Teaching Your Toddler to Answer Questions – Receptive and Expressive Language Delay Issues

Many toddlers with language delays have difficulty learning to answer questions. Common problems include:

  • Repeating or the last few words of the question rather than answering
  • Answering incorrectly such as shaking their heads yes when you ask them a question with 2 choices
  • Giving an off-target response such as answering, “Two,” when you ask, What’s your name?
  • Not responding or ignoring questions

By 30 months of age, most toddlers with typically developing language skills are consistently answering yes/no questions, choosing between 2 options (“Do you want your Dora shirt or flower shirt?”) and answering simple “What” and “Where” questions (“What do you want to eat?” or “Where did Daddy go?”).

By age 3 most children with typically developing language skills correctly answer common questions related to themselves such as, “What’s your name,” “How old are you,” and” Are you a boy or a girl?”

Listed below are the tried and true ways I recommend that parents work on answering questions with their children at home.

Basic Questions

Children learn to answer, “What’s that?” questions to label items before they begin to answer other kinds of questions. If your child is not consistently answering this question, practice often with words you know he can say across different contexts. For example, if says, “Shoe,” ask him, “What’s that,” while pointing to his shoes, while looking at pictures of shoes in catalogues, while reading books, and while playing with a doll or toy characters.

Toddlers also begin to answer questions by making verbal choices. Offer choices for everything throughout the day. “Do you want milk or juice? Which one should we play -blocks or cars? Should we read Good Night Moon or the Elmo book? Do you want a hug or a kiss? Does the cow want to eat or sleep?” If he is not yet using words, he can respond with a gesture such as pointing, looking, or even grabbing the one he wants. When he is talking or signing, you should wait him out for a verbal response, especially for words you know he can say or sign.

One way to make sure that your toddler understands choosing is to offer a non-preferred item as a choice. This is an especially effective technique for children who only “echo” the last words they hear. For example, ask if he wants to play with bubbles or a sock. If he repeats “sock,” make him take the sock. You can also use this with favorite snacks and a not-so-desirable option. If he echoes and says the wrong item, make an effort to have him take the item he doesn’t want, even if he’s initially upset or confused. Give him a second chance by saying, “You said, ____. What do you want, ______ or _____?”  Sometimes I hold the “correct” choice forward or shake it to call attention to it. I also the exaggerate the “preferred” item as I say the word and whisper the non-preferred choice.

Ask early “where” questions that she can “answer” with a point, look, or by retrieving an item. For example, hide a ball in your hand and ask her where it is. Ask her where common objects are in your home so that she can go get them. Ask her to locate family members by pointing or looking as you are seated around the table during meals. Have Dad or an older child model the correct answers as you ask your child. Practice these kinds of tasks often knowing that you are building a foundation for verbal responses.

When your child correctly “answers” with a non-verbal response, use words to describe what he did. As he’s pointing to family members when you’re asking, “Where’s _______,” say the family member’s name or a response such as, “Right there.” When he’s answering a location questions, use the correct words.? “Yes! It’s in the box.”

Moving On

Work on yes/no questions by giving them as “choices.” For example, “Do you want cookies – yes or no?”  Shake or nod your head to cue your child as you say the words “yes” and “no” so that he can associate those gestures with words and use them if he can’t or won’t say the words just yet.

When he’s answering “where” questions accurately without words, begin to model verbal responses by giving two choices for more complex questions. Say, “Is your hat on your head or on your feet?” “Is the ball on the couch or the floor?”  “Is the dog eating or sleeping?” Again, use visual cues to help him.  I use an exaggerated point to help cue the correct answer.

Higher Level Questions

For answering questions about recent experiences, use the choice method or the review method. Ask her, “What did you do at school today?”

Use the choice method to help generate an answer if she doesn’t respond to your first attempts. Try, “Did you paint or play in sand?” Again try to vary the order of your choices so she is listening for the “correct” answer. (A little foreknowledge of what she actually did is required for this to be effective!)

Practice the review method in daily routines and especially at the ends of specific play times. Narrate what you did and then ask questions. For example, “Today we played with the farm, ate Oreos, and blew whistles.” Then ask her what you did giving visual cues (pointing or holding up the objects) as she answers.

When you come in from playing outside, have her tell Dad what she did. Start with a review of activities by saying, “We played on the slide and then on the swings.” Then have Dad ask, “What did you play?” Model what she should answer if she can’t do it.

Another great time to practice is at meals. Review what she ate for dinner by saying, “You ate chicken, macaroni, and peas.” Then ask, “What did you eat for dinner?” Point to her foods as a cue of what to respond. Fade the review and pointing when she begins to answer on her own.

A very effective way to cue answers to questions is to have one adult “ask” the child questions and have another adult “whisper” the answers if he needs help. Fade the coaching as he becomes better.

For children with better language comprehension skills who understand humor, try using a ridiculous choice to entice her to respond without echoing. You might say, “Do want to eat ice cream or poop” Exaggerate the silliness of your offer so she knows you’re kidding and gets the “humor” in this question. (Beware the “poop” jokes. This may catch on and be a loooong phase at your house!)

For learning to answer the familiar name/age/gender questions, practice, practice, practice. A good way to begin working on this is to ask older children first so that your child can hear a model and it becomes a game. I also ask these questions with “yes/no” choices too. “Is your name Daddy/sibling’s name/pet name/character name?” Model an exaggerated, “Noooooo” with a big head shake and grin.  Ask a couple of “no” responses, then ask the correct version.

To help children learn gender, label “boy/girl” everywhere you go. I also use children’s clothing magazines with stereotypical pictures such as girls in dresses and with long hair and boys in pants since there are lots of pictures for practice. Be sure to?”teach” this concept for a long time before you begin “testing” by asking, “Is he a boy or a girl?”  You don’t want to let a child repeatedly make a mistake in answering since he then “over-learns” the incorrect response. Gender is often a difficult concept for children with language delays.

If you have any other “tricks” for teaching your child to answer questions, please feel free to share them with us by leaving a comment! Laura

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Comments

  1. Shaffon says

    Wow!! So i guess my husband and i have been doing something right, because everything you mentioned we have done or are starting to do it. I think our son will make great progress especially with the advice and information on this site. Thanks again Laura you have no idea how this site has opened my eyes and rested my worrying mind. Your’e Great!!

  2. niyati says

    Hi! Laura . I have been writing to you regarding both expressive and receptive speech delay for my 33 month old son. He goes to school and the teacher was complaining that he only follows limited instructions , and based on her feed back, these were instructions that we use at home with him (like sit down , come back etc). Beyond that he is only imitating what other kids are doing after an instruction is given. Just wanted to know is this the normal way for an improvement in the receptive language? He is also on Spoeech therapy and does a lot of echolalia

    Also I have been wanting to order your DVD and am based in India. Is is possible to place an order as I am geting a message that service is not available in India from your site

  3. Laura says

    Niyati – Keep reading the articles in the receptive language section for ideas on targeting these things at home. Don’t give up on helping him learn to follow directions. It takes a lot of work and follow-thru on a parent’s part!

    As you probably know, DVD players for televisions operate using different systems around the world. Teach Me To Talk The DVD will only work in DVD players in North America. However, if your computer has a DVD drive, you should be able to view the DVD using your computer. Check it out with any other DVD you have at home before you place an order. If that works for you, then you can order the DVD.

    All international orders also should send an e-mail to Johnny@teachmetotalk.com with your address so we can calculate shipping BEFORE you place the order thru Google checkout. Thanks! Laura

  4. Ramya's mom says

    My daugher Ramya is 3 years and 3 months old. She has:

    - very good memory
    - very good pretend play
    - intelligent and sharp
    - can count upto 20, recite and recognize alphabets (also in long format ‘a for apple’, ‘b for ball type’), days of the week
    - remember and recite stories and poems

    but in the following areas she does not meet the milestones:

    1) She does not answer when called. There is absolutely no response from her. (Let me specify that her hearing has been tested by a specialist and is perfect. She can hear and recognise the smallest of sounds)..To come back to t he problem, Even though she knows her name is Ramya. And she uses both I and Ramya while speaking about herself.,she does not answer if we call her…Everytime she has to be reminded to say ‘yes mom’ when called.

    2) If asked what she ate for breakfast, or what she did in school, etc she does not know how to answer. She simply repeats the question oin

    response. For eg. I ask: “Ramya did you finish your lunch?” Ramya replies: Did you finish your lunch?….If I ask: Did George come to school? Ramya

    replies: Did George come to school? …If I ask: Do you like Icecream? Ramya replies: Do you like Icecream? ….

    However, of her own accord, she is able to say things like, “I dont want banana; I want icecram; I dont want more of this biscuit, I shall eat the chocos; I want my pink frock; I dont want to wear tshirt, I want to wear dresses; i hurt my finger; I want to go to the park; ” etc. But asked as a question, she does not know how to respond. At 3 year 3 months, is this normal?

    3) Though she is a hyperactive child and is unable to stand still most of the time, when given a book to read or puzzles to do, she sits down and completes the task with great focus, concentration and wihout any fuss. At other times, she is hopping, jumping up and down the furniture and hugging and climbing all over us. Her Emotional Quotient is very high. She has been tested for autism and pronounced fine and fit by an eminently qualified doctor.

