Child Talk

Pictures, Autism & Creative Language: Using Pictures to Increase Creative Language Use

2013-05-20T14:19:00.002-05:00

Pictures and Autism: Using Pictures To Teach Creative Language

Note: This post was orginally published on as a Guest Post by me on Joy's Autism Blog. I'm sharing it here again for my Child Talk readers!

Over the past thirteen years of working as a pediatric speech-language therapist, I’ve found that pictures can be a highly effective tool for working with children who have a diagnosis of autism. Children with autism are often highly visual and concrete learners; pictures have a way of slowing language down and making it more concrete. I use pictures in a wide variety of ways, but today I want to share with you how I use pictures to facilitate multi-word phrases with children who are just learning to use language creatively.

Most children with autism use echolalic speech. We think that this is because their brains process information as whole chunks—something we call being a gestalt learner. As a result, many of the children I work with have learned whole phrases that they use without actually understanding that each of the words in the phrase has individual meaning. For example, I’ll often see young children with autism say, “do you want to swing?” when they actually mean “I want to swing.” They do this because this is what they’ve heard asked of them when they were standing in front of a swing that they wanted to swing on. Not understanding that each word has specific individual meaning, they just repeat the whole phrase they heard in an attempt to communicate what they want.

One of my strongest beliefs as a speech-language therapist is that we need to teach children with autism that they can create meaning through putting words into a wide variety of short sentences. This is the generative aspect of language that makes it so that we can all create sentences we have never heard before, and it’s an essential aspect of language development. Without it, children are left to memorize sentences for specific situations and this highly limits their language skills. When I work with children with autism, I make sure that they are using a wide variety of two-word phrases (see my list of early developing two word phrases here).

As a speech-language therapist, I will ofen use pictures to show relationships between words in phrases so that children can actually see how changing words changes meaning. Once they get this idea, the possibilities are endless! The actual pictures and words I use with a child vary depending on that child and his interests, but the general process I use goes a little something like this:

First, I find a situation where a child needs to create specific two-word phrases to communicate his specific wants. I look for a situation that is highly motivating for a child, one in which each specific phrase would be important to that child. Take, for example, a child who *loves* to play with a ball and hammer toy. His ball and hammer toy has a green ball, a red ball, a blue ball, and a yellow ball. and he knows which ball he wants. Given this situation I would:

Make a picture to represent “ball” as well as pictures to represent each of the colors.
Place a Velcro strip on the front of a binder, and put Velcro on the back of all the pictures as well.
Get out the ball and hammer toy and place it on the floor next to the pictures.
Hold up the balls and allow the child to reach for one so I know which one he wants.
Quick create the phrase on the Velcro strip that matches the ball he wants. Say, for example, he wants the green ball. I would put the picture for "green" and the picture for "ball" next to each other on the front of the binder, creating a small picture sentence ("green ball").
Point to each picture as I say the word in the phrase (“green ball”).
Have the child imitate me.
Give him the green ball.
Repeat the process, exchanging the color word on the velcro strip to represent the color ball the child wants.
As quickly as I can, I back off of prompting him to create the sentences and let him create the sentences on his own.
And, as quickly as I can, I get rid of the pictures and let him just use his verbal words.

The ball activity is just one of hundreds of activities where something like this would work. You might use this strategy to teach your child to create the phrase “eat + (food item)” or “watch + (movie)” or “play + (name of computer game)” or “go (location).” The key lies in finding an activity that allows you to teach your child that he need to mix and match words together to create his own sentences that have meaning to him. Once he understands the power of creative language, he’s well on his way to being an advanced communicator.

Building Language In The Bathtub

2013-03-26T09:23:00.000-05:00

Bathtubs can be a wonderful place to build language! Why? Because one of the most powerful ways to build language is inside of routines, especially those routines that occur on a daily basis. What's more, many children love bath time! The only thing better for language than a routine is a routine that children truly love. As a bonus, bath time is something that is already built into the day - no need to buy any new toys or find time to sit on the floor and play. As parents, we can create many teachable moments inside something we are already doing, almost every day. Here's how.

During baths:

Use self talk and parallel talk to describe what your child is doing or seeing. Label each part of the routine, each night you take a bath. Water on. Shirt off. Pants off. Socks off! Climb in tub. Water off! Wash toes. Wash tummy. Get out. Dry, dry, dry! Dry hair. Dry tummy. Dry toes. Bye water! Water's going down. Water's all gone. Diaper on. Pjs on. All done!
Every once in a while, interrupt the routine. Stop and simply wait! See what your child does. She might verbalize the next step of the routine.
Model first words with easy developing sounds (p, b, t, d, m, n, h, w) as well as nouns, simple actions, and simple concepts (on, off, up, down). Some of the words you might choose to model during bath time include: bath, water, off, on, in, out, up, wash, bubble, soap, pour, wet, nose, eyes, toes, knees, ears, go, brrr, dry, beep beep, boat, (while playing with boats or cars that float!), tummy, bye (while boats float away or toys sink to the bottom), more, two, done, tea, mmm & nummy, (while pretending to have a tea party in the tub!), milk, hot (when the tea you drink is too hot!), and eat (while eating the crackers that come with your tea).
Pair actions with words as you model the words. Model "wash wash wash" as you scrub her little body with a washcloth. Give her a baby to wash and a washcloth, too! Model "go go go" as you send a boat skimming across the water. Line up pretend animals on the edge of the tub and have them jump in one by one; say "in" each time an animal jumps in. Say "splash, splash, splash" as you splash the water with your little girl. Say "pour pour pour" as you and little boy pour water in and out of cups. Children are much more likely to imitate a word if it is paired with an action!
Use expansion and extension to respond to what your child says.

If he says, "wash," you say, "wash toes!"
If he says "water" you say "more water"
If she says "bath," you say "in bath"
If she says "boat" you say "go boat go!"

Create communication temptations to create teachable moments in the bath. Run a little water and then wait. Or, give her just one toy and then wait. Or blow bubbles (in our house, I love to blow bubbles in the tub! Much less mess that way) and wait. Or create a silly game in the bath, such as pouring water on her toes. Then, just as you are about to take another turn, wait. Remember to wait! As soon as your child shows you she wants more of whatever you were doing, model a higher level response than what she used. If she uses a gesture, you interpret her gesture with one word. If she uses one word, you model two. If she uses three words, model a longer, more grammatically correct sentence. Encourage her to imitate you and then carry on with the fun.
Structure your phrases carefully to encourage the use of early developing two-word phrases. To do this, I often pick one word in the two-word phrase to remain the same, while the other word changes. Then, I create an activity to match. You can do the same! Say, for example, you want your little one to use more "person + action" two-word phrases. You might line little animals up on the edge of the tub and command them to jump in, one at a time. Dog jump! (And the dog "jumps" in the water with a big splash). Cow jump! (And the cow does the same). Do the first few and then pause just before you have the next animal jump in. Your child might just follow your lead and come up with her own two-word phrase!
While using communication temptations, offer choices as a way to build her language. If she says, "water" to request more water, ask her if she wants "hot water or cold water?" When she giggles and requests more water poured on her body, ask her, "on toes or on knee?" As you wash up her little body, make a point of putting soap on each part of her body. When she asks for more, ask "soap on knees" or "soap on tummy?" Create fun, create a communication temptations, and then create a choice!

And most importantly, have fun and enjoy the moments with your little one. Building language is fun, but building memories is priceless. :)

Using Gestures to Predict and Promote Language in Children

2013-03-17T15:06:00.000-05:00

Most people don't automatically think of gestures as an important part of speech and language development. Quite the opposite, in fact. When most people think of the milestones that make up a child's early communication development, the focus tends to be on spoken language: first sounds, first words, first sentences. It turns out, however, that gestures play a big part in both predicting language and promoting it.

Gestures Predict Language Development

An important turning point in young children's early language development occurs when infants become intentional communicators. This occurs when children begin to communicate messages to others in their life and, in doing so, begin to control the environment around them. My husband and I jokingly called this the "Dance Puppet Dance," stage of babyhood- the time when adults are so enamored by the fact that their little one is communicating that they are willing to drop whatever they are doing to meet the whims of their child!

Although it may seem like children's intentional communication starts with their first word, communication actually starts long before this. Think of a nine-month-old child reaching toward something he wants, while looking back at his mom. This child is clearly communicating without saying a word. In fact, when we look at how children first communicate, we find that they use some very consistent forms of gestures along the way. According to Capone and McGregor (2004):

One of the earliest form of gestures is showing off. This occurs when infants repeat their behavior in order to get an adult to laugh or comment on what they are doing.
"Ritualized requests" occur between 9 and 13 months of age. These gestures occur when, instead of whining or fussing, children use more mature gestures as a form of requesting. Ritualized request gestures include reaching toward a desired object with hands that open and close rapidly ("I want, I want, I want!") and placing an object in an adult's hand to get help with that object.
Children begin to use deictic gestures around 10-11 months. Deictic gestures are "showing" gestures that are used to get someone to attend to something in the child's environment. Early deictic gestures include: showing an object to an adult to get that adult to look at it, giving an object to an adult to show it to them, and pointing at objects to draw another's attention to that object.
Representational gestures emerge prior to, and along with, first words. Representational gestures occur when a child uses a gesture in place of a word. For example, the child might flap his arms to indicate "bird". The ability to use representational gestures tells us that a child is starting to think symbolically; in other words, the child who flaps his arms is using a symbol to represent "bird." This early-developing demonstration of symbol use is something we all look for as early interventionists, because words are symbols! When a child shows us he is beginning to understand and use symbols, we know he is ready for first words.

Looking at gestures in little ones becomes a very important step in assessing communication skills for a number of reasons. First, gesture use indicates that a child is an intentional commmunicator. Intentional communication is a huge stepping-stone toward verbal language, so we get really excited when we see a child is communicating with gestures, even if he isn't yet communicating with words. We worry less about a child who is using the right gestures at the right time than one who isn't.

A lack of gesture use, then, helps us to identify those children who might be at risk for a more significant diagnosis. Research indicates that children who don't use the deictic gesture of pointing by 18-24 months are at risk for a diagnosis of autism spectrum disorder. You can find out more about this by reading my post on the Red Flags for Autism in Toddlers. Although it can be really scary to see these signs in a little one, early diagnosis and treatment can be extremely helpful for children with autism spectrum disorders. The earlier we figure out what is going on, the earlier we can help.

Looking at gesture use can also help us tell the difference between late bloomers (toddlers who speak late but catch up by the age of 3) and late talkers (toddlers who speak late and continue to struggle even at the age of 3). It turns out that late bloomers use significantly more gestures to communicate than do late talkers (Thal et al., 1991). Although late talkers use gestures, those gestures are more limited and are produced less frequently. If we see that a late talker isn't using a wide range of gestures to help communicate, we might be more likely to provide speech and language therapy.

Gestures Promote Language Development

So, gestures can be really helpful when we are trying to decide if a child needs some additional help with speech and language. And, they can help us identify those children who do need help at a pretty early age. That's the good news. Here's the even better news: gestures can also be helpful in assisting children to develop speech and language.

