Let’s see how you do.

Take a minute and think about it before you keep scrolling.

Before I relieve your suspense and tell you what they are, I want to ask you an even more important question.

How do each of these milestones relate to learning to talk and use words to communicate?

It’s an important piece of early language development that every therapist who works in early intervention and pediatrics should be able to explain to parents and teachers.

Parents and teachers value cognitive development and are teaching young children these concepts, but most of the time, they don’t understand the connection and how each of these milestones plays a vital part in early language development.

In case you need a refresher so that you can explain this better, here goes…

Learn how to explain the 3 Major Cognitive Milestones and How They Relate to Language Development.

The 3 Major Cognitive Milestones are:

Object Permanence

Cause & Effect

Simple Problem Solving

Here’s how each one relates to learning first words:

Understanding object permanence signals an important development in an infant’s working memory, as it means they can now form, and retain, a mental representation of an object. This is the beginning of learning to think “abstractly.” He can hold a symbol – the visual picture of the object – in his mind as he searches to find it. The visual picture (and desire!) drive him to search for an item that’s seemingly gone. Once a child understands object permanence, he’s ready to learn a label for that object. Now he’s ready for the word.

Cause & effect means that a child can use ‘directed groping’ to see what will happen next as he maneuvers an object. Eventually, babies make connections by manipulating objects during play… “When I do this, this happens.” This skill is an important cognitive milestone because through this kind of play, babies and toddlers learn communicative intent. Without intentionality, purposefully directing your behavior so that another specific event will occur, a child doesn’t learn to do something to get something. Isn’t that what early requesting, whether it be with gestures or words, is all about?

In this same developmental period, a child continues to learn and begins to move beyond cause and effect to solve simple problems. During play, a child learns through trial and error to pursue different options and produce new outcomes. If we put it into an adult’s words, babies begin to think something like … “The block does not fit in this hole. Where does it fit?” or…“Uh oh! My sippy cup rolled under the couch. How can I get it?” 

During play and everyday routines, babies and toddlers learn to move on and try various ways of doing something when their initial attempts don’t work. This ability to generate a new idea is the hallmark of cognition. This may be one of the reasons we learn to talk in the first place! We learn that we can use our voices and then words, rather than crying or gesturing, to explain to someone what we want. It’s much more efficient. As we learn more vocabulary and can say new words, it gets even easier.

SUMMARY

These milestones should be included in all our speech therapy treatment plans when a child is not talking yet. If you’re working with a child who has significant delays, this is also your starting point. Therapists should teach parents how to work on these three areas at home, primarily in play. I’ve compiled a post with toys and very brief descriptions for how/why to use the toys, but if you want to know more, I’d recommend the following resources:

Teach Me To Talk: The Therapy Manual… there’s a whole chapter on teaching early cognitive skills with pages and pages of activities and ideas to walk you through a detailed therapy plan to address these milestones which can be done in therapy sessions or at home by parents.

#450… I linked this podcast below that explains receptive language skills and cognitive skills by 12 months. Listen or watch for a longer discussion. Even if a child is older than 12 moonths and not talking, we should work on these goals until they are STRONG and STABLE. Scroll to to watch this course. If you’re working with a child who has significant delays, this is also your starting point. The recommended toys post is at this link for implementing the therapy ideas in the podcast.

ALL $5 CEU COURSES…IF YOU NEED TO WORK ON CEUs, I HAVE 75 DIFFERENT OPTIONS FOR YOU!

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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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One of my favorite little books that most parents remember from their own childhoods is Pat the Bunny. Written in 1940, it’s certainly a classic (aka OLD), but don’t let its age fool you. Toddlers still enjoy this darling little book IF you use the book as its intended… interactively.

The book is designed to help toddlers learn to follow directions. Each page offers something new for a child to do. For example…

Now YOU pat the bunny.

and YOU smell the flowers,

and everyone’s favorite…

YOU put your finger in the hole

(my modification that seems to work best).

For this reason, Pat the Bunny has become one of my go-to tools for a child who likes to look at books, but doesn’t follow directions or sit through an entire book.

The requests in the book are timeless and still pretty functional… even in 2019! I’ve witnessed dozens of toddlers wave bye-bye for the first time after reading this book for a few weeks during our sessions.

The social games Peek-a-Boo and So Big are included too and are a great opportunity for helping a child learn to participate during these fun little routines — and for helping parents remember to play these games with their child!

To make this book effective for toddlers, you will need to show them what to do on each page a couple of times and then encourage them to perform the action. If they don’t, help them. Stay upbeat and FUN the entire time, but take their little hands and make them do it in the most cheerful way possible. If you encounter lots of resistance, put the book away and try again at a later, more cooperative time.

For parents, this is a great book for snuggle time — after a child has settled in to your lap and he’s less likely to try to get away.

Therapists might use this book after a gross motor activity. I like it during snack time when a child knows he needs to keep sitting in order to get the next treat. Most of the time, I offer the next little piece of whatever he’s eating as soon as he’s completed the action on each page as a “reward” for continuing. I don’t necessarily set it up that way; it’s just becomes a natural part of the activity. Over the years, I’ve helped many kids learn to like  tolerate books using food as we read together and many parents have continued this when I’m not there fading the snacks over time once a child learns to sit and stay for the activity.

Experiment to find the “just right” speed for reading. Most adults assume that you casually read and complete each action lingering over the page. For some toddlers, that’s too B…O…R…I…N…G.

In my experience, most busy toddlers prefer that you amp it up and get through the book pretty quickly. Try it both ways to see what promotes the best attention and response.

With the most reluctant book listeners, do a page or two and then move on to something else, but gradually increase additional pages by adding 1 or 2 new pages each time you read (or over a few days or sessions) until the child eventually stays with you for the entire book.

Over time, fade your models so that you can see how well a child completes the request as you read each page. This activity can build a foundation for helping a child learn to follow directions making it a great routine for toddlers with receptive language delays.

For more tips for reading books and for a list of my favorites for therapy for toddlers, read Great Books for Speech Therapy which also includes a couple of Therapy Tip of the Week videos if that’s your learning style.

If you’re not much of a shopper, you can get your own copy of Pat the Bunny from Amazon and here’s the link for your convenience…

Either way…

Happy reading!!

Laura

**As an Amazon affiliate, I do earn a tiny commission for products purchased through links posted here at teachmetotalk.com.**

The post Pat The Bunny… Using Books to Teach Toddlers to Follow Directions appeared first on teachmetotalk.com.

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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Delays in receptive language, or how a child understands words and follows directions, are often ignored or glossed over in late talkers.

I believe that receptive language delays are the most overlooked issue in toddlers with any kind of developmental challenge. In my experience, it’s the #1 reason late talkers don’t make progress. We get so hyperfocused on what they can (or can’t!) say, that we miss what they don’t understand.

He understands everything.

Many times, parents (and even physicians and therapists!) erroneously assume that a young child understands “everything” when there’s no real evidence to support that belief.

Here’s the truth, a toddler who isn’t saying very much may not understand very much.

Instead of teaching those kids to new say words, we should be focused on helping him understand what words mean. One of my mantras for working with toddlers who aren’t yet talking is this…

A child must understand words BEFORE he can use those words to communicate.

Examples of early receptive language skills include identifying familiar people and objects, consistently responding to their own names, pointing to body parts on request, responding to “no” and “stop,” and most importantly, following routine commands. Routine commands include tasks such as, “Put your arm in,” during dressing, “Open your mouth,” as you feed them or brush their teeth, along with requests to retrieve items, such as, “Go get your ____.” This list of skills is a good place to begin when you’re determining a child’s ability to understand familiar words and follow simple directions. Take a look at additional considerations in this list below.

Questions for parents:

•        Does your child look when her name is called?

•        Will she turn toward her parents when someone asks, “Where’s mama?” or “Show me your daddy?”

•        Will he give you something he’s holding when you ask for it?

•        How many body parts can he point to when you say, “Where’s your ____?”

•        If he’s about to do something that’s off limits, will he stop when you say, “No!”

•        Can she bring you familiar items when you ask her to “Find your shoes,” or, “Where’s your cup?”

•        When you say things like “Let’s take a bath,” or “Are you hungry?” does he independently go to the appropriate place for that activity in your home?

Understanding and following these kinds of simple directions typically develops around the first birthday and should be firmly established by age 18 months.

If a 1 ½ year old toddler isn’t following very familiar commands, it’s a red flag for a larger developmental problem.

This issue is even more significant and likely when a child is 2 or 3 and isn’t consistently completing requests.

Understanding what people say is a part of everyday life for everybody. Improving a child’s ability to link meaning to words should be a top priority for any late talker.

The post “He understands everything.” Missing Receptive Language Delays in Late Talkers appeared first on teachmetotalk.com.