    In short, we have got all the medical tests done and doctors say she is ok. But I worry about points 1) and 2) above. Also, it is difficult to make her look at us when we speak to her though when she chooses to talk to us and demand our attention, her eye contact is perfect. Can it be plain disobedience? How can we explain her refusal to look us in the eye when we want to tell her somehing strongly? Is it becaue she does not chose to do what we want her to do? She is a strongwilled and stubborn child and seems to be extremely intelligent. Please advise at the earliest…we are very worried! Thanks a trillion!

  5. Laura says

    Ramya’s Mom – It is not normal for her to continue to repeat questions at her age. You have had her evaluated by doctors, but I am wondering if you have had her language skills assessed by a speech-language pathologist. Even though she is a handful behaviorally from what you’ve described, I don’t think “stubborn” or “disobedient” is the real reason she’s not answering questions or responding to you when you call her name. From what you’ve said, it sounds to me like she might have auditory processing issues. Simplistically this means she understands the single words/concepts per se, but she can’t synchronize or fully process all the incoming information she hears enough to forumulate an answer. Some professionals might still also call this “echolalia,” and some might label it a receptive language issue, but I think (again just from what you’ve said since I haven’t actually SEEN her) that her ability to fully integrate and process incoming language is the problem.

    So many children with these issues are initially suspected to be on the autistic spectrum, but because they lack the core qualities of autism, they end up being not “diagnosed” at all. However, it DOESN’T mean that there’s not a problem, and a huge one at that. I would search high and low for a speech-language pathologist who is willing to treat her and help you tease out these issues BEFORE she goes to kindergarten. She needs to learn how to understand and appropriately answer questions. Even if she can talk, she’s still not communicating at an age appropriate level since she can’t truly participate in conversations with you. Find someone who can help her and help you learn how to carry over strategies to help her at home. Responding and answering are essential skills, and the sooner you can find ways to help her consistently do these things, the better.

    Keep reading the articles here for ideas while you are looking for someone to assess her and help you in person! Laura

  6. Ramya's mom says

    Dear Laura,
    My very sincere thanks for your immediate response. I am grateful for your in-depth assessment of the problem and intend to work on your advice. However, I want to clarify one matter- the child seems to understand and assimilate full information/situation when we narrate stories to her. Even when we talk among ourselves, she seems to listen and take stock of the situation. For eg: when I talk to my mother about packing clothes, she at once understands that a train journey is in the offing and starts talking about it. When I tell that I have a headache, she hands over the pain balm to me. On her own accord, she narrates stories and copies all the actions of the cartoon characters. For eg. she would come home and talk to herself : “Rita caught hold of me and ramya cried and then the teacher came and took hold of ramya’s arm and said, never mind, don’t cry, daddy will come and fetch you in the afternoon and then I did not cry anymore and i smiled and became a good girl.” Listening to her soliloquy, if we ask her questions about what Rita did to her or if she cried in school or what the teacher said to her, we can not elicit the proper reply from her. But judging from her sololoquy, it is apparent that she has understood and grasped the whole incident and whatever her teacher has told her. Would you very kindly let me know if it does not prove that she is able to fully process all the incoming information?

    To give you more insight on the problem – Her paediatrician had suspected Attention Defecit Disorder and slight hyperacivity and told us to put her in a playschool when we frequently expressed our concern for her refusal to respond to her name. She said that mingling with other children might improve her communicating skills as she seems medically fit otherwise. As for ADD and hyperactivity, when the doctor ran a few tests with some montessory apparatus (when ramya was around 2 years old), she snatched the toys and all the apparatus and wanted to play with them in her own way..but when the doctor told her that she can play with them if she first does as she is told, she grabbed the toys again, did all that she was told in a jiffy and proceeded to play again. The focus and attentiveness with which she completed her task made the doctor wonder about the presence of ADD and the double-quick way she finished it made her wonder if she was hyperactive or overbright.. However, she asked me to put her in a playschool early which we did.

    Normally when we ask ‘what have you eaten?’ she repeats the question. However, while writing this reply, I was discussing with my mother her inability to answer simple queries like ‘what have you eaten’ and ‘what are you doing’. Although she was engrossed in another activity, we found her saying to herself “Ramya ate rice and butter while watching Tom & Jerry.” Which was exactly what she had done. Does this rule out auditory processing issues?

    Are there any specific tests that I can ask doctors for? (since despite giving these symptoms, the doctors here seem to think I am over-reacting).

    Sorry to take up so much of your time… Thank You!

  7. Laura says

    Ramya’s Mom – Ramya is an interesting child, isn’t she? Just when you think you might have an answer for her – BOOM! She goes and bursts the bubble of your theory! I would so love to work with Ramya because it would be so exciting to peel back her layers to get to the root of her issues.

    But I can’t do that from afar, so you are going to have to find a great SLP who can actually SEE the both of you and observe her and talk with you and try different things. She would be so fun to work with, so I hope you will give some lucky SLP this great learning opportunity!

    I will also caution you with one other point. You may NEVER find a good “diagnositic” fit for her. You may NEVER know one “reason” she’s the way she is. She is very complex in that she has her deficits and struggles while all the while, she’s excelling in other areas. She sounds like a wonderful little girl with lots of strengths mixed in with those weaknesses too!

    Just so you know how I have come to think about this – being able to spit back a story is not the same as formulating an answer to a novel here-and-now, on-the-spot question. It still could be processing the question, as well as her ability to generate a novel answer. Actually, it’s probably both.

    What I would do if I were her SLP (or her mother for that matter) is figure out a way to help her do the things she can’t do, as well as continue to support her with her strengths. Start with answering those basic questions using the suggestions I posed in the articles in the receptive language section. Give her choices, use the review method, have someone “whisper” coach her with the answer. These things really do work, AND it lets you channel your energies where they need to be – helping her excel rather than wondering what the exact problem could be. Again, you may never know!

    Take care! And let me know what the SLP you find thinks! Laura

  8. Ramya's mom says

    Dear Laura,
    I cannot thank you enough. Your comments have really helped me understand my child’s status. I intend to follow your advice word by word. I am based in south of India and finding an SLP with as much knowledge and experience looks like a remote possiility. However I have already started enquiring. If only me and ramya could come and see you. Meanwhile me and my family are going to study your website for more information and knowledge. We will keep you posted for any developments. Ramya is a wonderful child and I feel blessed to have her in my life. Thank you once again for everything. Your advice and assessment meant a lot to us. God bless you!

  9. Mason's Mommy says

    My son Mason will be turning 3 on Sept. 26th. He’s doing a few things that worry me. When you ask him a question he repeats it back to you, so then I’ll tell him “Mason, say “yes”. He says “say yes”.
    He repeats dialogue from his cartoons, and can sing whole songs. But when I ask him which snack he wants, or which show or book he wants he can tell me. He knows how to ask for things he wants. He also ignores us a lot. He hits other kids, and prefers to play by himself, but loves to be around other children. Please help me figure out what I need to do to help him.
    Mason’s Mommy

  10. Laura says

    Mason’s Mommy – It sounds like he just needs some additional help learning to understand and answer questions. Read the article above for ideas. Laura

  11. Mason's Mommy says

    Thank you Laura for your rapid response to our concerns. I was doing a lot of research online yesterday, and kept coming upon the definition of “echolalia”, and how its almost always connected to autism. Just wondering what you thought about that in Mason’s case, because he definitely does a lot of reciting and repeating.
    Thanks Mason’t Mommy

  12. Laura says

    Mason’s Mommy – Echolalia was my initial thought based on your report, BUT it doesn’t matter if it is or isn’t associated with autism since we work to treat the deficits, not the diagnosis.

    Sometimes when Moms are scared, I really ask them to shift the focus and work on what he needs help with rather than worrying about WHY he might need help for right now.

    You also indicated that he CAN ask for what he wants and ALL of his speech isn’t echolalic, so he definitely has some strengths to work with. If he’s mostly having difficulty answering questions, use the ideas above.

    One other idea for you – since he CAN initiate and tell you what when he’s asked for something, turn that into a question – “Do you want some milk?” and use the tag “Yes or No?” rather than immediately giving him the direct cue, “Say yes Mason.”

    Or ask, “What do you want?” like you didn’t quite hear him after he asks for something since he clearly knows what he wants at that point. Bear in mind, turning this into a question for him to answer trips up lots of kids, so keep working at it!!

    Now on to the more delicate question – have you thought of having him formally evaluated? I know that probably scares you to death, but since you’re so worried, an evaluation usually results in helping parents calm down at least a little bit, especially if the news isn’t totally unexpected. If he’s truly on track with language, he won’t get services since most good SLPs are so busy we wouldn’t dare qualify a kid who didn’t need therapy!

    On the other hand, if he does need some speech therapy to catch up, wouldn’t you rather it be sooner than later? The BEST part about speech therapy is that YOU will get specific ideas about how to help him at home, and from the sounds of things, you’re the kind of mom that could take a few good strategies and really run with them! Try to think about the outcome of an assessment as Mason getting whatever help he needs, rather than a specific diagnosis.

