over her head to watch TV. Those things can wait. Pay attention so she will pay attention!

BUT absolutely withhold or sabotage the activity by keeping the pieces of the toy until the child requests what he needs with words (if he’s verbal) or gestures/signs (if he’s not). Model what he should imitate if he’s not using spontaneous words or signs yet. Say the word or demonstrate the sign and wait.

As I’ve stated before on this site, I always give choices. Ask, “Do you want trains or cars?” Wait for him to pick one, either with a word or sign. If he can talk or sign, model the choice 3 to 5 times before giving in and playing. Take his hands and help him sign if he can’t/won’t do it on his own.

If he resists or becomes too upset, go ahead and play with what you think he wants. I think it’s too mean to hold out beyond this point. I want to keep the toddler engaged and wanting to play with me. I believe that it is counterproductive to have a toddler throw tantrum after tantrum in a session because he’s so upset. It should be the same during playtime with mom and dad too.

When kids are this upset, they don’t learn. Or the lessons he is learning are ones I don’t like. He either feels like, “This woman is so horrible to me that I don’t ever want to play with her again.” Or equally non-constructive, “This tantrum thing is working for me. All I have to do is scream and pitch a fit to get my way.”

When a toddler begins to exhibit these kinds of patterns, I do not use withholding or sabotage as my primary approaches. I still choose the activities so that I can make them fun and target language, but I do lots of modeling in an animated way with occasional withholding when he’s happy and can tolerate it. I use LOTS of praise and then immediately reward (with the toy or snack) when he’s participated in a positive way.

By praise I don’t mean a 5 minute lecture with language that’s over his head before I give him what he wants. Don’t “lose” the kid with this mistake. I do lots of smiling, laughing, tickling, and saying, “Yay!” I try to project sheer and utter delight that they have done what I wanted them to do with my facial expressions and actions as I am giving him what he wants (the real reward).

When we’ve done several sit-down play activities (or even one) and I sense that I may be losing him, I ask him if he’s finished and have him sign/say “All done,” or “Clean up,” or whatever other word or gesture he can use to indicate that he wants to move on. I always insist that kids help me clean up an activity. I am not a therapist who lets a kid drag out 7 or 8 different toys at a time. How in the world can a busy toddler stay focused on what we’re doing in that kind of clutter? Your child needs this kind of environment even during your special play times. It may be one thing to let him play as he pleases on his own, but when you are doing this together, specifically with teaching language in mind, it will help to limit his choices and clean up a bit so that he’s doing one thing at a time.

Several parents of children on my caseload save certain toys to use only when they play together with their child. They put them in bags or baskets and put them away in the closet until Mommy or Daddy can play too. The novelty alone will make your child want to interact. Think of the reaction you’ll get when you bring out the special bag! Playtime!

When my own children were toddlers, there were many kinds of activities that I never let them do alone. For example, play-doh, paint, crayons, markers, sand, etc… Get the messy theme here? If you have a child that continues to mouth toys, you may choose to introduce ones during this time that you’d never let him play with on his own while your attention is solely focused on him.

Back to my point about cleaning up – This cleaning up process does so much to help with transitions. It also prevents them from moving on to something else before you’re ready and keeps them engaged with what you’re doing. I sing the standard “Clean Up Song” from that old Barney show so much that they ought to charge me, but it works. Have your child try to sing this with you. If a kid can say “up,” I sing, “Clean up, clean … ” and then pause for him to finish “up” once he’s learned the song.

If you have a child that hates cleaning up, you could pick up 3 or 4 pieces to his 1 piece. The point isn’t to be a tyrant or a neat freak. The point is that activities have a beginning, a middle, and an end. Children, especially those with short attention spans or transition issues such as wanting to play with a few preferred things exclusively and who freak out when an adult tries to move on, need practice with this concept.

Additional Tips for Toddlers with Apraxia

Other tips to make the clean up process work are using giant zip-lock bags for most of your toys. I use the 2.5 gallon size since almost anything can fit in there. At home try baskets or bins. If your child won’t help you, try making it more fun by “throwing” the pieces in. Practice saying, “Bye-bye” to each piece. If you’re just beginning to work on sequencing phrases, by all means, use this “Bye-bye ____” during clean up time because the child is usually so focused on this process that the phrases are easier to produce.

I always alternate sit-down play with movement activities, especially with energetic little boys (and girls) who thrive on heavy work and deep pressure. These terms are borrowed from occupational therapy. This applies to the kid who is constantly moving or who needs to jump, crash, or in any other way “feel” his body in space to regulate. Kids who have systems like this usually display sensory integration differences.

My favorite movement activities for toddlers are bubbles, balloons, social games with movements like swinging in a blanket, chase, and jumping off furniture or on the bed. I will “hide” and let them find me or vice versa, to be sure we can run around the house. Many children have plastic slides or swings in their homes, and I never neglect an opportunity to use those kinds of things.

For older 2’s, I might use games with movement such as bowling with plastic pins or Elefun, a game with an elephant that blows butterflies out of his trunk that we catch with nets. I routinely use puzzles and turn this into a running game or obstacle course. Put the pieces at one end of the room and the board at the other. Have the kid ask for each piece and then run, climb, crawl, etc… to place the piece in the puzzle. (This also works better for kids who can’t/won’t sit for a puzzle.) Do the same thing to retrieve the pieces and target language comprehension. Ask him to “Run and get the _______.” Run, crawl, or jump along with him to get the pieces and increase the fun. Toddlers LOVE to see their parents act in unexpected ways.

I might also use other movement activities a child’s OT or PT recommend such as swinging in a blanket or Lycra with help from Mom or bouncing on a therapy ball if Mom mentions that these help a child to regulate. However, if a child associates this with “therapy” time, I avoid it like the plague and stick to more “playful” movement activities.

During the movement tasks, I require them to talk or sign to request more turns to continue. Words I routinely use for this are “more” or “please,” or better yet what they are really doing, “Jump,” or “Go,” or “Swing.” Don’t let this turn into a “break” from talking or signing! I hear and read about therapists who use this kind of play as the reward with no therapeutic focus (aka – talking). I think that they are missing “prime time” for communicating.

Once I think we’ve moved enough or read a toddler’s signals that he is ready, I go back to a sit-down play task. For many toddlers and even preschoolers, these movement breaks are absolutely essential. I cringe when I hear of therapists who make a 2 year old “perform” with several flashcards and then “reward” them with one turn from a toy or a lick from a sucker. BORING! Or more likely – FRUSTRATING!

A Word about Books with Toddlers with Apraxia

I only use cards and even books when it’s one of a toddler’s preferred activities. Otherwise, I don’t use them at all. You will NEVER catch me with a worksheet. Therapy is not as efficient as if I used cards or books, but what good is it anyway if a kid hates it? I do not see the value in this. It takes much more creativity on my part, and I may only get 5 productions of a word or sound vs. 10 attempts in the same amount of time, but again, what good is it if the child is miserable? In my experience, miserable children do not talk. When they do, it’s usually to scream, “No.” I will never see the point with making a child that upset. I do not get my kicks from having power struggles with toddlers. I may win the battle, but not the war. It’s just not worth it to me.

Again, I believe that specific sound practice is necessary for children with apraxia (or phonological disorders or whatever else you want to call it), but I rarely work on sounds without having a functional target. The way I work sound practice in is by seeing what sounds they do have and then getting them in words as quickly as possible. I practice new sounds vowels or consonants alone in isolation only in the context of play. For example, if a kid doesn’t have an/m/, we do “mmm” when we eat snacks, pretend to feed babies, let the toy animals eat, etc… Then I move to a word with an /m/ such as “more” or “mine.” I set up situations so that he has to imitate the word to get what he wants for the next turn/snack.

I use lots of phonemic cues when we start to pay more attention to specific sounds. For example, I call a /p/ sound a “popper sound.” When I want to teach or practice this sound, I use an activity when saying this sound makes sense, such as bubbles with “pop.” Or we might play baby dolls for a child who is starting to potty-train, and we practice words like “pee” and “poo-poo.”

I work in oral motor practice, or for children with apraxia, oral sequencing practice, into play activities. I exaggerate facial expressions constantly in play and encourage children to imitate me. I do this with WORDS ONLY. If something is exciting or huge, I exaggerate, “Wooooow!” We’re beginning that word with a relatively closed mouth and opening up to a huge vowel sound. I use lots of “oooh’s” and “aaaah’s” when we’re playing. I do animal sounds, and my favorite is the monkey so we can practice “oo oo ee ee,” which really is practice sequencing vowels and alternating mouth movements. When we’re playing with play food, I lick my lips and say, “Yummy!” When we’re playing with farm animals, I ask my little friends if they can wag their tongues like the doggie’s tail. You get the drift. Put everything into play.

As I stated before, as soon as I hear a new sound in isolation or alone, I try to get it in a word as quickly as possible. When a child is good at imitating a word, I set up situations for him to use the word spontaneously, or on his own. We keep it at the single word level until he’s ready for phrases. (By ready for phrases I mean 50+ word vocabulary that he says spontaneously.)

One thing I emphasize with all children I see, and especially those with apraxia, is to set up play when I have to get multiple repetitions of the same word. Repetition is how children establish the motor planning necessary for and make the brain connections that result in intelligible and consistent speech. Don’t settle for one production of a word. I always play the “my turn/your turn” routines with toys, so that kids expect me to get even a favorite toy back, and they have to request. If you have to, steal the toy (playfully) and make them ask for it again (and again)! I never let a kid get something and then silently play for even 30 seconds before I’m prompting that word again, or another one. Join in. Make it communicative, and more importantly, keep it fun!

For vocabulary selection, I try to teach words that toddlers can use and ones that represent things they love. Generally, I teach more nouns/names for people, toys, foods, and other objects first. I always begin using verbs/actions during play soon after, and I especially want to focus on these when a child’s vocabulary is near the 50 word level, so that he or she can have some words to combine with their nouns to make phrases. I work on prepositions/location words at that same time too.

Many therapists make the mistake of teaching parents the wrong way to “expand” a child’s from single words to phrases by emphasizing word classes out of sequence from the way typically developing children learn phrases. I sigh when I sit in meetings and hear SLPs suggest that parents expand their children’s vocabularies by offering “blue car” or “big truck” when their children say “car” or “truck.” This is not how typically developing children expand to phrases. For specific ideas for phrase practice (and ones that work!), please look for a new article on this topic in the next few days.

I do NOT target intelligibility or articulation as the primary focus of therapy until expressive (and certainly receptive) language is close to an age-appropriate level. For most of the children I see for early intervention, this doesn’t happen before they are discharged to school-based or private services at age 3. I focus on what they are saying (what they mean) and why they say it (their intent).

I don’t focus on how they say words, with specific sounds, unless they are really, really, really unintelligible and no one, including mom, dad, regular babysitter, or me, can understand them. Nothing is more humiliating to a new talker than a parent who overcorrects first word attempts. I can see this in their little faces. They look at me as if to say, “Why bother? My mom never thinks it’s good enough.”

What you can do is restate the word they intended to say correctly. But please, I am begging you here, don’t say, “No. You said it wrong. It’s ____. Watch my mouth. ______.” Please, for the sake of your little one’s self-esteem, avoid the temptation to overcorrect. This places too much pressure on your child. When I suspect this is happening too much at home, and especially for a child with apraxia, I put the parents on a strict “NO SPEECH” vacation. They are not allowed to prompt, cue, question, or correct anything their toddler says. They are only allowed to model and shower their children with praise. Most of the time a couple of week break is all everyone needs to restore balance and order again.

This post is terribly long, but I hope you’ve hung in there to read it all. I believe that this approach works for all children with expressive language delays, but especially children with apraxia, because you are making speech practice functional by teaching words he can use, integrating specific sound practice into play activities to make it age-appropriate, targeting vocabulary and utterance length in a logical and sequential order, and helping his sensory and alerting systems stay regulated and focused with regular movement activities so that he can pay attention and learn.

Whew! That’s a lot of information! If you have questions or need me to expand or give more ideas, please don’t hesitate to leave a comment below. This site is for you. Laura

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Get my DVD specifically for parents of toddlers who are suspected to have apraxia. More info here!

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Besides being adorable and fun, I’m using the verses to teach imitation… specifically, imitating body movements.

Imitating actions is such an important precursor to talking. Here’s why…

Toddlers always imitate actions before they begin to imitate sounds and words.

(The exception is a child with significant motor impairments to his arms and hands which limit his/her ability to move those body parts.)

Imitating actions is level two of the eight levels of imitation that help a child move from being nonverbal to imitating phrases. Read more about this in Building Verbal Imitation in Toddlers… now on sale for $10 off!

