Update on Fred: 2year old not talking

You might recall I talked about Fred who wasn't talking and that I'd made some suggestions:

1. To take the pressure off making him say things, so don't ask to repeat or ask too many questions in a story (handy rule 1 question to 4 comments). He is a very strong personality and knows whether the adult knows the answer so is unlikely to 'play the game'

This has been very hard as his mum is feeling very pressured by her group of friends who like to discuss how well  their children are doing. She feels some of them look 'pityingly' at Fred while others actually say, 'Isn't he talking yet?' We discussed the fact that Fred is so bright to be able to get what he wants without talking that she must acknowledge this, smile and rise above. Any parents have any better ways of dealing with this?

2. Step up the opportunity for him to as make as many choices (non-verbal at the moment) see http://www.smarttalkersblog.com/2014/02/reasons-means-and-opportunities-choice.html

Fred now chooses what he wants for drink and snack from a choice of two things. He does this by pointing to the preferred one. We discussed ways of building on this e.g. which tops to wear,which video to watch

3. Encourage non-speech noises e.g. animals, vehicles etc  

Wow, this has come on brilliantly! He can't repeat if asked but will spontaneously make the noises.

4. Keep adding language to his grunts/noises adding what you think he'd be saying if he could talk, children learn by echoing to start with so need a model to echo

His Mum is excellent at this e.g. he pointed out of the window and she said 'go outside?'  waiting for a response, 'Yes we will in a minute.' He brought an empty packet of raisens to her, she  said 'more raisens? etc

5. Use repetitive rhymes to hesitate on words to give him chance to add the approximation of the word (don't care how he says it just that he has an opportunity).Work out which songs and words so  both parents do the same.  

Fred now joins in with the missing word. His pronunciation is approximate ie only sounds  a bit like the missing word but that doesn't matter. I'm delighted!

6. Make a word book of Fred's things and people using photographs

His parents have done this on the ipad. We discussed printing off and putting in a book that she can use to show people a) as interaction b)in case we don't know what she wants, it will may give a clue

Fred cannot make noises on request and there is some groping when he tries to repeat which needs monitoring as it could indicate a motor planning issue. He can bob his tongue out in game but not if he is asked to. We decided to introduce Makaton as Fred already know some signs from Mr Tumble. This will ensure he has a functional communication system which will alleviate the stress for all concerned. It wont stop him talking, it will help. 

We'll keep you posted!

Another 2 year old not talking

This morning,  I went to the home of Fred, a lovely two year old who isn't talking. He did say some words but now doesn't. Understandably his parents are worried. When I first qualified, parents would have been a little concerned BUT there was no internet so they couldn't google their problem. (Let's face it we all do and  we could all convince ourselves that we have a terminal disease if we check our symptoms in this way!)

The same happens for parents: there's so much on the internet about Autism that parents are drawn to this as the only reason a child might not talk. However, there are several reasons why a 2 year old isn't talking, not just because they have ASD. They might just have a delay in the area of speech, language and communication (there might be a family history), it might reflect overall ability, they might not need to talk as everything is done for them or a combination of some of the above. We have had an influx of referrals for younger children who aren't developing language as they should be. We like to have referrals as young as possible so we can put plans into place to help. Early intervention is vital.

We're interested in:

• Interaction skills, do they want to interact?
• What is their eye contact and non-verbal ability like?
• What is their attention and listening like?
• What is the level of the child's play? This gives us a good idea of overall developmental levels
• Do they understand what is said to them? We need to see if they understand word and phrases. There is a difference between situational understanding so of you have your car keys in your hand and you say 'Shall we go in the car?', they don't need to understand the words to be able to work out what's going on?
• What are they communicating without words? 
• How do they get their message across?

In Fred's case, his interaction and non-verbal ability is really good. His verbal understanding is age-appropriate. Play is developing well. He gets everything without needing to talk but is sensing the pressure to talk. There is also a family member who had language difficulties as a child. His functional communication is great!