If you’ve picked up any parenting book or studied anything related to educating children for at least 5 minutes, you know that you should be reading to a young child pretty much from the time he exits the womb…

That’s fantastic advice for all parents and books are certainly a wonderful choice for speech-language pathologists who work with young children.

There’s no wrong way or right way to go about reading to a young child who is meeting all of her developmental milestones. You read. She listens. She understands. She talks. End of story. That’s typical development.

BUT using a few special strategies with toddlers with speech-language, cognitive, and other developmental delays can make books exponentially better teaching tools!

By changing HOW we read to a toddler who is having difficulty learning to understand and use words, we can help him link meaning to words and eventually begin to use those words to talk.

I’ve also had incredible success using books to teach young children to play with toys. Most toddlers, even some who aren’t yet talking, have no difficulty learning to play. However, many of our little friends with developmental delays don’t instinctively understand what to do with toys until we teach them. Young children who are on the autism spectrum or who are at risk for autism really struggle with developing and expanding their play skills. They may prefer to line up or spin a toy or hoard a group of toys rather than play. Toddlers with cognitive delays may chew, throw, or ignore a toy, much like a younger baby would, rather than play purposefully.

This fall I’ve worked with several families who have desperately needed these strategies since each of these kids have had HUGE visual interests and strengths, but also have had significant language delays…. in other words, these little guys love books and videos, but they’re not talking, following directions consistently, or playing with many toys. Each of these kids had also plateaued in therapy sessions and needed some new ideas to jump start their progress.

Earlier this month I filmed a video specifically for one child’s therapy team and extended family to provide concrete instructions for using books more effectively during therapy.

After watching, I realized how beneficial it would be to share something like this here at teachmetotalk.com to reach many, many, many more families.

Let me highlight a few of the goals for reading books with toddlers so you don’t miss them when you’re watching! Some of these things may be pretty subtle to you as an adult, but each can be a BIG step for a young child with a speech-language delay or disorder. As we read books in this way, we help a child learn to:

1. Pay attention.

2. Share an experience.

3. Understand new words.

4. Follow simple directions.

5. Play with toys purposefully.

6. Use early gestures such as pointing, waving, and clapping.

7. Imitate early vocalizations and play sounds.

8. Repeat familiar words.

Let me remind you that this entire list, ALL of these skills, are a part of learning to talk and are necessary steps for every young child before he or she begins to use words. Toddlers who are verbal pick up these skills pretty quickly. Our friends who are late talkers will need some help mastering some (or all) of these important milestones.

And just so you know, I could probably expand this list to 25+ goals for reading books with toddlers, but I don’t want to overwhelm you!

If  you’re a parent, I don’t want to scare you either. If your own child isn’t doing these things yet, THAT’S OKAY. You can play a big, big part in helping him!

If you’re a therapist, these are the same strategies we should teach parents so that they too can continue to work with a child long after a therapy session ends. I believe the best way to teach moms, dads, and everyone else involved (including preschool and daycare teachers, grandparents, and older siblings who are eager to help!) is to model or SHOW them all of the things they can do with a book! Explain what you’re doing as you read so that a parent or teacher understands your purpose and more importantly, knows that he or she can successfully use these same techniques. If your program isn’t set up for you to work with parents and other caregivers, or if you’re uncomfortable with direct teaching, sending them a link for this post is much, much better than doing nothing : ) If you’re looking for information to share with larger groups of families within your agency, program or school, here it is! As long as you credit me and link back to this article, please feel free to share this post on your websites and social media pages.

So no matter what your role is, whether you’re a concerned parent or a therapist perusing the internet, my purpose is to give you some different things to try. I want you to SEE and HEAR examples of reading a cute and fun book and hopefully, work in at least a couple of new ideas, for you and for that sweet little one who’s listening!

In this video I’m using a book from one of my all-time favorite series for toddlers… Little Blue Truck. This version is Christmas-themed, but the strategies can be adapted for ANY children’s book. All you need is the book, the kid, and you! If you’re working on play skills too, gather some toys or props similar to the ones in your book.

Although the video was not filmed with a child, it’s EXACTLY how I and other effective pediatric speech-language pathologists use books to target a multitude of goals during speech therapy with toddlers.

As you watch, think about how you can adapt these strategies. Sometimes a few tweaks here and there are all you need to make reading books much, much better! I wish you fantastic success as you read to your little ones!

One more thing… I hope you notice a predominant strategy is REPETITION! Toddlers need to hear things over and over and over in order to learn how to understand and then say a new word!

Finally…. you can watch now : )

Link for the book in case you want to get it:

Until next time –

Laura

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My therapy manuals are SO helpful for therapists who work with toddlers birth to 3. Click the links for more info!

Teach Me To Play WITH You

Teach Me To Talk: The Therapy Manual

Building Verbal Imitation in Toddlers

The post Using Books to Teach Toddlers Language and Play… VIDEO from teachmetotalk.com appeared first on teachmetotalk.com.

Try this one…

When you’re snuggling, ask, “Where do you want me to kiss you?”

Point to a body part and say, “On your ____?”

Plant several kisses there!

Laugh together repeating your key words such as, “I kissed your ____. _____.”

Begin the game again…”Where do you want me to kiss you? On your _______?”

VARIATIONS

Once a child knows a few body parts, ask, “Where do you want me to kiss you? On your ____?” and then wait for a child to point to the body part before you begin your kisses.

When a child can name body parts, wait for an answer after you say, “Where do you want me to kiss you?”

If kissing is not your thing or if a child dislikes it, try tickles instead, or make a beeping or honking noise when you touch the part.

This is super fun routine parents remember. When parents like a therapy strategy, they use it! I’ve had great luck with it and I know you will too!

Laura

This activity is from my therapy manual Let’s Talk About Taking…Ways to Strengthen the 11 Skills All Toddlers Master Before Words Emerge. Order here!

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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 delay, rather than the only issue. I’ve started a series of articles to address these concerns. In this post, we’re addressing the third red flag which is:

RECEPTIVE LANGUAGE DELAY

I believe that receptive language delays are the MOST OVERLOOKED PROBLEM in early childhood development. Many parents, physicians, and sadly, even some therapists miss this delay.

In my experience, IT’S THE NUMBER ONE REASON many toddlers with language delays aren’t yet talking. This makes complete sense when you consider the obvious…

Kids must first learn to understand words BEFORE they use words to communicate.

I hope this statement resonates with you because it’s a key message that all parents of late talkers should hear and consider when they’re trying to come up with the “reason” that their child isn’t talking yet. As I noted earlier, it’s often an area parents dismiss. Many times during an initial assessment, when I ask a mom how her late talker understands language, she responds with…

“She understands everything.”

While this is true for some late talkers, many times a toddler who isn’t saying very much doesn’t understand very much.

Before we go any further, let me give you some background information about receptive language.

What is receptive language?

Receptive language refers to the language a child understands. Speech-language pathologists may also use the terms auditory comprehension or language comprehension to refer to the receptive language.

The most common way a toddler demonstrates his ability to understand language is by responding to what you say. They look at you when you call their names, follow simple directions, and participate when you talk to them.

For example, you may casually say, “It’s almost time for your bath.” A toddler who understands you:

• may get excited
• shake his head enthusiastically (as if to answer “yes” or “no”)
• run to the bathroom
• grab your hand to pull you along
• begin to gather toys he wants to take to the tub.

Those responses are different ways a child lets you know he’s understood, all without saying a word.

(Side note…Expressive language means what a child says. The expressive language also includes what a child expresses through other methods. Facial expressions and gestures are ways all of us supplement what we say. Other options include sign language, a picture system, or speech-generating device.)

Signs of Difficulty with Receptive Language

A child who doesn’t follow simple verbal commands throughout the day by the time he or she is 18 months old has a receptive language delay.

So…. if you have a 2-year-old who doesn’t respond to his name, can’t retrieve familiar items on request, or won’t point to body parts, common items, or pictures when you ask “Where’s the ___?” a receptive language problem is something to investigate.

While it is hard to truly determine what a very young child understands, please don’t ignore these warning signs. Toddlers can be little stinkers at times when it comes to “obeying” your household rules. However, a young child who tunes out language much more than he listens and who can’t follow simple verbal directions during every day routines is a very different situation. He’s not choosing to disobey – he very likely doesn’t understand what you’ve asked him to do.

Typical Receptive Language Development

I want to include a word typical language development…. most babies and toddlers understand much more than they can say. There’s concern when a toddler isn’t saying as much as other toddlers, but there’s a real problem when a child’s comprehension isn’t keeping pace. If there’s difficulty understanding words, he’s at a huge disadvantage for learning almost everything.