According to Capone and McGregor (2004), gestures and verbal language are related neurologically. In other words, the brain mechanisms that support the use of gestures seem to be related to those that support speech and language. Encouraging use of one may facilitate use of the other. I use this all the time in my work a pediatric speech-language therapist. I've long known that pairing an action with a word is more likely to get a child to imitate the verbal word. Further, I frequently use Baby Signs as a bridge to verbal language. Although parents sometimes worry that this will keep their child from talking, I've found the opposite to be true: using the Baby Signs as representational gestures is an excellent bridge to verbal language. Gestures are also fantastic because:

Children often imitate gestures and verbal words at the same time
We can help children use gestures and signs by actually moving their hands to show them how to do the gestures or sign, something we can't do with spoken language
Gestures help children learn to understand language and seem to promote the conceptual, symbolic thought needed for language
Gestures and signs are more concrete and last longer in time than verbal words; this is a huge advantage for children who process information just a bit more slowly than others
Gestures and signs are great for children who are visual learners, such as children with Autism
Some children, such as children with Down Syndrome, have a very specific strength in use of gestures - tapping into this strength can be a beautiful way to increase language skills overall,
Gestures and signs increase a child's ability to communicate with those around him, which descreases frustration. And decreased frustration is good for everyone!

Capone and McGregor (2004). Gesture Use: A Review for Clinical and Research Practices. Journal of Speech Language and Hearing Research, Vol 47: 173-186.

Thal, D., Tobias, S., & Morrison, D. (1991). Language and gesture in late talkers: A one-year follow-up. Journal of Speech and Hearing Research, 34, 604–612.

Using Expansion and Extension To Grow Your Child's Language

2013-03-04T06:47:00.000-06:00

As a pediatric speech-language therapist, I often use indirect language facilitation strategies to help grow a child's language. I've written about these strategies before, such as when I wrote about how the way you talk to your child impacts his language learning and when I described how to use self-talk and parallel talk.

This time around, I''m pulling out a couple more indirect language facilitation strategies that parents can put in their language-boosting tool box: expansion and extension. These both fall under the category of "indirect language facilitation" because they are built around a child's utterance (what the child says) and because they do not require a response from the child. This differs from strategies
that are based on the principles of applied behavioral analysis (ABA). ABA techniques usually involve a specific, targeted response from the child that is prompted or elicited, required, and reinforced. (As a slight aside, I certainly think that both child-directed/indirect language facilitation techniques AND clinician-directed/ABA strategies can be- and often should be - used together. And, there is a time and a place where each is more effective than the other. But that's a different post all together).

Expansion and extension are very similar. The most important part of these techniques is that the parent uses them to respond to the child. This requires that a child initiate (start) an interaction somehow. The child might point, or vocalize, or say a word .... anything that starts an interaction. Then a parent either expands on or extends what the child has to say.

In my experience in working with parents, the hardest part about these strategies is that they require parents to wait. Often, when we are in teaching mode, we are inclined to instruct- to direct a child, to tell a child what to do or how to do it. Again, there is most definitely a place for this (heaven knows I have directed many children to do many things in my career). There also need to be times, however, when we respond to a child's language instead of directing it. And that's where expansion and extension come in.

So how are they different? When we EXPAND a child's utterance, we keep the child's word order the same and expand it just slightly to make it a bit longer and/or more grammatically correct. When we EXTEND a child's utterance, we simply respond to the child's utterance in a conversational way, providing a bit of new information that is related to what the child had to say.

So, if a child says, "Puppy outside...."

We can expand this utterance by saying, "Puppy IS outside". We've expanded because we've kept his word order the same (puppy is the first word, outside is the second- and we haven't changed this), but we've made it just a bit longer (in this case we made it just one word longer) and more grammatically correct (in this case we add in the 'contractible copula' grammatical morpheme- the fancy word for is). I coach parents to expand their child's utterance just by just one or two words. This makes the newly expanded phrase a perfect match for the child - it's not too simple because it's longer and more complex than what the child said, but it's not so tough that it loses meaning for the child.

Back to the "Puppy outside" phrase. If we choose not to expand it...

We can extend this utterance instead by saying, "He's barking." In this case, we've responded to the child's utterance and we've stayed on the same topic (the puppy who is outside) but now we've added new information. We've extended the conversation by adding a bit more information. This is the key to extension.

Expansion and extension seem to work best with toddlers and young preschoolers, or children whose language levels match those of a typical toddler or young preschooler. These children often imitate the newly expanded or extended utterances, which we think helps them to grow their language. Plus, because we are responding to the child's lead, we are tapping into whatever is interesting to the child at the moment, making our input (the language they hear) that much more salient, or pronounced, so that children are that much more likely to learn from it.

Research seems to indicate that many children learn language faster when their parents use more conversational language-learning strategies like expansion and extension, as compared to parents who are more directive with their children. And use of these techniques is also linked to longer utterances in children - in other words, children who are exposed to these types of responsive language facilitation techniques seem to use longer sentences overall. Seems like a good deal to me!

Looking for more strategies and activities to help your child learn speech and language?

Communication Temptations

Using Choices to Promote Language

Using Actions to Get Imitation

Babbling with Bubbles

Top 10 Tips for Late Talkers

Top 5 Carrier Phrase Activities for Speech & Language Development

2013-01-28T06:00:00.000-06:00

Carrier phrases are a handy little speech-language therapy trick. We use them any time we want to help someone extend the length of their sentence, but keep the sentence somewhat simple.

As speech-language therapists, we often work to gradually increase the difficulty level of a task. We do this so that we can help an individual stay successful by taking small steps toward their ultimate goal. Say, for example, a child struggles with fluency (or 'stutters'). We might teach that child certain strategies to stay fluent and then initially practice those strategies at the single word level where it will be relatively easy for him to execute the strategy. As he gains success, we then gradually increase the difficulty level.

Many times, we move from having a a child practice a skill at the single word level ("cat") to having him practice at the two-word phrase level ("big cat"), to having him work at the sentence level ("There's a big cat!"). However, the jump from phrase level to sentence level is sometimes a bit too big. Why? Because it requires a person to think of a sentence that makes sense. This increased pull on cognition significantly increases the complexity of the task, which then sometimes results in a backslide in progress. The solution? Carrier phrases.

As I explained in the post What are Carrier Phrases and How Do I Use Them?, carrier phrases are those phrases in which the first few words remain the same, and the last one changes. One example is "I see a ____," used during a book activity. The child might label "I see a horse," "I see a cow," "I see a dog" and so on. Because the first few words stay the same, he doesn't have to think of what he is going to say except to change the noun. This leads to a sentence that is longer, creative, and yet linguistically simple.

The use of carrier phrases can be a very important step when working with children who struggle with fluency. Carrier phrases are also really helpful for children with apraxia of speech or significant articulation disorders, because the speech sounds in the initial part of the sentence stay the same, which allows that part of the sentence to roll off the child's tongue without challenging his motor planning system as much as a totally new sentence would. I also frequently use carrier phrases with children with autism spectrum disorders when I am first teaching them to verbalize simple sentences. In this case, I will often use pictures along with the carrier phrase, so the child can visually see the nouns that are rotated into the carrier phrase. As he does so, he begins to understand that words are building blocks for sentences and can be combined in lots of different ways.

My Top Five Carrier Phrases
(And Activities To Go With Them)

I found a....

Sensory Bin Hide and Find

Most often, I elicit this carrier phrase by hiding objects or pictures inside of sensory bins filled with rice, sand, popcorn or oatmeal. Kids never get tired of digging and finding! Plus, playing in sensory bins seems to carry all kinds of other benefits, as well, as eloquently explained by teachpreschool.org.

When a child pulls something out, I have him say, "I found a....."

Everyday Sensory Play in Preschool

Memory

It's an oldie but a goodie. Lay out matching cards face down, take turns looking for pairs, and then celebrate and say what you found ("I found....") when you find a pair. This is a speech therapy classic for a reason: you can integrate almost any type of picture (and therefore any type of target) into the activity. I also recently found this fun fishy twist on the game, making it even more fun to play:

The Puzzle Game

To make puzzles more fun and elicit more language, I often get out two different peg puzzles. Then I dump all the pieces into the middle of the table face down and ask the kiddo I'm working with to pick one puzzle. I take the other, and we take turns pulling pieces out of the middle, saying what we found ("I found...."), and putting the pieces into our puzzles. First one to complete their puzzle wins! (And, since it's easy for the adult to tell which pieces are which, it's also easy to let the child win). Sound puzzles are my favorite.

Clothespin Surprises
I happened upon this activity from Chit Chat and Small Talk on Pinterest the other day. It looks easy, fun, and perfect for "I found a ....' carrier phrases!

chitchatandsmalltalkblogspot.com

I see a /I spy a....

Books

Books are a great way to elicit the "I see/I spy" carrier phrase. You can simply take turns labeling what you see in the book (you say, "I see...." and then wait for your child to take a turn), or you can play the classic "I spy ..." game ("I spy something that is...."). Playing "I spy" brings with it an additional benefit: working on describing, a language task that can be difficult for many kiddos with language delays. I usually choose simple picture books with lots of actual photographic pictures on one page when using the book as an activity like this.

I spy

Speaking of "I spy," this can be an excellent game to play even without books. I play it with my kids anytime I want to pass the time- especially on long car rides or during restaurant waits. I recently also started playing the below "I Spy" game with my eight year old. It's a great "I spy" game because it moves quickly, so it's possible to get lots of "I spy ...." sentences. And, it's a nice game for working on selective attention, too.

Flashlight Games and Hallway Hunts

Another speechie standby. Tape pictures on a wall and turn out the lights- find the picture by flashlight and say what you see! (I see....) Or, tape the pictures in various places throughout a long hallway and go on a picture hunt. For added fun, grab a paper towel tube and make some binoculars before you head out on your hunt. Either way, have fun shouting what you see as you go!

I spy bottles and I spy bags
Another great way to play I spy! Hide small objects inside of ride, but avoid the mess of sensory bins by enclosing the rice inside of an I Spy Bag (made in the picture below by homeadebyjill.blogspot.com). I've also seen this same concept presented in a see-through bottle. Either way, there is lots of time for "I spy" but a lot less mess!

homeadebyjill.blotspot.com

I got the...

Go Fishing!

In grad school, we flipped a table on its side and put paper fish with paper clips on one side of the table and a child with a magnetic fishing pole on the other. Then, when the child "caught" a fish, we had him tell us what he had caught by saying, "I got the....." The other day, I saw a fun version of this on Pinterest, courtesy of P igtails and Tutus. Definitely something fun to try out a home on a cold or rainy day!

Slap Game

This slap game, from Kindergarten and Mooneyisms,was originally designed as a game to enhance sight reading skills. But it got me thinking: with a few simple modifications, it could easily be a speech therapy game. Lay out pictures instead of words, and have a stack of the the same words face down in the middle of the table. Then, turn one card over at a time and race to be the first one to find the matching card and slap it ! Don't forget to say, "I got the .... " to label what you slapped!

