Here’s what I know after spending nearly 30 hours a week for the past 10 years in the homes of my little clients. Listed below are the 10 best ways to entice a child to interact, then communicate, then (FINALLY) talk!
1. Play, play, play, and when you’re tired of all that, play some more!
You absolutely, positively have to get down on the floor and play with your kid. You can narrate his and your actions all day long, but until you put yourself in the thick of things in his world, you may not get much of a response to anything you try. For infants, this means holding them in your laps and playing early social games. Try old standards like So Big, Peek-a-boo, and Patty Cake. Or make up your own such as leaning them backwards or down from your lap and then pulling them up saying, “Down” then “Up.” For older babies, it means being down on the floor on the blanket and using developmentally-appropriate toys (more about that in another post!) and singing simple songs with hand motions led by you (not the CD or the DVD player!) For toddlers it means moving around with them and using their budding interests to determine your next activity. For preschoolers, it means interjecting yourself into their pretend games. For children who are not routinely social, YOU MUST become their favorite playmate at least some of the time instead of letting them remain self-absorded in their own spinning, button-pushing, TV-obsessed world.
2. Exude warmth and joy when you interact with your child.
Now I know that this is a stretch for most parents 100% of the time, but as a parent, or even a professional working with a child, you have to act excited and happy to be with them at least some, if not most, of the time. This change in attitude alone can make children who previously seemed antisocial begin to respond. For the kids who are are interested in playing, but not quite interacting, it causes them to want to sit and play WITH someone as opposed to hoarding the toys or continuously running around the room. Don’t get me started on what it does to kids who are already little social butterflies! They are drawn to you like magnets, and so much so that they sob hysterically when you leave their homes.
For those of you who don’t know what this looks like or haven’t experienced being this “connected” to a child, try to imagine yourself “lighting up,” when your child walks into the room or looks at you. For the really clueless, it may help to start to notice it in other adults who interact well with children. Look for twinkly eyes and sincere expressions of affection. Sometimes I notice this in a Dad who walks into a room and immediately swoops a kid off his feet and then falls down on the floor in fits of tickles and riotous laughter. I also notice it in grandmothers who snuggle kids on their laps and talk sweetly and softly. It can come in all shapes and sizes, but the experience is the same. The kid who is on the receiving end of this usually responds in some positive way, although it may not be exactly what we’d want in the beginning. Even kids who don’t routinely initiate affection can learn to respond by allowing themselves to be hugged, or tickled, or caught as they run if a fun, caring adult persists in trying to woo them. If you’re not sure how you’re doing with this one, ask a friend or family member if you ACT like you love to play when you’re with your kid. (Not if you love them, but if you act like you love to play.) Watch yourself on videotape actually playing with your child. If you are not so mesmerized by your performance that you want to send it in to me as a great example for this post, try harder. It does get easier with practice.
3. Talk at and just above your child’s current language level most of the time during direct interactions.
Usually children understand at least a little more than they can say. (There are exceptions to this rule. For example, the child with autism who can recite lines from a movie, but she cannot ask for something she wants.) The theory here is that you want to challenge a child’s comprehension, support his ability to interact, and facilitate his ability to respond, all at the same time. Easier said than done, right? Actually it is pretty simple when you think about the purpose of why you’re interacting with your child. For most of you reading this blog, your concern is that you want to teach your nonverbal child to talk. This means that you need to say most of what you say to them in the same way they could actually respond.
If your kid is nonverbal, or that is basically quiet except for a grunt or babble here and there, you generally are going to want to try to elicit sounds at first rather than words. Why? (I can read your mind, and I’ve had so many parents react in such a shocked way when I say this that I naturally expect this response.) Because in babies whose language is developing in a more typical way, sounds precede true words. This doesn’t mean that you aren’t going to continue to talk to them using real words everyday; it just means that you are going to model and wait for soundsat least some of the time during play, rather than modeling and expecting words. Sounds can be anything from a true belly laugh in kids who don’t even make a sound when they are being tickled, to animal and car sounds during play with toys, to giddy sounds such as “wheeeeeeee” on the swing and slide, or “ooh yucky” when she dislikes something, or “ooops” when you pretend to drop her during roughhousing. Almost all nonverbal, quiet children first begin to imitate and produce these kinds of sounds before words are heard. If your child can say a few of these kinds of sounds, try to expand to other sound effect words during play and daily routines. Usually a kid needs to be noisey before he can talk.