Diagnostic Implications for Receptive Language Delays

Receptive language delays can be attributed to any number of conditions including:

• Hearing loss, whether it’s permanent or temporary caused by ear infections or chronic fluid
• Genetic diagnoses such as Down syndrome, Fragile X, etc…
• Complications during a mother’s pregnancy and at birth including prematurity, infections, trauma, and medical conditions such as loss of oxygen
• Environmental extremes such as neglect, institutionalization, or malnutrition
• Heredity or a family history of difficulty learning to communicate and with academics
• Other developmental disorders such as Autism

Remember that receptive language skills are inseparable from cognitive abilities in young children. If a child has a cognitive delay, he’s going to have difficulty learning to understand and use language. (Read more about cognitive delays.)

To be clear, let me restate this point…

Toddlers with receptive language delays will have expressive language delays.

If he doesn’t understand what words mean, he won’t be able to use those words to communicate meaningfully.

There may also be problems beyond late talking. When a child doesn’t understand what others say, she may also have difficulty learning to interact with other kids. Unless a child makes progress and catches up (which is very possible!!), he may also have trouble with academic concepts as he starts school.

Even though this may sound a little bleak to you, don’t get discouraged. I have treated many, many, many toddlers with receptive language delays due to a variety of diagnoses (global developmental delay, autism, cerebral palsy, mixed receptive-expressive language disorder, Down syndrome, and other genetic or chromosomal abnormalities) who have made incredible progress. Please do not feel defeated if you’re parenting a child with a receptive language issue – read on!

Ways to Help a Toddler Improve Receptive Language

There are lots, and lots, and lots of things you can do RIGHT NOW to help a toddler with language delays. Actually, I have built my career on it! I’ve written (and spoken) VOLUMES of information about receptive language. In fact, I’ve had more than one SLP refer to me as “The Receptive Language Queen.” What a compliment!!

Here are two posts with fantastic recommendations –

Receptive Language Delay in Toddlers, Advice for Parents. It’s FULL of advice and contains my best written information to get going TODAY!

Early Receptive Language Targets: Learning to Follow Directions for Toddlers  gives you a list of very early comprehension milestones for a toddler. If you’re at a loss for where to start, read this list!

If you’re more of a listener than a reader, let me recommend one of my podcasts about receptive language #285. The written post also contains good, practical suggestions.

Additional Recommendations for Parents

If you’ve been reading this series, you’ll recognize my plug for intervention. Therapy can help a child with receptive language issues improve TREMENDOUSLY… but only when you’re working on the right goals. Let me explain….

Many times parents identify late talking as their only concern for their child. This makes some therapists focus on the expressive piece and direct most of their efforts toward helping a child learn to talk. When the underlying problem is a significant receptive language delay, working on talking may not help. At all.

Actually, it could make things worse because everyone, (that’s the kid, the SLP, and the parents!) may get so frustrated that nothing new is happening.

In these situations, it’s always best to address the receptive language difficulties, figure out how to make language meaningful for the child, and work together toward that goal as a team BEFORE you begin to expect to hear new words and sustain any real, measurable progress with talking.

In some cases, all I’ve done with a child is convince his parents to focus on receptive language and then….words finally began to emerge.

If you’re reading this and realize that your child may have a bigger problem than you initially thought, please know that this is a very common issue for parents of late talkers. My first recommendation is to talk this over with your child’s therapists. If your child hasn’t yet been evaluated by anyone, schedule an assessment soon.

Begin with a call to your pediatrician’s office for a referral to your local early intervention program if your child is 2 or younger. If he’s 3 or older, contact your local public school system for an assessment.

If  you’d rather not use a state or local public school, go the private route. Ask your doctor for names of speech-language pathologists who specialize in treating toddlers and preschoolers. This is super important!!

Just as you’d not go to a cardiologist for a back problem, you’d never want your toddler to be treated by a therapist who rarely sees kids this young. It’s a niche area, or a specialty. You may be wasting your time and money if you don’t see someone who has experience with toddlers.

Or take a look at your insurance company’s list of providers, make some calls, and select a practice that feels like a good fit for you and your child.

Medical Intervention

Also… verify your child’s ability to hear! Many toddlers with a history of frequent ear infections have receptive language delays because they’ve had fluid in their ears for long, long periods of time. During those times, the child has had temporary hearing loss and the language he’s heard sounded muffled, like he’s underwater. No wonder words don’t always make sense to this child! He can’t hear people talk as well as he should!

Doctors may treat ear infections differently in different parts of the world. Some pediatricians will opt to use antibiotics fairly quickly. Others may take a wait and see approach. If your child’s ear infections have lasting repercussions, as in he’s not talking yet and not understanding language, then it’s time to be more aggressive. Discuss your treatment options with your doctor and ask for a referral to an ENT to explore tube placement if necessary.

Sometimes kids can have middle ear fluid with no other symptoms, so the parents didn’t know there was a problem. Their child never ran a fever, didn’t tug at their ears, or had no bouts of unexplained crying (especially at night). There was never a reason to exam a child’s ears beyond a quick look.

If you’ve had a healthy child (or even when you’ve seen the pediatrician regularly), talk to the doctor about your concerns related to late talking and receptive language. Ask for a formal hearing evaluation to rule out hearing loss as a reason for the language delay. Competent pediatricians will suggest a hearing assessment as soon as mention a concern. If not, your doctor may be taking too many shortcuts when it comes to discussing your child’s development. Have a direct conversation about your worries and ask for additional referrals and evaluations.

WRAP UP

Toddlers with receptive language delays will have issues learning to understand and use language. Sometimes kids catch up and these difficulties resolve fairly quickly with targeted intervention. In other cases, receptive language issues may be a lingering concern which will require speech therapy and specialized services once he reaches school age. Understanding language is the foundation for academic success.

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 receptive 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 limited use of gestures as a factor that indicates that a child is struggling with “more than late talking.”

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

My best resources include:

Teach Me To Listen and Obey (2 DVD Set) focuses on receptive language or what a child understands. When a child doesn’t understand words, he’s not going to use words (aka…talk). If a toddler is over 18 months and doesn’t follow simple directions, receptive language delays are highly likely. In this DVD for adults, you’ll learn important comprehension milestones and receive recommendations for working on these skills at home and during therapy sessions. You’ll SEE video clips of me working with children with language delays during speech therapy sessions so that you can duplicate the activities.

If you’re more of a reader or 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’s a chapter on social skills that’s a fantastic guide for targeting joint attention and social interaction. 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 social skills are:

Early Speech-Language Development: Taking Theory to the Floor is a comprehensive 12-hour course on DVD. All areas of language development (social, receptive, expressive, and intelligibility) are addressed. There’s a long section on receptive language with goal lists and fabulous therapy activities!

Is It Autism? Recognizing and Treating Toddlers and Preschoolers with Red Flags for ASD. This course on DVD has two parts. Part Two is all about intervention. You’ll learn the most effective treatment strategies and approaches to jump-start progress in a toddler with red flags for autism, including receptive language deficits.

Both 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

If you’re not sure how your child is doing with language, here’s a list of milestones to compare minimal expectations vs. typical or ‘average’ language skills. There’s quite a range.

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

The post Receptive Language Delays… The MOST Overlooked Problem in Late Talkers appeared first on teachmetotalk.com.

Earlier this week I started a series of posts called “Is This More Than Late Talking?” In this series, we’re exploring the factors that indicate that a child is struggling with a developmental issue beyond an expressive language delay, more commonly referred to as late talking or speech delay.

In the first post, I provided the list of these factors. Over the next few weeks, I’ll provide a short summary of each of these areas including:

• brief explanations of the specific skill and why it matters for language development
• what to look for – signs to indicate a developmental difference in that area
• possibilities for what this delay could mean (from a diagnostic perspective)
• things you can do at home to jump start this area of development

Today we’re looking at the first factor on this list:

DELAYED COGNITION

When I explain cognition to the families I’m working with, I say that cognitive skills include how a child thinks, learns, remembers, and pays attention. Therapists may add terms like “processing” and “planning.” Parents may think about these brain-based skills as “how smart a child is.”

WHY IS COGNITION IMPORTANT FOR LANGUAGE DEVELOPMENT?

Cognitive and language development are closely related. Until a child is over the age of 3, it’s very difficult to separate cognition from language development, especially receptive language. Remember that receptive language is also known as auditory comprehension, or the words a child hears and understands. If a child doesn’t understand the language he hears, he may appear to ignore what others say to him and doesn’t follow directions.

Here’s the correlation:

When a toddler has a delay in cognitive skills, his receptive language skills are also delayed. When a young child’s receptive language skills are delayed, his expressive skills are delayed too. Remember that expressive language means what a child says (or expresses with alternative methods like using gestures, signs, pictures, or a device.)