Kindergarten and Mooneyisms

I have a....

Bingo

Bingo is a super easy activity in which to to use "I have a..." carrier phrases, especially if you are using a Picture Bingo game. Every time the child places a bingo chip on her card, she gets to say, "I have a...." and label the picture she just covered.

Go Fish Card Game

Okay, I'm cheating a little bit on this one. When playing the classic Go Fish card game, the carrier phrase you'll most likely use is: "Do you have a....?" Even so, this is a fantastic game for carrier phrases, because you can use any cards you want, as long as you have pairs. This makes it a great game for working on articulation because you can use it with any sound cards you want!

   I made a....

Playdoh and Cookie Cutters

Little ones love to roll and squish playdoh. They love it even more when they get to cut out fun shapes with cookie cutters. And, since this is an easy thing to do, they'll want to do it over and over, making it easy to get lots of practice telling you what they made! (I made.....). I pull out play-doh and cookie cutters all the time to get this carrier phrase.

Water painting

Another simple and yet engaging activity I found on Pinterest, thanks to moneysavingmom.com. Grab a paintbrush and paint pictures on the sidewalk with water. Just like the playdoh and cookie cutters activity, this is easy and quick enough that kids will end up painting lots of different things, making it easy to get them to say, "I made a...." over and over again.

There you have it! My favorite carrier phrases and activities to boot.

Share and Enjoy! :)

My Toddler Talks: A Book Review and Giveaway!

2013-01-21T08:27:00.000-06:00

This post was originally published on Pediastaff.

Giveaway from 1/21/2012-1/27/2012! Details for entering are at the end of the post.

I recently had the pleasure of reviewing a new book: My Toddler Talks, by Kimberly Scanlon, MA, CCC-SLP. This book promises to provide parents with strategies and activities to promote their child's language development- and it delivers. After looking through it, I have lots to say about it, the first of which is this: If you like Child Talk, you will love My Toddler Talks.

Those of you who read this blog regularly know that I believe toddler language can be strengthened best inside of daily play and activities. From sidewalk chalk to bubbles to dishwashers and laundry and grocery shopping, there is little doubt that much language-learning can be woven into the context of meaningful and fun everyday activities. What's more, toddlers learn best when simple, yet specific, language facilitation strategies are integrated into those activities. Those two things - language-learning strategies and meaningful daily routines - pack a powerful punch. And it is precisely these two things that make up Kimberly's My Toddler Talks book.

Kimberly first does a beautiful job of describing language modeling techniques and elicitation strategies in a way that is easy for anyone to understand and apply. Then, she helps out the parent who is stuck, in her chapter: "Troubleshooting Tips: What to Do if the Toddler is Not Imitating You." I can't tell you how many times parents have said to me, "I talk to my toddler all the time- but he just doesn't talk back!" Kimberly wisely anticipates this and provides parents with some time-tested methods of motivating a child to imitate. Her other introductory chapters, "The Do Not List" and "Some More Tips: The Five Rs (Raise it up, Reinforce, Respond, Rearrange, and Relax!) are also spot-on.

The real value in My Toddler Talks, though, is provided in the 25 play routines that Kimberly provides. The activities are simple and familiar, as great activities often are: animal farms, bouncing balls, dolls, puzzles and play-dough are all activities many toddlers and parents already enjoy. Kimberly uses each of these activities to create powerful play routines, each with a beginning, middle, end and language techniques that are matched directly to the play routine. She also describes simple cues to increase the chances a toddler will imitate, such as when she suggests using a fill-in and the use of a phonemic cue ("I have a p...") to get a child to say, "pig" while playing with a farm puzzle. Her combination of play routines and language strategies is fantastic and will surely be helpful to parents who want to boost their toddler's language!

Lucky for all of us, Kimberly has offered to giveway one free copy of her book! To enter the giveaway: "Like" this post and leave me a comment (here or on ChildTalk's facebook page to let me know you did so! If you leave me a commment on the blog, make sure you leave your e-mail address in the comment so I can contact you if you win. I'll select one lucky reader on Sunday 1/27/2013.

Looking for My Toddler Talks? You can find it on Amazon.

And, you can find out more about Kimberly and her book here.

Disclosure: Although I did receive a copy of Toddler Talks to review, I did not receive compensation for this post. My views are my own.

Using Self Talk and Parallel Talk to Facilitate Toddler Language

2013-01-13T19:24:00.000-06:00

A while back, I posted about the power parents have in growing their toddler's language. So much power, in fact, that the amount of "family talk" that surrounds a toddler at home seems to predict a toddler's vocabulary at age three and, still later, at age nine. The more a family talks, the bigger a child's vocabulary.

Pediatric speech-language therapists have their own ways for describing the 'types of talk' that benefit children. Two of the most simple language facilitation techniques are self talk and parallel talk. These two strategies are pretty straightforward: talk about what you are doing as your child watches (self talk), and talk about what your child is doing or seeing (parallel talk). These strategies tend to come pretty easily to most parents, although many certainly feel a bit silly talking a blue streak to a little one who doesn't yet always talk back. But it gets easier as you go! (It helps if you already engage in "self-talk" on a regular basis with no one around.)

Short Phrases

In the video below, I'm using parallel talk and self talk to describe what I'm doing as I prepare for snack. I keep my phrases simple, using only two or three words at a time, because my little guy is at the one-word phrase level (he only says one word at a time). When I'm teaching parents to use parallel talk and self talk, I often suggest they use phrases that are just a bit higher level than what their child is currently using.

Choosing Words

As I talk, I choose simple concrete nouns (milk, apple) paired with common verbs (pour, eat, cut) and simple, early-developing concepts (bye, in, yummy). I do so because I know that as children start to talk, their first words tend to be nouns that represent the objects that surround them. They then begin to use words to represent the common actions they see, and then finally begin using simple locations (in, on, out, up, down), sizes (big, little) and quantities/qualities (more, one, all, yummy, yucky, hot, all gone). So it is these three categories of words that I weave into my comments as I go.

Indirect vs. Direct

You'll notice that I don't command my little guy to say words, because parallel talk and self talk involve indirect language facilitation, meaning that we don't require children to talk back or withhold anything until they do so. Instead, we surround children in specific types of language with the expectation that as children are exposed to these language models, they will begin to spontaneously talk in a very natural way. Although there is certainly a time when more direct language facilitation strategies are required, self-talk and parallel talk can be powerful in and of themselves. The effects are not always immediate, as young children might not talk back right away. But, over time, these strategies can be fantastic way to keep a toddler's language growing.

Responsivity

In the video, I'm also demonstrating responsivity - a fancy word that simply means I consistently and naturally respond to my little one's communication attempts. Maternal responsivity is positively linked to language development in both typically developing children and those children who have language delays. As I respond to my baby boy's comments and actions, I sometimes expand his phrases, such as when he says, "apple" and I respond by saying "Apple. Yummy apple. We're going to eat apple!" or when he says, "please" and I expand it to, "please, apple." And sometimes I simply imitate his actions in a playful way, such as when I comment on and imitate his yawn, which elicits continued interaction and a giggle from him. Although it might seem small, those little moments of shared social engagement build a beautiful foundation for language development over time.

Speaking of Apraxia

2013-01-12T19:02:00.001-06:00

From Leslie Lindsay, author of Speaking of Apraxia:

"Many thanks to dedicated SLPs like Becca Jarzynski---

Kids with CAS now have a bigger and brighter voice.

Becca's blog and speech tips can be seen in this book,

SPEAKING OF APRAXIA (2012).

Seen here at a Chicagoland Barnes & Noble.

Also available thru Woodbine House and Amazon"

Cool beans! :)

Fabulous First Words

2012-11-07T21:16:00.004-06:00

As a pediatric speech-language therapist, I find myself teaching toddlers the same first words over and over. Why? Because, based on the principles of speech sound development, I know which types of words will be the easiest for a child to imitate. And, I know what kids like! Combining those two factors together has led to a first words list that I keep tucked in the back of my head and rapidly sort through during therapy sessions as I find ways to sneak the words into toddler activities.

Parents are often amazed as their toddlers start talking quickly using these words. But what looks like magic is really just simple science. To arrive at this "magic" word list, I simply combine what we know about speech sound development with what what we know about the easiest syllable shapes. And, presto, words emerge.

Once a child has mastered words in one word list, I know he is ready for the next level. And up the word lists we go. This is especially effective for children who are diagnosed with apraxia of speech, but it works well for all children, typically developing or not.

So, what are these fabulous first words?

For very beginning speakers

Bye, Boo, Bee, Baba, Baby, Baaa (for a sheep),
Bee, Bye, Ball (ba is okay), Bubble (buhboh)

Me, My, Mo (for more), Moo (for a cow), Mama,

Papa, Pooh, Pea, Pow, Puppy, Dada,
Ni-ni, Nana (banana/grandma), Up, On, In, Out,
Two,Toy, Toe, Tree (tee) Eat, No, Neigh

Hoo Hoo (owl sound), Hi, Go, Wee, Woah! Wow, Yay!

The next step up

Ta-da!, Oh-no, Uh-oh, Oh-boy!
Mommy, Daddy, Num-num,

Apple (apo), Open (opuh), cracker (kaka)

Pop, Mom, Dad, Boom, Beep, Bam, Peep,
Nite, Hot, Hat, Hop Down, Done,
One, Dot, Toot, Elmo ("Emo")

One more step up

Pony, Cookie, Nummy, Nite, Muddy, Table (tabo)

Happy, Tummy, Duckie, Doggie, Kitty, Water (watuh)
Book, Bonk, Please (pees), See, Bed, Bike, Choo choo ("too too")

Truck (tuck), Spoon (poon), Duck, Milk

Cow, Cheese (tees), Candy, Bunny, Piggie,

Eyes, Nose, Toes, Bus, Car ("Ka"), Cup, Bed, Yes or Yeah,
Block (bak), Big, Juice (doos), Off, Wet, Dirty (dihtee)

So now that you know the magic words, how do you get children to say them?

Surround him with these words in All Kinds of Talk,

try some Communication Temptations,
and Combine The Words With Actions!

Happy Talking! :)

Theory of Mind, Language, and Conversation

2012-10-21T22:00:00.002-05:00

When I am teaching others about speech and language, I sometimes reference theory of mind. Although this is not a term that many people throw around in everyday conversation (with the exception of us crazy SLPs, of course), all effective communicators draw upon their theory of mind skills frequently and without even knowing they are doing so. Without well developed theory of mind skills, our conversations would be disjointed or repetitive- we would risk insulting our audience or boring them to death with way too many details.

Simply put, Theory of Mind is the ability to understand the mental state of others. In other words, it is the ability to put yourself in the mind of another person- to have a theory about their state of mind.

Check out the video below. In addition to revealing how cute this little girl is and how cool her mom must be (okay, full disclosure: it's my daughter), it also helps us demonstrate the idea of theory of mind.

