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Facilitating Words – Moving Beyond Grunting and Pointing

The following is an excerpt from an e-mail I received from our “Ask the SLP” post.

“My son is 18 months old and understands everything we say to him, but he is not talking with words yet. He mostly looks at us, will point to what he wants, and grunts. Is there anything we can do at home to help him learn to say words?” -From Claire in Wisconsin

There are lots of things you can do at home to help him talk! How do you teach new words? By doing what you’re doing now – modeling words in the middle of your routines and during lots of one-on-one playtime so that he can repeat you. Imitation is the number one way kids learn new words. Talk all day long to him about what you’re doing, but make sure that you are saying lots of single words (rather than speaking only in sentences) and then pausing to give him a chance to imitate. This was hard for me to learn as a new therapist. I would spend so much time talking that I didn’t give my little clients a chance to respond before I had moved on to the next thing! Thankfully I have learned to s-l-o-w d-o-w-n and w–a–i–t for my little friends’ brains and mouths to catch up!

Some kids respond well to parents who say the word and then wait long enough for their toddler to imitate the word. However, some kids need direct cues such as, “Say _(the word)______.” Another therapist’s tip – Don’t ask your child, “Can you say ________?” The answer to this question is “yes” or “no.” Simply use, “Say _____” or “Tell me.”

What’s my number one trick for getting kids to try to talk? I always use FOOD. Specifically junk food and lots of it. I also use their favorite toys or activities too, but usually after I “hook” them with cookies, goldfish, chips, fruit snacks (I call them “candy”) and everyone’s favorite, cheese balls. Some parents and therapists try to take the high road, look down their noses at me, and in the most condescending tone they can muster, tell me that they NEVER use food to “bribe” kids to talk. Why not? It works! And let’s face it, we all perform best for things we really like. Looking at pictures in books or pointing out objects to them with the hope that he or she will begin to repeat the word may work for some kids, but in my experience, food works with almost everybody. (Except maybe very, very picky eaters, but even then I can usually find some junk food they like!)

The food method (as I call it) always begins with?me sitting on the floor holding the bag or bowl of snacks. Try sitting on the floor first because it’s in their line of vision. I usually say something like, “Mmmmm. Cookies! Do you want one?” If I get no response, I say, “Okay. I’ll eat it.” That usually gets most kids riled up. Then I say, “What do you want?” Model the word (or sign) for them to imitate. When your kid tries, even if the word is not perfect, go ahead and give him the cookie. You can clean up the sounds later when he’s older and is not as apt to be frustrated. (See the post on What Doesn’t Work – Unproductive Strategies for more on this!) If he doesn’t try to say the word, withhold the snack and model the word again for a few more times. Sometimes it takes a few “models” before a kid can process and try to say it himself. Wait him out. If he still won’t try to say it after this long, go ahead and give it to him. Going beyond this number of prompts really is, for lack of a better word, MEAN! You want to keep him motivated enough to try again!

I usually cue a child between 3 and 5 times with a word before moving on or before giving him what he wants. If he’s too frustrated (throwing himself backward on the floor and screaming), forget the prompting and just give him what he wants. No kid learns anything when he’s that MAD! But a little bit of frustration sometimes does a child good.

I never accept “uh uh” or grunts and points from a kid when I know they can do better. I know he can do better when I have heard him try to approximate the word before or when he’s become a fairly consistent imitator. If not, I might hold out with a couple of models and then still give him what he wants if he truly can’t do it. Using signs or pictures is what I switch to if a child can’t consistently make himself attempt a word. (Look for a post later this week on using sign language to help kids learn to talk.)

An activity that I routinely have success with is blowing bubbles. At first I sit on the floor, and I always hold the container so that I am in control. If a kid fights to hold it, I give him a wand, and then I use another other wand to blow. If a kid really fights to hold the bottle, I stand up so he can’t reach it. Avoid saying, “No” or stating any other negative form or rule during this kind of play. Just plaster a smile on your face, keep your tone playful, and move what he wants out of his reach, so that you stay in the lead, and he has to “request.” Ask, “Bubbles?” Model the word (and/or sign) several times WAITING on his request. Blow only after he says the word, or after you’ve prompted the word several times with no response. Make a big deal out of watching and popping the bubbles. I pop them in the air with my fingers saying, “Pop! Pop! Pop!”, but I always let some fall to the floor so that I can smack the floor with a big gesture and scream, “Pop!” Lots of kids will imitate this gesture and word for me before they imitate anything else.

