Are you concerned that your child isn't talking as much as you think he should be by his age? Are other children in your playgroup talking a lot more and putting words together more easily and following directions better? There might be more going on than just "he's not picking up words" or "he's just a late talker." A receptive language delay/disorder may be an underlying factor in why your child is not picking up words as easily as other children around him.

Late talkers often have a receptive language disorder that is overlooked. It makes sense that a chid can't use words that he doesn't understand. Words don't make sense to a child who is not understanding fully the meaning behind the words.

Children who have difficulty understanding language or processing language have difficulty following directions. This can easily be mis-diagnosed as a behavior problem both at home and at preschool or day care. You might think that your child understands just fine because he understands many words. The breakdown typically occurs, however, when it's all put together in longer utterances and when simple nouns that your child may know individually are combined with adjectives and verbs and prepositional phrases.

Some characteristics of children with comprehension or processing problems include the following:

• repeating the last couple words of a question instead of answering it
• ignoring questions
• not following more than a single step direction
• giving off target (unrelated) responses to questions
• shaking head  for yes or no instead of answering
• may understand the individual words and vocabulary, but not when it's all put together in a longer direction or question

If this sounds like your child, I strongly encourage you to have your child evaluated by a speech/language pathologist or early intervention specialist. Click here to learn more about this process. The earlier your child receives intervention for this, the better off he'll be and the chances of overcoming this specific delay with be greater.

Ways you as parents can help at home:

• teach your child how to use words and what they mean - instead of just teaching them to say words
• teach words in context and generalize across many contexts (if you're talking about the word "shoe", use the word when you are tying his shoes and when you are putting your shoes on and when you go to a shoe store and see shoes or when you look at a book with your child and come across shoes, etc.)
• exaggerate words and actions while teaching meaning
• exaggerate vowels instead of consonants (b-a-a-a-l instead of b-b-bal)
• when giving a direction, break it way down if necessary
• shorten your sentences when giving directions and asking questions
• model the answer to help them learn how to respond and what you're expecting
• tell your child to do something - if he doesn't do it or doesn't understand, show him and then if necessary physically assist him
• don't just teach your child nouns, also teach verbs (action words), adjectives (descriptive words) and prepositions (location words)

In a subsequent post, I will address asking and answering questions with your child and what types of questions should be mastered by what ages.

I hope this article has been helpful. Please fill in below with any comments or questions you may have on this topic.

Thank you

A while back I discovered a website that can be a great support for mom's in all types of situations. The site is http://www.cafemom.com. They have groups you can join on all sorts of topics. You can use forums to ask questions and get support that way or you can read questions and answers that have already been posted.

If you are reading this blog, here are some groups that you might find helpful: "Mother's of Toddlers with Speech Delays", "Mom's Helping Mom's with Special Needs Children", "babysign", "Making Sense of Sensory Processing Disorder", "Children with Speech Delays", "Raising Children with Down Syndrome", "Developmental Delays", "Children with Apraxia". There are of course many, many more groups and it's a great place to get support.

So check it out!!!

I recently attended a very interesting and eye opening training and thought it would be helpful to share some of the information. The training was on Crisis Prevention (http://www.crisisprevention.com) in the classroom (I work in preschool with special education children). The majority of the emphasis, however, was on how to identify anxiety in order to prevent a potential 'crisis' in the classroom.  The information I am sharing here is relevant for both parents and teachers of young children.

Anxiety is a normal part of development and tends to follow a developmental sequence. Infants may show anxiety (fearfulness) when a loud noise occurs or a sudden loss of physical support occurs. Young children between the ages of 9 months and 2 years often exhibit separation anxiety which is an indication of the development of a healthy attachment to caregivers.

This type of anxiety is worse for young children who have had either too few or too frequent separations from caregivers. Young children who experience this anxiety will be clingy and usually cry at the time of separation - and some may even become more tearful and upset when their parent comes back to pick them up even if they have had a good day in the meantime. Separation anxiety usually decreases between the ages of 2 and 3 years.