So. Given the question, "Where will Sally look for her money?" what would you answer? If you have well developed theory of mind, you should answer "Sally will look under the yellow cup" because you understand that Sally hasn't seen that sneaky sneaky Ann move her money. Even though you know that the money is under the pink cup, you also know that Sally doesn't know this because she didn't see the money being moved. You understand Sally's mental state which, in this case, includes a false belief.

This classic "Sally Ann" test of false belief is generally failed by children under the age of four. I had secretly hoped my 3-year-old daughter would amaze me and pass the test, but she was highly predictable and failed--just like she should. The ability to pass a test of false belief generally develops between the ages of four and five; at this point, understanding of false belief seems to correlate strongly with and even predict an individual's ability to communicate effectively with others (Resches and Perez Pereira, 2007).

Theory of mind is needed for effective communication because we all need to carefully select what we say for our listeners. The concept of presupposition, or the ability of a speaker to make assumptions about a listener's background knowledge and modify his language accordingly, is closely linked to the idea of theory of mind.

As just one example, pretend you are going to tell a story about something that happened to you during the day. Your story involves the following: you went to the doctor, discussed something troublesome with him, and found out that you had no need to be concerned at all. Prior to leaving for your appointment, you had shared all your concerns with your husband; he is now is waiting anxiously for the information you get from your doctor. The moment you get out of the doctor's office, you call your husband and blurt out, "It's fine! There's no need to worry at all!" You can do this, because you know what your husband already knows about the situation. You know he's waiting on the edge of his seat, and you presume (or presuppose, if you will) that he will know exactly what you are talking about when you call him- and he probably will. Should you want to share this news with your coworker who has no knowledge of your day, however, you can't just walk into her office and blurt out, "It's fine! There's no reason to worry at all!" (unless you'd like to risk seeming a bit, well, odd). You need to provide her with some introduction to the topic at hand before sharing your wonderful news.

We all modify our language all the time, depending who we are talking to, what information they already have, what their ability to understand us might be (e.g., we use more simple language when talking with preschoolers than with adults), and even what their status is (we are typically much more formal in the way we speak to our bosses than we are with our close friends). We empathize, we apologize, we try to understand the perspective of others. Each of these pragmatic language and social-emotional skills requires us to draw on our theory of mind skills to make assumptions about a listener's state of mind and modify our behavior accordingly. And the more effective we are in doing so, the better we are at communicating with others.

Children and adults with language disorders, and those with autism, can especially struggle with theory of mind. Teaching them to understand the perspectives of others can be a huge part of teaching them to be successful communicators. In addition, addressing theory of mind skills can be an important part of helping any child succeed at interacting well with others.

How to address theory of mind? First of all, remember that theory of mind is thought to be a cognitive skill that develops over time. There are certain things that we simply can't expect young children to do. Here's some of what we know about how theory of mind develops:

Children as young as 9-12 months begin showing objects and pointing to interesting objects simply for the sake of getting another person to look at the object. Although these attempts to obtain joint attention aren't the same as theory of mind, they are thought to be a significant building block toward it. That's why lack of joint attention is such an red important flag for autism.
By 18-24 months old, children begin to understand and talk about their own emotions (Owens, 2012).
At 2-3 years old, children accurately label basic emotions they see in pictures
(Michalson, L. & Lewis, M., 1985).
Around 3-4 years old, children start demonstrating pretend play in which they take on the roles of others (Nicolopoulou & Richer, 2007).
At 4-years old, many children will pass a false-belief task like the Sally Ann task describe above; this indicates they are starting to understand that others can hold beliefs that are different from reality
4 -year olds also start to talk about the mental states or internal reactions of characters in stories they tell (Nicolopoulou & Richner, 2007).
By 4 years old, children begin to use words that represent internal states, such as know, forget think, and remember (Owens, 2012).
By 5 years old, children can accurately identify many of the emotions people might have in specific situations (Michalson, L. & Lewis, M., 1985)

It's important to ensure we know what to expect at certain ages, so that we don't require our children to do something that is just not possible. Having said that, here are some things we can do to promote theory of mind in young children:

Engage children in pretend play where they take on the roles (and perspectives) of others
Use verbs like think and remember and hope and believe when we talk about our own thoughts
Play games and discuss situations where children get to predict the outcome of an event and then compare their predictions to what actually happens ("I thought it was going to be dad at the door, but it was grandma!")
Help children to recognize, describe, and manage their own emotions
Help children to understand the emotions of others and what things lead to those emotions
Engage children in "barrier" activities, where they have to describe a task to someone without being able to demonstrate it. My grandma's version of a barrier activity was the "funny monster game," which involved:a. Me drawing a monster without her seeing it, b. Me telling her how to draw the monster without showing it to her, and c. Us comparing our pictures, which were invariably different (in a funny, funny way!). As an SLP, I use these activities all the time to teach children to use precise language that takes their listener's perspective into account.
Discuss the internal reactions, thoughts, and emotions of characters as you read books with your little one.
Explicitly teach your little one that others have different thoughts from them. Practice predicting what another person might be thinking and why they might be thinking this.
As always, talk, talk talk with your little one- the more language he has, the more he will use it effectively in a wide variety of ways.

Michalson, L. & Lewis, M. (1985). What do children know about emotions and when do they know it. In M. Lewis & C. Saarni (Eds). The socialization of emotions. New York: Plenum.

Nicolopoulou & Richer (2007). From actors to agents to persons: The development of character representation in young children's narratives. Child Development, 78, 412-429

Owens (2012). Language Development: An Introduction: 8th Edition. Pearson Education Inc. Upper Saddle River, New Jersey.

Resches & Perez Pereira (2007). Referential communication abilities and Theory of Mind development in preschool children. Journal of Child Language, 23, 219-239.

Babbles and Bubbles: How Bubbles Help Your Child Learn Language

2012-03-13T13:33:00.007-05:00

Hands down, bubbles are my favorite speech therapy toy. There's just something magical about their ability to entice a little one to communicate. They shimmer and shine, appear and disappear, float away and pop at random, tempting even the most grumpy child into smiles and laughter. And since engaging children in activities they love is the first step to working on communication, bubbles can be a beautiful bridge to language.

Before I explain how the bubble magic unfolds, though, I'll share my favorite bubble recipe. It's one I found back when I was eleven years old and spent hours upon hours perfecting HUGE bubbles, made with a spectacular bubble wand. To this day, I use the recipe I found back then, because I still haven't found one that works better. Plus, it's easy!

One cup Dawn dish soap
Ten cups water
2-3 tablespoons glycerin (found at a local pharmacy)

That's it. Makes the perfect bubble every time.

So then, what's all this about bubble magic?

Bubbles are a great activity for getting some first words going, because you can use lots of "b" and "p" sounds, These speech sounds are easy for children to imitate because they can see exactly what your lips do when you make the sounds. Obviously, the word "bubble" is full of "b" sounds; "pop" is another great word to model as you play, so is "up" as the bubbles go up up up into the air, and "bye" as the bubbles float away in the wind.
Because bubbles are hard for young children to blow themselves, they are a perfect communication temptation. To use bubbles as a communication temptation, blow them for a while, and have some fun. Then put the cap on the bubble jar and wait, looking expectantly at your child. Or, catch the bubble on the wand, hold it up high, and wait. Or look like you are about to blow a bubble and wait. It is during the wait that your little one is most likely to communicate, either through a sound, a gesture, or a word. When she does, build on her communication by modeling back something a bit more complex than what she did, and then give her what she wants.
You can also use my favorite three magic words: Say "Ready, Set, Go!" right before blowing the bubbles. Do this repeatedly, without any expectation of a response. Then, one time, say "Ready, Set...." and wait; the word "go" will often fall right out of your little one's mouth.
You can be silly with bubbles! Children love silly, and you can pair your silly actions with words to increase the chances that your child will imitate. When I am blowing bubbles, they often pop right into my face (sometimes by accident, sometimes by design) and I have to wipe them off with an exaggerated "uck!" I also squash bubbles with my hands and stomp on bubbles with great delight, saying "pop" as I go, wave "bye bye," as the bubbles float off into the distance, and diiiiiiiip the wand into the bubbles.
Playing with bubbles is a great time to model action and description words to increase your child's language. Action words are easily woven into the activity as you open the bubbles, blow the bubbles, and pop the bubbles; simple and early developing concepts are present too, as you blow big and little bubbles, as the bubbles go up and down, the wand goes in and out of the bubble jar, and as things get wet when the bubbles pop (or spill!), so you have to get a towel to dry them off again. These verbs and concepts can be worked on at the single world level at first, and then integrated into two word phrases as your little one's language develops.
Best of all, it's hard not to smile while watching your little one enjoy the beauty of bubbles. And smiling is good for everyone. :)

Better Therapy Sessions For Kids

2012-02-24T19:40:00.000-06:00

Ellen over at Love That Max has a great post up, full of tips from pediatric therapists about how to get the maximum benefit from therapist sessions. The tips came from Pediastaff bloggers, each of whom have their own blog, too: My Munchbug, Starfish Therapies, All 4 My Child, and, yes, Child Talk. :) Check it out here.

The ABCs of ABA in the SLP world

2012-02-03T14:26:00.012-06:00

We speech-language therapists have a lot of acronyms in our little speechy world. We are SLPs (speech-language pathologists) who have our CCCs (Certificates of Clinical Competence) from ASHA (the American Speech-Language and Hearing Association). When I graduated with my M.S. (okay, you all know that one) in speech-language pathology, I was pretty sure I'd mastered the alphabet soup of our profession.

Until I fell in love with kids with autism, that is. That's when I was introduced to the world of ABA. If you've loved a child with autism, you've no doubt run smack into this term, too, and probably very early along the journey you took. Despite the fact that this word swirls around the autism world with great furiosity, it is often misused and a bit misunderstood. Some people love it with a passion; others hate it with the same intensity. Me? I think it both extremely valuable and sometimes overused.

But I'm getting ahead of myself. My goal today is to begin to define the term for those who don't know it well. Later, when I've laid the groundwork just a bit, we'll delve into the true complexities that exist with what appears, at first glance, to be a very simple concept.

ABA stands for Applied Behavioral Analysis. It's based on the work of B.F. Skinner, a psychologist who focused on operant conditioning, or the study of observable behaviors and the events that cause and reinforce those behaviors. The applied part of ABA means that we take this system of looking at the way behaviors are shaped and apply it to everyday life; we use it to shape behaviors that are important to the lives we lead. When we peer at the world through the eyes of ABA, we find ourselves looking at three main things.

The Antecedent: What happened in the environment before the behavior occurred?

The Behavior: This part involves describing the overt behavior that you see or want to see. Not the motives, not the intent, not the feelings behind the behavior. Simply the behavior as you can observe it in front of you. Those who study and use the principles of ABA believe in describing the behavior as clearly and objectively as possible. For example, instead of saying "Sally got mad," a behavior analyst would say "Sally screamed and hit the door with her fist."

Consequence: What happens after the behavior? Does this thing that occurs after the behavior (the consequence) increase the chances the behavior will occur again, making it a reinforcement? Or does it decrease the chances the behavior will occur again, making it a punishment?

To help explain, let me share a couple examples.