One more thing I always try is using a toy with lots of accessories or pieces so that kids have to ask me for the next thing they need. You can sabotage the activity by having all of the pieces in a clear plastic bag so she can see it and has to ask for each item to play. I work with two-year-olds, so most of my little friends (even the boys) love playing with baby dolls. I gather small bottles of pretend juice and milk, sippy cups, a bowl, several different colored spoons and forks, a hairbrush and comb, baby wipes, diapers, a baby blanket or baby carrier, pretend foods, and lots of doll clothes – shirts, socks, shoes, and hats. If a kid wants a new item, he has to ask (or try anyway). The key is having lots of items to pick from and then offering a choice between two of the items. For example, ask if baby needs to drink or eat. If she picks drink, ask if baby wants milk or juice, then needs a cup or bottle, then have him choose between two different colors of cups, etc. I try to get a kid to make several different choices before we get to the actual activity. If your child is too frustrated with this waiting, stick to one or two choices before the activity, but always look for ways to expand his attention span and ideas in play. It’s not always just about talking! Be sure to join in the play modeling play and language at or just above his level. You may get more imitation when you’re actually playing than during the choosing.

“Ball” is an easy first word. Ball toys are always popular with one and two-year-olds too. I like ones that have more than one ball and are clear so kids can watch the balls go in, fall down, or pop out. Hold all the balls and have them ask you for one ball at a time. Make a big deal about catching the balls as they fall out saying, “Got it,” so kids know they have to ask for it if they want it again.

All of this type of play needs to be done in an animated, fun way. Don’t look like an ogre when you sit and hold the pieces. Don’t lecture, “You have to tell me the word first, or I’m not going to give it to you.” Keep it light, fun, and model the word many times PLAYFULLY withholding what he wants until he tries. This kind of approach typically works when a kid is interactive and ready to talk. If your child is too focused on the object instead of knowing that he has to communicate to get it, you may need to back up and work on more social kinds of games to make a real connection first before working on requesting.

I hope these ideas help! Laura

 

Laura

2 Comments

  1. Joe Minnuto on March 25, 2011 at 11:04 am

    Hello! First let me thank you for a terrific website – so much information! My wife and I have three daughters ages 8,5 and 20 months. Despite our best efforts, our 20 month old is still only grunting and saying very few words and seems to be saying less and less. However, she understands everything and can clearly let you know when she wants something through pointing and direction. She was recently tested and denied services through speech because they said she fell only one and 1/2 standard deviations below and not the required 2 SD for her age. I have read numerous articles on your site but we are really doing everything mentioned – play, attempts at reward with food, giving time to process…but nothing seems to be working. Any other ideas would be greatly appreciated as we are beginning to get very frustrated and worried. She does not show any attempt to even try to talk – she just makes all kinds of noises in a very fun loving and happy way but cannot communicate. Thank so much for establishing such a great resource and taking the time to read this comment! – Joe

  2. Laura on March 25, 2011 at 11:22 am

    Hi Joe! I love to hear from involved Dads! I’m so glad the website has been helpful to you and your wife.

    Have you introduced any signs? Take a look at the how-to articles in that section of the website. I’d also recommend that you take a look at the DVD clips for Teach Me To Talk so that you SEE those strategies in action as an SLP would use those. Sometimes just tweaking your approach just a little results in big changes. The DVD also has a section on introducing signs and you can watch how to withhold just enough to facilitate a early word imitations.

    Have you listened to my podcasts? The shows have lots of great how-to’s as well. You can listen by clicking the blogtalkradio icon on the right column.

    If all else fails, have her reasssessed after her 2nd birthday. There’s a big increase in expectation for expressive language after that point, and children who don’t qualify at 20 or 21 months often qualify for services then. I hate that’s how our state systems work! Hopefully by then she’ll be well on her way and you won’t even need the services anymore. Good luck to you!

    Laura

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