5 factors that may contribute to increased separation anxiety:

• change in child's routine
• change in family (new baby, divorce, etc.)
• child being sick
• change in caregiver or daycare or preschool
• child being tired

7 ways to support your child and possibly reduce separation anxiety:

• acknowledge how your child is feeling (i.e., "I get sad too when…")
• by saying "it'll be okay - I'll be back soon" - you are not validating your child's feelings
• try to be cheerful when you leave
• don't prolong your departure
• never sneak out - always say goodbye
• focus on the positive things that will happen when you are gone
• plan something special (even a yummy treat) for when you pick him up

Another anxiety seen in children is school anxiety. This is seen from young preschoolers on up.  Many young children have a fear of school and will resist going to school especially in the beginning of the year. For many this goes away as the fear of the unknown dissipates, but for some this fear persists and even gets worse. What confounds the problem is that young children are unable to put these fears into words and so they will often "act out" instead.

At home, this can look many different ways. Your child may not sleep well or be slow and apprehensive about getting dressed in the morning. He may be extra clingy and complain of stomachaches or headaches. His behavior may seem oppositional, but in actuality he is really fearful and anxious about going to school.

As parents, it's so easy and natural to want to take away the problem and the fear by saying something like "don't worry, you'll have fun today." How comforting is that to hear? Not very. This of a situation that you encountered that made you somewhat or very anxious. Does hearing "don't worry" help or is it more comforting to hear empathetic and understanding words? Of course the latter.

At school & daycare, it's important for teachers and caregivers to also know what anxiety in children looks like. If not identified and addressed, this behavior can escalate and turn disruptive and undesirable in the classroom.  On the other hand, a child's anxieties about school can cause uncomfortable shyness and this needs to be correctly identified as well.

8 behaviors to look for that may indicate anxiety in a child:

• fidgeting excessively
• excessive silliness
• fast rate of speech
• agitation
• avoidance and escape behaviors
• trembling
• looking away
• excessive crying / yelling / screaming

Empathetic Listening is the active process of accepting and confirming your child's/student's fears and it involves the following:

• give undivided attention
• always acknowledge the problem
• be non-judgmental & sensitive
• listen for feelings behind the behavior
• allow silence for reflection
• restate to help clarify their message (this helps them to communicate their feelings)
• an empathetic statement like "I get that funny feeling in my tummy too sometimes" can go a long way

For more reading on anxiety in young children, please refer to these two articles:
http://specialchildren.about.com/od/specialeducation/ht/anxiety.htm
http://school.familyeducation.com/back-to-school/anxiety/37623.html

I found a book that you may find helpful if you are dealing with separation or school anxiety with you child.

As a speech therapist who works with kids, I've been asked this question on more than one occasion so I thought I would address this issue here on this blog. From my own experience, I think this is not true and maybe just one of those things that you heard from your mother and she heard from her mother and so on.

I have found a great article on this exact subject and she also think this is a myth. She talks about the pros and cons of your baby/toddler using a pacifier and she does give suggestions for finding other ways to help your toddler self soothe.

In the first part of her article Laura addresses using sippy cups and how this can effect your child's speech and even more so cause dental problems if used too much. Laura's article is worth reading if you are concerned about your toddler using a sippy cup or a pacifier. Her website is teachmetotalk.com and if you follow this link it will take you straight to this article. I'm sure you'll find this article as informative as I did.

When your child is in the midst of a great jump in his language skills (between ages 30 months and 5 years) it's natural that putting sentences together in a fluent way might be difficult. Her brain is like a computer, working to pull up the right words in the right order and at the right time. While the computer is "searching," her mouth may go into a "pause" (translated: repeat) mode. So it may sound like this: "Mom … I-Mom … I-I-want-uh-I want you-gimme dat teddy bear!" The whole word or first syllable is often repeated, not usually the first sound. This is a normal developmental phase that most children go through. You may notice it more when your child is tired, excited, or upset.