We decided to do the following for 1 month:

1. To take the pressure off making him say things, so don't ask to repeat or ask too many questions in a story (handy rule 1 question to 4 comments). He is a very strong personality and knows whether the adult knows the answer so is unlikely to 'play the game'

2. Step up the opportunity for him to as make as many choices (non-verbal at the moment) see http://www.smarttalkersblog.com/2014/02/reasons-means-and-opportunities-choice.html

3. Encourage non-speech noises e.g. animals, vehicles etc  

4. Keep adding language to his grunts/noises adding what you think he'd be saying if he could talk, children learn by echoing to start with so need a model to echo

5. Use repetitive rhymes to hesitate on words to give him chance to add the approximation of the word (don't care how he says it just that he has an opportunity).Work out which songs and words so  both parents do the same.  

6. Make a word book of Fred's things and people using photographs

I'm going into nursery to discuss Fred's communication skills with them and to see what help they might need. We'll review him at home in 4 weeks and I'll keep you posted on how he gets on!

How do I know if my 2 year old's language is developing normally?

I've just had a very familiar conversation with a parent of a two year old. They don't know any other children of that age and don't come into contact with any. They do socialise but with older or younger ones. Their little boy is saying 3 words 'mama', 'dada' and 'car'. should they be worried.

This simple guide to normal early language development:

13 months of age: first words emerge (e.g. "here", "mama", "bye bye", "kitty")

17 months of age: fifty word vocabulary

18 months of age: First two-word combinations (e.g. "more juice", "here kitty", "cup floor")

24 months (2 years) of age: Average length of sentence is now two words with "-ing" emerging (e.g. "playing", "hiding", "running")

30 months of age: Average length of sentence is now 3.1 words with "is" emerging (e.g. "My car's gone!")

36 months (3 years) of age: Average length of sentence is 4.1 words with indirect requests emerging (e.g. "Can I have some cookies?")

Should they be worried?  We wouldn't expect everyone to understand a 2 year old so he might be saying words which are just unclear. We'd want to look at his interaction skills: does he have shared attention, make eye contact? We'd also want to know about his understanding: does he follow simple instructions or rather does he follow visual clues? There's a difference to understanding words or understanding situations. Think about if you were in the middle of Russia, you'd cope by following non-verbal cues and looking for any clues to what was meant. If you say, lets go in the car and they go to the door, if you have your car keys in your hand and your coat on, they may NOT be listening to the words.

Talking to his mother, I'm not too worried and I've given her some suggestions to try. He was premature and has been a little late with all his milestones. He's also a very passive child. We'll have a look at the suggestions next time for developing reasons, means and opportunities to communicate.

www.private-speech-therapy.co.uk

Do you have a pre-school child with ASD?

As a parent, you know how difficult it can be for your child with suspected or confirmed Autism Spectrum Disorder to interact meaningfully with others and connect with the world around him.

At Small Talk Speech and Language therapy we use The More Than Words Programme from Hanen. This was designed specifically for parents of pre-school children on the autism spectrum. Addressing the unique needs of these children, the programme provides parents with the tools, strategies and support they need to help their children reach their full communication potential.

More Than Words does this by empowering parents to help your child reach the following three goals:

1. Improved social skills
2. The ability to engage in back-and-forth interactions
3. Improved understanding of language

Here are some of the valuable things you’ll learn when we help you carry out the More Than Words Programme:

• How your child learns best and what motivates him to communicate
• Why your child behaves in certain ways, and what you can do to either increase or reduce those behaviours
• How to use your knowledge about your child to set realistic goals
• How to make interactions with your child last longer and be more meaningful
• Tips for using pictures and print to help your child’s understanding
• Tips on how to talk so that your child understands you
• Strategies for developing your child’s play skills
• Ways to help your child make friends

Practical strategies you can use in everyday situations

The More Than Words Programme focuses on your natural, day-to-day life with your child. You’ll discover how to take everyday activities like meal time, story time and bath time and use them to help your child improve his communication and social skills. And you’ll have fun together while you’re doing it!

The More Than Words approach is easy to understand and easy to put into practice. With every strategy you learn, you’ll be given ample opportunity to practice and discuss it so that you won’t forget it.

We have spaces from the middle of February. Register your interest: by contacting us info@smalltalk-ltd.co.uk

How to play with children to help develop speech and language development?

A guest blog post by Karolina Spałek from Poland

The following article is addressed to all parents of 0- to 3-year-old children.