Did you follow those last lines?

If a child’s cognitive skills are delayed, his receptive language skills are delayed, and then his expressive skills are delayed too.

(**Exceptions to this pattern are also atypical. If a child’s expressive skills exceed his receptive skills, or when he says more than he understands, it’s generally due to echolalia or merely “echoing” language. Echolalia is often associated with autism.**)

This factor, delayed cognition, can be the “reason” a toddler isn’t talking.

WHAT TO LOOK FOR

A diagnosis or a specific event in a child’s life may predict the presence of a cognitive delay. Cognitive delays can be attributed to any number of conditions including:

• genetic diagnoses such as Fragile X or Down syndrome
• complications during a mom’s pregnancy and at birth including prematurity, infections, trauma, and medical conditions such as loss of oxygen
• environmental extremes such as neglect, institutionalization, or malnutrition

Sometimes the cause for a child’s cognitive delay is multi-factorial, meaning there are several contributing factors. Sometimes, the exact cause is never determined.

Cognitive skills include things like finding items that are hidden (object permanence), understanding how objects work (cause and effect or operating toys), solving problems (such as how to get an object that’s out of reach or fitting a puzzle piece into the correct slot), imitating actions he sees and words he hears, and language-like skills such as naming objects and following directions. If you’re interested in looking at a list of specific cognitive milestones, I’ve included links at the bottom of this post.

Cognitive delays are suspected when a child misses milestones in several developmental domains. For example, the child is (was) a late walker, is now a late talker, and upon closer inspection, is missing other key social skills too. (Please know this is not always the case. A child can walk late and talk late and still have normal cognitive skills!)

DIAGNOSTIC IMPLICATIONS for Cognitive Delay

In previous generations, a child’s cognitive delay was referred to as “mental retardation” or “brain damage.” Now diagnoses like intellectual disability or global developmental delay (which includes other areas of development too) have replaced that terminology, but the meaning has not changed.

Kids with cognitive delays have difficulty learning language, problems with academics, and are always later to acquire the self-help or life skills that make children more independent as they grow up, such as potty training or learning to dress themselves.

Delayed cognition is usually chronic or long-term. Treatment will ALWAYS help, but the child may never completely catch up.

WHAT YOU CAN DO TO HELP A CHILD WITH DELAYED COGNITIVE SKILLS

The first and most significant recommendation I make to families of children with delayed cognition is to continue to have expectations that this child will  be able to learn! Our parenting and teaching methods must be adjusted to accommodate a child’s needs and learning style, but he or she WILL be able to make progress! That’s an important mindset for parents (and grandparents!) to adapt as soon as possible.

Secondly, know that teaching new skills will take more time. Repetition and repeated opportunities for learning the same concepts or new words is the most important strategy for very young children with cognitive delays. As I’ve said to parents of kids I’ve worked with, “Let’s think about teaching him to talk as a marathon and not a 50-yard dash. Our pace needs to be steady because we’re in this for the long haul. Speech therapy for this child won’t be over in a few months or even in a year or two.”

Sometimes a therapist may be reluctant to share this kind of brutally honest information with a parent because frankly, it’s hurtful, and we don’t want to take hope away. However, in not sharing the full extent of a child’s issues, I think that we’re essentially withholding information. I don’t want to be that kind of professional (or that kind of person).

Lastly, I’ll put in one more plug for intervention. Intervention may look different over the course of a childhood for a kid with cognitive delays, but in early toddlerhood and throughout the preschool years, I believe that specialized developmental services are critical. This period is when we can make the MOST difference in a child’s outcome. It’s when our brains are most “ready” for growth.

Parents of a child with a cognitive delay will also benefit dramatically from having a professional or team of professionals teach them ways to address their own child’s needs at home so that intervention isn’t 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 with delays in cognition will have difficulty acquiring a broad range of developmental skills including learning how to talk, how to understand, and how to process and then use incoming information. His or her challenges will overlap additional areas of development (especially academics and self-help skills). Although the delays are likely long-term, treatment will help tremendously.

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 related to delays in cognition. 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 difficulty with joint attention.

Laura

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

Kids with cognitive delays will have difficulty learning to understand and use language. My best resources for parents include:

Teach Me To Listen and Obey (2 DVD Set) focuses on receptive language or what a child understands. If a child is over 18 months and doesn’t follow simple directions, receptive language delays are highly suspected. In this DVD for adults, you’ll learn important comprehension milestones and receive recommendations for working on these skills at home and during therapy sessions. You’ll SEE video clips of me working with children with language delays during speech therapy sessions so that you can duplicate the activities.

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 the starting place for most parents (and therapists!) who want to learn real life ways to work with a toddler with language delays.

If you’re more of a reader or if you want detailed goal lists for both receptive and expressive language matched with activities to use with toddlers and preschoolers, take a look my book at Teach Me To Talk: The Therapy Manual. There’s a chapter on cognition that’s a fantastic guide for both therapists and parents of children with cognitive delays. 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 course that best addresses receptive language is 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. It’s approved for ASHA credit for speech-language pathologists (and if you’re in IL, it’s preapproved for EI credit!)

Links to Cognitive 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.) This means that 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

The post Cognitive Delay: What It Means for Language Development 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.

Here’s a follow up question she sent and my reply.

“One question…once I have his engagement in an activity, how long should we play the same activity? I know in your book you recommend 10 min starting of engaged activity but switching activities. I’m pretty certain tonight he would have played the “ahhh choooo” game all night long If I didn’t tell him we had to get out of the tub. Is it bad to hold his engagement in the same activity for 20 min at a time (or more)? Or should I sort of push him a tad to switch gears onto something else? He struggles with transitions (I read that section and will read it again but implementing the songs saved us from a tantrum tonight when we had to say night night to the bath .) Thanks again!!! God bless”

My response:

“You’re so welcome Barbara!! Moms like you are EXACTLY why I started teachmetotalk.com and have done my DVDs, books, and Therapy Tip of the Week Videos!! Look at what you were able to accomplish in ONE DAY when you had the right tweaks in place. Well done Momma ; )

To answer your questions – keep him engaged as long as it feels right to you and you’re both having fun, but do help him switch gears and move on to a very similar activity, especially since he has difficulty with transitions. I think 20 minutes on one fun game is a good benchmark for you to use. You DO want him to develop a nice attention span when he’s including you. Rushing on to the next thing too quickly is as much of a problem as poor transitions are! You want to develop that nice “happy medium” time span.

Since his attention is good in the tub, you can introduce all kinds of new games there. I love your clapping and exclamatory words and his brand new words “yay” and  “again.” Good job Momma!!  Be sure to add a couple of new gestures this week for him to copy at bathtime. I’d start with him giving you a “High 5” or exaggerated showing of a toy with some new fun words too like “Wow!” and “Look!” during showing and “Uh oh” as the animals splash. You have a good list of things to try in the Building Verbal Imitation book with the chart on the back page. This can be your cheat sheet while you’re playing. Don’t try to do all of those things at once either – just add one or two new words or gestures to copy per routine every 3 or 4 days. Make sure you give him plenty of time to practice “again” and “yay” and all of his other new words too. You want him to “own” those words and repetition and practice are the only ways to accomplish mastery.

As far as transitions go…A cleaning up game is a nice transition time in the bathtub so that you can focus on helping him identify his toys and follow directions. That’s what we mean by working on receptive language, or what he understands and there are lots of examples for those kinds of games in the DVDs you bought – Teach Me To Listen and Obey 1 & 2. A fun way to clean up is to have a bag or basket and let him “throw” the animal/toy in as you tell him what to get next. The “throwing” part is why toddlers like to do it and you can sneak in that receptive language practice. You start by saying something like, “It’s time to clean up! Let’s throw the toys in the bag. Are you ready? I’ll go first. Where’s the ____? Here’s ____! Throw ____!”

Be sure you ask, “Where’s the ___?” even when you’re getting the animals first so he learns that listening is part of the game. If he can’t do it, then you do a few more to show him what you’re doing. Try to use the same words for every turn emphasizing key words over and over… “Where’s the ____? There it is! ____! Throw ___! In!!”

Keep it super fun and fairly fast-paced so you don’t lose him. If he HATES this routine or if it’s hard, you could just pick up a toy, say it’s name, and then “THROW!” or “IN!” as you toss it in the bag for a few days until he gets the hang of it. Then you could try asking him to find specific toys again to see if it works better after you get the routine going.

Keep singing your songs too from the book to help with the final transition – meaning as you’re getting ready to pick him up from the tub. Songs DO work wonders for toddlers with transitions because you’re teaching them to anticipate what comes next and the singing helps distract or redirect their attention.