    I know it’s scary, but I hope this helps!! Laura

  13. Laura says

    LISA BEALE – I have tried to email you 3 times, but it keeps coming back as “undeliverable” so there’s some kind of glitch in how your email address was entered or reads. Please tell me what you coupon you tried to enter so I can see what the problem is. I will also credit your order. Thanks so much!!

  14. Mason's Mommy says

    Laura thank you so much for being honest and up fromt with me. Of course these concerns scare me to death, but like you said I would much rather he get the help he needs than just ignore them and hope they go away. Mason has his 3rd year check-up with his pediatrician on Oct. 15th, and
    I’m going to request that he have an evaluation. I’m eager to get started on working through this. I will keep you posted as to his progress as he is definitely making some. Thanks again for valuable knowledge and you generosity in sharing it. I so appreciate it and you will be blessed for helping all the people you do. Mason’s Mommy

  15. Laura says

    Mason’s Mommy – I’m so glad you’re pursuing the eval. Let me know how he progresses. AND, just for the record, I am blessed beyond belief every single day of my life and never cease being grateful for the wonderful people who cross my path! Laura

  16. Lorelei says

    thanks again for such a really wonderful website. I got great use out of your first teachmetotalk video, by the way. If you have time to answer this (no offense if you don’t), I wonder what you think about something. My son wound up dx’ed with an autism spectrum disorder at 23 mos., although I am not 100% confident it was the right dx personally. But although he often uses complex phrases (but rarely with a subject) now (e.g., often he says things like “mommy to go” but more often “climbing on the table” and when requesting, telegraphic commands “water, water, water!”) … and he’s great at “where” and “what” questions and even sometimes complex things like “what do you do with the cookie?” “eat it” … “yes” and “no” is still a struggle. after months of working on this, i could get a head shake sometimes but yesses not forthcoming. in desperation, I started offering ice cream one bite at a time … “do you want another bite?” … and made him nod or say yes before he could get one … but now he’s learned to say “please” instead which is sweet, but he will not answer yes or no. then I made up a story which has led to a script: “mommy said, “Bobby, do you want a cookie? and Bobby said, “__________” and I wait for him to fill it in. if he doesn’t, I ask “what did Bobby say?” over and over until he answers. guess what? this always works. although … it’s obvious that he struggles to spit out the word. (he does have some oral issues by the way). If I just ask him “bobby, do you want a cookie?” I wait all day with no response. Oh, he’ll lunge for it, he’ll point at it, and he might even say “please” and “cookie!” but he will never ever say yes, without the script. and by the way, he REALLY won’t say no. I have to be majorly pushy with something majorly gross just to get half a head shake. As I type this I feel a little crazy obsessing over this because he has come SO far (he is now 32 months but at 23 months he had no spoken words and about 10 signs), but it feels significant to me. Am I wrong to be worried about this? thx for listening.

  17. TL says

    I am concerned about my daughter who will turn 4 next month. Currently, she attends 1/2 day pre-school and her teacher asked that she be evaluated for speech and then recanted that statement once she heard my child speak. Let me explain, she was in school for 2.5 months before she spoke audibly. She would just whisper her request. Now she is speaking above a whisper but sometimes I still have trouble with her answering yes and no questions and all other questions where there are two options. Some times she repeats the last thing that I said or sometimes, if I say do you want juice, she will respond with “I do not want juice.” Then there are other times she is very clear with saying no! For example, do you want to go to bed, her response NO. She knows where and what. She is excellent at expressing her feelings and she often tells me about her day. I just do not know what to do in regards to the yes or no. Her teacher says she is doing well in school. There are somethings we have to work on but nothing of concern. Should I just push for the speech therapist?

  18. Laura says

    TL – I’d go ahead and have her evaluated to rule out any underlying speech-language concerns. You want to have these things identified and taken care of before she starts kindergarten so that she’s ready to learn to read and write and not still struggling with understanding language or expressing herself. You can start with your local public school system to see if she qualifies for services, or if you’d like, you can have her evaluated by a private clinic or children’s hospital. If she’s developing normally, the SLP will tell you so and not see her for speech. There are too many kids who do need special help to take up a slot for ones who don’t need therapy!

    About the yes/no questions- is she just confused with choices that could go either way? How does she answer when it’s a concrete yes/no question – Is this a car? Is your name ____? Are those your shoes? Is she just indecisive and shy, or is a real comprehension issue? If it’s a real comprehension issue, there would likely be other things she doesn’t understand. Can she follow mutliple step directions? It sounds like, from how you’ve described her, that this is situational difficulty when she’s feeling under pressure and this is more likely related to her temperament and personality rather than a true language delay. You’ll feel better if you have it formally rule out. You’re a good mom for being so concerned about her and not just blowing it off. Laura

  19. Emily says

    Hello! Love this website. Can PDD-NOS that takes the form of echolalia and perseverative speech (in a kid that does not ONLY speak that way) interfere with potty training? If so, how? Tips? Thanks!

  20. Laura says

    Emily – I think ANYTHING can interfere with potty training!! It’s so hard!!!

    One thing I make sure I recommend to moms with kids who learn in this way is to model exactly what you need him to say when he has to go. You say, “I need to potty” or whatever you call it, rather than asking him, “Do you need to potty?” Or you can use the yes/no method – “Do you need to pee pee, yes or no?”

    If I’m not on the right track with what you’re asking, send me another comment! Laura

  21. Emily says

    No, that is great advice. I just wonder if he TRULY understands that he is supposed to pee in the potty when he needs to pee! There’s been PLENTY of explaining. My gut tells me know knows. He has peed in the potty many times, but only with prompting. NEVER on his own accord (well, it happened randomly ONCE one day when he was naked anyway! But never on his own accord again. Very random), and he never, ever tells us he needs to go. He can definitely hold it (never pees on the floor or in the tub) but will gladly pee in underwear. For me, it’s the whole concept of, “Do you GET what you are supposed to do, my sweet boy?” Given that, again, he has gone many times when his dad or I bring him to the potty, how can he NOT understand?

    As for poop, when he is going he tells us to go away or he hides, etc. Good signs, I GUESS. (shrug).

    BTW, he sees an SPL once a week and will be evaluated next week by our school district, for possible Pre-K. It’s odd: when the SPL evaluated him she said verbally that she saw stong signs of PDD-NOS in my son, Will. Okay, was devastated but am moving on, taking action. He was VERY VERY upset at that session (with perseverative speech, also), so much so that after his first “real” session (I chose not to go to that one because I believe I make him anxious) she sent me a report raving about how different he was and all the good and “correct” things he said (not that there isn’t a problem. There is. Esp. with echolalia and “I”/”you” mixups). Turns out, her official diagnosis on her clinical, written report is “mixed language disorder” and “pragmatic language disorder.” Are these old-fashioned terms? Google is very scant on them. I won’t bug you after this…thank you so much for all you do!

    And yes, this process is SO HARD, it’s unreal.

  22. Laura says

    Emily – My only advice is to keep at the potty training. I think it’s great that he goes when you take him.

    Let me explain pragmatic language disorder. The official definition of pragmatic language is language use. Some kids know lots of words, but they don’t USE them appropriately. For example, they may label “milk” correctly when they see you pour it in a cup, but they don’t ask for milk using that word. They don’t understand the “rules” of language – that you greet others, respond to questions, ask for help when you need it, etc… Children on the spectrum have LOTS of difficulty with this area of language. Check out a related article here on the website with ways to help work on pragmatic language at:

    http://teachmetotalk.com/2008/03/01/teaching-toddlers-to-use-the-words-they-know-to-change-their-worlds/

    Mixed language disorder means that you have delays in both receptive (comprehension) and expression (speaking) skills.
    This means that he may not be understanding things even if he’s saying them. My advice to any parent of a child with language comprehension delays is to make helping him understand language even more of a priority than what working on what he can say. This may be why potty training is so hard for him (and you). He may not really get it yet.

    I’m so glad the second session went better for him, and I’m glad your SLP recognized success for him!!

    Feel free to keep your questions coming here on the site! You are not “bugging” me at all. I love what I do :)
    Laura

  23. Emily says

    Thank you so much; I have printed and will read the article.

    You re DEAD ON with what you are saying, and you made perfect sense.

    “Would you like some milk?” when HE wants milk is also a problem. The whole use of “You” when it should be “I” is really stronlg in my Will. A slight smile and a raised eyebrow from me typically elicits a self correction and then he says, “I would like some milk, please.” But I worry that his little neurons/synapses will never “change” so that he says “I” automatically. SOMETHING must change with intervention, as I have never met an ADULT who speaks that way.

    Well, thank you again, SO MUCH. Yes, you clearly love what you do and are good at it! I will read the article.