Say you are teaching a child to say "cookie." The steps behind teaching the word might go a little something like this:

Antecedent: You hold up a cookie and say, "cookie"
Behavior: The child imitates "cookie"
Consequence: You give the child the cookie. (This would be positive reinforcement, assuming that giving the child the cookie increases the chances he will say the word again in the presence of the the cookie. Or, in plain English, assuming the child actually wants the cookie--although behavior analysts would probably shy away from describing it this way, as it reflects the child's internal state, rather than his behavior).

Or, perhaps you are teaching your child to walk.

Antecedent: You hold out your hands and say "come here!"
Behavior: Your child takes his first step toward you.
Consequence: You cheer and throw your child in the air as he giggles. (Again, this is only reinforcement if it actually increases the chances your child will take a step toward you the next time you hold out your hands and say, "come here!" It wouldn't be a reinforcement if he hated being thrown in the air- in this case, it might decrease the chances that he'd come to you and would, then, become a punishment*. Consequences are different for different people- the exact same action that is a reinforcement for one person can be a punishment for another).

These three things- the antecedent, behavior and consequence (Or ABCs of ABA, if you will...yes, another acronym), make up the core of ABA. Those who live in the world of ABA focus very carefully on the ABCs behind any and all behaviors. They graph and chart and study these elements of life and plan interactions around them.

ABA is much more complex than this, of course; I took four full graduate level classes about ABA when I completed my graduate certificate in Behavioral Intervention in Autism. There are those that study ABA all their life and still don't have all the answers, and there are entire, complex, and well-graphed treatments for autism that are based the concepts behind ABA. It is not nearly as simple as I am making it at the moment. And yet, if you understand the ABCs behind ABA, you can begin to understand the world through the eyes of an applied behavior analyst.

How, then, does ABA fit into the world of SLP? As an experienced applied behavior analyst once told me, we all (parents, teachers, speech-therapists, all of us) use ABA in one form or another. SLPs are no exception. We use the principles of ABA to teach children first words (Antecedent: "Say, Ball!" Child's Behavior: "Ball!" Consequence: Child is rolled the ball). We use ABA methods to teach children how to behave and understand language (Antecedent: "Sit down please." Child's behavior: sits down. Consequence: "Here's your snack."). We call on ABA to help us figure why children behave in certain ways, so that we might help them find a better response and eliminate challenging behavior. For example, we might look at what comes just before a child hits another child (the antecedent), discover that it happens whenever another child obstructs the way, and then give the child a new behavior (saying, "move please") by teaching and reinforcing this new behavior.

So yes, we all use the concepts behind ABA, intuitively and frequently, to teach, motivate, and shape our children's behaviors. And yet, controversy behind these methods exists. Why so? Because there are significant differences in how and when we apply these methods, in how stringently we define the behaviors we expect, in how we select and apply consequences, and in how strongly we believe that the ABA lens is the only one through which we can view the world.

That's a post for a different day though. For now, we'll just be happy that we've learned our ABCs.

Every Day Language Learning: Dishwashers and Socks

2012-01-15T13:03:00.009-06:00

As a working mom, life is a perpetual balance of domestic duties, professional tasks, and child-related entertainment. When my son was young, I often attempted to maintain this balance by entertaining him with toys, books, and activities while he was awake and then feverishly trying to get all of the household chores done while he napped or after he went to bed each night. This worked well...except for the fact that the chores were rarely completed, I got way too little sleep, and I tended to be a bit, um, cranky due to both of these things.

With my daughter, I'm doing things differently. We still play and read books for sure. But I've also realized how much more fun chores can be when she is a part of them. And how much learning occurs inside those household tasks if I just slow them down a bit. Recently, we've been having a blast unloading the dishwasher and sorting the laundry. (No, really. Stop laughing).

Luckily, learning is easily woven into both these activities. The biggest thing we do right now is sort things. Sorting is a cognitive skill that really begins to emerge in the toddler years. As we unload the dishwasher, I let her sort the utensils into the right baskets; when we do the laundry, she sorts the clean clothes into piles of shirts, pants, socks and undies. (Yes, it helps that she's an agreeable little girl who wants to do these things with me. I think her propensity for sorting suggests that she may have inherited her organizational gene from me. Poor thing).

I didn't expect her to sort all on her own right away, of course. Laundry, for example, started out with just finding the socks and putting them in a sock pile. Then we moved to separating the socks from the shirts. Now-a-days, she sorts all the clothes out of the whole basket, but I still have to start the piles for her. Lest you think that I am just using some form of child labor, let me assure you that I sit right on the floor next to her (almost) the whole time. We go slowly, and there is lots of praise and excitement when she puts things in the right piles. Sometimes we even sing to a simple tune like Where is Thumpkin.

Where's the shirts?

There they are!

You found the shirts,

Yes you did.

Yes you did!

(I'm not a cool mom, but she seems to love me anyway).

Why is sorting important? It helps children begin to understand the concept of groups of things. A shirt is still a shirt- whether it's red or blue or tattered or new. Forks are forks whether they are small or big. Sorting helps children see the similarities in objects, even when the objects are a bit different at the same time. As they learn this, they gain the ability classify things in their mind--to create groups of similar things; this skill is important for language and eventually math as well.

Beyond sorting, laundry and dishwashing provide lots of opportunities for language, too. My daughter and I discuss the utensils and clothing items as we go along. At first I used parallel talk and self talk to model the words for her; as she got older and started talking more, I started using choices and expansion to grow her phrases longer. We often weave in concepts, too: size concepts (big, small, long, short), color concepts (red shirt, blue shirt), possession (daddy's shirt, mommy's sock), descriptive concepts (soft socks, dirty pants), number concepts (one sock, two socks) and position concepts (fork in, fork out) are all emerging in the toddler years.

Who knew dishwashers and socks could be so useful for learning?

Like this? You might also enjoy...

Everyday Language Learning: Grocery Shopping With a Toddler

Everyday Language Learning: My Love Affair With Mr. Potato Head

All Kinds of Talk: Using Your Language To Change Your Child's

Top Ten Tips For Late Talkers

2012-01-07T10:38:00.000-06:00

Worried about your late-talker? Here are my top ten tips for helping your little one grow.

Get his hearing checked. Some parents assume that if their child passes the newborn hearing test in the hospital, they no longer have to worry about hearing. This isn't true-- your child can pass the newborn hearing test and still have a hearing loss. If your child is a late-talker, talk to your pediatrician about having a formal audiological evaluation.
Take a peek at his use of gestures, his play, his eye contact, and his understanding of language. Find out more about what he should be doing in each of these areas here and here. If you notice that he is lagging behind his peers in any of these areas, talk to your pediatrician about a referral to your early intervention program. Late-talkers are more likely to need intervention if they have delays in gestures, play, eye contact, and/or receptive language.
Read repetitive books and sing repetitive songs with him. Hearing the same pattern over and over will help him anticipate what is coming next. Soon, you'll find that he starts filling words into those books and songs when you pause just a bit before the important words.
Help him learn the power of words by saying, "Ready, Set, Go!" before doing something fun. Do this over and over and watch as he starts to fill the word "go" into the phrase.
Talk, talk, talk to him. Use parallel talk, description, and self talk to describe what he is doing and seeing in short phrases.
Pair your words with actions. Children are more likely to imitate a word when the word goes along with a familiar, repeated action.
Think about using Baby Signs as a bridge to verbal communication. Parents sometimes worry that children will become dependent on signs, but research suggests the opposite: using signs and gestures with children can increase their language skills.
Use communication temptations--change your late-talker's environment to give him more opportunities to communicate. For example, put his favorite toys in a see-through box. Or put his snacks up in a cupboard so he has to ask for them. When he wants something, wait a bit to see what he does. He might say the word! If he doesn't, say the word for him and wait just a bit. If he doesn't imitate you, give him what he wants and repeat the whole process the next time. Over time, he'll start using the word before you do.
If he's not making progress, or if you just want some additional help, don't hesitate to talk to your pediatrician about a referral to an early intervention program. We don't bite. I promise. :)
Love him. More than anything else, children need to be in loving, responsive relationships with their parents. All of the above tips are important, but this is the most important one of all.

You might also be interested in...

Should Your Late-Talker Get Speech Therapy?

Everyday Language Activities: Grocery Shopping With a Toddler

2011-10-25T13:41:00.003-05:00

As with any other profession, the field of early intervention goes through periods of evolution. These days, we are talking a lot about the importance of weaving child skill development into the context of everyday experiences and activities. It's something that Ellen over at Love That Max blogged about recently in her post Sneaking in therapy for kids with special needs.

In her post, Ellen explains that her son Max gets therapy sessions throughout his week but that "the sessions are only 45 minutes to an hour long and it's the ways we put those therapy techniques into practice that matter most." She goes on to describe how attempting to accomplish therapy carryover at home used to be overwhelming and somewhat guilt-provoking, especially when therapists would leave long lists of tasks to be accomplished. Then, Ellen reflects on how she has learned to do only what she can and let the rest go (yay!) and, most importantly, how she has learned to integrate the things Max needs into fun family activities that they were doing anyway. Yes, I thought when I read her post. Yes. That's exactly what we are trying to encourage families to do when we work with them and their children as early intervention professionals.

With that in mind, I took my two-year old daughter grocery shopping. I'm learning that much of life is to be found in the joy of daily activities, so I decided to slow the activity down-- to enjoy it and her along the way. As I did, I realized how much skill development was occurring right in the context of this simple and potentially mundane daily routine.

Two-year olds are developing and understanding of simple concepts, so we wove them into our trip. She put things "in" the cart and "under" it as well. The cat litter was heavy (I let her drag it to the cart so she could experience what heavy meant) and the chips were light (as she threw them up and over the edge of the cart). The bread was soft (and a bit squished after we were done) and the cans were hard. The apples were big and the grapes were small. I paired actions with words as we compared and contrasted all these things, and by the end of the trip, she was starting to use some of the words on her own to describe what she was doing or what she felt. Even better, she had a blast helping gather the food, throwing thing into the cart, and just generally being involved in the experience.
Toddlers this age are also just starting to use simple grammar elements such as: plural -s (cans), possessive -s (daddy's), and -ing (pushing) I used expansion and indirect correction to model her sentences back to her, a bit more correctly. If she said, "two apple," as we counted them and put them in the bag, I said "Yep, two apples!" When she commented that she was holding, "daddy plum" I responded with, "These are daddy's plums!" And when she said "I push!" while pushing the cart down the aisle (and almost into the pickles), I replied that "Yes, you're pushing!"
Two-year olds are also merging into the word of pretend play and we wove this into our trip as well. At one point, a jar of olives was a microphone and we were rock stars. People may have thought us a bit odd, but we were certainly having fun.

The beautiful part of all of this is that it made the activity joyful for both of us. She was learning and I was shopping, but most of all, we were just being mother and daughter, loving up life.