Another thing that helps is to always make the step after the dreaded transition fun. When my children (now 25, 23,  and 18!) hated getting out of the tub, I scooped them up in a towel and shook them around or ran with them to (gently) toss them on the bed to dry off and get those pajamas on to get ready for bed.  When they didn’t want to come in from outside, I always talked about what was waiting inside – a cup of their favorite drink, a popsicle, a movie, whatever would make them “forget” about being upset.

Thanks so much for your sweet email and your question. Since I wrote you a book back (lol), I think I’ll use it as a post. I’ll leave off your name, but it’s fantastic information to share that will give other moms and dads HOPE that they can make a big, big difference in their child by changing how they play at home. Keep me posted on him and YOU!!! You’re doing a WONDERFUL job!!”

Isn’t she an AWESOME mom??? SHE is facilitating terrific progress in her little guy with her small tweaks to their daily routines. Did you catch the part about her also having a newborn at home? Here’s the take away message:

IF SHE CAN DO IT, ANY MOM CAN DO IT! 

If you’re in this same situation, parenting a late talker, take this as inspiration and make a commitment TODAY to tweak a few of your routines by being FUN and PLAYFUL while you focus on language. If you need direct guidance for how to do that, check out my links below.

If you’re a therapist who works with late talkers, then YOU have to teach the moms and dads you work with HOW to make these changes. They need to see you being fun and playful so they can copy your model. In addition to showing them how to to do it, include very specific ideas like I’ve done for this mom. Parents CRAVE this kind of direct teaching. They WANT you to teach them how to do it. Don’t believe anyone who tells you otherwise!! If you need some direction learning exactly what to teach parents, my resources can help you too!

Until next time…

Laura

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Resources this mom mentioned in her email…

Teach Me To Play WITH You – the book that mom mentioned with social games and FUN early play routines with step by step instructions – those “transition” songs and other helpful ways to solve 20+ common problems during play are included in the final chapter

Building Verbal Imitation in Toddlers – book to teach you HOW to teach a child to imitate words – it’s a process!

Teach Me To Listen and Obey 1 & 2 – DVD for parents with excellent examples of how to help your child learn to understand words and follow directions at home

The post Tweaking Routines for Late Talkers Continued… 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.

“I have a 25 month old. When he was 18 months he didn’t ask ‘What’s that?” but I also never said that phrase to him. Instead I just pointed out words and said them to him. If he pointed to a word he didn’t know as if asking a question I would tell him the word. Now he has asked me “Why?” once and asks “Where” questions but not what. Should I start asking him “What’s that?” I did it this morning and he can answer the question but he didn’t ask me what’s that in return.”

Yes you should! A toddler has to hear EVERYTHING, that’s every single word FIRST, in order to learn how to say it.

Books are a fantastic way to teach kids to ask, “What’s that?” Just point to a picture he knows and excitedly ask, “What’s that?” You’ll get lots of practice with this during one activity.

Do the same thing with his bathtub toys. As you’re about to put them in the tub, hold them up and excitedly ask, “What’s that?”

Every time he points to something new, say “Oh… you want to know what’s that?” It sounds a little odd to use this phrase until you practice saying it a few times, but it’s how I teach a child to ask this question in therapy. It’s also how I recommend to parents teach it at home and it really works!

He may not ask you the question himself in the next few days, but my guess is you’ll start to hear him ask “What’s that?” in the next few weeks.

Since he’s already asking other kinds of questions, he obviously understands how to ask questions.

For a child who isn’t asking any questions, take a look at how he’s ‘asking’ for other things.  Does he say, “Cookie?” when he’s asking if he can have another cookie or “Ball?” to mean… where is my ball?

Before a child begins to use a real wh- question word (such as what, where, who, or why) at the beginning of a phrase, he will use a rise in intonation at the end of a word or phrase to ask you something. If a toddler is not doing this already, be sure you are using an exaggerated question inflection/tone as you speak to him when you’re asking questions.

Talking in a monotone voice or a voice with a ‘glottal fry’ is fairly common these days. I hear it more and more in my work with young families. Sometimes parents who don’t use lots of inflection changes in their voices when they speak can teach their kids to begin asking questions just by paying attention to how many questions they model and how they use their voices to ‘teach’ this concept.

Hope these ideas help!!

Laura

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Learning to answer questions is HARD too for toddlers with language delays. Read more about questions – both answering and asking – in this post.

The post Questions about Questions? Tips for Teaching a Toddler to Ask “What’s that?” appeared first on teachmetotalk.com.

Receptive language means the language a child understands or comprehends.

This is how I explain the connection between receptive language (the words a child understands) and expressive language (the words a child says) to parents of late talkers:

Babies and toddlers must understand words before they begin to use those words to talk. It’s that simple. Comprehension comes first. When a child isn’t beginning to link meaning to words he hears, this is one of the main reasons he isn’t talking yet.

Learning to follow directions, especially easy ones such as, “Give me the ball” or “Wave bye-bye to Daddy” are the kinds of commands most babies begin to understand (and do!) just before they start to use their first words. Some parents mistakenly think saying the word “ball” or “Dada” come first, when actually, new talkers usually demonstrate that they understand what any familiar word means before we hear him use the word.

Around a baby’s first birthday, these are the kinds of things he or she should be learning. When a one year old can’t do these things yet, he or she doesn’t understand words well enough to begin to talk. Work on these kinds of things first and then words will be more likely to emerge:

• Responds to own name
• Responds with gesture to “Want up?”
• Recognizes family members’ names
• Stops when hearing “No” and other inhibitory words
• Waves “Bye-bye”
• Gives an object on request with and without cues
• Kisses on request
• Performs familiar activities in daily routines when asked
• Understands names for familiar objects and people
• Participates in social games with gestures
• Begins to identify a few body parts

While this list isn’t all inclusive, it’s a great place to begin to help your toddler understand and follow early directions.

Rather than setting goals for a toddler to talk, this is the list I use for initial speech therapy goals for children I see with receptive language delays. Naturally, these are the same things I recommend parents focus on at home before talking becomes a realistic expectation.

Receptive language is important and I believe it’s the most overlooked delay with late talkers, even among professionals. When I teach my courses for pediatric speech-language pathologists all over the country, therapists consistently thank me for the focus on receptive language. While we know it’s important, we don’t always directly target these skills as a critical first step in therapy with late talkers.

I’ve written many, many posts about receptive language and you can read those here.

If you need some help with learning how to teach your toddler to follow these early directions, I have some great resources for you!

My DVD set Teach Me To Listen and Obey 1 & 2 explains receptive language and shows you how to teach a toddler to understand words during play.

My book Teach Me To Talk: The Therapy Manual provides specific directions and activities to work on all of the above milestones and more! While it’s written for therapists, parents who like written instructions and discussion love the structure of this tool.

Teaching toddlers to Play Social Games is an important step for helping a child learn to “do his part” during an interaction. Check out the linked post above. For step-by-step instructions and tips for teaching toddlers, take a look at my book Teach Me To Play WITH You.

Remember…

you can teach words anytime, anywhere!

Laura

The post Early Receptive Language Targets… Learning to Follow Directions for Toddlers appeared first on teachmetotalk.com.

Many times during an initial assessment, when I ask a mom how her late talker understands language, she responds with…

“My child understands everything.”

While this is true for some late talkers, many times a toddler who isn’t saying very much doesn’t understand very much.

I hate it when I’m the first person to point that out to a mom who’s worried about her child.

Here’s the truth:

A child must understand words before we expect him to talk.

A child who doesn’t understand much really can’t (and shouldn’t) say much either.

This incorrect assumption can lead to other problems, such as problems in the “behavioral” realm… A toddler may be described as “bad” or “stubborn” because he isn’t doing what his parents, his daycare teachers, or his grandparents tell him to do.

Here’s what’s really going on in that situation:

He doesn’t follow directions because he doesn’t understand what’s being said. He seems to ignore language because words don’t mean anything to him yet.

When parents understand the connection between receptive language (what a child understands) and expressive language (what a child says), wonderful things can begin to happen!

By changing the focus, parents can make a huge difference in how a child begins to talk by helping a child learn to understand more words.

Several years ago, I wrote a longer post with great background information about receptive language.  It is a lengthier version of the tips I’m going to recommend below. If you want the “meatier” article, click here.

If you recognize that this may be part of what’s going on with your own late talker, let me give you some easy suggestions to get started…

Change What Your Child Hears

During your daily routines at home, pay attention to HOW you’re talking to him. Toddlers with receptive language difficulties often need very specific and focused “teaching” (for lack of a better word) to begin to link words with objects, people, and events.

When parents are resistant to changing the way they talk to a child, I (very gently, of course) remind them that we must change the way we’re talking and interacting with him in order to make a difference. Let’s face it, if the child were going to “pick it up” in daily conversations, it would have already happened, and there wouldn’t be a problem.