A two-year-old child should use about 200 - 300 words, including the names of family members (mummy, daddy), toys, onomatopoeic words and basic verbs (eat, sleep, drink, walk, etc.). Every day, I have to deal with children who do not use words. They just do not speak at all. It seems worrying. It can even be said that a child who is not able to speak, is at the same time not able to think. The ability of using speech promotes the development of thinking. If you want your child to develop properly from the very first moments of his life, the most effective way is to take advantage of fun and learn through play. 

An excellent method of learning a language is to create communication situations in which the child feels the need to talk: the situations concerning desires, satisfaction and joy.

The factor of the quantity of words and the quality of language you use to communicate with your child has an invaluable impact on the speech development. We should not underestimate the fact that the speech and language development has a lot in common with shaping other skills, such as writing, reading and learning. Language facilities are also crucial in establishing contacts and relationships with other people.

You can easily influence the correct development of your toddler. The following list consists of some inspiring tips for the speaking manners and some pieces of advice concerning the proper use of toys while strengthening the bond with your baby:

1.       Talk to your child as often as possible: during everyday activities, walks, shopping, etc. Speak slowly, clearly and correctly. Keep the eye contact while addressing your child. When you show animals, things and people - call them. If your child is in a pushchair, remember to keep him facing you! By using this strategy, you provide the child with an opportunity to observe your facial expressions, emotions and the movement of your mouth!

2.       Provide sound stimuli: avoid or eliminate television completely. It unnecessarily stimulates the child and leads to sensory processing disorders. Instead, listen to the sounds of the environment. Ask and answer: What is it? A car, a dog, a cat...

3.       Have fun by imitating animals - show pictures of animals, imitate their noises (cow: moo, cat: meow, dog: woof, au). Enjoy walking like astork, speaking or jump like a frog, moving like a cat or swing like a monkey!

4.        Imitate the sounds of vehicles: car engines, trains, aeroplanes. It is a good idea to use toy vehicles and onomatopoeic words to show how the real ones move and sound. You can put some toys or objects inside: a doll driver or your child's favourite bear. Do not forget to ask questions during the play: What can you see? What is it? It gives the child an opportunity to make a choice what he or she wants the vehicle to carry. A ball or a teddy bear? A cat or a dog?

5.       Be a storyteller. Read or tell stories to your child every day before bedtime. Take advantage of illustrated books or fairy tales. Read a passage and ask your child what he remembers: What was the story about? Who is in the picture? What's happened?

6.       Present illustrations, ask questions and give your child a chance to come up with the answer: Who is it? What is he doing?

7.       Talk about experiences. Let the child express his emotions while talking about a kindergarten or a day spent with a grandmother. Allow your child to talk about shopping with his mother or the animals met during a walk.

8.       Enjoy counting with your child: How many cats can you see in the picture? How many animals are there in the car? How many apples has daddy bought? One, two, three! Three apples! Ask questions and count together with your child!

9.       Use the mirror: make funny faces, touch your nose or chin with your tongue, lick your lips. By following your behaviour, by repetition, your child creates a sense of awareness of his own body. With your guidance, he does it in a pleasant atmosphere. Remember to let your child act on his own initiative and try to mimic his gestures!

10.   Draw. Use crayons and markers - inform your child what you are drawing: Mummy is drawing a cat. What does a cat do? Meow! The child scribbles but later follows the scheme. This is a combination of speech development and the improvement of motor skills. It prepares your child to draw, colour and write.

11.   Practice breathing: whistle, use pipes, flutes, fans. Make soap bubbles, blow feathers, pieces of paper or ping pong balls. Blow a drop of water using a straw or let your child have fun by blowing the paint around the paper to create fabulously abstract works of art. This painting can be attached to the fridge with a colorful magnet clip!

If your child does not speak, encourage him by all means to do so!

300 - 500 words -this is an amount of active vocabulary of a three-year-old child who uses them to build his first sentences. Remember that the onomatopoeic expressions, such as 'woof' or 'meow' are ones that vary across cultures and nationalities! If you notice that your child lags behind his peers in his ability to talk, it is necessary to contact a speech and language therapist. However, before the first visit, do not waste your time and take matters into your own hands! Help your child to move forward! I wish you good luck in all actions you will carry out to encourage your little ones to use language!

Karolina Spałek

www.Logotorpeda.com

Translate: Aleksandra Kmieć

Talking to toddlers: it's not an option, it's a necessity!

