Late-talking and expressive language development
I got this question recently. “My 2 year-old toddler is not talking yet. Do you think he is ok?”
To help her understand where her son is at, we first have to look at children’s speech development. According to the American Speech and Hearing Association, the average 2 year-old has around 200 words in their vocabulary. A 2 year-old child with only 50 words in his expressive vocabulary is behind 90% of his peers. And therefore, a 2 year-old toddler with no words is very delayed.
Even though some children do outgrow late-talking, they are the exception rather than the norm. Rather than waiting, my suggestion is to take a more preventative approach and implement strategies at home today so that you can help push his language in the right direction.
Prerequisites for expressive language
So we will start working on getting him to talking right? Much as we would like to jump right into expressive language, we first have to ensure that he is ready to talk.
Dr Louis Rosetti, in his book “Communication Intervention Birth to Three”, states that children must first be able to follow some simple instructions consistently, have an adequate level of social, cognitive skills, be able to imitate, as well as be able to vocalise many sounds before they can talk. You can read more about the prerequisite skills by following the link above.
Until a child meet these criteria, teaching a child to talk is unlikely to yield result.
Working on expressive language
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Assuming that the child has already met the prerequisite skills, we can move on to work on expressive language. Contrary to what it sounds, expressive language also includes signing and alternative forms of communication like PECS.
Depending on how readily your child is in imitating your words and actions, your speech therapist may recommend signing or AAC (Augmentative and Alternative communication) devices for your child as a first step while working towards talking as a future goal.
Model lots of language
To get your child ready, we first have to model the words and signs for him. The benefit of hearing a word many times is two folds, 1) it helps him understand the words; and 2) it provides a good model to help him say it correctly.
Actually it might be even better to go one step further back and start with modelling animal sounds and exclamatory words like “wow” or “whee”. Since these sounds are usually fun and easily understood by children, it is more likely that they will picked it up.
How exactly do we model? We use the words as many times as we can during interactions. In her presentation about recasting, Caroline Bowen shared that the child has to hear the word between 12-18 times before he can learn it. You can also read more on how to model language effectively.
In addition, keep in mind the zone of proximal development. Model at a level just beyond what a he is capable of so that he can see the next step to communicating in a more mature manner.
Establish verbal routines
Verbal routines are sequences of words that you say in the same way, in the same context every time. So you might count “1,2,3…go!” before throwing your child in the air in a game of “Up up”. Or you might say “Bye Bye” every time you put away a toy. Or you might model “Nom nom nom” as your child chews his food.
In fact, you can also try to create your own verbal routines for everyday activities. To begin, you can try to start and end an activity the same way each time.
Songs are also another form of verbal routines. Because they are very repetitive and predictable, it allows a child to pick them up easily. Some good examples of songs with predictable lyrics are “Wheels on the bus”, “If you are happy” and “Twinkle twinkle little star”.
If you’d like to read more, Laura Mize from teachmetotalk has good articles and a book on verbal routines.
Add pauses
After your child has had many opportunities to hear a word or verbal routine, you may start to hear her imitate you occasionally. Once this happen, you can try to insert pauses in strategic points and see if your child might attempt to fill in the blanks.
For example, when singing “Twinkle twinkle little…….” pause and look expectant just before “star” and see if your child might fill in the blank. Try to insert the pauses for words that are more likely to be known by a child of her developmental age.
Also make sure that you target words that are age-appropriate. Using the song “Itsy bits spider” to illustrate, you might insert the pause at “Wash the spider….(down)” rather than at “Went up the water…. (spout)” because a 2 year-old is much more likely to know the word “down” than “spout”.
Practice requesting
Have you tried holding on to his favourite snack and getting him to ask for it? It’s ok if you have done it because most parents I have met had tried this strategy in some way or another. For some children, requesting works magically to help them talk. However, not all children share similar success.
The difference between one who goes on to talk and one who goes into full meltdown-mode is whether or not a child is ready for it. If a child has not demonstrated that he can perform the tasks like saying and or signing it first, doing so is not likely to be successful. In fact, it is more likely to result in needless tears and frustration. In the worse case, you end up with a child so defeated he stops trying.
So pay attention when you are modelling. As you start to notice your child imitating you and filling in the blanks, you might want to give him even more chances to practice the word by teaching him to request. This can be done using food, toys or social games.
In the example of a social game like tickle, you might pause with your hands raised and see if your child might make a request by using a word or signing.
When using food and drink, give tiny bits to your child each time so he has to repeatedly request for more. With regards to toys, choose those that have a clear ending (e.g. wind up toys, pop up toys) and those that require an adult to operate, so you don’t end up fighting to get the toy back from your child.
However requesting is a strategy that is best used with care. There is a fine line between giving a child a little nudge and being down-right mean so we certainly want to do it the right way. Here’s my step by step guide to using requesting as a strategy.
One last note about requesting. Be realistic with your expectations. It is unlikely that the child can say a word or form a sign correctly right away. So reward any sign or sound that resembles the target initially and gradually adjust your expectation as he moves along.
Encourage more words
When a child is starting to use the target words more consistently, offer choices throughout the day so that he has even more chances to practice it. This is important in helping him to maintain and generalise the words to other contexts.
Help your child to use words spontaneously
Lastly, you want to create opportunities for your child to use words spontaneously through a process called “Communication Temptations”. This means that you are creating situations where your child is motivated to communicate.
For example, you may put toys in clear bins. Or store your snacks in clear air-tight jars. You can also leave people toys (i.e. toys that need you to operate) lying around your home such that he might be inspired to bring them to you to request a game. Or you might play his favourite toy in front of him and not invite him to play.
Another name for this process is called “Environmental Sabotage” which entails adding some curveballs into his activities. These includes giving him a cup but “forgetting” his juice, giving him his daddy’s shirt or giving him the tracks without the trains. Your child will thus need to get you to “correct” these situations.
Here are more ideas on using communication temptations from Katie Yeh of Playing with Words 365.
When he comes to you, wait and give him a chance to make a request at his current level. So if he has shown that he can say the word, expect him to say the word. If not, follow the steps in withholding to cue him along. As he becomes more consistent, step it up by modelling two-word phrases to keep his language moving along.
Conclusion
Late talking can be a sign of a more serious developmental disorder. Therefore, sitting and hoping that your child will outgrow it is not helpful as they are missing out on therapy during their critical years if it turns out for the worse.
Even though therapy may be some time away because of long wait lists, there are many ways that parents can do to help their children at home today. Start by meeting your child where he is and work from a level where your child can succeed. He may not talk right away, but he will, some day if you keep working at it.
What are some other ways you have used to help your child talk?