Young children with difficulty understanding and processing language need adults who are there to “interpret” the world for them. These toddlers benefit from nurturing parents and teachers who can provide support to help them understand words and begin to make associations throughout the day.

How can you do this for your child?

Practical Ways to Work on Receptive Language at Home

1. Reduce the complexity of what you’re saying.

Use mostly single words and short phrases.

Sometimes this isn’t stated to parents clearly enough. The advice is simply, “Talk to your child.”

This approach doesn’t always work with children with receptive language disorders. Since there’s a problem with your child learning to understand, you must simplify what you’re trying to teach since he’s not getting it the “regular” way.

Perhaps you can relate to this example:  Imagine being dropped off in a country where you understand very little of the native language. You may recognize a few common words or phrases, but you need to find out how to get to the nearest airport to book the next flight home. Because you can say just a few words in that language, the person you’re talking to assumes you “understand everything” and makes no adjustments in how they speak to you. How do you feel? You know you’re in over your head! That’s how it is for a child with a language delay. He understands some of it, but not enough to get him through the day.

Use lots of single words. Use lots of short phrases. Avoid long explanations or questions. When you’re asking your kid with language delays if he wants a cookie, don’t launch into, “Do you want one of these yummy chocolate chip cookies that Mommy just bought at the grocery store?” Hold up the cookie and ask, “Want a cookie?” See the difference?

2. Watch your child and talk about what he’s paying attention to at the moment.

When you’re eating breakfast in the morning and he’s looking at his cereal and milk, use those words and talk about the meal. Don’t discuss what happened at daycare yesterday or grandma’s visit next weekend. Keep it simple and in the here and now so it “makes sense.”

3. Talk directly to him using words he can use.

Kids with language problems need parents who go out of their way to “teach” them the words they need to communicate.

This means that you shouldn’t spend your time talking to a child with baby talk. While we all break into, “Look at mama’s sweet, sweet little, bitty baby girl,” your child needs to hear language she can use.

When a child is having difficulty learning to understand conversations and follow directions, we have to talk directly to them for much of the time we’re together.

Reduce the amount of time spent listening to adult conversation. While we all spend a good deal of time talking to our spouses and older children while a toddler is there, don’t miss opportunities to talk directly to the child using mostly single words and simple sentence structures he can eventually begin to repeat.

4. Give him clues (or “cues” in SLP terms) as to what you’re talking about.

Usually, children with language comprehension delays rely heavily on visual cues since they don’t consistently understand or process words. Point to direct his attention. When practical, show him the object. If you’re using books, point directly to the picture, say its name, and then make a brief comment. Provide other visual cues including gestures such as leading him and moving objects within his line of vision to be sure that he knows what you are talking about.

Because they need visual cues, kids with language delays may depend on your facial expressions to add meaning to your comments. Make your expressions match your words. If you’re upset and he’s about to be in trouble, don’t send mixed messages by continuing to smile as you warn him. He may misread your cues.

When he’s not responding, move closer to him, get down on his level, and touch him to redirect his attention.

Some children respond to clapping or finger-snapping more readily than a word to get his attention. Beware! Don’t overuse this technique, or he may start to tune this out.   Children do this because it’s annoying, not because they don’t understand.

Some kids need picture schedules to help them know what to expect next. Many preschools use these kinds of systems to provide additional support. Take digital pictures and put them in a small album or post them on the refrigerator to “show” him things he doesn’t understand in daily routines.

5. Repeat directions when he doesn’t seem to understand.

Toddlers with language delays need extra repetitions of information to be able to process what’s been said. Resist the urge to think and say, “I’ve already told you once (or twice).” Repetition helps his little brain to learn.

6. Break commands into smaller chunks of information.

Until he’s following directions consistently, limit yourself to simple commands with one piece of information.  Use “Go get your cup,” rather than “Take your cup to the sink.”

Once he’s gotten the hang of familiar directions, then work on adding more parts. “Get your shoes and bring them to Mommy.”

7. Reword what he doesn’t understand.

When you’re getting that look (like “Huh?”) or if he’s tuning you out, try using other words. If you’re saying, “Our family is going to church now. We have to get ready to leave,” and he’s not looking, you might try calling his name and saying, “It’s time to go bye-bye.” Pause. “Come here.”

8. Give him frequent opportunities to demonstrate that he understands.

Consistently ask him, “Show me the ____, ” and “Where’s the _______?” If he’s not pointing yet, encourage him to look around to find what you’ve asked him to locate. Other activities you can include in your daily routines:

• Have him point to pictures in books. Focus on the names of objects & actions. “Where’s the dog?” and “Show me who is sleeping.”
• Once he’s mastered basics names for objects and common actions, up the ante. Teach object use/function with words such as, “Which one is for riding? Which one goes on your feet? Which one do you use to drink? Which one says moo?” Help him identify parts of an object rather than the whole picture – “Find the door of the house, the wheel of the car, the dog’s foot, etc…”
• Retrieve objects on requests. Have him get items or put away specific toys on request.  “Get your ball,” or “Bring me your puzzle.”
• Have her perform familiar tasks related to daily routines. Toddlers can get diapers or wipes before changing time, throw things in the trash, put their own cups in the sink, take off their own shoes and socks, close a door, wipe off a high chair tray, pet the dog, and help you clean up toys by placing them in a basket. Involving them regularly in these kinds of activities increases their opportunities to follow directions (and help you out!)
• During playtime give short directions and help him perform the action. For example, “Put ball in,” and then help him do it.
• When you’re playing with puzzles, hold up a piece and label it with a single word as he completes the puzzle. When he is finished, have him retrieve the puzzle pieces one at a time by asking, “Give me the ________.”
• When dressing, tell her to put her arm in the sleeve or her leg in her pants. Hold up a sock and shoe and ask her to, “Get the sock.”
• When he’s seated near a toy, hold out your hand and say, “Give me the _____.”
• Place several items related to your play in front of her and ask, “Where’s the ______.”
• In the bathtub or during diaper changes, ask him to point to body parts, and help him follow through.
• During playtime ask her to give her baby doll a drink or put her baby down to sleep.

9. To build compliance with everyday tasks, try telling him to do things that he’s already about to do.

For example, if he’s headed for a ball, say, “Get the ball.” If he’s reaching for a book, say, “Read your book.” A child may not yet be following directions because you asked him, but using this method gives toddlers a way to “get in the habit” of doing what Mommy says.

10. Insist that he follow directions by providing physical assistance as necessary.

Once you’ve given him a verbal direction and repeated it once or twice, help (or make) the child complete the request. Repeat the direction so he can link the activity with the words.

11. Pause frequently when you are talking to him to give him time to process what you’ve said.

This is hard for chatty parents, me included! Give him enough time to think during your conversations. You may have to purposefully (but silently) count to 5 before moving on to your next point, or before you repeat yourself to be sure he’s had time to respond.

12. Have fun too!

Make some directions fun too, such as “Come here so I can tickle/hold/kiss you.”

Teach games like, “Gimme 5,” so that everything isn’t about behavioral compliance!

13. Lastly, but probably the most important, be very consistent with realistic behavioral expectations.

Children with difficulty understanding the language need the same rules day-in and day-out that are easy to remember and follow. They need to be able to count on consistent routines.

If your child’s ability to understand language is much lower than his chronological age, you’re going to need to keep that in mind when determining behavioral standards and even disciplinary methods. For example, time out is recommended for children who are 2 and older. If your child is 26 months old, but his comprehension is at the 16-month level, time out is not an appropriate choice for him.

Some parents disagree with this and think that this is how you “teach” a child to obey.  Believe me, though, you’re fighting an uphill battle. This would be like trying to teach a 3-year-old to tie shoes or jump a full-size hurdle. He’s just not ready yet. Use the same discretion when determining what is and isn’t appropriate behavior based on a child’s ability to understand.

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If you’d like to SEE how to work with toddlers to help them understand more language, let me recommend my DVDs Teach Me To Listen and Obey 1 and 2. Here’s the link!

If you’re a therapist and need some new ideas for developing comprehensive treatment plans with a heavier focus on receptive language, that’s my specialty!! Check out Teach Me To Talk: The Therapy Manual. In this post, you’ll see a description of that book and my other manuals for pediatric SLPs!

The post Receptive Language Delay in Toddlers… Advice for Parents appeared first on teachmetotalk.com.

This can break a mom’s heart, particularly if she likes reading or if she feels unsuccessful trying to “teach” her child.

This may also frustrate a therapist who thinks, “How am I ever going to get this kid to sit through an entire book?”