I was unfortunate enough to be stuck in an A and E department for 2-3 hours the other afternoon. The only thing to do was people-watch. There were several elderly  ladies who had had falls, a teenage girl who was constantly being sick, two workman who were limping and many more walking wounded. Among them was a mother and her baby with a rash, who was probably about 18 months. He was strapped in his pushchair with nothing whatsoever to occupy him. His mum was talking on her phone, texting, listening to music on her head phones and looking out of the window which was too high up for him to see.

He had nothing to occupy him whatsoever! The best thing he could have had was otherwise occupied with her own things.

The only words she said to him were 'no' and 'stop that'.

He tried making her laugh to get her attention, he tried wriggling to get out, he cried, he made eye contact and jargoned, he pointed....indeed he tried every bit of his communicative repertoire but all to no avail. In the end he just screamed and then sobbed!

This made me feel really sad. The mother obviously cared for him. He was clean, fed and his physical needs were met but he was being neglected! The mother would not have sat there for all that time with nothing to do yet that's what she expected of her son.

I maintain that all parents want the best for their children but they need to know what that is. Let's have a public information drive so parents realise they should be talking to their babies and young children! It took a while before 'clunk, click every trip' took off but now everyone wears their seat belt. What catch phrase can you think of to headline the campaign?

Should you be worried about your 18 month old's language development?

Many people feel that 18 months is too young to worry about a child's communication but in actual fact, if there is a problem, the earlier you get help the better.

We know that 'normal' language guidelines are very loose so that each child is different but generally a  18 month old:

• has a short attention span i.e. can concentrate for short periods on an activity
• Shows some early pretend play 
• Enjoys playing with other people 
• Plays with a range of toys/activities 
• Likes routines but can be flexible 
• Follows simple commands and understands simple questions as part of an everyday routine
• Uses babble or some words which family understand 
• Communicates through gesture rather than words (e.g. pointing, waving)
• Eats lumpy food with no problems

However, the following could indicate a problem and could do with investigating further:

• Does not seem to understand what is said
• Does not demand much attention
• Pays attention for only a few moments
• No pretend play
• Reluctant to let others join in their play
• Interested in everyday objects rather than toys. eg light switches, plug sockets, opening/ shutting doors
• Unusually distressed if there are changes to routine
• No babble or words

Small Talk are very happy to see young children to give advice or support you further.

www.private-speech-therapy.co.uk

What's communication like for a 2 -3 year old?

Another in the excellent series 'Through the eyes of a child' from the Communication Trust

Through the eyes of a child: 1 - 2 years

I never cease to be amazed at how babies and young children learn to communicate. Have a look at this excellent video by the Communication Trust.

Toddler not talking?

When we're called in to see  toddler who isn't talking, many parents are surprised that we don't start to work on getting them to say words . We have talked before about there being a pyramid of priority, as below

However, for some children, about whom we may be concerned about social interaction, we will suggest a different approach. As Hanen licensed therapists we might have these 5 top goals:

1. For the child to enjoy social interaction
2. To understand and use non-verbal communication (especially gestures)
3. To pay attention to people’s faces and words
4. To help the child imitate
5. To respond to bids for Joint Attention (RJA)

These can all be done through play.

Tips for Toddler Talking

This is useful for all the parents who want to know what to do:




By Kimberly Scanlon

Activities and Tips for Parents to Help Develop their Child’s Speech, Language and Communication Skills.

We currently live in a very fast paced world; sometimes we take for granted the skills we need to be effective and successful communicators. During my pre-school language groups I try to take the time to discuss with parents the importance of means, reasons and opportunities.

In brief, this model is a holistic approach to describe communication, and was devised by Money,D. & Thurman, S (1994).

Means refers to HOW we communicate e.g. speech, signs, pictures, gestures etc.

Reasons is the WHY we communicate e.g. wants/needs, feelings, choices, requesting information, giving information etc. Giving your child choices is really important!

Opportunities is the WHEN, WHERE and with WHO we communicate e.g. time and place, shared communication system, family, friends etc.

Therefore, according to Money, D and Thurman, S; to be a successful and effective communicator ideally you need an element of each aspect. These means, reasons and opportunities are important to bear in mind when interacting with children. Please see below for a few suggestions of things you can do with your child to help them become successful, effective and confident communicators.