Keeping that in mind, for toddlers who aren’t yet talking, one of the best things you can do is teach them to copy what you do. A great way to begin is with hand motions to songs like this one… We Wish You a Merry Christmas.

Sing the first verse as you would normally…

We wish you a Merry Christmas.

We wish you a Merry Christmas.

We wish you a Merry Christmas.

And a Happy New Year.

Then add a verse with an easy hand or body motion like this…

Let’s all do a little clapping.

Let’s all do a little clapping.

Let’s all do a little clapping.

And spread Christmas cheer.

Other ones I’m using are…

Let’s all do a little waving. (Great for kids who need practice to learn to wave consistently!)

Let’s all blow little kisses.

Let’s all do a little jumping.

Let’s all do a little stomping.

You get the idea!

If you come up with more creative verses, send them to me!

This little song has worked for me and I know it can for you too!

Wishing you a merry time this last week before Christmas!

Laura

For more ideas for songs, games, and play routines to help a child learn to imitate, check out Building Verbal Imitation  Skills in Toddlers… on sale for $10 off for a few more days!

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When you buy all 4 of my therapy manuals, Teach Me To Play WITH You, Teach Me To Talk: The Therapy Manual, Building Verbal Imitation in Toddlers, and FUNctional Phonology, you’ll receive my best-selling Creating Verbal Routines Therapy Guide for FREE.

Here’s a brief description of each of the therapy manuals:

Teach Me To Play WITH You is a therapy manual written for parents working with young children who have difficulty interacting socially with others. Instructions are included for beginning play with developmentally-appropriate activities using simple games and toys that are readily available in most homes. There are separate chapters with explicit directions, words, and hand motions for many familiar fingerplays and traditional childhood songs. Activities are written so that professionals can copy pages of a specific activity, complete the activity during a session, and share the copy with parents with homework. The final chapter explains approximately 20 different common problems related to sensory processing issues that we see interfere with a child’s ability to engage others along with multiple strategies for addressing these challenges during play at home. (Regular price is $48)

Teach Me To Talk: The Therapy Manual is written specifically for speech-language pathologists and other early intervention professionals who work with young children birth to 4 with receptive and expressive language delays and disorders. Because this project was written for professionals, it may not be as family-friendly as other teachmetotalk.com products, but many committed mothers and fathers report that this manual gave them more direction and specific instructions for what to work on at home than any other resource they’ve used. This manual is especially helpful for goal writing and for designing fun and developmentally-appropriate treatment activities for toddlers and young children functioning from the 6-9 month developmental level up to the 48-month developmental level. It’s the ultimate how to tool for working with infants and toddlers with language delays. (Regular price is $54)

Building Verbal Imitation in Toddlers – Learn the 8 levels of teaching a late talker to learn to imitate. Many times parents and therapists don’t see success with late talking toddlers because the adult isn’t working on the right things. The child actually needs to learn several “in between” steps before he’s ready to begin to imitate words and learn to talk. This simple, straight-forward approach is evidence-based and easy for both parents and therapists to understand and implement during familiar play-based activities and daily routines. (Regular price is $48)

FUNctional Phonology is my therapy manual designed for treating articulation and speech intelligibility in toddlers. Find out what kids are ready to target articulation (or specific speech sounds) and which ones aren’t – so you don’t waste your time – AND find out the 6 priority patterns for working toward intelligible speech with toddlers. (Regular price is $48)

Buy all 4 and receive my Creating Verbal Routines Therapy Guide for FREE! Here’s the link to more info about that Therapy  Guide at www.myei2.com.

To purchase, choose Therapy Manual Combo Pack SPECIAL here at Speech-Language Therapy Manual Combo Pack Special.

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This chart is EXCLUSIVE for email subscribers only…

Here’s your FREE pdf of the chart outlining the 11 Skills Toddlers Master Before Words Emerge from my new therapy manual Let’s Talk About Talking.

Before you download, a few reminders…

Please remember that this material is copyrighted. Permission is granted to print this chart in limited quantities for clinical use only. ALL POSTING AND/OR LINKING ONLINE IS STRICTLY PROHIBITED. 

CHART of 11 Skills Toddlers Master Before Words Emerge from Laura Mize and teachmetotalk.com

You can also read the following posts:

Let’s Talk About Talking…Ways to Strengthen the 11 Skills Toddlers Master Before Words Emerge

Let’s Talk about Talking… An Outline

Sample Pages

Listen to a podcast with a mom walking through the checklist of the 11 skills (another super handout included in the book!)

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Today I received this email from an SLP about her own son:

My little guy has is almost 2 years old and as his expressive vocabulary continues to grow with words like octopus and pizza?, he still signs milk instead of using verbal speech. This baffles my mind because it is such a high frequency word in our household as you can imagine! 

Here’s my response to her:

It sounds to me like his ‘motor plan’ (meaning how his little brain conceptualizes the word “milk”) is signing milk rather than saying the word.

To get him to say the word, try some of these options which have worked for me:

Feign ignorance when he uses his sign and say, “What???? Tell me! What????” and wait for the word.

Just as he begins to sign, playfully turn away so you don’t see his sign for milk. This will force him to try to get your attention. Hopefully he’ll use a word. Say things like, “What? Do want something?”

Go a completely different direction – more like sabotage. Give him the wrong drink and see if he’ll try to correct you.Give him the wrong drink. When he protests, say things like, “Huh??? What’s wrong?” or “Uh oh. You don’t want juice. Tell me what you need!”

After that, if he doesn’t say milk on his own, model “milk” a few times just as you would cue other “new” words. In this case, act like you’re starting over and teaching a completely new word.

Still no response? Try a totally different approach.

As you’re holding up the milk, ask him if it’s juice or milk. Here’s why… sometimes a child will answer a verbal question with a word, even if he signs as a request. (Try to figure that one out! It’s the same principle. If he learned to use the sign to make a request, he may say the actual word since he’s using a different pragmatic function – responding rather than requesting.)

Practice saying the word “milk” in a new context or setting. For example, when you’re at the grocery store, semi-shout “Milk, milk, milk!” when you’re at that spot in the dairy section. Sometimes kids will do something new when you’re in a different place because you interrupted their normal plan.

If a child loves vocal play and imitation games, begin by having them copy you as you do easy motor actions like clapping or patting a table, and then bump up to saying familiar words he can easily repeat. When he’s on a roll, sneak the word “milk” in there. Try another word or two and then go back to “milk” to give him additional practice. If this is successful, have that cup full of milk ready to quickly reward him when he says it. If he responds well to verbal praise, make a big deal when he’s said the word “milk” to reinforce his verbal attempts.

When these ideas don’t work, I have tried playfully holding a toddler’s little hands (so he can’t sign) and saying something like, “I know you can say this… tell me milk.”

Those are just a few strategies that have been successful for me.

Overall, don’t worry too much about this situation. He’s already talking, so you know everything is moving along. As nearly all children get older and begin to talk more and more, the signs will fade (since words are more efficient!), and then you’ll probably even miss those signs!

Laura

For more ideas for signing (and lots more!!), get my book Teach Me To Talk: The Therapy Manual. It walks you through how to teach signs and use picture system for late talkers and other toddlers with language delays/disorders. You’ll also see strategies and activities for every receptive and expressive milestone from under 12 months to age 4. It’s a must-have resource for pediatric SLPs!

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Between 12 and 24 months a child with typically developing language learns to understand some early prepositions or location words including in, out, on, off, up, down, here, and there. Late talkers and other toddlers with language delays may need some extra help with these kinds of words.

Remember — you must make sure a child understands the word before we can expect him to say (and use!) the word!

Here are my best tips…

1. Think about word placement. Many toddlers learn new words best when you use them as single words and at the ends of your phrases.

2. Repeat the new word often as you talk – not just once or twice. Research tells us that we should plan to model a new word 12 to 18 times before we expect a child to try to repeat it.

3. Toddlers learn best by doing. Teach these words during context while playing using objects to demonstrate the concept. For example, if a child is playing with a garage, say things like, “Look! In! Your car goes in! In! In the garage! In!” Then when he’s taking the car out, emphasize that word with “Out! Here comes your car! Out! Car’s out!”

Include these words in your everyday routines too. For example, when he’s taking his shoes off, be sure you’re saying something like, “Off! Take your shoes off!” Or if you’re walking downstairs, say something like, “Down, down, down! Let’s walk down these steps! Down!”

One fun way to target prepositions is to use the child himself to model each concept. Place him “in” a laundry basket and then take him “out.” Lift a child, “Up, up, up,” into the air, and then back “Down!” on your lap. Climb “on” the couch, and then jump “off” to the floor. A toddler’s favorite way to learn “on” and “off” maybe flipping the light switch or pushing buttons on the remote control!

While you might label and point out examples of prepositions/location words while reading books with a child or playing an app, please don’t rely on these as your primary method of teaching this important word category.

One last tip…

With typically developing children, these words are often learned in pairs as “opposites” such as in vs. out, off vs. on, and up vs. down. However, it may be necessary to teach one concept at a time for a child with significant delays to avoid confusion.

Need more tips like this? This information is from Teach Me To Talk: The Therapy Manual. Get your own copy to teach every receptive and expressive language milestone from under 12 months through 48 months. It’s a great resource for SLPs and parents of late talkers! (Be sure to use the coupon code SAVE15 for 15% off!) Quick order here.

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None of us can talk unless we know how to produce sound purposefully!

Some babies are extremely quiet and make noise only when it’s reflexive, meaning they cry, burp, cough, sneeze, and laugh, but it’s not something they seem to know that they can control.

In typically developing babies, vocalizations become more and more intentional as they learn to coo, squeal, grunt, whine, and babble. They learn to use their voices in different ways for different purposes, so there’s variation in the sounds we hear.

Questions to ask to determine if this skill is present:

•             Does a child make noise to get my attention?

•             Does a child look at you when he’s making noise?

•             What kinds of noises do I hear every day?

•             Are those vocalizations strong, loud, and intentional, or do they seem random?

•             Is she babbling?

•             Do I hear anything that sounds like a word?

Parents may miss how quiet their child is.

Sometimes a parent is thankful that their child hasn’t been too noisy until they realize how unnatural that is. Typically developing babies and toddlers make noise all day, every day. They learn that they can use their little voices to get your attention. Babies babble and make purposeful noises for months and months before vocalizations begin to sound more like words. When a child is very quiet for most of the day, he’s not getting the practice he needs in order to be able to talk.

There are several reasons that a toddler may not vocalize purposefully – too many to list here! Delays in language may be partially due to difficulties with speech production. However, if we can get a kid vocalizing intentionally as early as possible, we lessen the effects of even a significant speech problem.

Learn great ways to get this going in my book Let’s Talk About Talking… still in stock for a few more days! Don’t miss out!

Laura

teachmetotalk.com

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Initiating is important for language development because none of us can depend on other people to read our minds! We have to be able to ask for what we need.

Initiation is so important for language development that it’s actually included in one of the 11 skills all toddlers master before words emerge. (Read more about these skills in my therapy manual Let’s Talk About Talking.)

Before a late talker truly begins to initiate (meaning completely on his own), we can help him begin that process by the prompts or cues we use.

I found several infographics I like for a prompting hierarchy on Pinterest. The best ones were geared toward  AAC users (including speech-generating devices), but they are highly relevant for verbal kids too. If that’s your thing, pop right over there and search Prompting Hierarchy or try these links here and here. (These are also the sources for the info below.)

If you’re more a list gal (like me!), here’s a quick and easy summary:

Wait to give a child time to initiate. Many times we jump right in there to talk too soon! If we wait a little bit, a toddler may surprise us with her own words! Hold back for at least a few seconds before you begin to talk yourself. That can be so hard for us sometimes! (Read more about the power of waiting .)

Create interest and motivation with an expectant pause. This means that you’ll use body language to “look” like you know a child is about to initiate. An SLP who was a guest on my podcast once called this your “Tell me face!” I love that! Lean forward with wide eyes, an open mouth, and maybe even gasp a little as if to say, “I know you’re going to talk…”

Add even more body language. Shrug your shoulders as if to say “What?” Or even use a hand motion to gesture to what you think the child wants or to display options. By doing this, you’re giving a visual cue without using any words yet. Again… silence can be a powerful motivator for a late talker.

Begin with a leading, but non-specific statement or question. My favorite thing is to say, “Hmmmm….” like I’m thinking. Lots of my little friends begin to imitate this. (It’s even cuter when you add a gesture like tapping your chin with your finger.) You could be a little more direct and say something like, “Now what?” or “What should we do now?”