If your child can already produce a variety of sounds, then start to model simple, familiar, single words. Target “power” words so that he can immediately use them to make something happen in his world. Model names for favorite foods, toys, and people over and over and over again so that he can hear the word many, many, many times in the course of the day. Again, if he’s not saying many words, you need to keep most of the things you say to him at the single word level. For example, when you’re playing ball, don’t say, “Do you want to play soccer with me? Mommy is going to kick this soccer ball to you right now. You better get yourself ready to kick it back! Are you ready?” Try saying, “Ball? Kick ball. Ooooh - Ball.” See the difference?
On the flip side of this, when your child is using mostly words and phrases to communicate, stop with the “gitchee, gitchee, goo” and stick to real words most of the time, except for the endearing little rituals you’ll want to persist in doing until they roll their eyes and tell you frankly, “Enough of that already!”
4. Repetition is the mother of skill. Or as your mother would have said, ”Practice makes perfect.”
Not to bore you with a discussion of neuroscience, but a baby’s brain must “practice” how to say something many times before the pathway is truly activated and it becomes easy. Think back to learning how to drive a car. In the beginning you had to concentrate on each little movement. You had to think almost out-loud: Adjust the seat, put your seat-belt on, put the key it, turn the ignition, put the car in reverse, No Wait - look in the mirror behind me, etc… Now you can drive, talk on your phone, and scarf down what’s left of your toddler’s chicken nuggets all at the same time. It became automatic. Until your little one has said any word several times and truly “learned it,” he has to rehearse. This is why some kids, especially late talkers, and especially in the initial phases of learning to talk, are overheard babbling or saying a new word again and again in their cribs or car-seats when no one is listening or there’s no real purpose in the repetition. (I must interject a cute story here. I have one little guy on my caseload who is just beginning to try to produce 2-word phrases. I always carry snacks in my therapy bag to entice my little friends to ask me for things they really want, and let’s face it, food works better than anything with most of us, not just two-year-olds! This particular little friend loves my cheese balls. His mother is a pediatrician and quite naturally does not routinely offer her children vile foods such as this. He, however, has become obsessed. His mother told me that she has heard him on the monitor practicing, “Ball ball.” Then a pause as if he’s thinking, No, that’s not it. “Ball cheese.” Another pause, No, that’s not it either. And then “Cheese ball!”)
New talkers, particularly those with verbal motor planning problems, or apraxia, can sometimes pop out a word once and then never again. This is because the “pathway” for the word has not yet been established in their little brains. To help this process along, try to get them to repeat new words several times; don’t just settle for once! This works best when a toddler actually has to “use” the word in a functional way, and not just repeat it because Mommy asks him. Chances are if you are reading this, your child can’t imitate words well anyway, so stick to the purposeful activity. For example, if his new word is car, collect every Hot Wheels car you can get your hands on, devise a long ramp with a piece of wood on the side of a table, and then have him ask you for ”car”one at a time to roll down the track. If his new word is cookie, don’t hand him 3 or 4 cookies on a plate for snack time. Break each cookie and make him ask you for each little piece. This kind of technique works because it creates opportunities for repetitive practice.
5. Imitation really is the sincerest form of flattery, and it’s the only way most of us learn anything.
If your child is not able to repeat or imitate sounds or words, you need to begin with having him try to imitate actions. Try to copy his actions and then wait for him to respond. When he slaps the tray on the high chair, smack it back. If he holds a ball in each hand and bangs them together, you do the same. If he jumps, jump. If he yawns, yawn. When he laughs, laugh.
Set aside several short times everyday to imitate all of your child’s vocalizations, even if he can’t yet imitate yours. Match your pitch, loudness, volume, and sounds to his as closely as you can. This technique, called vocal synchrony, can be found in Pamela Marshalla’s short and easy to read book Becoming Verbal with Childhood Apraxia.
Learning to imitate is absolutely essential to learning to talk. Another way to work on this is to model words or sounds you’ve heard your child say in order to teach him to imitate you. In all of my initial assessments I ask mom and dad for a list of words or sounds their toddler says. Sometimes it’s none, but usually a toddler has a couple of words he tries to say. I model these words in the session, usually by giving him a choice during play since this kind of request is best to facilitate a response. Since he or she can already say these words, the theory is that it’s easier for him to be able to imitate what he can already do rather than a new word. Once your child can consistently imitate words he already says, he can usually make the jump to imitating new words more easily than if you started with new ones.