Nursery Rhymes and Singing:

·     Working on a child’s language skills. They can hear the rhythm and flow of language, speech sounds, and words; it helps them connect words to actions, to understand and remember words.  They also help attention and listening skills.

·         Increases their confidence. 
·         Helps with their pre-reading skills.
·         You can let your child make a choice of which song to sing, giving a child choice is really important; it gives them a reason to communicate.
·         Use songs that have actions and repeating lines, this helps maintain their focus.
·         Try stopping in the middle of the song and encourage your child to continue with the next action or word.

Daily Routines: Daily routines provide a good opportunity to help your child to learn new words.  Mealtimes and bath-times can give you a chance to reinforce some new words without even thinking about it!  Choose some Key Words that you will use every time – this helps your child learn through repetition. Just like us, children will have some days better than others. Tiredness, behaviour, time constraints etc. can all have an impact on the ability to learn new words.  But as often as you can, try to use these natural routines to help your child learn and use these common words.

Bath Time: During bath time you can use the words ‘wet’, ‘wash’, ‘dry’ etc. lots of times to show your child what these words mean. You can also name body parts e.g. ‘wash your feet’ ‘dry your tummy’ etc. Always make it fun!

Meal Times: offer constant opportunities for learning. Children benefit from the social aspects of eating together; learning how to take turns and sharing. This is a great time to talk about different foods; developing their vocabulary. Meal times can provide an opportunity for your child to use his/her language to request things.  Help your child to repeat some new words ‘more’, ’hot’, ’yummy’, etc. Name things as you put them on the table. Give your child a choice of foods & drink – juice or water?  This gives you child a reason to communicate and helps them to ask for things in a meaningful & functional way.

Reading Books: Story-time is a routine which is enjoyable for you and your child. It is a rich language activity, it can help develop your child’s attention and listening, their understanding, extend their vocabulary and; develop their reasoning skills.  It also provides a fantastic opportunity to introduce your child to literacy; letters and written words and the concepts of beginning and end.

Books aren’t just for bed time; they are great for any time of the day! Again, give your child the opportunity to choose a book and show you what he/she finds interesting to talk about. Again incorporate some Key Words e.g. – book, again, finished, my turn etc.

Play: Is a fantastic opportunity for you to interact with your child, and is an enjoyable way for your child to learn:

·         They can become familiar with objects, touching, textures, looking etc.

·         They can practice new skills

·         Improve motor skills and co-ordination

·         Integrate many of the senses i.e. touch, sight, smell etc

·         Learn about communication i.e. turn taking, asking questions etc.

·         Learn about language i.e. vocabulary

·         Learn about other people

·         It is a safe way to release excess energy and reduce the build up of any frustration.

General Hints and Tips:

During play and day time routines these tips can really help your child:

·         Comment on what your child is doing but, try not to ask too many questions

·         Show your child that you are listening and interested in what they are saying by repeating what they say.

·         Follow your child’s lead during play activities

·         Play pretend games e.g. tea parties

·         Allow your child plenty of time to respond

·         Talk to your child about what you are doing every day e.g. when you are in the car, doing the washing, cooking etc.

·         Try not to put too much pressure on your child to talk or say words they find difficult

·         Try not to criticise or directly correct your child when he/she makes an error with his speech sounds, just give them the correct model.

·         Get on your child’s level when playing; don’t be afraid to get on the floor with them.

·         Try and get your child’s attention by saying their name first, or tapping their arm before you ask them to do something, or are making comments about things around them.

·         Use simple repetitive language

·         Make learning language fun!!!!

   By Georgina White

Do you know about two year old's speech, language and communication?

If you are in the Stafford area and work with 0-3 year olds, you are welcome to attend some free training. 19th April 1pm - 3pm at Silkmore children's Centre. 

By the end of the session participants will:

• be able to describe the development of speech, language and communication skills in children under 3 years
• to be able to understand the processes of pre-verbal and early verbal development
•  to be able to identify risk factors that impact on the development of communication skills
• understand the role practitioners play in supporting speech, language and communication development in children aged 0-3 years
• be able to gather information regarding any difficulties along with knowledge of when and where to refer

To book a place see www.bookwhen.com/smalltalk Places are limited, so reserve your asap!