If there’s still no response, move on to more direct cues. Try:

Requesting a response. Say to the child “Tell me what you want” or “You have to ask.” Here you’re not modeling what he should say, but you are clear that you expect him to try to tell you on his own.

Try a carrier phrase to get him started. Say “I want a…” and then pause to let him complete the sentence.

Some kids need a bigger hint with a phonemic cue. In everyday language that means the first sound of the word. For example, if a child wants to ask for milk, say, “I want mmm…”

If all else fails, model the word for him to imitate. It’s not initiation because you’re telling him what to say, but it is imitation, another key skill for late talkers to master! Kids have to hear words for a long, long time before they begin to try to say them.

Don’t feel like a failure if a child doesn’t begin to pop out words on his own right away. All talking begins with imitating and it’s “good enough” for many of our little friends for a while! (For more information about how to teach a child to imitate, check out my book Building Verbal Imitation Skills in Toddlers. If you’d like to see examples, get the CE course Steps to Building Verbal Imitation in Toddlers!)

Beyond cues, there are lots and lots of other ideas for teaching a toddler to initiate. Environmental sabotage or creating opportunities for a child to ask for things is my #1 strategy for helping a toddler master initiation. Read more about that A Little Frustration Can Go A Long Way. If you’d like more how-to instructions and ideas, there’s a whole chapter about initiating in my book Let’s Talk About Talking.

Listen to a podcast about these strategies…

#321 How Can I Increase A Child’s Ability to Initiate? Choose Your Prompts!

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If you’re the kind of person who likes detailed step-by-step instructions, along with an explanation for why you’re doing something, you’re going to LOVE my therapy manual Let’s Talk About Talking. It’s filled with the rationale AND short cuts so that you can get excellent results with minimal effort. You’ll find the best of both worlds for treating toddlers with language delays. Here’s a sample page:

Teach Me To Imitate Words with SNACKS!

In this activity, a late talker learns to imitate words to ask for something to eat.

How to Play and What to Say:

Pick your bite-sized snack. Pour them into a bowl so that you maintain full control of the snack and offer a child one at a time. Small pieces allow for lots of repetition and practice so that a child learns the word. Options are goldfish or other kinds of crackers, bite-sized cookies, fruit snacks, or any other “treat.”

Select your target word. You can begin with all-purpose requesting words like “more” or “please,” but don’t forget about teaching specific words too! In this example, we’ll use cookies. For now, accept any approximation of the word cookie. If that’s too hard for a toddler, default to an easier and more general word like “eat.”

Teach a child to imitate the word using these steps:

1. Excitedly show him the snack, saying something like, “Look! I have ___! Mmmm!”
2. Say the word a few more times. “____. Yummy ____!”
3. Ask the child “Do you want _____? Tell me ____.”
4. Expectantly wait for him to say the word. Cue him 3 to 5 times as necessary.
5. As soon as he tries, immediately give him one little piece to eat.
6. When he wants another bite, repeat the entire process.

If he doesn’t try to say the word, model a word that’s easier, or back up and cue a sign. When imitating words is a brand new skill and still hard for a child, give him the snack anyway, even if he doesn’t say the target word. We want to keep him motivated to try.

Here’s how this activity looks in real life:

Hold up a cookie. Enthusiastically say, “Look! I have a cookie. Want to eat? Tell me cookie.”

If a child seems unaware or uninterested, eat the cookie yourself and act like it’s the best food you’ve ever tasted! Or give him one little piece to pique his interest. Repeat your prompt again. Say something like, “Mmmm! Cookie! It’s so good! Do you want a cookie? Tell me cookie.” Look expectantly and wait a few seconds to see if he will imitate you.

If he doesn’t, say the word “cookie” a few more times, or go ahead and change your target to an easier word you think he can say, like “eat,” or another word you’ve heard him say. As soon as he tries, immediately give him one little piece of the cookie. As he’s eating the cookie, continue to say things like, “Mmmmm… cookie. It’s so good! Cookie!”

When he wants another piece, begin the process again. Use this method to teach other words.

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Hopefully, these instructions will get you started! I have lots more for you in Let’s Talk About Talking…  Order your copy today!

Laura

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In this post, let’s look at more suggestions for car games with toddlers who are beginning to talk.

The best ideas are always the simplest. They’re the ones that are easy to do and easy to remember. All of these recommendations qualify:

MUSIC!

The car is probably the place where people listen to music the most. While listening to music isn’t bad, the very best way to use music with a late-talking toddler is by SINGING yourself.

The good news is that it doesn’t even matter what you sing or how well you sing it — toddlers love it! The car is the perfect place to establish a song routine too because you don’t have much else to do, especially when you’re waiting for older kids or are stuck in slow-moving traffic.

Singing can also calm a fussy toddler who may be sick of being strapped in the car seat. It may distract you too from the frustration of being cooped up with a cranky baby. Music resets the emotional tone for all of us.

Pick songs that are catchy and repetitive to give your child a chance to join in with key words. Traditional favorites are Old MacDonald, Wheels on the Bus, and Head Shoulders Knees and Toes.

Or make up your own songs with simple words! My favorite original one right now is a hybrid I came up with during a session years ago. It’s sung to the tune of Wheels on the Bus, but with an animal theme like Old MacDonald. It’s Animals on the Farm and here’s how it goes:

Cows on the farm say, “Moo, moo, moo.

Moo, moo, moo. Moo, moo, moo.”

Cows on the farm say, “Moo, moo, moo,”

All-day long.

Repeat with various animal sounds. (This song and more are from my book Teach Me To Play WITH You.)

When you’re not moving, pick songs that have hand motions to give your toddler even more reasons to watch you, listen, and then finally, participate! Good choices here are If You’re Happy and You Know It, Itsy Bitsy Spider, and Open Shut Them.

If you’re not much of a singer or when you’re sick of listening to yourself, move on to the next games…

COPY ME!

In the last post about car games, we discussed a couple of good ways to get vocal imitation going. In addition to those turn-taking games, introduce simple actions a toddler can imitate from his car seat. This game is especially suited for times when you can (safely!) move your hands and arms.

This activity can fill an important in-between step for lots of late talkers who aren’t yet imitating sounds. Before a toddler can imitate sounds, he imitates actions and t his game gives him lots of practice honing this skill.

The truth is, ALL toddlers like this game. It’s been a big hit for me at daycare, preschool, and places like the nursery at church with all kinds of kids.

It’s easy too. All you have to do is model an action a child can imitate. Start with something simple like clapping. Clap a few times and then wait. (And wait… read the last post about the benefits of waiting for late talkers!)

If a child doesn’t clap, give him a little encouragement. Say, “Clap! Come on… clap with Mommy. Clap! Clap!” If possible, reach back, take his little hands and help him clap. Smile and act excited when he does it so he’ll want to do it again to see your reaction.

After a couple of rounds of clapping, move on to a new action. Try lifting your arms up, waving your arms from side to side, opening and closing your hands, blowing kisses, patting your lap or the window, etc…

For kids who aren’t very vocal yet, sneak in sounds with this kind of practice. Sometimes a kid who doesn’t yet imitate sounds will do it in this context because he gets in the “habit” of imitating and it happens before he even realizes it. Read the previous post on car games for other ideas for these kinds of sounds.

For kids who can imitate words pretty well, try these ideas…

TODDLER I SPY

Instead of having a toddler guess what you see, you’ll tell him by saying, “I…see…a…______!”

Fill in with a familiar word you think your child will try to say. It’s even better when you can point to what you see and encourage the child to point too.

Of course, this game is best when you’re stopped and the scenery isn’t constantly changing. It also works well when other kids are in the car. Preschoolers and even elementary-aged kids like this game and will participate too, especially when you explain to them that you’re helping the baby learn to talk. Encourage them to point when they find the object you name. Or give an older brother or sister a chance to take the lead and be the person who says, “I…see…a…____.”

Be sure to build anticipation and create excitement with your voice as you say, “I…see…a…” A toddler will participate best when you act like you’re having a good time. Be as playful and as fun as possible!

Encourage your child to repeat the key word. Say something like, “BIRD! BIRD! You say it too! I see a…BIRD.”

Be sure to implement your best strategy here… expectant waiting for him to try to say the key word. You may even set it up again by saying, “I…see…a…” with your expectant pause so that he tries to fill in the word.

Just before you sense that he’s getting tired of that word, move on to a new object. Say something like “Let’s see more. Wanna play again?” Pause to give him a chance to respond. Unless he says “No,” begin the game again with, “Get ready. Here we go. I…see…a…_____”

Until a toddler is talking pretty well, he won’t be able to come up with his own original answers for “I see a ____.” Even preschoolers who are talking pretty well will still enjoy imitating what you’ve said and then finding it.

This game is great receptive language practice too – following directions by pointing to identify what you’ve named.

Remember, toddlers will need extra time to process and find what you’ve named before they’re ready to point and show you. Help them by modeling how to point and by playing this game A LOT before you expect them to become proficient. It may take days (or sometimes weeks) of consistently playing before a late talker begins to respond, but don’t give up too soon. Sometimes parents quit just before a child is ready to do something. Don’t! Keep trying…

Laura

If you need help with the little songs I mentioned, you’ll find all the words and hand motions to loads of these sounds and routines in my book Teach Me To Play WITH You, along with step-by-step goals for helping your child learn to play these little games. Use the coupon code PLAY to save 20% on this book.

The post Car Games for Toddlers…Part 2! Make the Most of Your Commute for Late Talkers appeared first on teachmetotalk.com.

“We spend lots of time in the car, especially waiting for my older children to be released from school and other activities. Do you have any ideas I can use during that time with my toddler who is not talking?”

Yes I do! Here’s my list of…

Car Games for Late Talkers

My BEST strategies for targeting language in the car with late talking toddlers are EASY. Start with this one…

1. Listen, listen, listen!!

Some late talkers are more vocal in the car than anywhere else. Maybe it’s the movement of the vehicle, maybe it’s the chaos of the older kids that provoke a toddler’s attempts to talk, or maybe it’s the one time of the day that a child who is always on the go is still enough for you to notice that he is beginning to try to talk!

No matter what the reason, listen!

What’s he trying to say?

If it’s a word you can make out, repeat it! Recognize and reinforce those early attempts. For example, if he says, “bu” when you’re parked beside the bus, say, “BUS! There’s the bus! You like that song about the bus. Wanna sing about the bus?” The launch into your best version of “Wheels on the Bus.”

If you can’t make out what he’s trying to say, but you think you know his intent, go with it! Give him the words he needs. For instance, if he sees his brother coming and starts to jabber, say “Hi! There’s (brother’s name). Here he comes! Hi (name)! Hi!!!”

If you don’t have a clue what he’s trying to say, that’s alright too. Many times late talkers are doing what other toddlers did at younger ages… practicing! They’re not really saying any true words yet, but they’re getting ready by vocalizing and practicing sounds and sound combinations. When this happens, say whatever it is that you think she might want to say, or use the next idea which can be super successful…

2. Imitate and Wait!

This strategy can be very powerful for toddlers who are usually quiet.

Whenever she makes a sound, copy her. Try to match her in every way you can – the same sound, same volume, and same intonation – as closely as possible.

Imitate her and then…

Wait.

And wait.

And then wait some more.

Experts say that you should allow at least 10 seconds before offering a new sound with a late talker. Here’s why… late talkers often need more time to hear a sound, plan to say it, and then finally, to say it. Think about it this way… if imitating sounds were easy for them, they would already be talking. For whatever reason, it’s not. So we have to give them extra time. If we move ahead too soon, we cut them off before they’re ready.

Ten seconds can feel like an eternity for chatty-patty moms — and especially for super chatty SLPs! I, Laura Mize, a speech-language pathologist with almost 25 years experience, also have a problem waiting.

Sometimes I have to press my lips together as a reminder to keep my mouth shut while I wait. When it’s really hard, I count silently… 1 Mississippi…2 Mississippi…3 Mississippi… (an ode to my childhood home…)  

No matter how hard it is, waiting for her next sound is exactly what you need to do to entice a late talker to make another sound.

Let me add that waiting here is much different from waiting when a toddler has said nothing. (More about that difference in another post…)

If, after about 10 full seconds, she doesn’t try again, then repeat the sound she made or another one she can do and then…(you guessed it) wait some more.

Don’t just wait. Wait expectantly. Lean forward, widen your eyes, raise your eyebrows, and maybe even let out a little gasp.  Act like you know your child is going to say something. Granted, this is not as effective when a toddler can’t see you, but if you make this a habit when you are face-to-face, it will work, even when a child can’t see your face!)

You will be surprised at how these simple changes can make a big difference. It may take a little while to get going, but imitating and then expectantly waiting, will help many late talkers begin these fun little vocal duos with you.