  24. Sharon says

    Hi Laura,

    My daughter who is 25 months old really picked up her speech around 19 months. She started a few words around 10 months but due to recurring ear infections and subsequent ear tubes procedure at 15 months potentially delayed things. My question is, is it too early to detect echolalia? While she is not consistent in repeating everything we say but she does quite often just repeats the question we ask her. She initiates speech and lets us know most of the time what she wants. Still does not say “I” or “me”. She refers to herself as “baby”. She has a lot of repetitive speech. For example, every evening when I come home she would go on non nonstop: “Hi Mama, how are you?” I would answer her “I am good Sophie”, “Hello Mama, how are you?” I would answer “I am good, how are you Sophie?” “Hi Mama”, “Hello Mama”, “Hi Mama”….she would go on until I remind her to ask once only. If she wants something she does the same thing: “More Cheese mama” “more cheese” I would say “please wait” but she goes on and on. Sometimes she gets the concept of waiting but it is inconsistent.
    We have a Speech evaluation appointment next month but I am skeptical on how that would go as she gets extremely anxious in new surroundings (partly bad experience from recurring ear infections). I don’t think she would cooperate and hence would get the wrong diagnosis.
    Due to her anxiety around new surroundings, people (peers and adults) and speech concerns, I suspect that she may have an underlying issue. Here is a list of her milestones:

    - Walked at 9 months
    - First words around 10 months then slowed down
    - By 15 months could count to 5, identify the numbers 1 – 5 and could also count objects 1 to 5. By 28 months could count to 20
    - Same with Alphabets. Can now spell and read some of the words like “STOP”, “NEMO”, ELMO”, “MAMA”. Not sure if she is memorizing them. But she knows the sounds phonetically
    - know lots of colors including the difficult ones like grey, purple, turquoise by 18 months.
    - same with shapes – trapezoid, octogon, pentagon, etc
    - can do puzzles for hours – 36 pieces
    - makes good eye contact, has joint attention, very alert
    - Toe walks every now and then
    - very very anxious around new people. Her nervousness pours out in her speech. She would go on nonstop with a frown. “bye bye lets go mama”, “bye bye, all done”, “Lets go mama”
    - Hates crowds, does not like being touched by other children
    - repetitive speech

    I would really appreciate it if you could offer some advice on what you think of her repetitive speech.

    Thanks!

  25. Laura says

    Sharon – I’m so glad you’re getting an assessment for her so they can see these things she’s doing and balance that with your concerns about her. I love how you’ve listed them out here, and I’d share that list with the SLP if I were you since it’s very detailed and may help to provide a clearer picture of her strengths and weakness as well as a diagnosis for her.

    Since I can’t SEE her, I can’t say for sure what’s going on. Based on the list you provided, she is exhibiting lots of red flags I’d be concerned about as well as sensory issues too (hates being touched, is anxious in new surroundings, toe walking), so I’d look at an Occupational Therapy eval as well. The very best way to test her might be through a facility that offers team assessments. Another option might be through your state early intervention program which may provide services in your home vs. an office setting.

    To answer your specific question about repetitive speech, imitation for children with typically developing language usually peaks around 19 months then decreases as they expand their spontaneous vocabularies. Echolalia is the term used to describe “scripts” that children repeat, and as I’m sure you know, is typically associated with children who go on to be diagnosed with autism spectrum disorders. It doesn’t sound exactly like she’s using those phrases she repeats in this way based on how you’ve described her, BUT I do think it’s a red flag, and I’m glad you’re pursuing a professional opinion.

    And since you’re asking what I think, I’d also lay off the focus on the pre-academic concepts – numbers, letters, shapes, colors, etc… Many parents get so excited about early success with these kinds of concepts that they hyperfocus on teaching these kinds of things and miss out on all of the other more important language skills that really do matter at 2. Instead, focus on developing her back and forth conversational skills, pretend play, and expanding her vocabulary with words that she needs for everyday life. Although she seems to have real visual strengths for recognizing numbers and letters and even reading, and she may really enjoy these activites, I would not focus on these skills right now. As her mom you want to make sure her world is full of all kinds of new real-life experiences at 2 and not so “academic.” There’s plenty of time for that later, after she masters foundational social and language milestones that are important right now.

    Thanks for your questions. Let me know how the eval goes. Laura

  26. Sharon says

    Hi Laura,

    Thanks so much for putting things in perspective for me. You are absolutely right about focusing on developing her conversational skills and other areas that she needs help with . The reason for mentioning Numbers and letters were to indicate that she perhaps indicate signs of Hyperlexia.
    For the SPL evaluation, I will take your advise and highlight just concerning areas so not to confuse things.
    I haven’t looked at getting her services in home setting. I didn’t think that was an option. I will look it up right away. We did take her to the OT once as it is very obvious to me she has sensory issues, however, she was so anxious that the therapist decided to stay out and talk with me in private while her dad played with her alone. After that, I have to be honest, I haven’t had the courage to take her back again. Although since then, I have read up a lot of books on SPD and we are engaging her in various experiences. It is helping a little bit. But professional help would definitely be better.

    Thanks again for your input. I really appreciate it. Sophie is set to see the speech pathologist early April. I will definitely post the outcome of the visit. S.

  27. Laura says

    Sharon – Keep us updated! You’re exactly right about the hyperlexia too. I didn’t mention that initially, but that’s exactly what that is. Let us know what the SLP says and what she recommends. Hopefully you can follow-up for OT too! Good luck!! Laura

  28. Michelle says

    Hi Laura,
    I recieved a copy of your article “Helping Your Toddler Listen and Obey” from my sons’ speech therapist. I visited the website with plans to order a DVD and found so much more in these posts.

    My son Anthony is older than the children I have read about here; he is 4 yrs old. By the time he was 9 months old he literally had already had 8 ear infections and recieved his first set of tubes. He then recieved his second set of tubes (after the first ones fell out)at age 2. As far as milestones he was right on schedule and potty-trained at age 2 1/2. We were told early on that he would more than likely have some speech delay because of his hearing problems.

    Hearing this, I was not alarmed that his vocabulary was limited but I began noticing echolalia and even reciting parts of stories and movies he had heard or seen. I started asking other parents who I knew with children with ET tubes and inquired about any speech delay problems. I became worriedthat something was really wrong and took him in for a speech evaluation.

    He answers “yes” when he is called, and can follow instructions, “throw this in the trash”, “get your coat”, “time for bed”,can articulate very well what he does and does not want, can recognize the alphabet in and out of sequence as well as numbers up to 20, can spell his name, and tell you his address. He is very social with other children and does well in large play groups. However, like I have noticed in some of the other posts, if I ask ‘what did you do at school today?” he will echo and repeat the question.

    He was diagnosed with severe expressive and receptive speech delay and has been in speech therapy for 2 months now. A lot of the echoing has decreased, but he still gets that blank look with questions about what he has done during the day.

    I feel so bad that I didn’t notice there was a problem sooner…he is currently in Montessori for preschool but we have decided to send him to another school in the fall that provides speech therapy in the ciriculum. I know it will take time and committment and possibly even holding him in preschool another year, but can you offer any other advice?

    Thank you for this forum
    Michelle

  29. Laura says

    Michelle – I’m so glad you’re being so proactive with him now by having him in speech and in preschool. Try not to beat yourself up too much. You’re doing the right things now. I would highly recommend that you work with him as often as possible at home. Children with the best outcomes have parents who are absolutely committed to working with them at home. Even though he’s older than the children in the DVDs, if his language is delayed, the techniques are still applicable. You may change the toys since he’s a little older (like using Batman toys rather than Fisher Price Little People), but you’re still going to concentrate on building his vocabulary and helping him understand a variety of words. Remember that if he’s repeating you, he still may not necessarily understand what he’s saying, so work to give him enough cues to help him. In my Teach Me To Listen and Obey DVDs I stress the cues, “Tell him, show him, them help him” so that parents remember to say what you want him to do, give him visual cues by pointing or demonstrating what you want him to do, then lastly, by providing physical help if he can’t follow through with your request. Understanding language is the foundation for being able to functionally USE language, so keep at it. Use the strategies your SLP gives you in therapy too since she actually knows your son and what he needs to work on. Thanks for your comment. Laura

  30. Candace says

    Hi Laura,

    My son just turned 4 years old and went through a really rough time with ear infections starting when he was 20 months old. There was a lot of middle ear fluid that persisted, and I immediately enrolled him in a state-provided speech therapy program for children under 3. I am home with him, and we spent a lot of time with the pediatrician, ENT and SLPs. He tested out with a receptive language level of 14 months, expressive language of 16 months, social and emotional at 33 months (!), gross motor at age-appropriate, plus a slight fine motor skills delay. A team of SLPs and OT’s also evaluated him as “no way” autistic (they commented specifically on his empathy, nurturing and warm behavior and his terrific sense of humor) and also noted his ability to be quite willful (he refused to participate in some parts of the tests).

    Well, he tested out of fine motor skills OT in less than a month! And when his ears finally cleared on their own (we barely avoided ear tube surgery), he began talking in one weekend. He continued speech therapy for 9 months, until he was released (4 months before turning 3) as being at “age-appropriate” levels, and his SLP indicated that he was very unlikely to qualify for school district services. We were all thrilled, and I was very happy that I had learned so many things that as a stay-at-home mom, I could continue to model for him and coach as his language continued to blossom.

    I won’t go into all the fabulous things my son can now do (ride a tricycle and a scooter, read board books (sounding out words!), play hide and seek with other kids, play Candyland with his family, do puzzles meant for 5-year-olds, play pretend like being a rescue superhero all over the house), but what I am writing to ask about is some continued delays I am seeing with asking and answering questions. I was fascinated by your page on teaching your toddler to ask and answer questions — he was doing a lot of those “top four common problems”! At age 3, his doctor asked him at his checkup what his name was and his age and gender (we had been practicing), but he wouldn’t answer her. Then I was strapping him into his car seat 15 minutes later and he mischievously said, “Hi, my name’s Jeremy and I’m fwee (3) and I’m a boy!” Um, did I mention my son hates being put on the spot!