Disinterest may occur because the words aren’t meaningful to the child yet. All the toddler with difficulty understanding words hears when someone reads to him is “blah blah blah.”

So what does a very young child in this predicament do?

She moves on to something that makes more sense to her.

Or he might try to grab the book himself to quickly flip the pages and a wrestling match ensues as the adult fights for control.

Here’s a better way to capture a young child’s attention and promote initial interest in books.

Use props to make the story come to life.

For example, when reading a book like Five Little Monkeys Jumping on the Bed, grab yourself a stuffed monkey and act out the words to the story. Read the story while sitting beside the bed and make the monkey jump as you enthusiastically read, or better yet, sing, “One little monkey jumping on the bed…” Make the monkey fall to the floor as you chant, “He fell off and bumped his head.”

If you don’t have a stuffed monkey, no problem. Raid your stash of toy zoo animals and use a plastic monkey.

Still no luck? Find a monkey puzzle piece. Any representation of a monkey will work to make the word “monkey” meaningful for a young child.

I discussed TONS of other ideas to make books better for toddlers with language delays in a 3 part podcast series last year.

Like every project I tackle, the ideas are arranged in a hierarchy, or by skill level, from simple to more complex. Ideas for younger toddlers or those with significant delays are provided in Part 1. This show also includes ideas for adapting and modifying books for young children with motor challenges. Recommendations increase in difficulty with higher developmental skills through Parts 2 and 3. I shared my favorite books for toddlers and CUTE therapy ideas I’ve used effectively in therapy sessions with very young children.

Grab a pen before you listen so you can jot down notes as you plan super FUN therapy sessions for your little friends or your own baby this year!

Part 1

Part 2

Part 3

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Assessment tools used by pediatric speech-language pathologists include the following age ranges for this early skill:

• Points to two different body parts by 12 months
• Identifies at least 6 different parts and/or clothing items on himself or a doll by 18 months

Parents often begin by trying to teach a child facial body parts, usually eyes, nose, and mouth, and all at the same time! It’s no wonder that many children with developmental delays mix these up!

I recommend to parents that we begin with body parts that are relatively far away from each other, and include at least a couple the toddler can see!

I teach belly (or tummy), toes, and hair first, and in that order.

To make this more fun, turn this activity into a little game. When the toddler is on her back, use your voice to build anticipation as you say, “Where’s your belly? I’m gonna get your belly! Show me your belly!” If she likes tickling, quickly tickle her stomach as you say, “Belly! I got your belly! There’s your belly! Belly!”

When she’s consistently reaching for her belly as you play this game, you’ll know she’s understood.

Only then should you move on and teach a new body part.

I also suggest to parents that they focus on helping a child learn to point to body parts on his or her own body, rather than teaching the body part on the adult. Many times toddlers, particularly those with developmental language lags, aren’t able to generalize this skill. A young child may grab mom’s nose when mom says, “Nose,” but not point to her own nose when asked, “Where’s your nose?”

Another important way to help a child learn body parts is to PRACTICE. When a toddler is having difficulty learning to understand and use words, repetition is critical to make sure that a child is exposed to new words and concepts many, many times throughout a day and throughout the week. Working on learning to point to a body part during a weekly therapy session or even once a day at bathtime may not be enough to help a young child learn to respond.

At home parents can faithfully label body parts and clothing items during baths, diaper changes, and while getting dressed.  These events are predictable and occur over and over in a toddler’s life, making them the perfect times to naturally work in these kinds of words. Helping busy parents incorporate language into their daily routines improves the likelihood that moms and dads connect with a child and remember to target new words?during these mundane tasks.

When a child has mastered pointing to belly, toes, and hair, select the next body parts to learn based on what a child likes to do. For a child who likes to clap, teach hands. When a child frequently mouths toys, teach mouth or teeth.

Make learning body parts as fun and interactive as you can. Teach eyes by blinking yours, and help a child learn to blink his own eyes. Pretend to sneeze, snort, or snore when you’re teaching nose. Teasingly act like you’re going to eat his feet when you’re teaching toes.

These strategies also help a young child learn how to imitate your actions, a very important precursor to imitating words.

If you’re using a body parts book, a baby doll, or a puzzle to help a child learn body parts,make sure that you’re also pointing out the REAL body part on the child and on yourself! Even when you’re using a mirror, be sure the child finds the body part on his or her own little body too. Since that’s how the skill is measured, that’s how we should teach it!

I have a short video in my Therapy Tip of the Week series about teaching body parts. Watch it here.

Not understanding body parts by 18 months is a red flag for a receptive language delay. Receptive language means what a child understands. For more information, check out a more detailed explanation of receptive language here and read for ideas for parents to use at home here.

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For more ideas for helping a child learn early language milestones, take a look at my book Teach Me To Talk: The Therapy Manual! 

For parents, Teach Me To Listen and Obey 1 & 2 will get you started working on LOTS of receptive language during play and games at home!

The post Teaching Body Parts to Toddlers appeared first on teachmetotalk.com.

In this week’s video I’m sharing tips for working on higher level receptive and expressive language skills for late talkers. These ideas are also perfect for toddlers with receptive language issues and expressive speech delays.

We’re using one of my favorite toys for older toddlers and preschoolers… Lovin’ Family play sets. The accessories provide lots of opportunities for learning to understand and say new words.

Pretend play is important not only for a toddler’s cognitive development, but to target higher level language skills at the 2 1/2 to 4 year old level.

Developing Pretend Play in Toddlers

Play is a developmentally appropriate way to teach ALL of these kinds of language skills including not only what a child says, but how he understands language. A young child must UNDERSTAND new words before he can say those new words!

In this video I’m talking about helping a child learn to follow two-step commands, identify objects by funct, group objects into categories, make inferences and learn gender.

For a complete list of these kinds of goals that are appropriate for toddlers at this developmental level, check out Teach Me To Talk: The Therapy Manual from www.teachmetotalk.com.

The post Pretend Play Speech Therapy…Therapy Tip of the Week 8.31.12 appeared first on teachmetotalk.com.

However…

Some late talkers don’t like books. Many of our busy little friends can’t even sit through a whole story!

Sometimes it’s because the words don’t make sense yet. We have to help the words and then the pictures become meaningful, especially for a toddler with receptive language delays.

Many times that means beginning with real objects, and then helping a child move toward identifying pictures.

If you’re not quite sure how to do that, take a look at this short video for some great ideas!

Watch for strategies for helping young children with speech delays begin to attend to books and identify pictures from Laura Mize, pediatric speech-language pathologist from teachmetotalk.com.

SIMPLE Tips for Using Books in Speech Therapy from teachmetotalk.com

ADDITIONAL RESOURCES FOR HELPING A TODDLER WITH RECEPTIVE LANGUAGE DELAYS

For more ways to help a child improve how he understands words, or what speech-language pathologists refer to as “receptive language,” check out this article filled with every day ideas, Receptive Language Delay in Toddlers… Advice for Parents.

If you’re a parent looking for more ways to help your child learn to understand words, Laura’s DVD series Teach Me To Listen and Obey is a fantastic guide! You’ll see toddlers with receptive language delays and watch the most successful activities to help them begin to catch up! (Now with ASHA CEUs for SLPs!)

For a comprehensive approach to working with toddlers with receptive and expressive speech-language delays, check out the #1 resource for pediatric speech-language pathologists, Teach Me To Talk: The Therapy Manual.

The post Using Books in Speech Therapy… Therapy Tip of the Week appeared first on teachmetotalk.com.

Researchers found that labeling, simply stating an object or an event name, is more effective than any other kind of talking to help a child maintain attention to what he is doing.

Many times adults “mindlessly narrate” when a child is playing offering all kinds of words, or descriptions, or directions that make no sense to a child based on what he’s attending to or his language level. Can’t you hear it now A non-verbal two-year-old eyes a rubber ball. His therapist begins her diatribe,

“I think you’ve found something you want to play with. What do you think you’ll do with that right now? Are you going to bounce it high up in the air or will you roll it on the floor? Maybe you want to kick it over here to me. Let’s play a game and take turns.”

Do you recognize the problem? Although the SLP is certainly talking about what’s captured the child’s attention, she didn’t label “ball?” or use a language-level that’s appropriate for him.

A better way would be to say something like,

“Ball! There’s ball. Wow! Ball! Let’s play ball!”

By using simpler language and repeating your target word,there’s a much greater chance the toddler will actually make the connection between the object and the word.

Many times we overwhelm late talking toddlers with too many words. They walk away looking disinterested or bored when they’re really trying to say, “I don’t understand a word you’re saying.”

Sounds a lot like common sense to me! Laura

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To read the whole article, take a look at Chapter 4, Helping a Child Learn to Attend or Well-Intentioned Ways We Mess It Up in Therapy Session from Teach Me To Talk: The Therapy Manual.