3. Begin a Turn Taking Game of Your Own

A similar strategy is initiating a turn taking exchange, but not with words unless the child is already talking pretty well. Here, you’ll begin the routine with something you know the child can say. The cool part is, it doesn’t have to be a word.

Can your child fake cough? Try that! Here’s how…

Cough.

Briefly check to see if your child is listening and watching, then cough again.

Wait…

Cough again. Maybe this time, clear your throat too. Or cough bigger.

Try it several times before moving on to a new sound.

BUT… if he imitates the cough, keep it going! See how many rounds you can get in before one of you drops out.

Then try a new sound… like an animal noise she can already do. Or a whine. Or a loud grunt. Fake cry. Pant. Pretend to sneeze. Click your tongue. Make kissy noises. Or even let out a little scream.

The key here is to get a toddler to be NOISY and TAKE TURNS.

Both of those foundational skills are extremely important for late talkers, and now you’ve given yourself a new way and a new time to work on them!

I’ve got some other car games for late talkers who are just beyond this phase. Here’s part 2:

Car Games Part 2

Laura

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Can’t wait until then for ideas? My first DVD Teach Me To Talk will teach you how to get started!

The post Car Games for Late Talkers…Great Ways to Maximize Your Commute with Your Late Talker appeared first on teachmetotalk.com.

This week we’re continuing to discuss things you can do TODAY to help a late talker.

If you’re a parent, this recommendation is something you can immediately incorporate into your normal routines with your child. Eating, dressing, bathing, playing, riding in the car, reading, snuggling… these are all fantastic times to use today’s tip to teach your child to talk!

Or if you’re a therapist (like me!), this is the kind of information you should be sharing with parents. In my experience, parents who have their child enrolled in therapy want ideas. They want to make a difference. These tips will give them confidence and empower them to work with their own child.

Today’s tip is this…

When you’re talking to your child, don’t just focus on words. Include this:

PLAY SOUNDS

What are play sounds?

Play sounds are noises and silly words we use when we’re having fun. The best way I’ve found to describe them to families are “sound effects.”

Babies with typically developing language skills use these kinds of vocalizations on their way to learning to talk. Fake coughing, squealing, and blowing raspberries are prevalent as a baby learns he can purposefully use his voice. Soon his utterances become communicative with sounds like grunting or whining to let you know when he wants something or is unhappy. After this, a child begins to try all kinds of new verbalizations that sound a lot like early word approximations. Finally, you recognize definitive first words.

What If Early Words Aren’t Coming

For a variety of reasons, “real” or “true” words are too difficult for nonverbal children. (If that weren’t true, the child would be talking!)

When we ‘back up’ and provide easier things for them to try to say, they do! They try!

I learned this lesson many, many years ago as a young speech pathologist. I’d work so hard to get my little clients to try to repeat familiar words in session after session. Fortunately, some kids were ready and my strategies worked.

But some kids weren’t ready. I’d struggle for weeks, sometimes even months (yikes!), before hearing consistent word attempts.

Then I learned a secret I didn’t learn in grad school…

Sound Like a Kid

I began to focus on doing what a kid liked. (More about that tomorrow!)

I noticed how kids sounded when they enjoyed what they were doing. What kinds of things did they try to say?

I didn’t hear a lot of words.

Many times, the only things I heard were play sounds – or sound effects.

Things like crashing noises when they played with cars, a “woof” or “meow” in imitation of a family pet, “mmmm” as they ate a food they liked, a big exhale after slurping down an entire sippy cup.

Once a child became consistently noisier, I noticed that late talkers did begin to try to say things that seemed closer to real words.

Little words like “whee” as they were swung around or “uh oh” when they dropped something.

When I very purposefully began to target these kinds of vocalizations in therapy rather than words, and when I worked just as hard on those sounds as I’d worked on real words, I noticed faster progress. It was no longer a surprise when a child popped out a play sound. I expected it because I was working on it.

You Can Do This Too!

Take this lesson I learned and use it for yourself.

Instead of trying to get a kid who is hardly saying anything to repeat a real word, focus on something easier. Begin with the ideas I included above. For a longer list, read Let’s Make Some Noise! Eliciting Play Sounds in Toddlers.  

As I said at the end of that post, remember to get NOISY to help a toddler move toward using words!

Laura

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If you’d like other suggestions for using play sounds or if you need detailed, “how to” instructions to introduce this powerful strategy, check out my book Building Verbal Imitation in Toddlers. SLPs – Be sure to use the great handouts in this book as parent education or homework for families! There’s also a one page chart to keep everyone on track!

SLPs and other pediatric therapists – This strategy is such an effective technique for nonverbal children. In fact, I’ve included play sounds and exclamatory words as entire ‘levels’ in my course Steps to Building Verbal Imitation in Toddlers. Find out how to maximize the use of play sounds, plus the other “in between” skills a child needs before targeting single words is realistic for toddlers with speech-language delays.

The post Today’s Tip for Late Talkers…. Don’t Focus on Words…Use Play Sounds! appeared first on teachmetotalk.com.

WAITING

Waiting to mention to the pediatrician that they’re worried about their child

Waiting to make the call to set up an evaluation

Even waiting to try to do anything on their own to help their baby

Waiting may seem like a good option when you’re not sure what else to do.

But the problem with waiting is that it can drive you crazy! Even though you try not to worry, you feel that internal tug to DO something….to try something.

If you’re the parent of a late talker, I can help you with that. I can teach you what to do at home TODAY to help your child begin to say words.

This week I’ll be sending out a series of emails with practical strategies any parent (or therapist!) can use immediately to get language going. (If you’re not on the list, you can be! Click back to the home page and subscribe.)

Here’s today’s tip….

Introduce verbal routines.

What’s a verbal routine?

A verbal routine is a set of words that are repeated at a predictable time during an activity.

We use verbal routines any time we say…

the same words, in the same way, for the same things, at the same time

For example, common verbal routines are things like saying, “Ready, Set, Go!” as you roll a truck across the floor.

Verbal routines are powerful  for kids who don’t talk yet. They’re often the missing link for many late talkers. I say “missing” link because most parents don’t know how to use a verbal routine or how effective it can be.

In my 20+ year career as a speech-language pathologist, I’ve found that the toddlers who respond best to this tip are ones who understand words, but who don’t respond when you tell them, “Say ____.” A child’s reluctance to try to repeat words can leave a parent feeling helpless and like there’s nothing that will work.

Thankfully, setting up verbal routines DOES WORK for many late talking toddlers.

Here’s why:

Our brains are wired for recognition.

When you use the same words during a specific sequence of events, a child begins to recognize the routine and respond. Once the routine is familiar, the child begins to participate, link meaning to the words, and then finally, say the words himself.

Here’s how we introduce verbal routines:

Say the same words, in the same way, for the same things, at the same time.

For example, every time you get ready to pick up your child, you could say, “Up, up, up!” And then when you’re going to put him down, you say, “1…2…3…down!”

Or you could sing little songs and tie them to your daily routines. For instance, when you’re getting a child dressed, you could sing these words to the tune of “Here We Go ‘Round the Mulberry Bush.”

“This is the way we put on socks, put on socks, put on socks.                                                                                                     This is the way we put on socks, early in the morning.”

After a while of using the routine, you’ll begin to pause to wait for your child to fill in the missing words.

Additional “Tricks”

There are additional “tricks” for making verbal routines even more powerful for late talkers. If you’d like step-by-step instructions, you can find those in my hour-long online video Creating Verbal Routines. You’ll learn how to implement this successful technique today with things you already do at home every day.

I won’t just tell you how to do Verbal Routines…. I’ll show you! You’ll see over 30 minutes of video clips from REAL LIFE speech therapy sessions when I’ve used Verbal Routines to teach toddlers and young preschoolers to talk. You’ll see parents right there participating in therapy, working with their child, and most of all, having fun!

In addition to the online video, you’ll receive an eight-page written guide to pairing with the activities demonstrated in the video. If you’re a parent, you’ll have instructions in your hands to help you remember what you’re supposed to do! If you’re a therapist, you’ll have written information to share with parents as you use this strategy during therapy sessions. Essentially, you’ll be starting a family’s at-home therapy program.

So instead of waiting, get started right now with the online video! It’s effective, convenient, and affordable – only $19.99. Click here to purchase and watch today!!

Laura

Laura Mize, M.S., CCC-SLP
Pediatric Speech-Language Pathologist

In some cases, the link to the video may expire after a few days. If this happens to you, email me at Laura@teachmetotalk.com and I’ll send you a new link you can access forever!

**Sorry, but coupon codes are not valid for this purchase.**

​

The post Biggest Regret Parents of Late Talkers Share appeared first on teachmetotalk.com.

A mom recently asked me for suggestions for teaching her child to use other people’s names. Many times, children with autism or social communication delays have difficulty learning to do this. Sometimes late talkers struggle to call anyone by name. Here are ideas that have worked well for me:

Play calling games!

1. The Mama Game

To help a child begin to use a person’s name, set up a game that I call “The Mama Game.” Since I’m usually working with mothers and their children during therapy sessions, and since it’s the one word moms want to hear most, “mama” is the name we target first. Actually, you can use this game to teach a child to say anyone’s name!

The most success I’ve had with this game is when we’ve placed the child in a confined area. I’ve used a crib or play pack, behind a baby gate, or in a room with a closed door and me. Mom hides outside the room, behind the door, or bends down below the crib so that the child can’t see her. Then I model calling, “Mama. Mama. Maaaaaaamaaaaaaaaa” several times using an exaggerated, playful, and animated tone of voice. I can’t stress how FUN and ‘over the top’ you need to be when you’re playing this game.

After calling for mom in this way several times, Mama excitedly jumps out from her hiding place with a big smile and shouts, ”Mama! Here’s Mama! Mama!”

Then we all laugh and smile and hug and tickle. We want it to be very clear that this is a fun game that we all want to play again.

And then, we play it again. And again. And again, until I think he’s ready to begin to try to imitate “Mama” when I model this word. If he even hints that he’s trying to say this word on his own, I ask Mom to pop up with the biggest reaction she can muster so that he links his action (saying the word) with her return.

Coach mom or anyone else you’re playing with to increase their affect if they’re not being as excited as they should be. Sometimes this one change in how mom reacts is what entices a child to begin to try to say “Mama.” When a mom can’t seem to respond as happily as she should, I go in to “goofy” mode to help everyone loosen up and let go. Making a fool of myself seems to encourage most parents to try a little harder : )

Expand the Game

Older siblings are GREAT at playing this game with mom and younger brothers and sisters. The act of having someone else “call” you and label you as “mama” sometimes helps a child solidify this concept. If you have no other children, then have Dad, grandma, your sitter or even a neighbor come in to help you teach your child this fun game. Don’t try to do it alone. Having another person call you “mama” is what makes this game work. Watch a video with more recommendations.

2. Simon Says – The Toddler Version

To teach a child to correctly identify people using their name, include at least 3 people in this game so that a child can get it “right” or “wrong.”

This game works particularly well for children who seem to be “stuck” on one person’s name. For example, if a child calls both mom and dad “Da,” we work on this game to highlight the difference between the two and the consequences of using an incorrect label.

In this more advanced game, say a person’s name and then give a simple direction such as “Mommy… pat your head” or “Daddy… jump up and down.” Have the adults model the game for a while before it’s the child’s turn to direct the game.

At first you may have to cue the child with what to say, especially if he doesn’t seem to know how to take his turn. An adult should “whisper coach” the child. By this I mean, get behind him, bend down, and whisper in his hear exactly what to say. “Say…. Daddy… clap your hands.”

If a child isn’t this verbal yet, modify the game by saying something like, “Let’s all jump. Let’s take turns! Whose turn is it? Mommy…jump!” After mom jumps, then ask the next person such as, “Daddy…jump!” To simplify the game, especially in the beginning, use the same action word for several turns and change only the person’s name.

When a child isn’t verbal enough to add the second word, but she can say some approximation of “mom” or “dad,” then I cue her to use that single word and I supply the command.

For a while, pause after saying the person’s name for emphasis. Eventually, you’ll shorten your pause to sound more natural as in “Mommy, look at me!” Shaping the target response in this way will help the child begin to sound more conversational.

Again, everyone playing should exude playfulness so that a child becomes super interested in the game.

Expand the Game

To help ensure that a child generalizes using a variety of names, add other people to the game whenever possible. This ensures that the child will begin to generalize the skill. Older children can be fantastic play partners for this game.