Below, please find blog posts I found from other speech/language pathologists that help to differentiate between normal developmental dysfluency and the speech pattern of a child who may develop into a school age child who stutters.

Stuttering or Normal Dysfluency?

Occasional easy repetitions of whole words or phrases at this age can be typical and is referred to as “normal dysfluency,” not stuttering, by a speech-language pathologist. Often it occurs when a child is experiencing a surge in his …

Therapy Thursday: 4 Facts about Stuttering

On a personal note, The Flash had some of the WORST preschool stuttering I have heard. He could easily stutter on a sound for 20 seconds. They were always "easy, loose" stutters but this went on for about 2 years. …

Stuck on Words? Is My Child Stuttering?

… phrases at this age can be typical and is referred to as “normal dysfluency,” not stuttering, by a speech-language pathologist. Often it occurs when a child is experiencing a surge in his language development. Tips for responding: …

Additionally, an excellent resource for parents is the Stuttering Foundation's page entitled "If You Think Your Child Is Stuttering". This article also breaks down the difference between normal, age-appropriate dysfluency, mild dysfluency, and more serious dysfluency. From this page, you can follow a link to frequently asked questions from parents about stuttering, view a list of risk factors and a list of ways you can help your child who is exhibiting stuttering behaviors.

I found a book that breaks down communication development from birth to five years. This book really touches on all aspects of language development and has a section devoted to stuttering and normal dysfluency. Children's Communication Skills: From Birth to Five Years

Why not give your apraxic child a way to communicate?

Most of what I'm including in today's post are experiences from parents who have a child with dyspraxia and how they have used sign language to help them communicate.

Using Sign Language With Children Who Have Apraxia of Speech

Often when someone raises the idea of using sign language for a child with apraxia, parents may experience confusion and even fear. After all, “The child can hear just fine! Why would we use sign language for a hearing child? …

Making the Leap from Words to Phrases…. Tips for Helping Your …

If your child has used sign language, it may be helpful to model the sign as you are saying the word. Even if your child has “dropped” signs in lieu of words, you may want to pull them out again as a strategy to help him “motor plan” …

Childhood Apraxia

She is learning sign-language to help with communication with others, and we work at home on various techniques. Her Speech Therapist is very pleased with her progress. It is because of this that I now find myself homeschooling her for …

List of resources for ASL

Using Sign Language With Children Who Have Apraxia of Speech http://www.apraxia-kids.org/topics/sign.html Signed Speech or Simultaneous Communication http://www.autism.org/sign.html The Use of Signs by Children with Down Syndrome …

I hope this information has been helpful to some of you. If you are interested in teaching your baby or toddler sign language, first consult with your child's speech therapist and then check out this program that is fantastic for teaching children sign language. It's called Signing Time. Click on the image below to be taken to their site.

The answer to this question is "yes". When a child has a middle-ear infection, fluid accumulates in the middle ear. The middle ear space behind the eardrum is typically filled with air - not fluid. This fluid can actually remain even after the infection has cleared. The presence of this fluid can cause a temporary hearing loss or reduction in hearing. And of course children with repeated infections or fluid build up have a higher likelihood of speech and language delays.

Many children have at least one middle-ear infection (also known as Otitis Media) before the age of one and 10-20% of children have more frequent ear infections. Fluid can last on average up to one month per infection. Of huge importance is that persistent fluid is more common for children under 2 years of age than for older children.

Why is this of huge importance? This is a critical time for language learning and speech development. During a child's first three years is when the most amount of language learning is taking place - both learning to speak and understanding language. Children do this by interacting with people around them. If hearing is muffled during this time, it only makes sense that speech and language development may be delayed as a result.