I must note, of course, that this won't work for everyone, in every activity. My daughter loves grocery shopping. My son? Hated it. With him, getting through grocery shopping was an exercise in survival; my sole focus was on keeping him contained long enough that we could get the groceries we needed. It wouldn't have worked to slow it down, even if I had tried to engage him more. It's just how he was as a toddler: full of boundless energy that was exceedingly hard to corral. When he was little, it was much easier to weave learning into football than into grocery shopping. The activity has to fit the child, not the other way around.

And, there is also the danger of believing that every single activity throughout the day has to be a learning experience. It doesn't. Sometimes grocery shopping just needs to be grocery shopping, and that needs to be okay. But when it doesn't, when time can slow down just a bit, when children can learn in the context of an activity that is truly a delight for everyone involved, that's the sweet spot for sure.

Give-away! Awesome Apps: Speech With Milo

2011-10-21T06:00:00.007-05:00

Scroll to the bottom of this post to find out how to enter the Speech With Milo App Give-away!

I am always on the look-out for fun activities, games and toys to help facilitate language in kids, and am always super excited when I find them. As I mentioned in a comment recently, I'm pretty sure I actually drooled the other day at a store when I happened upon wind-up toys that were priced 10 for $10.00. A speech-therapist's dream! (Yes, we are an odd breed at times).

One fun new discovery I've made recently is the Speech With Milo Apps Series developed by fellow speech-therapist Poorani Doonan. I love her apps, because they are designed to be used interactively with children to promote language growth. They are simple, yet well thought-out, fun, and motivating. The best part is that they can be used in a variety of ways with a variety of children, both typically developing and those with language delays or other diagnosis.

Speech With Milo: Verbs, for example, can be used a number of different ages or levels of language development.

If your child is just starting to use verbs, you can use Speech With Milo: Verbs to label the verb as you and your child watch Milo ("glue!").
Around two years old, children starting using the verb tense "-ing" to describe what is happening; at that point, you can emphasize this part of the verb while talking with your child about Milo ("Gluing! Milo is gluing").
Around 3 and 4 years old, children start using different types of verb tenses. At this point in language development, you can talk about what Milo is going to do ("He's going to glue!"), what Milo is doing as it is actually happening (He's gluing!") and what Milo did, after it is done (He glued!). Children with language delays often struggle with these subtle differences in verb tenses; this app is a simple and yet motivating way to work on these aspects of grammar repeatedly.

Speech With Milo: Sequencing can also be used a variety of ways.

Toddlers will enjoy sitting with you and simply narrating what Milo is doing in each picture ("Mixing!") and then watching as you turn it into an animated story.
As children grow into preschoolers, you can use Speech With Milo: Sequencing with them to work on their sequencing skills by putting the pictures in order. This helps them begin to develop an internal narrative structure, which will eventually help them to organize and understand stories during their academic years.
This app is also a fantastic way to work on time sequence words such as "first," "then" and "finally," which can be particularly hard concepts for children with language delays and autism.

Then, there's Speech With Milo: An Interactive Storybook, which, from my perspective, is the most versatile app of them all. As Poorani explains in her demo, this app can be used to address a wide variety of skills: storytelling, describing, making predictions, improving utterance length, and improving grammatical skills. One of the coolest parts of this app is that you can have your child record his own voice to tell the story...a great chance to get him talking!

Poorani has also created Speech With Milo: Prepositions, Speech With Milo:Verbs (in Spanish), and Speech With Milo: Prepositions (in Spanish). All awesome and all found at her Speech With Milo App Store.

And (here's the best part!) she's letting me give away two of her apps here on Child Talk! Yay!! :) I'll be giving away one Speech With Milo: Interactive Storybook App and one Speech With Milo: Sequencing App, each to one lucky reader. To enter the give-away, do one of the following by October 28th:

"Like" or share this post on Facebook and leave me a comment here to let me know you did this,
Retweet the tweet about this on Twitter and leave me a comment to let me know you did this,
Follow Child Talk on Twitter and leave me a comment to let me know you did this, or
Follow Child Talk via e-mail or a feed and leave me a comment to let me know!

Make sure you leave me a comment here on Child Talk to know which of these you've done if you want to enter the give-away. I'll use the comments to pick two winners via random.org and announce the winners in a post on October 28th. Also, make sure you either leave your e-mail address in your comment or check back on October 28th to find out if you've won! Good luck!

Advertising Disclaimer: I accept cash and product compensation for some of the posts on this blog, and if you click on an advertising link or purchase an advertised product I have placed on my blog, this will sometimes result in a monetary compensation for me, which I use as a means of supporting Child Talk. (Trust me, it's much less than you imagine it to be!). However, my opinions about the products I blog about are my own.

If At First You Don't Succeed: The Importance of Failure in Child Development

2011-10-18T12:35:00.005-05:00

I love watching children develop. So much so that I'm pretty sure one of the main reasons I entered this profession is this: it gives me the chance to watch children discover the world, over and over and over again. Since I am a mom, I get to see this process unfold in front of me at home, too. And honestly, it is a beautiful thing to behold.

The other day, my baby (um, toddler) girl was playing with blocks. I started to try to help her and then I stopped. Instead of interfering, I simply sat back and watched. Her patience astounded me (it's a trait that I can only wish to acquire) and her inquisitiveness delighted me (I am a mama, after all!).

After observing for a bit, my speech-therapist brain kicked in and I began to realize what I was watching. At 24 months, children are natural explorers- they are trying hard to figure out the world around them and find out how they fit in. They are starting to develop mental models, which means they are starting to hold representations of objects (and eventually ideas) in their head. And yet, their mental models aren't quite fully established, and, as a result, they end up doing a lot of trial and error to see how things fit together. As they try things out, they begin to develop more accurate mental models. Eventually, they develop an understanding of how things go together without having to try those things out first.

Back to the blocks. My daughter was clearly working on developing a mental model of the blocks. She knew what she wanted (a fully stacked tower) and she knew when her tower wasn't quite working out as she wanted. She also seemed to know that when the tower wasn't working out, she had to remove a block or two. And yet, at just 26 months, she doesn't yet have the cognitive powers to analyze the situation fully in her head-- instead, she must rely on the trial and error process of removing and adding blocks as she goes. In doing so she's creating a series of mini-experiments. Over time, the results of her experimenting will add up to a new understanding of how things fit together, and, eventually, she'll be able to figure tasks like these out in her head, without ever touching a block.

So how does this relate to language? (This is, after all Child Talk). Here's how: we know that cognition--the scientific term for the mental processes in our head--and language go hand-in-hand. Problem-solving, remembering, and decision-making are all mental processes that both require language and inspire language. Spurring cognition spurs language, and vice versa.

All of this to say: Don't underestimate the importance of letting your child fail sometimes. It's such an essential part of learning. If you are like me, you may have to fight your instinct to help, to step in, to teach your child exactly what to do, to save her from the frustration and agony that come from not having things work out like they should on the first try. And yet, it's worth the fight. Step back, watch, and let your little one explore on her own...and in doing so, know that you are handing her the keys to understanding the world around her.

Every Day Language Learning: My Love Affair With Mr. Potato Head

2011-10-14T13:39:00.007-05:00

Today's guest post is written by fellow speech-language therapist Brie Schindel, who blogs over at Toddler Talk. I follow up her post with a few thoughts of my own about the different types of strategies you can use while playing potato head with your little one. Enjoy!

I'm expecting a baby in 3 short weeks and in an attempt to be VERY organized before my second child arrives, I began my Christmas shopping a few weeks ago! While shopping at Costco for my 22 month old nephew Tyler, I was overjoyed to discover a jumbo Mr. Potato Head multi-pak. This kit has at least 3 different sizes of Mr. Potato Head and all the accompanying body parts.Mr. Potato Head is such a universally popular toy for young children that I shared my purchase with Tyler's mom, in order to be sure she didn't pick one up for him before Christmas.

As a Speech-Language Pathologist, I may love Mr. Potato Head for slightly different reasons than the average parent. Vocabulary sizeat age 2 is a critical predictor of future language and literacy development in elementary school. Mr. Potato Head is a fantastic tool for teaching one of the core vocabulary groups for young children - body parts. Along with providing one more way to teach your child about body parts, Mr. Potato Head provides the opportunity to model some great position words like 'in', 'out' and 'on'. Now throw my Costco purchase into the mix and you've got the opportunity to talk to your young child about 'big' and 'small' Mr. Potato Head and the different sizes of accompanying pieces, which may be 'too big' or 'too small' for the Potato Head your child is playing with.

When I'm working as a Speech-Language Pathologist, these are the things I'm thinking about, but when I'm playing with my own daughter I use the words and concepts very naturally and we just have fun with a classic, favorite toy.

Read more of Brie's thoughts on speech and language by heading over to Toddler Talk!

Becca's note: I love Brie's post because it underscores how easily we can use every day play time to work on language. And there are lots of ways to do so:

As Brie noted, it's super easy to use parallel talk, self talk, and description to model (say) the name of the different body parts as you play with them. It seems so simple, but it's a step that parents often forget. Say eye as you pick up an eye, nose as you hand her a nose, and teeth as she puts the teeth on. Do this many, many times (yes, you will sound like a broken record!) and pretty soon your child will start doing the same.
You can also pair actions with words during this activity. Say "on" every time you put a piece on, and "off" each time you take a piece off. These concepts of "on" and "off" are very early developing ones; toddlers will naturally repeat the words as they do the actions. Potato Head can also "walk walk walk" across the floor, go "boom" as he falls on the ground, and "jump" off the couch onto the floor (creating great excitement when all the pieces fall off along the way!). Say the word each time the action happens.
Give your child choices. Hold an ear in one hand, and a nose in the other, saying "ear? (hold up ear) or nose?" When your child reaches or points at one, give it to him while labeling it again ("Ear! You want ear."). Eventually, he'll start making the choice by saying what he wants.
Give him a chance to find the body part that matches the potato head part you have. Hold an ear up to your ear, saying ear and then give him the nose....see if he'll hold it up to his. Work on receptive language (understanding) by making a game of finding the part that you name.
Use expansion when he uses a single word. This is a great chance to work on early developing two-word phrases. When he says, eye when putting the eyes on, you say eye on; when he says shoe while talking a shoe off, you say, shoe off; when he picks up a big nose and says nose you say (anyone?) big nose; and when you clean the pieces up, you can model eyes done, nose done, shoes done one at a time while putting the pieces back in the box (pairing your words with your actions yet again!)
Because it has pieces, Potato Head also lends itself to being a communication temptation. If your child lets you, you can hold the pieces in your lap and hand him a piece one at a time. Then wait. See if he communicates that he wants more. Depending on his language level, you can ask him to say or sign "more," ask for a specific piece (nose or eyes?), or use a two word phrase to clarify which piece he wants (Blue shoes or red shoes? Big nose or small nose?). It's also an easy way to work on carrier phrases such as "I want a...." or "I have a...."
Finally, my potato head loves to eat food, dance around, go to sleep, and play hide and seek. All beautiful ways to work on pretend play, which begins emerging around one year and takes off in earnest by 18-24 months.

Looking for more every day language learning tips?

Snow Sprinkles and Speech

Chugga Chugga Choo Choo!