For more information, click here

The post How To Talk So Toddlers Listen appeared first on teachmetotalk.com.

If this is your first visit, I’d like to tell you how I recommend “first timers” navigate the site because I have TONS of info on here that may not be apparent to you with your first click!

The site is organized in chronological order with the newest entries listed first here on the home page below the green banner.

However, lots of my best information is in the older articles and most of those articles are listed by category in the BLOG section. Click BLOG for a drop down list and choose the topic that most interests you. Once you’ve clicked on that section, you’ll see articles beginning with the most recent. I started this website in 2008 so there are hundreds of posts. You may want to scroll down to the bottom of the page and hit “next page” until you’re all the way back to the beginning of so that you can read those detailed “how to” posts first. I wrote lots and lots and lots of those kinds of posts in 2008 and 2009. The information is still EXCELLENT for parents as well as professionals. If you’re looking for in-depth information, start there!

Another category I’d like to tell you about is in VIDEOS. I have over 35 short (most are less than 10 to 15 minutes) videos here for free in my Therapy Tip of the Week series. You can also watch those on teachmetotalk.com’s  youtube channel. Most of the videos are ideas for a particular toy or activity. I walk you through how to work with toddlers and young preschoolers with language delays and provide suggestions for goals for each issue you might be working on at home or in therapy.

In 2008 I started a podcast where I host a weekly show about topics related to late talking toddlers. I used to do the show with a co-host and you can still hear those, but now I have guests or it’s just me! The podcast has thousands of listeners, both parents of children with developmental delays and professionals who work with young children with language delays. Scroll through the podcasts until you find show titles that are most applicable for your situation. You may also want to subscribe to the podcast on iTunes and listen from your smart phone or another device.

If you’re looking for resources, I’ve developed a whole line of DVD and therapy manuals to help parents and early intervention therapists. Click here for more information about those products.

If you haven’t signed up for my free eBook, do it now! It’s full of information, particularly for parents who are just beginning to search for answers. You’ll also receive updates and special offers when you subscribe including a coupon code for a nice discount on any teachmetotalk.com product.

Thanks for stopping by, and I hope you find what you’re looking for to help your baby! If not, leave me a comment with your questions, and I’ll try to point you in the right direction.

Laura

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More information about Laura

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Teresa G

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The sister was so different from most of the toddlers I’ve ever worked with in my career as a pediatric speech-language pathologist. Her parents, both highly educated professionals in the medical field, had managed to teach her not only all of the traditional body parts by the time she was 21 months old, but they had also helped her learn ones I think some full-grown adults might have trouble locating, like her kidneys! Did I mention Dad is a radiologist ?

To quote my very Southern grandmother “That’s all well and good.” (Whenever she used this phrase, it was always followed by a “but….”, and in this case it’s a very big “but.”) BUT this little boy and any other future siblings will likely never be able to fill his older sister’s very big shoes.

That may never be a problem for my little friend, if he continues with his current temperament, because he’s as happy-go-lucky a toddler as I’ve ever seen. It doesn’t bother him to hear “no.” Actually “no” might be one of his favorite words since he seems to take it as the beginning of his next challenge.  He doesn’t mind if he’s reprimanded and made to sit in a chair or a toy is removed. He’s happy regardless. He likes it alright when we clap for him after he’s said a new word or completed a request we’ve asked him to do, but so far, approval, or even lack of it, doesn’t seem to motivate him as much as it did with his sister.

Herein lies the problem. This is how his mom and dad have been trained to parent, for 4 1/2 years now, by that older sister who learned to understand words quickly and still does most everything the very first time she’s told. Mom and Dad have learned to use praise to their advantage since this method was so successful with #1. When she was praised for good behavior or for learning a new task, she wanted to do it again and again. When her parents shoot her a disapproving glance or say her name with a disappointed tone, she responds.

When baby brother came along, like most of the other toddlers who’ve been born into this world, it’s not been that easy. He’s not cognitively challenged at all, but as far as language goes and certainly with behavioral directions, you have to tell him more than a time, or even two, in hopes of getting him to respond.

If these parents had had him first, they’d fully be able to appreciate just how easy older sister was, and is, and probably always will be. But this is hard when all you’ve known as a parent is a child of that variety. Little brother looks like he’s much more difficult than he really is.

By comparison he seems like he’s having real learning difficulties, when in fact, he’s likely just demonstrating a different learning style. Although older sister was a late talker, her strength so far seems to be strong auditory learning skills. You tell her, she hears it, she knows it. You read her book, or even 20 books, and she sits for the entire time, very engaged, and very interested in the wonderful explanations her parents give her. She was also very, very responsive. At 21 months she would sit and happily point to any picture her parents asked her to find. This was an enjoyable activity, not only for her, but for her parents.

Not so much for little brother. He won’t sit still for one book, and actually on most days, even half a book! This is especially true when his parents are asking him with questions and expecting the same level and style of participation. It’s not just that he won’t do it, he can’t do it. Not yet anyway.

To me at least part of the “issue” (and I use this term loosely because this behavior?is likely more “typical” than his sister!) for this little boy seems to be that he’s a do-er. This little guy has to feel it, and experience it, and DO it to learn it. Looking at a picture of a ball isn’t nearly as exciting as throwing, and kicking, and catching a real ball. Seeing the picture of a bird isn’t as much fun as watching the real bird fly and land right in front of him when he’s playing outside.

When Mommy or Daddy expect him to sit down and look at the book, he feels like he’s crawling out of his skin! When they start asking all the “Where – Where – Where” questions, he bolts! Without words he’s saying, “Get me outa here!!!”

One thing I recommended last time I was visiting this family was to make a philosophy shift in how we approach helping this little guy. Don’t get me wrong and misunderstand what we’re dealing with here. It’s not that he’s not making progress. In fact, he’s making great progress! In the short time I’ve seen him, he’s progressed from saying no words to using about 40 different words now on his own. He even imitated a few two-word phrases last time I was there. He’s now following simple directions in his daily routines most of, well at least some of, the time. He now plays with me for at least 45 minutes of our hour-long session IF I’ve planned ahead and include lots of FUN and movement-based activities and I’m sure to keep it rolling along so that we’re switching to a new toy when he’s giving me the signals that he’s “all done.” (Meaning he’s saying it, signing it, looking around for, or is getting up to find something else to do!)

I’m talking about how his parents work with him on a daily basis. Again- don’t get me wrong. It’s not just the hour he spends in speech therapy every 2 weeks that’s helped him. It’s how his parents have faithfully carried out recommendations when I’m NOT there that’s made the real difference.

But at this point in therapy, I do want to help them shift not necessarily WHAT they do, and maybe not even HOW they do it, but how they THINK about what they’re doing while they’re working with him.

With this little guy, it may be more helpful for them to think about him learning words from them while they are teaching him, and not necessarily testing him.

By this I mean dropping lots of the direct questions that he’s not responding to just yet. I mean that instead of asking questions to verify that he comprehends, that they do more telling, showing, and helping him learn while they play inside, play outside, eat meals, take a bath, get dressed, go to the store, AND even the dreaded book reading!

With this little guy and with all children like him who are not consistently responding to our barrage of questions, we should tell him more, show him more, and help him to do more rather than just asking him and then expecting him to perform.

This shift in mindset alone can take the pressure off a child who wants to do nothing more than escape. When the pressure is removed with these kinds of kids, wah-lah, they often rise to the occasion and “perform” more than they’d ever do otherwise.

Even if your wah-lah moment with him isn’t that same day or week or month, focusing on the TEACHING part rather than the TESTING will take the pressure off you too. When the focus becomes teaching him instead of measuring what he knows by how he responds, parents can relax and know that just because he’s not demonstrating that he “gets it” just yet, they are doing what they can to help him learn to understand.

In real life this looks like parents who go out of their way to label objects, actions, and people they want their child to know. They don’t just provide these words once to twice and then expect their children to know how respond to the questions.  They say these words over and over again, knowing that it may take a while to “see” results.

In phonological therapy there’s a widely-used method called “recasting.” Using this technique parents are instructed to say a target word 12-18 times over a few minutes and then repeat that same word 3 or 4 times later in the day in shorter bursts each time, say 4 to 6 repetitions, to help their child “hear” and “process” the word correctly. I’ve started mentioning these numbers to parents I’m seeing now to use with their children with receptive language issues. By using this number, I hope to give them a way to measure progress, not their child’s, but their own. If they are repeating a select number of target words this often, then they can feel successful that they are doing “teaching.” When parents focus on a few words like this several times a day for several weeks, chances are, their children will link meanings to the words and learn to understand, and hopefully, finally demonstrate that they understand. Isn’t that what teaching is all about?

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