Signs of a Possible Ear Infection:

• child pulls on ear
• child says ear hurts
• fever
• irritability
• difficulty sleeping
• drainage from ear

Otitis media can actually be present with no symptoms at all. If a child is prone to ear infections, this will often occur with a cold. There are two types of Otitis Media (inflammation of the middle ear): Acute otitis media is simply an infection in the middle ear and like mentioned above, fluid can remain even after the infection is cleared up. Otitis media with effusion is the presence of fluid with no infection. This type often occurs with no symptoms at all. If your child is showing any of the above signs, see your child's pediatrician as soon as possible. As with any condition, the earlier treatment is started, the better.

Signs of a Possible Hearing Loss:

Children with otitis media will often have a mild to moderate temporary hearing loss. If you suspect your child may have trouble with her hearing, check for a difference in behavior and check for these signs:

• has difficulty paying attention
• not following directions well
• saying 'huh" often
• not responding when spoken to
• needing volume turned up on tv or radio

If you continue to suspect that your child may have a hearing loss, you'll want to first take her into the pediatrician for a hearing screening. If a hearing screening is failed then the next step would be to see an audiologist. An audiologist will be able to do a more in-depth hearing assessment and can provide treatment for children who suffer from even temporary hearing loss.

Here are some helpful resources:

My Ear Hurts! offers clear explanations of the causes of ear infections and up-to-the-minute discussions of:
* traditional medications, including the overuse of antibiotics
* surgical treatments, from insertion of ear tubes to new laser techniques
* alternative treatment options, such as herbal and homeopathic remedies and chiropractic treatment.

In this updated and revised second edition of his bestselling Childhood Ear Infections, Dr. Michael Schmidt describes the current controversy in medical journals questioning existing treatments for chronic earaches.

Additional resources from around the web that may be helpful:

• Weekend Ear Pain Action Plan - The Pediatric Insider
• Chiropractic Care & Ear Infections

May is Better Hearing and Speech Month

Your ability to communicate with others is precious. Good hearing is an important part of that ability. If you or someone you know is showing symptoms of a problem - Have Your Hearing Checked by a Certified Audiologist!

For autism awareness month I wanted to bring awarenss to a less well known syndrome that is on the autism spectrum. This syndrome is called Asperger's Syndrome - also known as high level autism. I found a great article written by a woman (Lynne Soraya) who says she always felt different but never quite knew why until she came across an article called "The Geek Syndrome".

After learning about Asperger's for herself she shares her thoughts on what it means to have Asperger's Syndrome, how it affects a person's interaction with their world, and what are the specific challenges a child or an adult with Asperger's faces. She writes:

"In general, people with Asperger’s generally have trouble with social interaction, communication, as well as regulation of the motor skills and sensory systems.They also can develop obsessive and compulsive tendencies, which manifest themselves in various ways."

Lynne then goes in depth about their social challenges, their verbal communication, their interests and obsessions, and also their sensory and motor challenges. You can read her entire article here: What Does It Mean To Have Asperger Syndrome?

What are the 7 biggest challenges you'll experience with your child who has Asperger's Syndrome? Would you like to know what these are and how to overcome them? Click here to learn the secrets to successfully parenting your child with Asperger's Syndrome.

Additional Resources for Autism and Asperger's Syndrome

I have recently written a post entitled Tips To Help Your Child Learn New Words that provides you with a list of general things you should be doing to indirectly enhance your child's language learning. Here, I'd like to provide you with specific words and concepts that you can add into your daily routine with your toddler that will enhance the development of new words and overall language development.

What is important to understand is that even if you have a toddler with a language delay, you don't have to make extra time throughout your day to enhance and work on language development and language learning. This should be incorporated into everyday activities such as meal time, bath time, getting dressed and even play time. Incorporating language learning in this way enhances meaning and context which are both incredibly important for your child to learn new words and concepts.