Photo Books

FAQs About Using Pictures to Help With Beginning Language

2011-10-04T13:33:00.005-05:00

In Part One and Part Two of this three-part series on picture use, I explained how to go about teaching your child to communicate with you using pictures. Many parents, though, have reservations about using pictures with their child. In the third and final post of this series, I answer some of the most common questions I hear from parents. Here we go!

Won’t using pictures keep my child from talking?

Won’t he just use pictures and never learn to talk?

Not in my experience, and not in the experience of many others. Quite the opposite, in fact: there are many reports in the literature of children whose verbal language increased as they were taught the use of pictures to communicate. On a logical and a practical level, this makes sense to me. If we teach our children that they can communicate with us through pictures, this will increase the likelihood that they will learn that verbal language can be used as a form of communication, too. Then, as children learn to communicate verbally, pictures can be dropped out. Children who learn to access the power of verbal speech will choose this route over the more work-intensive route of going to find pictures, selecting the picture and taking it to a person. Speaking is easier and much more efficient and children will learn that quickly once they start talking. I have seen this happen more times than I can count.

However, this has not been proven without a doubt through empirical research. To my knowledge, there are still no large, well-controlled studies that prove that pictures help increase verbal language. BUT, there are also no studies that prove beyond a shadow of a doubt that they inhibit verbal language. So. Can I tell you definitively and absolutely that pictures won’t inhibit language? Nope, I can’t. But I sure don’t think they do.

Aren’t pictures only for children who we know will never talk?

We used to think this way. In the past, picture use was reserved for the most severe cases, when all other options were exhausted. Now we tend to move much more quickly into picture use, especially when we know that there is a gap between what the child wants to express and what he is able to express verbally. A child in this situation is often terribly frustrated, and picture use gives him a quick way to communicate his basic of needs—until he is able to do so verbally. In my opinion, I see no need to exhaust other options. Instead, I often use pictures along with other language development strategies.

Does my child actually have to hand me a picture?

Can’t he just point to a picture in a book, on a page, or on an I-pad app?

He can. This is certainly one way to use pictures. However, the value in having your child physically exchange a picture is that he learns that he *needs* to use a communication partner to communicate. Requiring a child to exchange a picture makes it very obvious that a communication partner is involved in the exchange in a way that simply pointing to a picture in a book does not. Teaching a child to actually exchange a picture with a person prevents him from standing in an empty room, pointing to a picture and expecting something to happen. When he knows he has to give the picture to a person, he will go seek out that person. When we teach children to exchange a picture, we hope that the child will then learn that he needs to exchange verbal words with a partner as well; all of this highlights the idea that an attentive partner must be actively involved in the communication process.

In my humble opinion, this is most essential for children with autism, as they have the most difficulty understanding social dynamics. If you’ve got a highly social child who simply cannot communicate verbally, allowing him to point at pictures to request and comment might be the easiest route for everyone involved.

What can I do to find out more?

Using Pictures To Help With Beginning Language: Part One

Using Pictures To Help With Beginning Language: Part Two

PECS Training

Using Pictures To Help With Beginning Language: Part Two

2011-09-13T13:39:00.003-05:00

In part one of this three-part series, I discussed how to help your child learn to give you a picture as a way of requesting something that she wants. I talked about the first three steps I take to teach a child this skill:

1. Find a motivating object,

2. Take and print a picture of the object that represents that activity, and

3. Teach your child to use that picture to request the object.

So, what next?

This is where I often deviate from the PECS protocol set out by Frost and Bondy. At this point, they would recommend teaching a child to cross a distance to exchange a picture with you. They would also recommend teaching persistence; that is, teaching your child to continue attempting to give you the picture, even if you don’t acknowledge him the first time. I do understand why they include these steps, especially for children with autism, but I will admit that I often skip them and move on to picture discrimination instead. If I find that a child needs it, I will go back and teach crossing distances and persisting later. So, my step four is...

Step 4: Teach your little one to select the right picture. Up until now, you’ve only had one picture out at a time. The next step is to teach her to discriminate between two pictures and select the picture that actually represents what she wants to request. I usually do this in three smaller steps:

Put out a picture of a desired object (e.g., bubbles) and a blank picture; see what she does. If she starts reaching for the blank picture, guide her hand toward the correct picture and help her hand it to you. Do this repeatedly until she starts selecting the desired object picture on her own, consistently.

Put out a picture of a desired object (e.g., bubbles) and a picture of a undesired object (for example, a washcloth--assuming your little one doesn’t groove on washcloths). If she gives you the picture of the undesired object (the washcloth), hand that object (the actual washcloth) to her. This natural consequence may lead her to the understanding that she needs to hand you the picture of the desired object (bubbles). If not, physically guide her to choose the picture of the desired object and hand it to you. Repeat until she consistently hands you the picture of the desired object.

Put out pictures of two desired objects (bubbles and ball) and give her whichever one she requests via picture exchange. If she begins to get frustrated, move back to helping her select the correct one.

Step 5: Add in new pictures, one at a time, making sure your child can discriminate among them and pick the one she really wants. If she starts having difficulty, move back to fewer pictures.

Step 6: Find a place to keep the pictures. Many people keep them in a three ring binder, using Velcro to secure the pictures to pages that are kept inside the binder. This is nice, of course, because the binder is easily portable, and for some people, this is essential. Other people keep the pictures on their fridge, since this is a central location that works well at home, where the pictures are used most often. There’s no magic place—do what works best for you and your family.

And that's it! Bondy and Frost recommend many mores steps, and, if you are planning to use pictures on a long term basis, you'll want to check out their recommendations here. But in the short term, pictures can be a great way to build a bridge to communication, easing frustration for everyone involved. Good luck!

Looking for more information on using pictures with children? Stay tuned until next week,

when I post my answers to Frequently Asked Questions about pictures and language. If you have a question now, leave it in the comment section, and I'll do my best to answer it next week!

Using Pictures To Help With Beginning Language: Part One

2011-09-06T12:31:00.004-05:00

As a pediatric speech-language therapist, I use pictures to help with language development all the time, in a variety of ways and for a variety of reasons. I’ve already written about how I turn vacation pictures into photo books to increase vocabulary, grammar and narratives skills. I’ve also written about how I use pictures to help children learn to use creative two word phrases. Today, though, I’m writing about the use of pictures at a beginning level--to help children request the things they want, using one picture at a time. This type of picture use, formalized by Frost and Bondy in 1985, is often called the Picture Exchange Communication System (PECS). The idea is simple but powerful: teach children to exchange pictures with a communication partner to allow them to request the things they want.

Many children can benefit from this type of picture use, but the children for whom it is most applicable include children who aren’t yet talking at all or who have a very small vocabulary, children who are very visual learners, children who are (or could be) highly frustrated by their difficulty communicating, and/or children who have a very hard time producing speech sounds. This means that teaching a child to communicate using pictures is probably the most appropriate for:

Children with autism
Children who are transitioning to a new language due to international adoption
Children with a speech sound disorder, such as severe apraxia of speech or dysarthria
Late talkers who are not responding to other types of language facilitation strategies

There is a carefully defined, formal way to teach the actual Picture Exchange Communication System, and you can find it here. My process is similar, but I am a bit more lax in general, and I take certain liberties to modify the approach depending on the child. That being said, here’s the general method I use as I work to teach children to communicate using pictures:

Step 1: Find an activity your child loves. And I do mean *LOVES*-- so much that she’s willing go the extra mile to get more of it. It should also be an activity that is easily started and stopped. Check out my post on communication temptations for a detailed explanation of how to set up the activity to create lots of opportunities for practicing picture use.

Step 2: Take a picture of the object your child wants. Laminate it (sorry, Sean—in this case it just has to be done).

Step 3: Teach your child to exchange the picture to request the object. This is, often, the hardest step. To accomplish it:

Get your child engaged in the activity. Ensure she is interested and motivated. Then stop the activity.

Put the picture out next to the object that she wants.

As your little one reaches for the object, gently help her to grab the picture and hand it to you. Do this as quickly as possible, ignore tantrums, and give her the object she want the minute the picture touches your hands. The quickly part of this step is very, very important. At this point, I’m not looking for a child to look at the picture, recognize what it is, or even really understand what is happening. I just want her to tolerate me teaching her to exchange the picture.

Don’t say anything until the picture touches your hand. This can be very hard to do—our natural inclination is to verbally direct the child as we go—“get the picture!” “give it to me!” So why say nothing? There are two potential problems with using verbal speech to teach your child to exchange a picture with you. First, many children who are learning how to use pictures to communicate simply don’t yet have the receptive language to understand your directions; it will only confuse and frustrate them more. Second, if you tell your child what to do (“give me the picture!”), your child may become reliant on that verbal direction and will only exchange the picture when you tell them to do so. Instead, we want them to learn to independently go get a picture and bring it to you to request things they want. The physical prompt of helping a child exchange a picture is more easily faded out than the verbal prompt of telling him what to do. This is most often true for children with autism, so this part is the most important to remember when working with children with autism.

Do say the name of the picture the minute the picture touches your hand. This is a very important step, for all language learners. At first, children may only learn to exchange the picture with you. But, if you consistently pair the action of handing the picture to you with the verbal word that goes with the picture, your child will most likely start saying the name of the picture on her own (eventually making the picture unnecessary!). I have seen this happen more times than I can count….and it is why I do not believe that using pictures with young children prevents them from learning to talk. Instead of being a roadblock to verbal communication, pictures are a bridge.
Note: This step is most easily done with two people—one adult who holds the object of desire and receives the picture and one who physically guides the child to pick up the picture and hand it over. However, this can be done with one person- I have done it many times.

The key to this step is to do it quickly and repeatedly, until your child learns to hand over the picture on her own. At first, you'll need to help her do the whole thing. After a while, though, you can give her chances to give you the picture all on her own. To do this:
- Place the picture next to the object she wants and wait. She may reach for it on her own and hand it to you—hooray! Some children will reach this point very quickly.
- However, some children need extra help. You may need to touch her gently on the elbow to cue her to reach for the picture. Or, you may need to help her do the whole thing again. Do so...and then give her a chance to do it on her own again a bit later.
- Eventually, with practice and consistency, she will start doing it on her own. And that’s when you can move to step 4.
Looking for step 4?
Check out: Using Pictures To Help With Beginning Language: Part Two

A Tech Spin on A Picture Is Worth 1000 Words: Using Photo Books to Increase Vocabulary, Grammar, and Narrative Skills

2011-08-30T07:21:00.002-05:00

I'm very excited to share this *awesome* guest post by Sean J. Sweeney. His tech spin on my photo book post is both inspiring and practical.

I recently read with great admiration Becca ’s post in which she described how to make and use photo books for language development . It is true that children love bright, colorful photos, and they love to talk about them even more when they are personally relevant! Becca’s specific descriptions (and video demonstration) of language strategies to use in the context of creating and reviewing photobooks are definitely going to be helpful to many parents and SLPs.

