By Harriet Englander, MS, CCC-SLP
this article was taken from the ADVANCE magazine
I enjoy working with toddlers and observing their obstinate focus on one activity. When parents referred to a child's favorite toy or pursuit as a fixation, I began to wonder, "Is this a symptom of a speech and language delay, a behavior on the autistic spectrum, or a step in language development?"
When we go into the home, we want to show parents that talking to their toddlers about what they are doing, where they are going, and how they are going to get there during their daily routine is how they can help their children develop language. Parents and caregivers can help toddlers make good progress if they have consistent involvement in their routines of eating, dressing, brushing teeth, going out, and going to sleep.1
The toddlers I work with learn to produce language through shared attention during play routines. Why not repeat the same activity that the toddler feels comfortable with? Letting a child begin the session with a favorite toy or activity can lead to listening, labeling, commenting and communicating.
I began speech therapy with Peter when he was 2-and-a-half and his favorite activity was Thomas the Train. We sprawled on the floor together, putting down tracks and lining up the small cars. Peter could name "Percy," "James" and "Emily" early on, but his communication skills were slow to appear.
A few weeks after we began, we were ending a session on the front steps of his house, playing with small airplanes and waiting for his older brothers to get off the bus. I suggested he say "hi" to his brothers when they approached us. Peter did, and his 6-year old brother looked at me as if I were a magician. "Peter never spoke to me before," he said.
Peter's behavior seemed to be obsessive and uncommunicative, but he was beginning to make eye contact as I talked about what we were doing. He began to indicate preferences: these tracks instead of those, this train instead of that one. His mother watched the progress, and we discussed her busy schedule. She admitted that Peter spent a lot of his day in a car seat. I told her they didn't have to be silent in the car. She could talk to him about where they were going and what they were going to do. She began to ask him to indicate what he wanted to eat. Peter was dialoguing by age 3 and became a talker by 3-and-a-half. He soon was thriving in a pre-K program with rules and schedules, communicating easily and intelligibly.
Lois Bloom, PhD, reminds us, "A language will never be acquired without engagement in a world of persons, objects and events. The motivation for learning a language is to express and interpret contents of mind so the child and others can share what each is thinking and feeling."2
Devin was not yet 2 when I began to work with him. He had a basement filled with toys and liked his kitchen. We played kitchen every session. He allowed me to vary the play as long as the basic sequence remained the same. We had a shopping cart, canned goods, and a doll to sit in the cart for shopping.
We had a stove, pots and pans, and a rotisserie with noise and orange light to prepare the food. We had a tea set, plates and spoons, and a table and chairs to enjoy our "meal." Devin had a feeding problem, but once we established this routine, he began eating the raisins, fruits pieces and crackers that were part of our "meal" as long as we fed the doll first.
Devin developed his own feedback therapy. During our play routines, he pointed and named what he wanted. I clearly and slowly repeated what he had said, he repeated it, and I reinforced it. We completed his early intervention program in a year, moving from silence to single word utterances and jargon and then nearly full intelligibility. He communicated easily with his family.
Real words are embedded in the jargon of children when they begin to combine words. If we pay close attention to their utterance and know the content, we can deduce the meaning, repeat the word or words for them, reduce their frustration, and initiate real communication. If the parent is doing the same, it is a winning situation.3
Other 2-year-olds who needed to do the same activity over and over have done simple puzzles, pushed their miniature cars off a coffee table, and begun each session with the alphabet song. When these toddlers could not talk or communicate, they wanted to do what they could do easily. They created their own play routines. It was easy to do intensive modeling while going along with their preference. Repeating the activity they chose seemed to increase their motivation and led to overcoming language delays.
Woods, J.J. (2010). Getting into the family routine: Intervention strategies for early intervention. Long Island University, Feb. 5.
Bloom, L. (1998). Research perspectives: Language development and emotional expression. Pediatrics (Supp.: New Perspectives in Early Emotional Development), 102 (5): 1272-77.
Marshalla, P. (2005). Apraxia Uncovered: Seven Stages of Phoneme Development. Anaheim, CA: Marshalla Speech and Language.
Harriet Englander works in the Early Intervention Program in Port Washington, NY. She can be contacted at firstname.lastname@example.org.
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