Over time, be sure to embed “calling” in more casual conversation so that it does become spontaneous. Parents of children who struggle to use names may need more specific recommendations so that they can provide the level of practice a child needs. During sessions, I spend time with parents brainstorming situations when they can work on this at home.

Do you have any fun calling games? If so, I’d love to hear them!! Leave a comment below or email me at Laura@teachmetotalk.com.

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If you’d like other practical and FUN therapy ideas like this, you can find those in Teach Me To Talk: The Therapy Manual. It’s always on sale when you use a coupon code!

The post CALLING GAME…Tips for Helping a Child Learn to Call People by Name appeared first on teachmetotalk.com.

Yesterday I received this email from an SLP who asked a question that’s very common for those of us who work with late talkers. I thought I’d share my response in case you need these tips too!

“What are your best strategies for “this” and “that” kiddos? I have a couple kids on my EI caseload right now who request and label using generic terms like this, that, and these. I’ve modeled the target words many times, and encouraged imitation, but we’re just not having much success yet.”

I’ve encountered this issue over and over in my caseload too! Here’s what I do when I have little friends that are stuck on saying “this” and “that.”

Look at Receptive Language

Many times we look at a child’s expressive language issues (what a child says) without considering receptive language (what a child understands).

Start with ruling out any receptive issues. Many times receptive language delays are very subtle. You end up thinking a kid understands much more than he truly does!  During sessions work on following directions with specific labels to make sure a late talker understands the vocabulary he hears.

Note any gaps in a child’s ability to follow commands and try to tease out the specific problem. Is there an overall problem with language comprehension or is it more definitive? Do you need to teach a child less familiar nouns (labels)?

If that’s the case, you probably need to go beyond those nouns and take a closer look at other word classes too. Does he also need help with verbs (actions words)? Can she differentiate prepositions (location words) such as in vs. out on vs. off?

Analyze What a Child Hears

Analyze the language models a child hears.  Many times adults speak using very general language such as “Give it here” instead of “Give me your cup” or “Do you want that?” instead of “Do you want apple juice?” Talk with a child’s parents (and other primary language models – teachers, grandparents, whoever you have access to see & educate!) about being SUPER SPECIFIC as they talk to a child avoiding non-specific pronouns like “this” and “that.” This process is harder than most people think!!

A Practical (But Sneaky!) Strategy

Pretend to misunderstand when a child says “this” and “that” giving them what they don’t want several times in a row. After a few misses on your part, then say something like, “Oh… you want ___. You have to tell me ____.” Hold out as long as you can for imitation of the specific label, without making a toddler too frustrated, of course!

Try Non-preferred Choices to Teach Decrease Non-specific Vocabulary

This last strategy is tricky to implement, but effective. Set up some clever choices when you’re asking them to choose things they call “this” or “that” by the specific label contrasted with another non-preferred choice you label as “this.”

For example, if they call a truck “this,” call the truck “truck” in your choice and another non-preferred toy “this” to see if they default to “this,” even when they obviously want the truck. Here’s how this looks in practice: you would ask, “Do you want the truck (which he previously labeled “this”) or this (offer another toy you are pretty sure he will decline)?”

If he defaults and says “This,” and then gets upset when you give the non-preferred choice, you’ll help him make the association with the correct label.

Food choices generally work best for this strategy because it may be easier to know what he definitively likes and doesn’t like.

If food items are impractical or won’t work because the child is a picky eater, select ANYTHING you KNOW he hates for the non-preferred choice. Call it “this” or “that” when you’re offering your choices so that he learns to use the correct label or he risks being misunderstood.

Remember too that older children who have difficulty with word finding (which is what this problems really is!) probably learned to over-use pronouns and non-specific vocabulary as toddlers. It’s up to us to address this issue NOW for our little friends to be sure that word finding doesn’t continue to plague them as they grow up!

More Ideas

Do you need more strategies for helping a late talker child learn to use more words? Read my best Tried and True Strategies.

Laura

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Do you have a question you’d like to see me tackle? I’d love to hear it! Email those to me at Laura@teachmetotalk.com with QUESTION in the subject line.

The post “This” and “That” Kids…Strategies for Reducing Non-Specific Vocabulary in Late Talkers appeared first on teachmetotalk.com.

Research reveals that there are several risk factors that let us know that a child’s late talking is likely a part of a child’s developmental differences, rather than the only issue. I’ve started a series of articles to address this concern. In this post, we’re addressing the fourth red flag:

Limited Use of Gestures

What are the gestures?

Gestures are actions or body movements we use to share a message to others.

This nonverbal method of communicating is important because it signals that a child understands that he can convey his idea to you by doing something. He’s becoming symbolic, meaning that he can perform actions that represent his intentions and thoughts. For example, when a child reaches for something, it means, “Give me that!” When he waves, he’s essentially saying, “One of us is leaving. See ya’.”

Other common gestures used by toddlers include pointing, showing, giving, clapping and shaking your head.

Why are gestures important for language development?

Gestures are an important marker for language development and a precursor to words. Typically developing toddlers begin to use gestures just before they learn to talk. Many times, a baby will make sounds intentionally and begin to produce a few early word approximations as he’s using a gesture. For instance, you may hear him grunt as he raises his arms to be picked up.

Speech-language pathologists think about gesture use as an early part of expressive language development. We place just as much importance on a child’s ability to use gestures as we do on her ability to produce sounds. Gestures are a “sign” that a toddler’s language skills are progressing.

When we see a lag in a baby’s ability to use and understand gestures, we suspect that he or she will be a late talker. Research confirms that a toddler’s ability to use gestures at 18 months can predict her language skills at 36 months.

Signs of Difficulty with Gestures

Babies who are typically developing begin to use gestures between 9 and 10 months and add on average two new gestures every month. Experts, namely speech-language pathologist Dr. Amy Wetherby, tell us that a child should be using at least 16 gestures by 16 months. When a child isn’t using at least a couple of gestures by the first birthday, it’s a red flag.

Diagnostic Implications for Limited Use of Gestures

Toddlers who don’t understand and use gestures have difficulty with the nonverbal aspects of communication. Many times this difficulty is linked to limited engagement and interaction with others. Current research tells us that early, intentional gesture use is so important for social skill and language development that any toddler who isn’t using gestures should be screened for autism.

Children with cognitive delays also have a hard time learning to use gestures. They may not understand what a specific movement can mean to others and may not have learned to imitate others’ actions.

A child with motor and muscle tone issues, such as cerebral palsy, will likely have difficulty using gestures because any kind of physical movement is challenging.

On the other hand, when a nonverbal toddler is using a variety of gestures to communicate, we don’t worry as much. We know that their expressive skills are developing, even if words aren’t!

Ways to Improve a Child’s Ability to Use Gestures

There are lots of things you can do to help a toddler learn to use gestures. First, model gestures yourself. The easiest way to remind yourself to do this is to talk with your hands! Be active and animated when you’re talking, playing, and taking care of a child. Point out things you want as you’re retrieving them and to direct a child’s attention toward something interesting. Shake your head as you say “yes” or “no.” Wave and blow kisses to people when you’re coming and going.

Get those little hands moving with lots of intentional practice! Teach a child to give high 5’s and a big thumbs up. Clap when something exciting is happening and to cheer successes. Play games and sing songs that involve familiar hand motions. Try “If You’re Happy and You Know It” and “Patty Cake.” Move on to new actions such as “Itsy Bitsy Spider” and “Wheels on the Bus.”

For additional ideas, read more about teaching gestures here. If you’re more of an auditory learner, listen to my podcasts about gestures here and here.

Recommendations for Parents

The most important recommendation I can make for parents of a child who is struggling with understanding and using gestures is to pursue professional assistance. Begin by discussing the concerns with your pediatrician or another healthcare professional. Ask for a referral to a speech-language pathologist or state early intervention program to evaluate your child’s overall language skills. If your doctor dismisses your concerns, get another opinion! You know your child better than anyone else ever will and if you’re feeling uneasy about your child’s development, trust your instincts!

Early intervention is especially critical for a child who is not trying to communicate by using gestures. As I’ve said in other posts in this series, maturity alone does not usually resolve these kinds of issues. By this, I mean that a child won’t “grow out of it.” Intervention is absolutely necessary! In early toddlerhood and throughout the preschool years, I believe that specialized developmental therapy services are critical. This period is when we can make the MOST difference in a child’s outcome. It’s when developing brains are most “ready” for growth.

Parents of a child with any kind of language delay will benefit dramatically from having a professional or team of professionals teach them ways to successfully address their own child’s needs at home. Therapy doesn’t need to be a once or twice a week thing when a child attends therapy or goes to preschool. By working with therapists and teachers who have had experience treating other children with similar backgrounds, you’ll be able to trust that you’re doing everything you can to help.

WRAP UP

In summary, a toddler who doesn’t use gestures may have difficulty acquiring a broad range of developmental skills including learning how to talk. These challenges may overlap into additional areas of development including a child’s fine motor skills. Assistance when the child is young can be highly successful for significantly improving, and in some cases, even eliminating these problems.

If you’re a parent, I hope that this information will help you understand what may be going on with your own child.

If you’re a therapist, this is the kind of information that doctors and other professionals may not be sharing with parents of a child with a language delay. It’s up to us to help families understand the depth of a child’s issues and provide hope that therapy, along with consistent parental commitment, can make a huge difference!

Keep watching for additional posts in this series! Next, we’ll discuss pretend play.

Laura

Product Recommendations from teachmetotalk.com for Helping Toddlers with Language Delays

Toddlers who don’t understand and use gestures will have difficulty learning to understand and use language. My best resources for parents include:

Teach Me To Play WITH You is my first book written for both parents and professionals. In this therapy manual, you’ll learn my best tips for helping a toddler learn how to consistently interact with you during fun games and social routines. It can be the starting point for therapy for any child who isn’t using gestures because you’ll learn how to teach hand motions in songs and fingerplays. Each activity is written in a “homework format” with step-by-step instructions and goals that are clearly delineated. Parents who use this method rave about how quickly they noticed changes in their toddlers once they implemented these methods.

Teach Me To Talk the DVD focuses on expressive language or what a child says. In this DVD, you’ll see the 6 beginning strategies I teach parents of late talkers. The DVD is filled with video clips of children with a wide range of abilities from 12 months to 3 years. It’s a great starting place for most parents (and therapists!) who want to learn real-life ways to work with a toddler with language delays. There’s a section about teaching beginning sign language, the natural extension of gestures for late talkers.

If you’re more of a reader, the therapy manual Building Verbal Imitation Skills in Toddlers has an entire chapter on teaching gestures – especially when that has not come naturally – for the child or you! If you like an organized, easy to follow approach, get this book!

If you want detailed goal lists for both receptive and expressive language matched with activities to use with toddlers and preschoolers, take a look at my book at Teach Me To Talk: The Therapy Manual. There are specific activities for teaching gestures and a great chart to use to help parents remember to include gestures in everyday routines. This book was written for speech-language pathologists, but many parents use it as their basis for “at home” therapy.

For therapists (and ULTRA committed parents who are working with their children intensely or parents who don’t have access to services and need professional-level information), my CE courses that best address early language skills (including gestures) are:

Is It Autism? Recognizing and Treating Toddlers and Preschoolers with Red Flags for ASD is a course on DVD. Part One entails a comprehensive look at the diagnostic criteria for autism so it takes some of the guesswork out of this process. If you’re a professional and find yourself wondering if a child would or wouldn’t get an ASD diagnosis, this course is for you! Part Two is all about intervention. You’ll learn the most effective treatment strategies and approaches to jumpstart progress in a toddler with red flags for autism.

Early Speech-Language Development: Taking Theory to the Floor. In this comprehensive 12-hour course on DVD, all areas of language development (social, receptive, expressive, and intelligibility) are addressed. There’s a discussion about the importance of gestures and strategies for improving early language skills.

Steps to Building Verbal Imitation in Toddlers is a course that outlines how to move a nonverbal child toward using words and phrases in a sequential, step by step approach. It includes an entire section (it’s Level Two) on teaching gestures.

All courses are approved for ASHA credit for speech-language pathologists (and if you’re in IL, it’s preapproved for EI credit!) with a certificate of completion for other therapists to use toward licensure or certification requirements.

Need a coupon code? Join my email list and you’ll get one! It’s on the last page of the FREE parent eBook. You’ll get emails with the most current sales with coupon codes not published here on the site. Sign up in the green banner.

Links to Milestones

Follow these informative links to the Center for Disease Control website with lists of skills and pictures to show you what’s normal for a child’s age range. Remember that most babies will have easily achieved the skills listed there – meaning that the standards listed are set at a minimal level to account for a wide range of “normal.” (In other words, the bar is pretty low.) If a child hasn’t met all the skills on these lists or especially exhibits the concerns in the bottom “Act Early” boxes, there is a definite reason to speak to your child’s doctor or healthcare professional.