6. Use a sing-song voice, or parentese, when modeling words for your child to imitate.
Since I’m from the deep South and am a bit musical and dramatic most of the time, this is not a stretch for me at all. Most of us southern girls have that melodic drawl naturally. (This has been a little scary for some parents when I meet them for the first time. The really bold ones who have transferred in from states far away from Kentucky will even ask, “She’s not going to end up sounding like you, is she???”) Research tells us that parents around the world use this kind of speech pattern with their young babies. We all raise our voices several octaves when speaking to a newborn. This practice is still very effective for toddlers who aren’t yet speaking. Again researchers would tell us it’s because little brains like patterns and rhythmicity. Don’t feel like you have to speak this way all day. My own children, now 11, 16, and 18, ask me not to talk in my “therapy voice.” However, when you are modeling a word for your baby to try to imitate, overemphasize the vowels and exaggerate the syllables. For Mommy, try “Mooooo-mmyyyyyy” with your voice going up then falling down.
This is also a very effective technique when children are beginning to learn to combine words into two-word phrases. Again use the up-down intonation.
7. Balance the lead during interactions.
Since many language experts have suggested that adults follow a child’s lead during interactions, some parents and therapists have mistakenly believed that an adult should never choose an activity. This is simply not the best strategy to employ all the time because once again you may find yourself doing nothing but running around and chasing a kid without accomplishing much of anything. (I know of one therapist who spent several weeks during sessions just following a kid around the perimeter of a room and imitated him tapping furniture. Imitating him for a few minutes is one thing, but spending the majority of a session like this for several weeks in a row without accomplishing a role shift so that he imitated her or at least became more interested in her? This kind of following a kid’s lead is ineffective.) I usually follow a child’s interest during therapy sessions by offering two acceptable choices and then letting him pick what we do. For example, I might hold a toy in each hand and ask, “Choo-choo or bubbles?” If a child can’t verbally tell me which one he needs, I might prompt him with a sign (more about that later in this post), or let him gesture by pointing, looking, or in some cases, wrestling it away from me, to indicate his choice. If a kid routinely obsesses about a certain toy and doesn’t want to give it up or won’t let me join in, I don’t offer that choice at all or I save it until the end of a session when I want to talk to mom. This way he still gets to play with his preferred toy, but I dictate when.
When a child begins to tire with an activity, even if it’s just after a couple of minutes, I start to transition to a new activity by singing Barney’s infamous “Clean Up Song.” It would be better to move on before I’m quite ready than to lose him altogether. If I know that a child hates books, I don’t insist that we look at more than a page or two (Or more often than not, none!) during a session. In my mind, this is what the experts mean by following a child’s lead. Don’t risk accomplishing nothing by following, or even leading, the entire time.
8. Withhold pieces of a toy, a snack, or anything else a kid needs to complete a preferred task, and wait.
This technique is similiar to environmental sabotage. When you are trying to set up a situation to entice a kid to talk, never, ever, ever give him all the pieces of anything at once. For example, if your kid likes to complete puzzles, don’t place all the pieces on the floor and let him put them in on his terms. Place the puzzle board and all of the pieces in a large zip-lock bag (I buy the 2 gallon size in bulk!). Have him first choose between doing the puzzle or another toy. Then have him tell you how to get the puzzle out by saying “zip” or ”open.” Then let him indicate which piece he wants in his most sophisticated response possible by either telling you, signing, or pointing. When he’s finished the puzzle, don’t just let him walk away. Have him help you put away the pieces, again one at a time. If you are working on comprehension, ask him, “Where’s the _____?” and have him place the piece in the bag. Again, don’t settle for simply finding the correct piece. Have him tell you what’s he’s found or at least say “Bye bye” to each piece as it’s placed in the bag. When you are finished, have him zip the bag again saying ”zip” or “close” and then finally “All done.”
9. Use signs, gestures, or pictures to introduce him to the power of communication.
There are lots of programs on the market today to teach parents how to use sign language with their babies. Research supports this technique and has proven that some children may learn to speak more quickly by using signs than if they had not. The reasons are two-fold. First of all, speech is a motor movement, and pairing another gesture with a word is a powerful combination. This aids in motor planning, or helping his little brain establish the neural pathway for the word. Secondly, it reduces the frustration level for everyone involved. Let’s face it, with a late talker in the house, everyone is more than a little frustrated. Signing gives a way for your child to communicate his basic wants and needs in an acceptable way rather than the alternatives, namely grunting, whining, or screaming.