However, if you know my work at all , you know that I am always asking how technology might assist in any learning and language process. I am also one of the least craftsy and most printer-hating and store-averse people on the planet. Therefore ordering photos, picking them up at CVS, decorating with stickers and other flair, laminating (*shiver*) and binding the books...not a list of verbs I personally relish. Let’s not say it’s a guy thing, but maybe that’s just the elephant in the post. So, if you want to hear about a few digital options for implementing Becca’s terrific methods, read on!

I first have to point out that creating all-digital (or mostly digital) versions of these activities is facilitated by the way that families often do photography these days. Many families own and know how to use digital cameras (including the ones on their smartphones), and archive their photos in places such as Kodak Gallery, Picasa, iPhoto or even Facebook. So, whether photobooks as a language context are to be created by the families themselves, or a clinician is going to create the product while eliciting language from the child, the raw materials are often already digitized, easily downloadable and e-mailable! If actual prints are involved, it is no longer an arduous process to scan them, or it can often be easier to place them out of glare and just take a nice shot of the picture with a digital camera or smart phone. Once you have digital photos to work with, there are a few options you might consider.

One of these is Little Bird Tales, a free online picture book creator. Little Bird Tales has a simple, kid-and-family-friendly interface (and a great tutorial) and the added bonus of allowing you to add voice captions to each picture. When the book is complete, it can remain “private” and password-protected, but you can also share it with others via email. The book remains digital, however, and cannot be printed.

The text and “Add Your Voice” features of Little Bird Tales are a great opportunity to develop vocabulary and sentence structure!

Another great option is Glogster, the online digital poster creator, also free except for certain premium features. Glogster has an EDU version, and parents can also sign up at home through the regular portal. Glogster also has a very kid-friendly interface, and allows you to create a poster of your event’s images, along with supplementary graphics and audio clips.

Glogster’s Magnet tool is all you need to upload your images, add text, and record sound! As children choose “Frames” for pictures, additional descriptive language can be elicited.

Glogster creations can be printed for offline use, and can also be marked private and shared via email. Glogster is a little more complicated to use than Little Bird Tales (but not much!), so you might want to check out the tutorials I posted on YouTube. Additionally, both Glogster and Little Bird Tales are Flash-based (and therefore will not work on iPad, until their apps are available?) so if you run into trouble, you may want to make sure you have the latest version of Flash and update your browser, steps that are important for keeping your Web workin’!

When I mentioned iPad, did that make your ears perk up? One of my favorite recent discoveries is Skrappy ($4.99), a robust iPad app that you can use to create a decorated and annotated scrapbook of your photos! Like many iPad creation tools, Skrappy has a built-in-tutorial (in the “Getting Started” Scrapbook, so you and the kiddos can be creating in no time!

Skrappy’s simple tap-based interface lets you add whatever you’d like to your photobook: images, video, audio captions, text, decorative shapes and graphics to associate with the pictures, even music!

For another iPad take on photobooking, check out Mobile Education Store ’s new app , Speech Journal (3.99), “a customizable voice recorder that you pair recorded messages with your own imported images and image sequences.” Speech Journal is super-simple to use, contains its own video tutorial, and allows you to pair voice recordings with single images or continue recording across multiple images, resulting in a slideshow (and sequenced narrative)! When complete, the journal can be emailed and played on a home computer in QuickTime player, a free download.

Finally, if you’d like a simple and quick (but perhaps a little more expensive) digital take on the photobook, iPhoto on Mac features a tool for you to create and order books to be delivered to you (for example , you can buy a 3-pack of one 20-page softcover book from Apple for about $11.00). Alternately, go to the Create menu on Picasa (on either platform) to create and email/print a photo collage (expensive in a toner cartridge sense, but easy to do)!

Hope you enjoyed this digital spin on photobooking; if you have any other tech tools you’d like to suggest for use with personally relevant photos in order to build language, please let us know in the comments!

Sean J. Sweeney, MS, MEd, CCC-SLP is a speech-language pathologist and instructional technology specialist working in the public school and in private practice at The Ely Center in Newton, Massachusetts. He consults on the topic of technology integration in speech and language and is the author of the blog SpeechTechie: Looking at Technology Through a Language Lens.

Childhood Apraxia of Speech: Through a Mother's Eyes

2011-08-23T07:55:00.005-05:00

Today, I'm privileged to share this guest post from Leslie- devoted mom of two, one of whom happens to have a diagnosis of Childhood Apraxia of Speech (CAS). Leslie has a book on Childhood Apraxia of Speech coming out in early 2012...and after reading this post, I can't wait to read her book! Enjoy.

Many thanks to Becca for allowing me to be a guest blogger on her site today. It’s ironic how this world of apraxia works…there’s not much “out there” until you start looking. I “found” Becca because she was a guest a blogger on PediaStaff. Her article on “waiting to see” intrigued me. I contacted her, and well…the rest is history. But the point I am trying to make is: you just never know what stone you will upturn when you start picking them up.

Everyone Has a (apraxia) Story…Here’s Ours

At two years old, Kate was a beautiful, energetic and happy toddler. Amidst the hustle and bustle of a new sibling and a pending move, there were concerns. With the exception of one word—hi—Kate was as quiet as a box of crayons. It made us wonder if something was wrong. Even as a baby, Kate rarely babbled and cried. She was, in a word, “perfect.” So why were we worried? After all, she could understand everything we said, even the big words. “Play classical music. Dance with her. Babies need that so their brains can develop,” I was told by others. And so we did. We talked to her like she was a little adult, making conversations even though we didn’t expect answers. The books I read about late-talking children, didn’t seem to really apply to our little Kate. “She’ll talk when she’s ready,” I was told by my mom-friends. Only they bragged that their toddlers were saying words like “elephant” and when we met at the park. I cringed and rolled my lips into a tight line, sucking in a deep breath. Was she stressed because there were changes going on her world? No, that isn’t it. I shook my head, confused and frustrated. We provided a loving, stable environment. So, what was it?

As first-time parents, we didn’t want to appear “delinquent,” so when Kate was 15 months old, exactly, we headed to the doctor (the same one who delivered her) for her scheduled well-child check-up. I say “we,” because both doting parents were off work for the occasion. It was as though it were a pre-kid business meeting marked well in advance in our planners. This time we came armed with our wiggly daughter; along with thoughts, questions and toddler antics to relate to our doctor.

After Dr. Baumgartner whirled into the exam room, plopped down and smiled at us, she asked a series of questions . . . was Kate doing this, doing that? Yes, yes, and yes, we nodded and smiled proudly. “Is she saying ‘mama’ and ‘dada’ and a few other words?” Nope. We held our breath, awaiting her response.

As a first-timer, I didn’t want to jump the gun. Kate was only 15 months old after all. She still wore diapers, took a pacifier when distressed, and was rocked to sleep. In many ways she was still a baby, and babies don’t talk, do they? Plus, I knew kids—through my teen years as baby-sitter and as a child psych nurse.

We told our doctor that all Kate was saying was “hi,” and that she started saying that around 13 months. Wasn’t that good enough? Our caring doctor probed a little further and eventually she referred us to a local speech-language pathologist (SLP). “You can do it now, if you want to be aggressive, or wait until she is 18 months if you want to take a conservative approach,” she instructed us.

We took the conservative approach, finally making the call when Kate was 18 months. The impetus was easy: Kate still wasn’t saying “momma” and I wanted to hear my little girl call for me by name, instead of grunting.

I’ll admit I was totally skeptical of the capabilities of a speech-language pathologist at first. What could she possibly do to get my kid to talk that I couldn’t? And this SLP didn’t even have kids—what was I thinking? But we stayed the course—and learned that Kate has severe Childhood Apraxia of Speech (CAS). She was diagnosed at 30 months (2.6 years)

As bright, beautiful little girl preparing for her first day of first grade this week, we are pleased to share that Kate is no longer grunting and pointing to get our attention. Was it magic? No. Was it something she needed to “grow out of?” No, again. It was the hard work and patience of a skilled pediatric speech-language pathologist (SLP); the determination and motivation of a child, and the tenacity of her parents. It was the environment and nurturing curriculum of a hands-on, language-based preschool. It was a village that helped our little girl speak at a level that was developmentally appropriate.

If you suspect your child of having a speech disorder like Childhood Apraxia of Speech (CAS), it is important that you make an appointment with a qualified SLP for a thorough assessment. CAS, though fairly rare—about 1% of the pediatric population—is a serious speech disorder that requires intense and frequent intervention to overcome. But it can be done! If you are looking for more information on CAS, poke around on this site, ChildTalk www.talkingkids.org for related topics, my blog can be reached at www.leslie4kids.wordpress.com (I devote Mondays to apraxia), and also the CASANA/Apraxia-KIDS website, www.apraxia-kids.org.

Hi, I’m Leslie. I am mostly a full-time mom, former R.N. and part-time writer. My family and I live in the Chicagoland area and do all of the things regular families do. With one exception: we cope with our daughter’s Childhood Apraxia of Speech on a daily basis. When I was first learning about Kate’s diagnosis, I was stumped: we never learned about this in nursing school! I was on a quest to help my daughter. In early 2012, my book, Speaking of Apraxia: A Parent’s Guide to Understanding & Coping with Childhood Apraxia of Speech will be available from Woodbine House.

More Information on Apraxia of Speech

Childhood Apraxia of Speech: What It Is and What To Do

Carrier Phrases: What They Are and How to Use Them

Repetitive Books For Language Learning

Bilingual Children, Asperger's Syndrome, The Power of Stories, Boogers, Books, and Babies: It's the Fabulous Friday Round Up

2011-08-19T13:22:00.003-05:00

A few posts I think are great...

The Huffington Post reports on a study published in the Journal of Experimental Child Psychology. The study suggests that children who are raised in bilingual homes may have better cognitive skills, at least in some select areas of cognition-and that this shows up as early as two years of age. The authors of the article theorize that growing up with two languages requires children to develop flexible attention skills so that they can shift rapidly back and forth between two languages. This leads to better development of "executive functioning" skills-- the higher level thinking skills we all use to manage our attention, prioritize, hypothesize, and plan.

PsychCentral shares this thought-provoking post on The Power of Stories in Personality Psychology. As SpeechTechie wisely pointed out on Twitter earlier this week, this post is a great reminder of why it is so important to help our children develop good narrative skills. (Looking for ideas on how to do this? Check out this post on using photo books for narrative development).

In a turn toward the highly practical, ArticBrain posts on the use of boogers and dog food for helping your child improve his articulation and language skills. Once I got past my initial repulsion, I greatly enjoyed the creativity of the idea. (And yes, ArticBrain is written by a guy.)

In her post on The Surprising Things Babies Might Do (If Given The Chance), Janet Lansbury at Elevating Childcare reminds us that babies and toddlers often hold much more potential to be independent then we might think--if we only give them the chance to show us what they've got.

The Sixty Second Parent has some awesome suggestions for their top ten books that 2-year-olds will love (you'll find many of the same ones on my list of Repetitive Books for Language Learning!).

Finally, Be Real PDD/NOS directs us over to this video where Arthur ( from the PBS show) explains Asperger's Syndrome. I think I like it.... what are your thoughts?

Happy Friday!