    Anyway, sometimes (and even his SLP commented on this) my son just doesn’t want to speak because he feels like he’s being tested. And this is where we are having issues with questions (which I know can even make non-speech-delayed kids clam up). He has been asking “what” and “where” questions for some time (“What’s that?” “What’s wrong, Daddy?” “What are you doing?” “Where did it go? Where’s Mommy?), and we have been working on when and why and how. A year ago, we were having a lot of trouble getting him to answer yes or no questions, but because of his SLP I used a lot of the techniques you used here, and now he is a pro at it. I hardly ever have to prompt with him with “Yes or no?” anymore. And he can answer lots of other choices questions (“Smoothie or juice?” But I can tell that the more abstract questions are causing him trouble – I can see the gears grinding, but he’s not sure how to respond to “why do you want the red car?” when we’re playing or whatever or even “Why do you want to go outside?” His cause-and-effect understanding has also gotten a lot better in the last year, “Put on seatbelts, so we can be safe!” and “No, I don’t want to go – I’m still playing with trains!” He can also understand three-step instructions at this point. But there are some questions where I can tell he is just not sure how to respond, and that is the one and only time he will repeat things back to me – when I ask him a question and he’s buying time to try to answer it. Do you have any advice as to how I might work on the more difficult abstract questions? And is this delay with these sorts of questions still part of the original speech delay (could he still be catching up?)? By the way, I love the trick about using one parent to whisper the answer while the other parent asks the questions! Can’t wait to try it! I feel like my son has come so far in the last 2 years, but I am not sure if what I’m seeing is continued “catch-up” or a sign of overall auditory processing disorder.

    Thanks so much for your advice!
    Candace

  31. Candace says

    Sorry Laura,

    But I also forgot to add that the whole reason I decided to ask this question in the first place is because sometimes I feel like my son is the only 4 year old in the world not bombarding me with “Why?” all the time. And I’m guessing he’s not asking why questions yet, because he’s still trying to figure out what why means when we ask him!

    Sorry to add to an already long post, but I thought it was important to point out.

    Candace

  32. Laura says

    Candace – First of all congratuations on his progress! That’s super! I do think he’s still in the process of catching up, and it sounds like he still needs some help filling in the gaps. The best way to do that is to do exactly what you’re doing. When you see “the gears turning,” step in and help him fill in those gaps. Keep explaining things so that you are constantly helping him link meanings with those difficult abstractions. Give him some choices even with those kinds of “why” questions. When he’s told you “No” to something ask, “Why?” If he’s not wanted a certain snack, say, “Why not? Would you rather have something else? Are you not hungry right now?” GIVE him those answers when he’s not answering readily. It sounds like you’ve both come so far, so just keep going! If he DOES end up diagnosed with an overall processing disorder, you’ll deal with that too, just like you have this initial language delay. You sound like a great mom, and if it happens, it happens. You can do this regardless! Thanks for your email. Laura

  33. lori says

    Hi Laura – do you have any specific advice on how to get my almost 3 year old to stop repeating questions rather than answering them? he will answer some questions but he still mostly repeats what we say to him. any help would be appreciated. thank you!

  34. Laura says

    Lori – Repeating means that he doesn’t understand what you’re asking him, so keep building his receptive language skills. You can find specific ways to do this on my DVD Teach Me To Listen and Obey 2 AND by looking at the articles here onb the site regarding echolalia. Giving visual cues and choices is usually is the best way to target this, but read the ideas in the articles about echolalia. Laura

  35. Nadim says

    Hey laura,
    I have a baby girl 2yrs 8 monhts… when she was 18 months old.. she started learning a few words etc.. here and there and could answer us back also eg: if we asked what sound a cat makes.. she would go “MEOW”.. likewise.. but since then she has dropped on most of the talking.
    Now she does not use words.. but just points fingers and cries if she needs something, when we sit with her to try to talk to her it is impossible as she just wants to jump and run and play all tshe time… so it is difficult for us to sit with her and talk to her.. although she understands us very very well and is very sharp at catching on to movements and can imitate you only after being shown once.

    I am very concerned about her not speaking any words almost at all… me and my wife speak different languages..however with the baby we speak only english.. she watches a lot of Tom and Jerry..and also imitates them in many ways.. and i think this could be a reason why she thinks its perfectly normal not to talk??..

    I am in UAE.. Dubai/ can i buy your CD here.. if yes are there any authorized dealers?

    thanks and regards

    Nadim

  36. KAH says

    Hi Laura. I have a 17 month old little girl who I believe might have a speech delay. She is my 1st child so I’m not sure how much a 17 month old should understand. She seems to understand a lot but doesn’t use the word no/yes regularly. She actually just started saying “yes” to questions like, do you want a cracker (as she’s in the pantry signing cracker)? or do you want me to read this book (after she brings me the book)? I had to teach her this and sometimes I wonder if she is just saying it because it’s what she thinks I want to hear, not that she truly understands. She still doesn’t use the word “no” though. If she doesn’t want something, she’ll turn her head to the side and grunt something that sounds like “no” but it isn’t a shake of the head or a clear “no”. Yet, if I ask her to say “no”, she’ll then shake her head no. SOOOOOO, I’m concerned. Shouldn’t she be using/understanding yes/no often by this age? She knows over 40 words (not all clear of course) and constantly wants me to name things but won’t say a simple “no”! When I ask her if she wants her diaper changed, she’ll run in the opposite direction (while whining), so I know she understands. She seems to understand lots of other things like “let’s go outside”, “bath time” (she’ll go to the bathroom), where’s your______(she’ll go and get it), etc.
    Oh, and she also doesn’t sign “more” when asking for more of something even though I’ve been teaching her this forever. If I ask her to say “more” she will then sign and say “more” but otherwise she’ll just point (sometimes will whole hand) and grunt (while looking at me) to whatever it is she wants more of. I have contacted Early Intervention in my state. What is your take? Any help is greatly appreciated

  37. Brenda says

    Hi!
    My daughter is 3.4 years old. She goes to preschool part time. But we’ve noticed that sometimes she can not answer well to basic questions like “how old are you”, she usually answers with “My name is 3″, even though we have explained her so many times that she should said “I’m 3 years old”. It seems like she can not get it right even though we keep asking her and giving her the right answer. Sometimes we ask her how old are you? and she will ansewer with, “My name is Olivia”….If we ask her other questions she usually gives us a short but correct answer, but she is not able to carry on a conversation. We are billingual. She knows all her alphabet, numbers, shapes since before she was 2 years old. She can ask for stuff that she wants, like “i want juice” or “I want to go outside”, or “i don’t want to eat”. She is polite like she will say good morning to her teacher or excuse me when she burps or bless you if you sneeze, thank you, please, etc. She can say a lot of words in spanish and english. She will switch from spanish to english depending on who she is talking to. She can tell us what she can see in a book and if we are reading she can answer some questions about the story. But she can’t tell us what she did during the day. She was evaluated by a speech therapist when she turned 3, but it seems like everything was right even though she was not talking a lot by that time. Do you think she should be evaluated again? It is something normal for her age to get confused with her anwers even if we provide her with the right answer and we try to practice all the time? Please help!!

  38. Ashley says

    I have a question for anyone on here that can answer it. My child is 7 and about 2 months ago she began to start hesitating when asked a question. Sometimes she will ask me a question back once I ask her one, she just won’t answer me at all, or she hesitates and says “Uhhh”, “Can I say”, “What about I say”, “maybe”, “I’m just going to say”, and “well sometimes”. I am at a loss for what to do anymore. I have talked to her teacher about it and she didn’t know what to do as well. What do I need to do? Is there something mentally wrong with her?

  39. Audrey says

    Hi,
    I have had my daughter evaluated however we did not have her evaluated for speech because she apparently speaks so well. I say apparently because one of the evaluators said she is definately echilalic. I have automatically been doing some of the things you mention in the article. I want a speech pathologist, but don’t quite know what to ask. I will try to have her evaluated for speech but was warned BOE probably won’t grant it because only her receptive language seems to be delayed. but we have started to realize that she doEsn;t truly understand a number of simple things we really thought she understood. Like the difference between good and bad. She is three yrs old. Does not interact with other children, is unaware of where she is in space. Would not answer questions for the longest time. Getting better in the last 6 months when I started saying things like yes or no and realizing that her repeating back second half of ? was not an answer.
    What should i look for? do they usually accept insurance? do they all work with children? How do I know if they are any good?
    Thanks!!!