12 months

18 months

2 years

3 years

4 years

Here’s a link to a FANTASTIC resource outlining the importance of gestures by Dr. Amy Wetherby.

16 Gestures by 16 Months

Photo credit: slate.com

The post Gestures Predict First Words appeared first on teachmetotalk.com.

We’re continuing our series with the 11 skills toddlers must master before words emerge.

Today we’re talking about skill #8 – Vocalizes Purposefully. When I explain this to parents I describe this as “becoming noisy.”

This skill is necessary for EVERY child. None of us can talk unless we know how to produce sound purposefully! Some late talkers will already be doing this, but some may not, so let’s talk about how to help move a nonverbal toddler toward becoming more noisy.

I also spent a little time discussing reasons (or diagnoses) associated with limited vocalizing in case you need that background too.

Listen to the show below or at this link.

Summary of strategies I shared during the show to help a late talker learn to vocalize:

1. Get moving! Children are more likely to vocalize when their little bodies are active!! Run, swing, bounce a kid on your lap, jump on the bed or couch. Try anything like this to elicit any kind of sound your child might make as he’s moving. Do anything you can to get some sounds!
2. While the child is moving, you (the adult) should model more sounds and early vocalizations rather than real words.  So… how does that sound? This means that rather than talking, you scream, squeal, say single syllables (like “Oooooooooooh!” or “Duh” or “Yah”), and model play sounds (such as car noises, animal sounds). Think in terms of using sound effects, rather than words.
3. Try vocalizing in a large space that echoes. I like to go in to a family’s empty garage or a large, open gym. Remember to model more sounds and less words! Yell. Laugh. Run around like a crazy person making all kinds of noise. Set the stage for a child to try to make noise too.
4. Simulate “crowd noise.” This means having everyone talk, laugh or sing all at the same time when your child is present. Often times this helps a child “let loose” and begin to make noise, just like everybody else.
5. Play with toys that amplify sound. Try those cheap $1 microphones, a paper towel roll, a funnel, pot or pan. Listen to the show for ideas and how to use this easy technique.
6. Introduce games and songs that include easy, early vocalizations like yelling or a simple word like “Yay!” I sang my favorite version of this kind of song in today’s show : )

Remember… a child has to become noisy BEFORE she begins to talk!

Ready for the next show? Click here!

Laura

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If you’re a therapist and need more specific ideas like this to use in sessions and share with families, check out my best resource for you – Teach Me To Talk: The Therapy Manual. It’s filled with recommendations that match the goals/milestones for children developmentally under 12 months all the way to 48 months.

If you’re working with a child who isn’t talking and need a step-by-step guide for helping him learn to say words, I highly recommend my book Building Verbal Imitation in Toddlers. If you’re an SLP or another therapist and would rather take a full course on DVD (with continuing education credit!) outlining these strategies so that you can SEE how this looks with toddlers and preschoolers, I have one for you with this information Steps to Building Verbal Imitation Skills in Toddlers. 

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If you’ve missed the earlier shows in this series, check them out below:

#275 Introduction Show – Why These Skills are Important

#276 Overview of Skills 1 – 5

#277 Overview of Skills 6 – 11

#278 Responds to Things in the Environment

#279 Responds to People

#280 Building an Attention Span

#281 Developing Joint Attention

#282 –  Developing Early Play Skills (part one)

#283 – Early Play  Skills (part two)

#284 Understands Gestures

#285 Understands What Words Mean (Follows Simple Directions!)

The post #286 – 11 Skills Toddlers Use Before Words Emerge – #8 Vocalizes Purposefully appeared first on teachmetotalk.com.

Today I received an email from an SLP who asked me this question:

“How can I get a child on my caseload who can talk to say more words during a session? He likes me. He likes toys. He’s in a good mood most of the time, but I still can’t get him to use many words, even though he’s a pretty decent imitator.”

Instead of reinventing the wheel for my answer, I replied to her with sections I copied and pasted directly from my book Teach Me To Talk: The Therapy Manual. These tips are so useful I want to pass them along to you too!

The best way to dramatically increase the number of words a child uses is by offering choices. Although this is still usually an imitative task since you’re providing a model by asking, “Do you want ____ or ____,” you’ll still significantly increase the number of words a child says in a shorter amount of time.

Don’t just offer a choice to select each activity in sessions, but keep the choices going throughout the play routine. For example, give a child a choice between playing Potato Heads or a puzzle. Once he imitates the word to select his toy, continue asking for every step of play by saying,

“Should we close or open the bag?”

Then ask,

“Who will unzip it, you or me?”                                                                                           

Then as you take out the Potato Head, ask the child where to put it down saying,

“Where do we put it, up or down?”                                                                                               

“Here or there?”

Then offer the pieces one by one by asking,

“Do you want shoes or hat?”                                                                                            

“What’s next – eyes or nose?”                                                                                         

“Teeth or arm?

Continue with every single piece until Mr. Potato Head is assembled.

Once you’ve admired your finished product, give a child some initial practice with any of the receptive language concepts you’re targeting with Mr. Potato Head. If you’re working on understanding action words, let the child use Mr. Potato Head to demonstrate action words after you’ve given him the choice offering,

“Should he walk or run?”                                                                                                               

“Fall or jump?”                                                                                                                   

“Will he laugh or cry?”

If a child doesn’t participate, keep him interested by being silly as you hold Mr. Potato Head and exaggerate each action.

Your goal here is to offer choices in a fast-paced way to keep him imitating and talking. It’s not unusual for me to elicit 25 or more different words within a single play activity using this technique. When you facilitate constant conversation like this, you’re building a habit of using words consistently and frequently. Again, this usually has to happen with imitation before it’s spontaneous.

The main reason choices are so powerful is that it gives a two-year-old the illusion of control within a session. You’re honoring what he says. If he chooses an activity, he gets to do it. The kicker is you can’t offer anything that’s not an acceptable option. Remind parents of this important strategy. Sometimes during a session when a child is having an off-day or is misbehaving a mom might ask him, “Do you want to play with Laura, or do you want her to go home?” I interrupt her only to say, “If he says Go home, then I’m out of here!” Teach parents that they should never give a choice when they can’t live with the outcome.

Another pointer for parents is to teach them to offer the choice they really want the child to pick as the last option. A child at this developmental phase often just echoes the last thing he hears. Later you’ll probably want to help him learn to listen carefully to both choices and say the one he really wants. Children with echolalia will struggle with this for a while, and for them, you’ll need to use a non-preferred option as the last choice so that they purposefully choose rather than imitate rotely. However, at this phase of development, an adult can use word placement to steer a toddler. A really smart toddler may catch on and trip up an unsuspecting adult despite our efforts. I just love it when that happens! The child has finally learned that words have power!

Teach parents to offer choices all day long at home. Most of the time, moms and dads have to watch this strategy multiple times, week after week, before they can get anywhere near the number of words that a skilled therapist can elicit with one activity. If you or parents aren’t as successful and need to see this technique in action, watch several examples on my DVD Teach Me To Talk in the section on Choices.

Another powerful way to increase the words a child uses is by creating opportunities for a child to ask for what he wants. This is referred to as Communication Temptations or Environmental Sabotage. Set up situations so that a child is more likely to ask for the object or event he wants. Some parents think of this as “playing dumb.” Begin a familiar activity, but don’t give the child everything he needs to complete the task. For example,

• Put him in the bathtub, but don’t run the water until he asks.
• Put on only one sock and shoe leaving the other foot bare so that a child is prompted to ask for the other sock and shoe.
• Eat his favorite food in front of him or give his siblings a snack, and wait for him to ask for a bite.
• Give him an empty cup with nothing to drink to prompt his request.
• Play with his favorite toy, and don’t share until he asks, or store that toy out of reach so that he’ll have to ask to get it down to play.
• Place his toys or favorite foods in clear containers so that he will have to ask for help to open the container.
• Introduce a wind-up toy since a child won’t be able to activate it alone.

Carefully consider the existing words in a child’s vocabulary before you orchestrate these tasks. The chief requirement is that a child must already be able to say the word you’re trying to elicit. If he’s never before said “juice,” he’s probably not going to be able to pop out “juice” for the very first time during this type of situation. A brand new talker will need to imitate the word for a while before he’s able to use the word spontaneously to request an item or event. Use withholding to encourage imitation on request. Once he consistently uses a word during withholding, move the word to this kind of activity to increase spontaneous use. If the child also exhibits a receptive language delay, be sure you’re helping him understand the new word first, before you expect him to say it.

Hope those ideas help you help a late talker you know!

Until next time –

Laura

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If you like this kind of advice, get the entire copy of Teach Me To Talk: The Therapy Manual for yourself!

My books are always on sale when you use the coupon code SAVE15 for 15% off.

The post Tried and True Methods for Helping a Late Talker Use More Words appeared first on teachmetotalk.com.

This morning a mom who read my “First Sessions” toy list asked me if I would send her a list “just like that” for my favorite books to use with toddlers during those first few speech therapy sessions. This post is my answer to her request!

Before I share my list of GREAT Books for Toddlers, let me pass on my BEST tidbits of wisdom I’ve discovered during my 20+ year career for using books with toddlers with speech-language delays. The first recommendation is critical:

If a young child HATES books, don’t force him to read!

Some parents and therapists are surprised at this advice because we all know how beneficial reading is for kids, but let me tell you why forcing a toddler to read is counterproductive.

When you force a toddler to participate in a truly non-preferred activity, particularly during the first few therapy sessions when you’re just getting to know each other, he’s not going to learn anything other than YOU are someone he DOES NOT LIKE because you make him do things he HATES. Therefore, he may begin to HATE you too. (Sad, but true!)

As a parent, we have to make our own children do things they don’t want to do every day – take baths, brush their teeth, change a dirty diaper, turn off the iPad or TV, go to bed, take medicine, and on and on and on…

But as a speech pathologist, you really don’t have to do things a toddler doesn’t like, especially in the beginning. During those first few sessions concentrate on building your relationship, or as I like to think of it, developing a special friendship with a child. I don’t understand why a therapist would want anything else. My cornerstone philosophy is this…

I want the child to like me.

So do you!! Here’s why…

When a child likes you, he wants to be near you. Being near you is necessary because he has to be near you to learn ANYTHING you want to teach him.

When he’s running away from you, he’s not learning. When he’s hitting you, he’s not learning. When he’s crying, he’s not learning. When he’s doing anything except looking at you and listening to you and engaging with you, he’s not learning. Period.

As I tell parents all the time, I want your child to come to associate me with fun and to believe that I am “the giver of good things.” In order for that to happen, I have to give a child something he likes, rather than something he HATES.

If you continue to insist that a toddler read a book with you and he doesn’t like it, he’s naturally going to do everything he can to resist. Ignoring you, moving on, running away, hitting, biting, or just plain checking out. As we’ve already established, NONE of those behaviors facilitates learning.

So it’s YOUR job, as the therapist or a parent, to make this activity something he doesn’t want to resist. If you can’t figure out ways to help him happily participate in reading, then my best piece of advice would be:

Don’t try books… yet…

Establish a child’s participation with you by playing together doing whatever he loves FIRST and then gradually move toward including books as a part of your therapy session. For additional information about why I believe it’s important to choose things a child likes during therapy, take a look at this post:

Why Motivation is Important

The good news is…

I have some super tricks that will make reading much more fun for many of our little friends who don’t necessarily HATE books, but who don’t exactly love them either. I’ll be including those tips as I present my list of books.

If you’d like to dig in with a more comprehensive discussion of these ideas, a couple of years ago I did a whole series of podcasts about books called “Making Books Better.” It includes milestones and theory in addition to a TON of practical, usable information and more specific “how to” guidance than I can list here in a post. Here are the links to those shows for you:

Making Books Better Podcast

Part 1

Part 2

Part 3

Other quick tips to make reading books with toddlers with developmental delays easier for YOU:

1. Choose CARDBOARD books for toddlers and preschoolers. A long, long time ago I realized that I tend to get a little cranky when one of my little friends rips a page… To avoid that unfortunate but very common occurrence, I use only cardboard books!

2. Consider when you read with a toddler. Pick a time when a child is more likely to participate. If a child is all wound up, it’s probably not a good time for a book. If a child needs to run around to release some pent up energy, let her do that first, then read. If a child is hungry, feed him first, or better yet, let him eat while you read. Choosing better timing is all it takes for some children to begin to like books.

In sessions with busy kids, I try to pull out a book when a child is seeking comfort or is settling down. This is why reading at bedtime is so popular.