Here comes the part I just love about signs. We can’t make a kid talk (Goodness knows I’ve tried!), but we can make him, or at least help him, use signs. Many parents tell me that they have tried sign language with their kids unsuccessfully. By this they mean that they have modeled the signs many times, but their baby hasn’t attempted to use the sign himself. Once I show them my solution, they wonder, “Why didn’t I think of that?” Take your child’s hands and help him perform the sign. Some tactile sensitive and defensive toddlers may balk at first, but if you keep trying this in a happy, upbeat way, and then immediately reward him with the thing he’s requested with signs, he usually quits resisting and catches on pretty quickly.
There are some children who don’t have the motor or cognitive skills to be able to sign. There are some kids who just plain hate it. There are some children who just don’t get it because they don’t understand the symbolic nature of signs (or speech for that matter). For those kids I try pictures. There’s a specific program I use called the Picture Exchange Communication System (PECS) that teaches children to trade pictures for objects they want. It’s a very systematic program, and it should be implemented in exactly the way it was designed to be most effective. Look for a later post about this, search the Internet for it, or ask your speech-language pathologist to help determine if this is a good match for your child. Initially it was designed for kids with autism, but now it’s widely used for kids with all kinds of reasons for a language delay. The point is to teach a child to learn to initiate requests so they learn that through communication, they control their worlds. This is powerful stuff no matter what method you’re using.
Some parents are afraid that their children won’t learn to talk if they are given the option of signing or using a picture. I have never seen this happen in all of my career. Children are not born “stubborn,” ”lazy,” or simply “choose” not to talk. Most of the time, there’s a reason we can suspect is the cause for a language delay, and although we may never know for sure, I am very certain that it’s not that a child is choosing to subject himself to the pain of not being able to communicate. When kids can talk, they do talk. When they can learn whatever skill has been missing, the words do come. Until then, doesn’t it make sense to give them another way to let you know what they want? I have had a few families initially hesitate in teaching signs or using pictures, and thankfully I have always been able to talk them into it after a few more exhausting weeks with a frustrated toddler. There are certainly some favorite signs that a child may hold onto for months after he has begun to say words, but signs usually disappear pretty quickly when a kid finally discovers his voice. There are other ways a talented therapist can help you and/or your kid kick the habit once he and you are ready, but this is rarely needed.
On the other hand I will occasionally have a mother who wholeheartedly embraces signing and might say to me, “He is saying the word, but he won’t sign it.” After I stare at them for a minute or two, they usually grin and say, “Oh. I get it.” We teach the sign to get the word. Talking is the overall objective.
10. Establish verbal rituals and repeat them at the same times every day.
Remember the earlier advice about repetition? This is the same concept. When you create little games or say the same things at the same time over and over, day after day, your little one’s brain begins to expect it as part of a routine. Sometimes your toddler will even “pop out” a word you normally would say without even meaning to do this. That’s when we know that language is in there, and we just have to get it out. You can help this happen by purposefully planning to use the same words and phrases in your daily routines. Try to also stick with the same intonation (sing-song) patterns so again his brain picks up on the rhythm and timing. If you’re not too creative, try using the same songs and reading the same short books every day. When you have used the phrase or song for a long time, start to pause and wait for your child to fill in the last word of a line. For example, try singing “Twinkle, Twinkle Little Star” every night as you look out the window as part of your night-time routine. After several weeks, pause after singing, “Twinkle, twinkle little …….” and look expectantly toward your child for him to fill-in “star” or his own version of this word. Or you might practice waving bye-bye to all the people, pets, and whatever else you choose in your home as you leave. Be sure to build the routine by saying, “Say bye-bye to ________. Pause. Bye-bye (as you wave). Say bye-bye to ________. Pause. Bye-bye. Say bye-bye to ______. Pause and wait for him to fill-in his own “bye bye.”
Some parents like to try counting items as a routine. This is fine, but I usually prefer to label things instead of saying number for new talkers. Instead of counting a row of puppies in a book, I say, “Dog, dog, dog, dog,” as I point to each picture. Help your child begin to point as you label the items. After several days or a couple of weeks doing this, don’t label the last one and wait for him to say it. This would also be good to use when sorting socks, setting the table, or any kind of repetitive household activity. Look the patterns and use them.
While I have other tricks up my sleeve to help toddlers talk, these are the most effective ones and easiest ones for parents to implement. I welcome your comments as you try these with your children at home.