  40. Laura says

    Hi Audrey – Kate and I are going to address your question on tomorrow’s podcast 1/29 on show #101 or on next week’s if we have time. The short version of this response is that you should definitely have her re-evaluated by an SLP who works with very young children. I am quite surprised that a program WON’T qualify her for speech therapy services since a gap in receptive-expressive language with expressive being higher is a huge red flag. Combined with her other social and sensory processing issues that you reported, I would be concerned about autism. Of course I can’t see her, so I don’t know for sure what’s going on, I’d encourage you to see an SLP and an OT for her, even if it means you use your insurance or pay privately. With or without a formal diagnosis, she STILL needs treatment for the language, social, and sensory processing issues so that she’s as ready for kindergarten as she can be. Again – we’ll talk more about this on the show. Thanks for your question. Audrey

  41. Heidi says

    I have a 4 1/2 yr old child that we are having a difficult time getting her to answer questions. Questions like why did you do that?Why are you in here? I will give her ideas like, were you, mad, sad,scared,hurt,angry,happy and she answers with why or because. Then I further my question with because what and repeat any emotions or actions that could be possible. I get the same answers over and over.I have tried asking what is the reason? I just get blank stares. She has some speech challenges and has been screened but they don’t think she needs any therapy or sevices. I disagree. Should a child her age be able to answer why questions?

  42. Kathie B says

    I recently came across your site and I am excited about all its useful information. I have some questions concerning my 2.5yr old son. Several months ago I was concerned about his delayed speech, since he’s my oldest and didn’t have a lot of interaction with other kids his age. We were referred by our pediatrician to an E.I. group . They have signed him up with a D.I., O.T., and a SLP. They have brought up a couple of times that he might have a autism spectrum disorder, but they haven’t requested any testing. I’ve looked up the spectrum disorder and, besides speech, I don’t see any red flags. We have seen some improvement in my son from the group but not much. And my son runs away the SLP every time she comes to our house. She doesn’t interact with him much while she is here.

    Then recently we went to an ENT who diagnosed my son with negative ear pressure. He said that this could be why he was delayed in his speech. It has been three weeks since my son had a surgery for the removal of his tonsils, adenoids, and tubes placed in his ear. He’s had improvement but its been gradual.

    My questions are this:

    What can be expected to change with this surgery? Will he gradually start speaking more on his own?

    Should I expect more from the E.I. group? Or should I get a new SLP?

    Should I have my son tested for any disorders?

  43. Laura says

    Kathie – If the physical reasons were the only factors, you should start to see a pick up within a couple of months. More often than not, there’s usually multiple factors a child isn’t talking yet. I have seen remarkable improvements after surgeries for children when this was the main/only issue.

    I’d definitely get a new SLP who is more engaging for him. Therapy should be fun. If it’s not, get a new game plan. Have you seen the DVDs? That’s what you’re going for in sessions – and he should be engaged with you in the same way at home when you’re working on language.

    If you’re pleased with group, by all means, keep going. If not, ask what your other options are.

    If the therapists continue to mention autism, ask what the next step should be in getting him evaluated and this ruled out. They may be waiting on you to take the next step and ask some questions about the process. If you don’t, they may assume that you’re not interested in pursuing this. Many times parents are so turned off or upset by the mere hint that a child may be on the spectrum that professionals don’t push for the assessment until parents take the initiative.

    Thanks for your great questions! Hang in there!! You’re doing the right things for him!!! Laura

  44. Laura says

    Heidi – A child should be answering “Why” questions at 4 1/2 if language delays or auditory processing issues are not present. Since you continue to be concerned about her, I’d definitely encourage you to get her assessed, even if that means paying for it yourself in a private clinic.

    The eligibility requirements for public school programs are very stringent – meaning that a child usually has to be in the bottom 5% of performance when compared to their peers to get services – so even children who barely functioning just above this level will not qualify for free services.

    I would definitely pursue an eval now BEFORE she begins kindergarten. You want her as ready as possible for success in school. When a child is still struggling to understand language, she’s not ready to fully focus on reading and writing, which is expected to begin in kindergarten now.

    Good luck to you and your little girl! I hope you can find someone to help you!! Laura

  45. Susanna says

    Hi Laura,

    I’m so glad I found this site. I’ve read through a lot of your earlier responses but still wanted to write and ask my own questions. My son Asher just turned 3 this month, but he was born 3 months early, so technically he’s not developmentally 3 years old until May. It is only just now becoming apparent that there is something “wrong” but we can’t figure out what it is; his “symptoms” don’t really match up with any of the typical diagnoses that we know of except for Sensory Processing Disorder. We are on the waitlist for a great PT/OT group. I’m just having a hard time waiting and am quite anxious. You’ve been so thoughtful and thorough with other people’s questions, I thought I’d try to describe my son and see if you have any insight.

    He is a very social, sensitive little guy. He wants to hug (and kiss, if possible) every child he meets (he doesn’t seem to have impulse control regarding this, and will repeatedly try to hug a child that doesn’t want to be hugged. We say “Let’s do hi-fives instead” and he will do the hi-five but then try to hug again a minute later. Then the whole routine happens maybe 20 times in a 2 hour playdate), and enjoys affection and roughhousing. He loves music and sings along to his favorite songs. He walked late, is hesitant with gross motor skill stuff, and still can’t jump yet. Transitions are hard for him, though he has improved to the point of total enjoyment of preschool. (The first few weeks were very hard, with meltdowns with each and every transition. Now he moves through the 2 hour session just like all the other kids.) His language skills sound A LOT like Ramya up at the top of this page. He loves to recite entire stories as he turns the pages– it looks like he’s reading but really he has an amazing memory, I guess. He responds to a lot of questions by repeating the question back to us. Often when we ask him a question it seems like the question didn’t register at all. He responds to his name and acknowledges that we’re talking to him but seems utterly baffled by what the answer to the question could be. To tell me that he wants some cheddar bunnies, he’ll say, “Do you want some cheddar bunnies?” If I ask him “Do you want some cheddar bunnies?” I CAN NOT get him to answer Yes. I tried til I nearly went crazy today. I said “Do you want some cheddar bunnies? Yes (while nodding and moving the cheddar bunnies closer to him) or No (while shaking my head and taking them away)?” and then he would reach for the cheddar bunnies and say “Do you want some cheddar bunnies?” and we did this over and over and over again. He doesn’t randomly repeat questions repetitively like some kids do with echolalia; he remembers questions and uses them to communicate. He woke up from his nap the other day saying, “Should we get you some milk?” It only just occurred to us that he doesn’t answer “Yes” maybe a month ago (Mother of the Year Award!). Today I asked him if he wanted apple, pear, or banana and it was a HUGE accomplishment that he answered “pear.” He talks about himself in the third person most of the time and rarely says “I/mine.” He’ll say “He saw Grama and Grampa today.” He will follow multi-step directions and understands that things happen in a sequence. Because he was a preemie, he saw a PT and OT as part of an early intervention program, and because he was hitting gross motor skill milestones late. We weren’t really happy with that group and by the end of our time there the closest we got to an understanding of what he “has” is Sensory Processing Disorder. The OT didn’t think he has autism. He covers his ears a lot when there might be a loud sound, or when he wants to somehow protect himself from a super stimulating experience. It took him a long time to eat solid food and to feed himself. He is terrified of the Happy Birthday song/ritual. (I think that’s due to the sheer number of people singing loudly combined with the food on fire.) Transitions he’s not expecting are hard for him (at preschool he is doing well now because he can expect the day’s rituals) and when he hits the point where he can’t seem to integrate the transition all he can do do is cry. He doesn’t get aggressive or throw violent tantrums, he just cries like he is utterly sad and distraught with the state of the world. I do think he has Sensory Processing Disorder– he fits the description of a mild version.

    It’s interesting because in some ways his social skills have always been a little advanced, I think: great “conscious” eye contact from a very early age, responsive smiling, very loving and interested in other people. But when he is in an environment where there is a lot of stimulation he’ll find an activity that he can immerse himself in and it is very hard for another child to get his attention. It’s like he’s having a hard time processing everything and is playing (with the dollhouse as the case may be; he LOVES pretend play with characters with faces and has no interest in cars and such) with intense focus just to hold himself together.

    This might be your longest comment/question ever. Thank you in advance for your help.

    Best,
    Susanna

  46. Susanna says

    oops, one more thing!

    He is really great with checking in with other people about an experience he’s having. For example, if I’m reading a book to Asher and his friend Ellery, he’ll look eagerly at Ellery to see if he can name the animal I’m pointing to. Likewise, Asher will give the correct answer when I ask him “What’s that?” while pointing to something he recognizes like a duck or necklace or something.

    thank you!!!

  47. Laura says

    Susanna – This is such a great question, and I simply do not have time to do it justice with a written response since it’s nearly midnight! However, I will have time to answer on the podcast this Sunday at 6 pm. Have you had a chance to listen to my show yet? You can listen in from here on the website on Sundays at 6 pm eastern time, or anytime thereafter since it’s recorded.

    I have treated several little boys who sound a lot like how you’re describing your little guy. All ended up with with different diagnoses as they got older, saw a different set of professionals, and had different issues persist in their preschool and early school age experiences. We’ll talk about all of those scenarios on the show, and perhaps it will give you some insight. I’m glad you’re getting him evaluated, and I hope you’re going to someone who is quite skilled since his issues are somewhat complex and don’t fit one specific diagnosis.

    The IMPORTANT thing is that you sound like a great, very committed mom who will be able to help no matter what’s going on with him. Congratuations to you for that and for diligently pursuing help for him!

    Tune in on Sunday at 6 pm for the longer version of this reply!! Laura

  48. Blair says

    Hi Laura,

    Question. I have a 20 month old daughter. When i ask her a question, such as “do you want milk” if she wants milk she will say “milk”, if she doesn’t, so will say “no”. Is this something i should be concerned about. I’ve also tried, handing her her milk, and saying “do you want this” and she will say “milk” if she wants it. lately, i’ve been making her actually say “yes” (which she can say). so before i give it to her, i will make her say yes. is this normal for her age, or something i should look into?

    Thanks in advance!

  49. Laura says

    Blair – Great question! Many children don’t begin to answer “yes” for a while, but you’re doing the right thing by teaching her to say yes. What she’s doing is right on track for her age, but keep working with her so that she learns how to answer questions correctly. Laura

  50. says

    i have a two in a half boy who speaks jibberish, but can identify what he has been drilled to recognize. he is in speech therapy but still does not speak in two word sentences. he has a receptive and expressive delay. he has poor eye contact and is not yet potty trained. he can sing songs and repeat commercials but if i say go get the ball he has no idea of what im talking about.lately he has been laughing for no reason but his ece says he isnot autistic. im at a loss at times he gets so frustrated. how do i teach eye contact and build his receptive skills? also i would like him to answer to his name?

  51. Laura says

    Camille – By the way you describe him, I’d really wonder about autism too, but since I haven’t seen him, there’s no way I can offer any specific diagnostic information other than to recommend that you get a formal evaluation to rule out autism.

    Since he’s not following even familiar directions such as, “Get the ball,” he exhibits a severe receptive language delay. You’re going to have to help him consistently link meanings to words. The best way to do that is outlined in my DVD series Teach Me To Listen and Obey 1 and 2. The cues we use are “Tell him, show him, and help him” so that you’re helping him follow-through with every single direction you give him. You’ve already said he responds when he’s been ‘drilled,’ so you’ll have to get very deliberate in teaching him to understand. Check out those DVDs to see what I mean and show you how to work on understanding more language at home.

    Laura

  52. Valerie says

    Dear Laura, my son is 32 and is not putting two words together on his own to make a sentence when I ask him a question like where is your cup he will answer cup. most of the day he speaks in songs or dialog from a commercial or a cartoon. he uses single words to ask for things he will say hug I tell him do you want mommy to hug you he just repeats hug he will say teeth and I ask do you want to brush your teeth and he will repeat teeth. when he asks for food he does go into more detail when I ask do you want cereal he will say cereal, milk, cold I’m not sure if that counts as putting words together. He doesn’t answer question like what’s wrong, what are you doing, where are you going. He is my first child so I’m not sure if all this is normal or not.

    Valerie

  53. Laura says

    Valerie – I saw your comment, “My son is 32 and is not putting two words together,” and it made me smile. I know you meant 32 months! Some moms feel like their child may be 32 before he’s really talking!

    All kidding aside, from what you’re describing, his language is delayed, and I’d recommend that you have him evaluated as soon as possible. Putting words together for phrases means that he says things like, “Bye bye Mama,” “Truck go,”and “more cookie,” so according to what you’ve written for examples, he’s not doing that yet. Toddler with typically developing language are using those kinds of phrases by 18 months, and at the latest 24 months, so he’s quite behind in what he’s able to say, which is expressive language. In addition to his expressive delay, from how you’ve described him, he’s also exhibiting a receptive language delay since he’s repeating so much of what you say rather than understanding and answering your questions.

    Again, I’d recommend that you have him evaluated as soon as possible so that you can help him catch up. You can call your state’s early intervention program which provides therapists who evaluate and provide therapy for toddlers until they turn 3. You don’t have much time left for that program, but I’d call anyway so that you get an idea of what’s going on with his language and general development. The evaluation is free.

    After a child turns 3, the local public school system is responsible for providing free assessments and therapy services in addition to preschool services for children who are 3 and 4 with delays. You can find out about your program by calling the school board and asking for more information.

    In the meantime, there are LOTS of articles here on the website that will teach you how to target language. You may also want to check out my DVDs so you can SEE how to work with him yourself at home.

    Good luck with him! You can make a big difference at home! Laura

  54. Valerie says

    Laura, thank you so much for replying back. I have checked with our state’s early start and he would have had to be reffered to them before he was 24 months but thank you for the advice. I have brought up my concerns with his pediatrian a couple of times and he made feel stupid for bringing it up. I changed peditricians and at his two year physical I told the new doc that he wasn’t putting two words together he asked how many words he knows and told me he was fine. I am in the process of trying to get a refferal from the doc to the speech and language dept since I was told I would need one. Is there any advice you could give me on how to deal with and say to the doc so that I am not given the run around or told to just wait a little longer.

  55. Laura says

    Valerie – I am so disappointed when I hear that a pediatrician has blown off a mom’s very valid concerns…. Since he’s older now, he should get the referral without too much arm twisting. Tell them he’s not using phrases on his own to ask for things he needs, that he’s turning 3 soon and that you’ve been worried for almost a year now, and that you’re tired of not being taken seriously since you’re his mom and you know him best! Hopefully that will work for you! Good luck and nice job being so persistent! Laura

  56. siba says

    Hi Laura.
    My 4 year old son,Sidu has mild autism. His major challenge is answering questions. He can only answer familiar questions now, but if we change the pattern of the question.. he is lost. eg. if i ask him what’s your school’s name. he will answer “Eurokids”, but if i ask him which school do you go? he is lost. It seems he has memorised some questions and answers to that. How do i help him. Secondly if i dont revise this question session for a week a so… he forgets everything, rather he cannot answer promptly.. we have to give him clues. He is undergoing speech therapy since past 6 months and the SLP is also not able to achieve much. Do you have any tips and tricks? Pls help.

    one more thing.. ive seen many kids talking after 4 – 4.5 years. Sidu’s SLP too says that sidu will start talking fluently. Do you have any idea how this happens?

  57. Laura says

    Hi Siba. You’re right. He’s memorized the “scripts” for the answers to your questions and doesn’t really understand the question. Keep working to build underlying comprehension – not just the verbal response. Otherwise, it’s just echolalia. Sometimes using the completion method or providing choices are more successful techniques IF he doesn’t just echo automatically. Pictures sometimes help you explain things when he needs more than a verbal description to really comprehend what you’re talking about for the question. I’d also build in the variety when you’re teaching a concept or questions since he’s struggling to generalize. You might also want to take a look at the strategies for working with echolalic kids since those may help too. Treating the underlying processing/comprehension is really the key to helping him understand and then answer correctly. Laura

  58. siba says

    Thanks Laura for the response. His SLP usually asks the same questions in every session. She tells that he will understand the meaning of the questions eventually. Do you think this will work?

  59. Robert's Mom says

    Hi Laura,

    I was wondering if you could advise me on my almost 3 year old son. At 24 months, he had a vocabulary of 75 words. He was using some two-three word sentences, but none which were his own combinations. The doctor said because he had so many single words, not to worry that he wasn’t combining them. Sure enough around 27 months, he started to combine them. Now, at almost three, he says many 5-7 word combinations and sentences. My concern is that when asked a yes or no question, he never says yes. He uses no without fail when he doesn’t want something, but yes is another story. Instead of saying yes when I say “do you want to go outside?” he repeats “go outside”… etc. Sometimes if I direct him to say either yes or no he will repeat “yes or no.” I just worry because I feel like he should be saying yes with no problem at this age. On other questions like “What’s your name?” he answers “Robert” or “how old are you?” “I’m two.”, “are you a boy or a girl?” he says “boy.”… so he definitely can answer some questions just fine. Is this considered echolalia? He has plenty of spontaneous speech and definitely can answer what and where questions without problem.

    Anyway, thank you so much for taking time to read this. I would appreciate your kind response. Thank you so much!

  60. Angie says

    Hello! I’ve been trying to find an answer to my question for quite a while, but I guess I don’t know exactly how to word it correctly! My question is- When are children supposed to understand and use “Why” questions?

    My son is three and a half right now and did have a speech delay. He was treated for several months until he “graduated” from early intervention on his 3rd birthday. I feel like he is speaking at an appropriate level now (although he still cannot pronounce “R” or “L”!), but he has no idea how to answer any “why” questions. Even something simple, like, “Why did the baby cry?” and he knows the baby hit her head. But he can’t answer the question. I’ll ask him something like, “Why did you come out of your room?” He will say, “Because I’m in my bed.” He knows the answer starts with “because” but past that, he doesn’t know cause and effect. He also never, ever asks, “why.” Am I just expecting too much from a three and a half year old?

  61. Brady's mom says

    Hi Laura,
    I have a very active 26 month boy, Brady. He climbs everything and is constantly on the go. We are finally starting to be able to read books with him again, but 1 or 2 very short books at a time. At 24 months, he only said about 3 words and is up to about 25 words off and on (some of which are just the beginning sounds). He understands everything we say, but when we ask questions, he doesn’t respond. He will just look at me with a “what do you want from me?” type of look. I’ve tried asking him “what is this” and pointing to his shoe, but he doesn’t respond when I ask. However, he will point to shoes and name them all day long just as long as he isn’t being questioned about it. His pediatrician told me to make sure he tells me when he wants something, so I’ve been trying to have him say “milk” when he wants it. He will sign milk and makes a “ggg” sound every time. He has the “m” sound because he says mom just fine. Just wondering what you think about this? Should I give him more time since he has progressed in the last 2 months or should I be very concerned and have him evaluated? Thanks so much!

  62. Laura says

    Angie – His language skills are still slightly delayed since he’s not able to answer a “Why” question like that at 3 1/2. Did the therapists feel he wouldn’t qualify for school-based speech services, so you didn’t have him tested, or was he tested and no longer was eligible for services?

    If he doesn’t qualify for services at school, you may want to still pursue services for him privately using insurance or paying out-of-pocket.

    Sometimes children don’t answer those kinds of questions because of an auditory processing/receptive language issue, and sometimes it’s an expressive reason; many times it’s a combination of both. Talk with the SLP who completes his evaluation so you make sure you understand exactly what his issues are. You want to be sure you’re working on the right things at home.

    To target these kinds of things, you’ll need to talk about WHY things happen, so include these explanations in your everyday conversations. There are also some great examples of these kinds of therapy activities in my therapy manual Teach Me To Talk: The Therapy Manual if you’d like to take a more pro-active approach at home.

    Thanks for your question! Laura

  63. Laura says

    Brady’s Mom – I love that he’s made progress in the last couple of months, and I’d like to congratulate you on that, but I’d still recommend that you have him evaluated. Based on what you’ve said about him, late talking isn’t all that’s going on with him. While the pediatrician’s advice is good in that we do want children to initiate requests, it sounds like your concerns reach beyond that very basic advice.

    As an SLP I’d never consider that he “understands everything” if he’s not labeling when asked, “What’s that?” at his age. Answering questions is the way we know a child is truly processing what language he hears, so if he’s not doing that, we want to know why. Is there a social/engagement issue which prevents him tuning in when we’re asking? Is there an underlying receptive language/auditory processing issue so he truly doesn’t understand the question, even though he likely knows the answer? Are there sensory processing issues so that he can’t regulate/attend long enough to get what you’re saying to him? There are several red flags here that a professional can help you tease and sort through to determine what’s going on and how best to help him.

    He also needs therapy since his phonological/articulation skills aren’t developing in a typical manner. Although I’d not be as concerned about this as the other issues you’ve identified, it’s one more reason you’ll need to see an SLP rather than waiting for maturation to cure all. Many times children do not outgrow these kinds of issues on their own, particularly when there are other concerns. Now is the time to address these kinds of things for him. Parents constantly tell me they wish they’d pursued help earlier rather than waiting, and then you can spare yourself an unnecessary guilt for not acting when you were first worried.

    My DVDs may be helpful for you while you’re getting services initiated. Begin with Teach Me To Talk since that outlines the basic play-based approach, but you may also benefit from the strategies in Teach Me To Listen and Obey 2 to help him truly link meanings with language.

    Thanks so much for your question, and good luck to you all! Laura

  64. Sonali Diddee says

    Hello Laura,

    This is a fantastic site wish i had found this earlier. My son is going to be 3 in November and has had a speech delay. We have been working with SLT and a paediatrician has had a look at him. He in last 5 months has improved a lot and is at 3 to 4 word level now. My question is whether your DVDs are still useful. I am especially worried about -
    1. Question and Answers – i think i did not do that much with him and am starting to do it now
    2. Prepositions – And, ON, Under etc
    3. What books are good to read to kids and how to read them to them where language is helping.

    regards
    sonali

  65. Laura says

    H Sonali – He sounds like he’s moving right along! I think you’re past when the DVDs will be most helpful since the strategies you’re using are working. My therapy manual Teach Me To Talk: The Therapy Manual lists options for working on those kinds of goals if you feel like you need new or different ideas. However, the book IS directed toward therapists, so I don’t want to mislead you there. There are some ideas for addressing these kinds of goals here on the site too. Hopefully you can find things you can use! Laura

  66. Em Walker says

    I found this through a couple of other mothers and am wondering what anyone’s take is on my son.

    He is almost 39 mos. now and through a bit of help with some very nice STs he has come a long way but, I feel as if we’ve hit a plateau and it’s breaking my heart.

    When he was 1 he finally started to babble. When he grasped that words meant things, he had a tendency to say one word and it meant multiple things. Like “ba” meant bottle, bath, ball, bye, etc. He now only does this with “elephant”, it means elephant and ambulance now.

    I’m told that his “expressive language” is great and I concur really. He speaks well, using words correctly and saying them, for the most part as any 3yr old would do. All that being said, he almost always will not answer to his name being called, no matter how loud or who it is calling him. Most importantly, his “receptive language” is, well, it’s hard to explain.

    Forget asking him “Wh” questions. He will either repeat part of your question over and over again in response, or he will give a partial answer and repeat that over and over again. For example, if I say: “where’s your toy?”. His reply, is something like “over der”. With no pointing or even eye glance. I will say, over where and one of two things happen. Either he says something like “behind the door”, again with no physical indication of what he’s talking about or he’ll simply repeat “over der”, over and over and over again until my repeated pleas for clarification lead to him yelling and screaming his response and a tantrum follows. It doesn’t matter how simple or easy the “wh” question is, he never seems to be able to answer in a way that shows he comprehends the question fully.

    To make matters worse, I like he kind of gets it because, those that don’t know him think by his answers to their questions that he does. For example, his OT asked him if he had a pet one day, he replied, “I have dog.” Now, we don’t have a dog but, his response indicated that he knew the subject was pets. Or we work really hard on colors and he still seems to not be able to grasp them but, when asked randomly, what color is this, he will reply with a random color. He’s right about 50% of the time but, more often than not, he’s wrong but, again, he knows the answer needs to be a color!

    He does have a VERY poor attention span don’t get me wrong but, I don’t feel that this is really his problem. I mean he gets it to a degree in that his answers are in the general vicinity to the questions, you know? He’s a smart kid in some areas and picks up some things really quick but, communication seems to be something he struggles with greatly. As his mother, I don’t know what to do anymore. Even his SLP, told me today that maybe they need to increase his sessions to more than once a week. She really couldn’t even give me any ideas anymore on how or what to work on to help him. Which they’ve always gave me things to work on!

    I’m at a loss right now and looking to see if anyone out here has any ideas on what I can do to help him.

    Thanks so much,
    Em

  67. Concerned Mom says

    Laura,
    I have a 26 month-old daughter, who is quite verbal and outgoing. She can construct good sentences (i.e., “Mommy, how are you today?”), knows the correct responses for “How old are you?”, “What is your name?”, “What is your sister’s name?”, etc. However, in response to other questions of confrontation (e.g., “what is ____ ?”), 50% of the time, she will respond with “I don’t know.” If we pause without quickly responding, she will often jump in with the correct answer. She will also correctly respond with prompts of “You know” or “you remember.” Might this be an indication of a speech delay, or am I being excessively concerned?
    Thanks so much.
    Concerned Mom

  68. murphy says

    Hi Laura,

    I have a 28 month old daughter. She constructs very small sentences of 2 words and 3 words (example, When she hurts herself, she says “leg pain” when you offer milk she says “Don’t want”, in case of chocolates she screams “Chocolate”.

    She is very active, keeps jumping and running and like to play hide and seek. She calls me “dad” and her mom “mommy”. Some times she blabbers very big sentences of no meaning.
    she talks to her self while playing and blabbers very long sentences non stop.

    Looks like she is very moody. Some time when we ask her “what is your name” she answers rarely. She can also tell her body parts with out missing. She can tell numbers from 1 to 15 and days in week and all months name in the year.

    So the main concern is she doesn’t answer this when required. Very rarely she will answer my questions, if I ask specifically she wont answer, she either give off target answers and divert our attention saying “there is a butterfly” “cow says moo” or doesn’t respond.

    When ever any relatives or friends come home they often ask her name, and she doesn’t respond to them. I some how felt that she hates the question “what is your name”. I can some how get the other question answered by her if I make thing exciting while answering, but not this question.

    When ever I call her with her name she turns back. And I’m sure she knows her name, but some how she doesn’t answer.

    Can you give some suggestions ??

    Did she meet all the milestones at this age??

    Thanks,
    Murphy

  69. bimbola says

    Hi Laura, i’m so grateful for your website. Its so informative and i’m glad i found it.
    My 27 mth old daughter i believe is speech delayed. She has about 50 or more words majority of which erupted in the last one month. Most of these words are in recognition to objects or items or when asked to label. She just started putting 2 words together like thank you, sit down, stand up and whats it. Its only thank you and what’s it/ what’s this that she says on her own though. She knows her letters, numbers, shapes, she answers me when i ask whats your name, how are you?.
    She’ s very chatty but i can only understand about 30%. Her pediatrician says she’ s improving and isnt worried but i got her evaluated anyway.

    I was told she’s at 14mths for receptive language and needs therapy and she failed her hearing test and she’s seeing her ped for referral. Problem is my husband doesnt want her getting speech therapy, he says she’ s improving and just taking her time since she has always met her milestones
    a bit later than her peers. Is there something i can do at home to help her with your materials?

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