It’s also why reading during a therapy session can be a challenge. Sometimes we’ve worked hard to rev up a child’s little system to get him to the point where he can talk and perform, and then we switch gears and expect him to listen to a book. This can be too passive for many of our little friends, especially when they don’t really understand the words they’re hearing. We’ll have to tweak when and how we present the book to make it more active and more meaningful during therapy. These same strategies can work at home too for a child who has rejected a parent’s attempts to introduce books.

3. Sit together to read. I hold toddlers in my lap all the time to read books. Body on body contact is regulating and calming for young children, particularly when a toddler has a tough time sitting still. Holding him or her will also help build that all important social and emotional connection with a child. As therapists who work in early intervention, establishing this connection should be one of our first and primary goals. If a child will let you connect with him like this, it is a great beginning.

For toddlers who don’t like to be held, sit across from them and hold the book facing them to show them the pictures. If you’re having a hard time establishing joint attention while reading, meaning that the child no longer includes you in reading once he sees the book, sitting across from him will make it much more likely that he remembers you’re still there! Sometimes I even place a kid on a low coffee table or couch. I sit on the floor so that my face is level with the book and it’s more likely they’ll notice me as we read together.

4. Do your best to maintain control of the book. If a toddler gets upset and won’t let you hold the book, do your best to stay engaged and making yourself a necessary part of the activity without forcing him into a meltdown. No child learns language during a power struggle, so do everything you can to avoid them!

When a child won’t look at books unless she’s in total control, reading is not a shared activity. Until a child lets you participate and listens to you talk about what she’s seeing, there’s no language component to this activity. Remember the way children learn the language:

A child has to hear words before she learns to understand words.

A child must understand words before she learns to say words.

In a nutshell, an adult has to be a part of reading books in order for books to “count” as helping a child learn language. You can make an argument for providing books as a valuable solo activity for all children. However, for a toddler with a language delay, there’s no real language teaching going on unless you’re helping a child learn to link meaning with the pictures they’re seeing.

Upon closer inspection for some of these children, you may realize that she isn’t really even looking at the pictures. She may flip pages hurriedly or hold her face close to the page. In this instance, the child is engaging in visual self-stimulation, or “stimming,” and a book is not going to be your best tool to teach that child to understand and use words. Back up and teach this child to play together with you and include you in her activities. My best resource for this is Teach Me To Play WITH You.

Now that we’ve covered those basics, let’s move on to my list of Great Books for Toddlers! I’m also going to share with you a few of the ways I use these books during therapy sessions because frankly, you should be using different books for different purposes to target different goals with different kids. Do you see a theme here? You should tailor the book to the child and the specific skill you’re working toward. Of course you can use the same books for multiple purposes, but as you read, you’ll see what I mean…

1. Photograph Books with only 1 or 2 pictures per page

I LOVE Roger Priddy’s simple picture books and own so many that I can’t pick just one! Here are a few of my favorites for toddlers who don’t understand very many words yet.

Because you’re using photographs instead of cartoons or drawings, these pictures are more like REAL LIFE. This is particularly important for children with global, cognitive, and receptive language delays who may have difficulty understanding any kind of symbolism or have difficulty making associations and connections. They may not “get” that the picture of the sippy cup in the book is the same as their own sippy cup. When we use simple, realistic pictures, books become more meaningful for these toddlers.

The most obvious way to use this kind of beautiful book of real photographs is to teach early picture identification. You’ll do this by first “teaching” the words, which means you should point to the picture as you say the name of the picture OVER and OVER and OVER again. To learn to understand words and to eventually be able to point to pictures, a child has to hear the word OVER and OVER and OVER. There’s a theme here! It’s repetition.

When you are working with any late talker, one of the first things you have to do is to make sure is that a child understands words. If a two-year-old cannot point to several familiar pictures on request, and by that I mean consistently looking for and finding the right picture when you say, “Where’s the ____?” then he likely has a receptive language delay. This means a child doesn’t understand words as well as he should for his age. Many, many, many parents miss this important reason a toddler isn’t talking. If you suspect this could be a remote possibility for your child, please read this post:

If you’re thinking, my child knows the pictures, but he just won’t point when I ask him AND if this same child doesn’t consistently follow simple directions, then I would also, very gently, encourage you to consider the possibility of a receptive language delay. Receptive language delays are so overlooked in early intervention and even by pediatricians who mean well, but who don’t really understand language development themselves. I specialize in receptive language delays in toddlers and have some super information in my DVD series Teach Me To Listen and Obey 1 and 2. Take a look at those fantastic resources for hands-on and immediate help for you! Just today a mom emailed to tell me how effective the DVD has been for her son after she implemented my “Tell him. Show him. Help him” approach.

Back to photography books…

The very BEST way I use simple picture books is to teach a child to follow directions using a book like this one.

Using this cute book about babies, you would teach very simple actions such as:

Kiss the baby. Pat the baby. Tickle the baby.

This kind of teaching is wonderful for kids who like books, but who don’t have great play skills yet or who have difficulty following verbal directions. In addition to working on receptive language, what you’re really teaching a child here is to imitate actions. This is the one of the first developmental steps in learning how to talk. Here’s a little summary of how I introduce this kind of activity with a book:

Keep your language very simple. Avoid over-talking since you can overstimulate a child with too much language and actually drive him away. Label the picture and keep your comments brief. Then once you’re sure the child is staying with you, begin to model the action you want him to complete. For example with this book with babies, this is what I would say:

“Baby! Ahhh baby! Look! Baby! Kiss! Kiss! Kiss the baby! Kiss! Give baby a kiss.”

Model and practice that same action several times as you’re saying “Kiss!” If a child doesn’t lean in to try to kiss the baby, move the book toward the child’s mouth. Don’t force him, but do help him. Keep it light and fun and keep kissing the baby’s picture yourself as a “model” for what you want him to do.

Patting is another action to try. Say something such as:

“Pat, pat pat! Pat the baby! Ahhh…. Pat! Pat that baby.”

If a child doesn’t pat the baby’s picture, offer hand over hand assistance and help a child complete this action.

Other movements you can try are tickle, hug, and give the baby a “high 5.” With a few props you could teach: wash the baby, feed the baby, hide the baby, etc…

If a child doesn’t like babies, find a book with something he does like. Here are other ones I’ve used based on a child’s individual preferences.

Here’s another hint…It doesn’t even have to make sense to you! If a child LOVES trucks, then you could even use a book like this one to teach him to imitate actions and follow directions – I  have! My little friend who was obsessed with trucks was fine kissing and patting his beloved “tu.”

Certainly you can extend this concept with other kinds of books. If you’re using a book with a picture of a door, model knocking on the door. If there’s a flower, pretend to smell the flower. Imitating actions is always a great beginning goal for late talking toddlers and using a book can be a very successful way to help a child learn how to do this!

Here’s one more suggestion in this category of simple photo books. I bought this book several years ago and have replaced the batteries, but it’s still going strong!

As a rule, I don’t like many “sound” books or books with buttons, but this one is EXTREMELY enticing for toddlers who don’t usually attend to books. You’ll want to be sure a child doesn’t perseverate or become “stuck,” pushing the buttons. To prevent that, MAINTAIN CONTROL OF THE BOOK! Here’s the BEST way I begin with this book to focus on learning words rather than pushing buttons…

Open the book. Point to the picture as you’re naming the picture several times. Then say, “Let’s find it! Where’s the ____?” as you point to the buttons. If the child has difficulty finding the correct button, use your hand and arm to cover most of the buttons except the correct choice and 1 or 2 other options. Provide gentle hand-over-hand assistance if he needs help to push the button or can’t locate the correct button. Let the child push a couple of times, then return your attention to the pictures. It may help to flip the page to redirect the child’s attention. I also tap the picture several times to call attention to the picture. Some toddlers become fascinated with that tapping sound and will begin to imitate pointing.

2. Books Based on Songs

When a child likes music, books based on songs are a natural extension of this interest. If I’m working with a child who loves for me to sing, but hates reading books, this is my go-to trick! The song is your “hook” to capture a child’s attention.

Begin by singing the song as you normally would, and then the second time you start to sing the same song, pull out the book based on the song. Point to the picture that corresponds to the words you’re singing. It’s important to continue to sing the song in the same way you always do so that the child stays with you and begins to associate the book with the song.

Over time, move from true singing to using a more sing-song kind of speaking voice, and then to a more natural (but still animated!) reading voice with the same books. After a while, introduce other kinds of books still using your sing-song voice since you know a child responds well to this strategy.

Here are a few other titles to consider:

If you need some help remembering children’s songs or simple games and could use a little guidance with how to make these activities FUN for children who love music but who don’t interact or play with others very well, take a look at the description of my book Teach Me To Play With You in that link.

3. Moo Baa La La La

All of Sandra Boynton’s books are precious, but my favorite is the one I have here, Moo Baa La La La. I’ve adapted this book to use with my little friends who are so BUSY that they can’t sit still for a book.

It’s easier to explain this on video than in writing, so watch this Therapy Tip of the Week video to see how I’ve modified this kind of book and then make it even more fun by adding other options for the pictures.

When you adopt the book, you’ll be giving a child something to do with the book, which means that he or she now has a reason to stay with you. Personally, I’ve had so much success with this method for years during speech therapy. After I published this Therapy Tip of the Week video last year, SLPs and Moms have emailed me to RAVE about how well this idea has worked.

It will take some extra time and a little investment to prepare this activity, but it can result in dramatic improvements.

I’ve also adapted other board books using this same method with great success. The Very Hungry Caterpillar is a fantastic one to try because you can use it to teach so many concepts! For my youngest friends, I copied and laminated the first caterpillar and the food pictures. Make the caterpillar “eat” the food pictures for another fun extension of this book!

4. Happy Colors – Bright Baby Books

This darling set is similar to the books listed in #1, but the complexity increases since there are several pictures per page. The activity I’m going to share is so special that it’s worth its own category! Here’s the book I used to set up this activity in 2010 and I’m still using the set today!

In this activity you’re teaching a child to match pictures to objects. For this activity, you will need to do additional work, but the results will justify your prep time! Let me share all the types of kids who will benefit from this activity:

• A BUSY toddler who needs something more to do with a book than listen in order to keep his attention, but who is ready for a slight increase in difficulty.
• A young child who understands some words and is following a few simple directions like those in #1, but who does not “get” pictures yet and is not pointing to pictures when you ask “Where’s the ___?”
• Kids who only ‘tolerate’ books love this activity and with exposure to books in this context, they learn to like reading.
• This is my favorite ‘beginner’ activity with books for many toddlers when language delay is the only or primary issue.

To organize this activity, you’ll gather objects to match pictures in the book. Try to match objects and pictures as closely as you can so that it makes sense to the child. It will not be necessary to find an object for every single picture, but try to get at least a couple of objects per page/s.

Because this is one of my standard therapy activities, I keep all of these things together in a bag so they’re ready to go when I need them. Moms I’ve worked with have also put together their own bags and have even taught babysitters and grandparents how to use this activity.

I also like to have a container or a bucket for the child to put the object away after she’s selected it to keep her on task and coming back to the book – otherwise, she may decide just to play and not come back to you and the book!

When you’re a first beginning, you’ll only ask a child to find one object for each page so that you can keep it moving pretty fast. I like to start with objects and pictures I think a child already knows so we build in a pattern of success from the beginning.

Here’s how to play:

Set out a few of your objects – don’t overwhelm a child with too many choices – pick 2 or 3. Say something like, “Look! Let’s find this one!” as you point to the picture and then say, “Where’s the ________?” as you say one of the objects you have available for her. Praise her liberally when she finds it or provide additional cues if she doesn’t.

I also have a child turn the pages if it seems to keep them involved in the book AND if it doesn’t provoke them into wanting to hold the book.

If  you’ve bought my first course on DVD or if you’ve seen me teach that course live, I show a CUTE clip of my little friend Kellie and me using this activity in the Receptive Language Section. Take a look at that for a refresher!

This matching activity is a great way to keep kids involved, but it isn’t solely dependent on the book. Beyond teaching matching, you’re helping kids who don’t seem to understand the symbolism of pictures. You’re teaching them that the picture represents the object.

This one way of integrating real objects has been hands-down the most successful strategy I’ve ever used to help a child learn to identify pictures and to participate with books when he or she has shown little interest in the past. If you’re the kind of person who says, “Just give me one great take away idea …” then this one is it!  Get this book or a similar one, dig through your toys to find matches, or if you have to, get to Dollar Store and find the objects for your book. You’ll prep for this one time and then you have the activity FOREVER which is totally worth it!

5. Little Blue Truck

This has become my standard therapy activities in the last year because it’s SUPER engaging, especially for little boys who are fascinated with trucks and other things that go! The book has been even more fun now since I began to read it with “props.” As we did in the last activity, find toys that look very, very, very similar to the pictures in the book and then act out the story as you read.

As with the last activity, you’re giving the child something to do besides sit there and listen, which is huge for our busiest little guys who become “antsy” when they aren’t moving. This strategy has also helped several of my little friends who love books, but who don’t know how to play with toys. The book serves as a “script” for what to do and how to use the toy.

I implement this idea in therapy by reading a page and then playing with the toys. If a child doesn’t catch on immediately, I slow down a bit, read a line in the book again, and then very purposefully show a child exactly what to do with the toys. As I play, I rephrase any words I don’t think he understands.

I’ve taught this method to several families (and therapists) over the last year for kids who like books, but who have significant language delays and limited play skills. My Little Blue Truck bag has become a staple for their therapy programs and at home with parents to teach them how to play and associate the words in their books (or movies!) with real life. It’s also been helpful in teaching a child to consistently follow your directions with very few of the “compliance” issues we can sometimes see because they think they’re just playing. I’m sneaky like that and it works so well!

Last Christmas I videoed an extensive version of this idea. Before you watch, let me caution you… DON’T BE INTIMIDATED by the lengths I went to in order to recreate this book. My “every day” therapy sets of books with toys don’t have nearly the number of objects I included for the video. Start small! My original set for the Little Blue Truck I have linked here consisted of a blue truck, a dump truck, and several of the animals in the book. Over time, I built up inventory of potential props and I went all out for this Christmas Little Blue Truck since I was making a video for a course I was teaching.

6. From Head to Toe

I love any book by Eric Carle, but this one has become my favorite. Let me tell you who it works for:

• “Busy” kids who can’t sit still and need to move.
• Kids with limited vocabulary words – teach ACTIONS or verbs!
• Groups of kids (You know when you walk in the daycare and suddenly, you’re the teacher!?!?)
• Toddlers who are isolated and unaware of others but who respond to books.
• Children with limited social skills who are ready for the next step. They may notice peers during gross motor activities like running on the playground, but they don’t yet participate in true parallel play.

Your goal is to get a child to imitate and perform the action in the book. Introduce the book by saying something like, “Let’s do what’s in the book!” Read a page, show a child how to copy the action, and encourage the child to imitate too. Everyone present should participate, including mom, siblings, or other children in a child’s class if you’re using this as a group activity. Read the entire book keeping it light and fun, even if the child isn’t 100% compliant. Use hand over hand assistant to help a child perform the movements if it’s not too disruptive and it doesn’t evoke negativity or an avoidance reaction from the child.

This book is repetitive so there’s a Verbal Routine. The repetitive line is, “Can you do it? I can do it!” I think it’s always fun if you can get your group to “yell” that line with you after they’ve heard you read it a time or two. The group yelling usually entices little ones who are reluctant to participate to try the action and they begin to anticipate the words. You may even get some early word attempts as their friends or family “yell.”  This technique is called Vocal Contagion and it’s so effective for late talkers!

The two important language strategies you’re using with this book are teaching a child to imitate body movements and verbal routines. You can find detailed instructions for using those techniques in my book Building Verbal Imitation in Toddlers.

Other books I’ve used to teach whole body imitation, particularly with groups of toddlers, are:

7. Chicka Chicka Boom Boom

If you’ve followed teachmetotalk.com for very long, you may be surprised that this book made my list since I PREACH teaching words that are meaningful and functional for late talkers.

Let me restate this… you should not worry about teaching a late talker letters, numbers, colors and shapes. Working on those words makes no sense at all when a child is not talking! A child should learn to say words he needs and can use all day long rather than ABCs, counting, or any of those other “academic” concepts. We should never focus on teaching this kind of vocabulary until a child is communicating pretty well. I encourage parents of the children I treat to hold off on teaching colors, shapes, numbers and letters until a child is consistently using short phrases.

BUT…

There are some children who seem to have taught themselves letters, numbers, colors or shapes. I’ve seen children who were fascinated, almost obsessed, with this kind of visual information. When I see a child with this “splinter skill” for therapy, I use it as my way “in” with that child. I teach him to include me in his play by sharing his interest.

For young children like this, start with a book that includes his preference. With a child who is fixated on letters, I introduce this book and target listening practice by reading the book and then asking him to “Show me the b,” or “Where’s that r again?” or “Find the g and the h,” or “Where’s the yellow t?” You’ll make him feel successful since this is what he LOVES, but here’s what else you’re doing in those early sessions:

• Making a connection with a child who may be difficult to engage
• Targeting language processing or “listening” since he’s following directions
• Building compliance since he’s responding to what you ask him to do
• Meeting him where he is by using his quirk as a STARTING point and then bumping up the complexity as you become more creative about what you ask

I add magnetic letters like those you put on your refrigerator and “act out” the book with the letters as I read. You can use the side of the refrigerator. I’ve made a tree from construction paper and taped it on a metal cookie sheet for the background to play with the letters. It’s a great way to draw a child’s attention to me when he tends to leave me out of reading books.

Children who are “echolalic” with their favorite books, meaning they memorize and repeat the book out of context, often are initially confused when I demonstrate the book or what they’re saying, but if you keep at it, they will become intrigued. In some instances I’ve quickly noted huge progress in how they connect with me during an activity like this using their “echoed” topic.

If you have a child who FREAKS OUT over numbers, then I’d go with this version:

Here’s a Therapy Tip of the Week video where I’m discussing using a child’s special interest in this way with books:

8. Brown Bear, Brown Bear

I’m going to end this list with the quintessential speech therapy book that every SLP can quote in her sleep. We ALL own and use this book. Let me share a few of my best ways to use this book with toddlers.

For starters, the version I’ve posted here has a very cool sliding feature that even the “most belligerent hater of books” kid cannot resist! I’ve seen children dramatically improve their ability to point after we’ve practiced with this book because they learn to isolate their finger to slide the page.

Our little friends who are iPad-addicted like this version of Brown Bear, Brown Bear because it’s like ‘swiping’ an app! If you’re trying to help a little one break their addiction to technology (and I’m not even kidding!) or if you’ve become too app-dependent yourself in therapy, this is a great transition activity to help either of you back to interacting during real life with real people with more traditional activities!

Other excellent ways you can use Brown Bear:

• Teach the signs for the animals. It’s a great vocabulary extender!
• Do one Google search for matching pictures and use them on AAC devices!
• Copy and laminate your pictures to use with Velcro like we discussed for book #3 or matching objects as I talked about for book #4!

But my second FAVORITE thing I do with Brown Bear is teaching…

Play Sounds!

Many toddlers begin speech therapy with the ability to make an animal sound or two and aren’t ready to jump to single words. Spend some time in this vocal play stage since you know this is where they can be successful! Check out this post for more ideas with play sounds… Let’s Make Some Noise! (For SLPs who need more help knowing the prerequisites for talking, get your hands on my CE courses on DVD – Early Speech-Language Development: Taking Theory to the Floor or Steps to Building Verbal Imitation in Toddlers!)

My BEST way and my FAVORITE way I use Brown Bear is to teach the word (or sign) for “me.” The word “me” is the last word of every page so it’s repetitive and qualifies as a Verbal Routine. A child begins to expect that word and if you set it up right, will often blurt it out before he even knows he’s talking.

Once a child has mastered the word “me,” I try to elicit “see” using the same strategy of reading the book until a child becomes familiar with the word and anticipates it.  I use my facial expressions, my body language, pacing my voice so that it primes his little pump to talk, and then the PREGNANT PAUSE, where he fills in the word. I don’t have a great clip of this to post today, but I’m going to do one soon just so you can see this SUPER SUCCESSFUL strategy.

This also has been the book I use most often when I’m working on teaching the vowel sound “eee.” Vowel sound errors are common in apraxia, a motor speech sound disorder. For more information about apraxia, check out my DVD Teach Me To Talk with Apraxia and Phonological Disorders.

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While there are DOZENS of other books I like, these books are the ones I use over and over and over because they work!!

The books and the activities I’ve shared have been the most successful for me during therapy sessions AND, more importantly, in helping (moms and dads) know how to work on language when I’m not there!

Get the books.

Copy the activities.

HAVE SOME FUN!

Until next time…

Laura

The post Great Books for Toddlers with Speech Language Delays (with Therapy Activities!) appeared first on teachmetotalk.com.

One of the prompts on the test is asking mom (or dad or grandma – whoever is the caregiver during my visit!) to sing a familiar song or nursery rhyme to the baby to gauge his or her reaction.

Over the past several weeks, I’ve heard my share of standards:

Old MacDonald, Itsy Bitsy Spider, Twinkle Twinkle Little Star and Patty Cake, to name a few.

But then something unexpected happened!

In all my years as an SLP, I’ve never heard variety and creativity like I did last week!

When asked to perform this task, a grandmother beautifully sang every note of “These are a few of my favorite things” to a set of squirmy twins who both stopped (momentarily anyway!) and listened to her rich tone. Me too! I haven’t heard that one in years!!

A few days later, a 20-something mom who’s also a special educator introduced me to,

“Uptown, funk it up. Uptown, funk it up.”

As she sang those words I wasn’t sure I understood…

But it didn’t matter,

Because her 6 month old was enraptured!

When I left that eval, I couldn’t wait to find this video on youtube! Catchy song! I do love Bruno Mars!

Later that same day, I asked a dad to show me a song or game his baby liked. He sang something like…”Jump-a baby jump-a! Jump-a baby jump-a! Now you up-a!” His 9 month old anticipated the actions and then belly laughed while his dad lifted him high over his head.

This made me remember a lesson I learned when my own children were babies:

It doesn’t really matter what you sing to a young child, just sing! The truth is that most kids like all kinds of music.

Now occasionally, especially when working with toddlers with developmental delays, we will encounter a child who may not always respond so well to your attempts to sing. If a child covers his ears while you’re singing, it’s always more about her than you! Ear covering nearly always means that the child has an auditory sensitivity, not that you have a terrible voice! Chanting usually works for those kids, so channel your inner cheerleader! Rather than using your regular singing style, rhythmically chant the words to the song instead.

The benefits of singing with babies and toddlers are numerous, but the ones that intrigue me most as a pediatric speech-language pathologist are these:

1. Singing captures a young child’s attention almost better than anything else. It’s different than listening to someone talk. Novelty is what makes us all stop and zone in when something changes. This reminds me of one of my favorite tweets I saw about a year ago…”Attention is the gate keeper for learning any new skill.” I wish I could remember who posted it to give them full credit! This is a HUGE lesson! We have to get and keep a child’s attention BEFORE we can teach them anything. Singing is a great way to redirect a busy baby’s or wild toddler’s focus. When all else fails, SING!

2. Singing promotes connectedness between an adult and a child. Professionals in disciplines across the board, from medical to psychological to educational fields, recognize the importance of helping babies form strong attachments to loving parents as the foundation for a lifetime of healthy relationships. As an SLP, I can tell you that you don’t have to birth the child to experience that sense of “I get you and you get me.” The warmth that bubbles up inside when you elicit that special spark from a little one feels pretty darn good to a grown up too!

3. Singing prepares a baby’s brain to learn to understand and use words. When a baby listens to a song, especially one he hears over and over, he’s imprinting the speech sounds of his language and forming important neural pathways… in other words, he’s getting smarter and smarter!

There are oodles of other developmental benefits of music too: learning to imitate hand motions, improving fine and gross motor coordination, increasing body awareness, setting the stage for literacy, etc…

The good news is you don’t need to be able to name any of those to know that singing is a fantastic activity that all families can enjoy, even if their song choices and taste in music isn’t the same as yours!

My take-away message from the last few weeks has been to eagerly anticipate the new songs a family can teach me, rather than coming up with my own playlist for a little friend. If a family wants some ideas and guidance, I will certainly provide that, but I can’t wait to be surprised by what I might hear when I ask them to “sing whatever your baby likes.”

Until tomorrow….

Laura

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If you’re a parent, an SLP or another professional who would like some new ideas and guidance for using music, social games, and easy, early play routines with late talking toddlers, take a look at my book Teach Me To Play WITH You.

Need some new ideas? Check out my book Teach Me To Play WITH You which is filled with over 50 different songs and finger plays and rhymes along with step-by-step instructions for helping a child learn to “do his part” during these social routines. If you’re not sure what I mean by, “do his part,” then take a look!

The post Sing…Sing a Song! How Singing Builds a Strong Foundation for Language in Babies and Toddlers appeared first on teachmetotalk.com.