Tips For Talking During Meal Time

1. Use action words like eating, drinking, tasting, chewing, cutting and pouring to both describe what you are doing and what your child is doing.
2. Use simple names of everything around, like food names, utensil names, furniture names, names of dishes, etc.
3. Use descriptive words such as colors and textures of food (crunchy, messy, mushy) and other descriptive words like thirsty, hungry, full, all gone, more, etc.
4. Use opposites such as hot/cold, empty/full, half/whole, on/off, yummy/yucky, etc.
5. Use location words like on, next to, under, behind, away from, etc.

Tips For Talking During Bath Time

1. Use action words like wash, scrub, splash, dry, rinse, rub, drip, etc.
2. Use simple names of items used such as, towel, washcloth, bathtub, soap, shampoo, names of bath toys, etc.
3. Use descriptive words and opposites such as, wet/dry, clean/dirty, cold/hot, empty/full, little/big, rough/smooth, warm/cool, hard. soft, etc.
4. Use names of body parts.
5. Use location words such as, up down, behind, in, out of, under, next to, over, on, etc.
6. Use time words like first, next, then, now, later, before, after, etc.

Tips For Talking During Dressing Time

1. Use action words like pull, put, stand up, sit down, button, zip, snap, tie, etc.
2. Use names of body parts and clothing.
3. Use descriptive words and opposites such as colors, clean/dirty, new/old, long/short, same/different, pretty/ugly, light/dark, right/left, etc.
4. Use location words such as, on, off, under, in, out, through, around, etc.

Use these lists of ideas not only for children who present with a language delay, but all children would benefit from incorporating these kinds of words into everyday activities. A speech therapist working with a two year old or a three year old or even a four year old who had a language delay would be encouraging these kinds of words and concepts.

How To Help Your Child Learn To Talk Better In Everyday Activities is a wonderful guide/e-book that informs parents and others who want to help a child begin talking or to talk better. This book gives immediate help with thorough and straight-foward explanations and lots of examples.

Language learning is an ongoing process that occurs all day long during everyday activities and especially during play. When you get at your child's level and "play", you're enhancing language and communication skills in a very indirect kind of way. Even when your child is an infant and you play little repetitive and imitative games with her you are enhancing her communication skills. I found an article on TalkAboutSpeech.com that describes this kind of interaction very well.

With a child who is developing language more slowly than his peers there are some things you want to keep in mind during your playtime with him.

During play it is so natural for parents and other adults to ask the child questions, like "what are you playing with?', "where does that go?", "what color is that car?", etc. This is counter-productive for the child who may have a language delay. Instead, your child would benefit from objects and actions being labeled in more of an indirect kind of way. Make comments instead of asking questions. Asking questions during play or expecting your child to repeat what you have said will only put pressure on your child, especially if she doesn't know the vocabulary. Think of it in the same way as an adult learning a foreign language. You'd pick up the language much better if everything was labeled for you in context, rather than if you were constantly asked questions. Enough said.

5 Points to Remember While Playing With Your Child

• Follow your child's lead and follow what he is interested in.
• Use single words or signs or short phrases while commenting - not long sentences.
• Don't feel you have to comment of every action.
• Repeat words and phrases often. It may seem dull to you, but it's not to a young child.
• Try to vary your inflection pattern and pitch. Young children are more likely to imitate this.

3 Methods of Indirect Language Stimulation to Use While Playing

• Parallel Talk - This is centered on what your child is doing, seeing and hearing as they are playing. For example: "You have a ball.", "You are pushing the car.", etc.
• Descriptive Talk - This is centered on the object and you provide the word or sign labels for the objects your child is playing with. For example: "The ball is rolling.", "The ball is red.", etc.
• Self Talk - This is centered on what you are doing as your child is watching. Again use short phrases or sentences. For example: "I'm tying my shoe.", "I threw the ball.", etc.

Children need to hear language (or see signs) in order to learn how to use language. By giving labels and describing actions to the things your child uses and is playing with, your child can begin to make the connections between the object and the word. Your child will eventually use these words. And remember, repetition of the same word or action is necessary for that connection to take place.

Here is an excellent article on the importance of play in a child's overall development: