Research tells us that toddlers with typically developing language possess a single word spontaneous vocabulary of 35-50 words before they begin to combine words into two-word phrases. We should use this same guideline when deciding when to target phrases with children who are late talkers, those with language disorders, and especially in children with apraxia, or motor planning difficulties.
There are many things that you can do at home to work on the prerequisite skills necessary for spontaneous phrase production.
1. Before you begin working on two-word combinations, be sure that your toddler is saying at least 35 words on his own (meaning without imitating you) in daily routines. (This point is so important I’m repeating it in case you didn’t process it the first time.)
In my experience, many late talking children, especially those with apraxia, or motor planning issues, have single word vocabularies well in excess of 50 words before they can begin to consistently imitate two-word phrases, much less say novel ones on their own.
If your child’s vocabulary is not this size, continue to work on adding new single words.
Some children can imitate phrases before they are truly using 50 words on their own. In many cases, they are learning the phrase “holistically” or as one unit. In other words, the entire phrase is just one long word to them. Children with difficulty processing and understanding language often learn phrases in this way.
The only way to know if your child’s vocabulary is at this level is to keep a list of all of the words he says on his own (not imitated) over 2 or 3 days. I routinely ask the parents of children on my caseload to do this. Most parents have good luck keeping a running list on the refrigerator or in the den. Sometimes parents are surprised at the results. Some parents underestimate their child’s vocabulary and are excited when they realize just how much he/she is saying. Some are disappointed when they realize their child might be using a core set of words over and over. If you’re not sure how your child is doing, I definitely recommend this exercise.
2. Your child needs to have a variety of words in his vocabulary from different grammatical categories before he can sensibly combine words into phrases.
When analyzing the early vocabularies of toddlers, most of the words they use are nouns/names for people and objects. This is the case in typical language development too. But if you’ll think about it, a child needs more words than nouns, or names for things. It’s hard to make a sensible phrase using two nouns. (Other than those for agent + object such as “Daddy shoe.”)
Children also need:
- Social words (such as bye-bye, hi)
- Requesting words (such as please, more, again)
- Verbs/action words (such as go, eat, sleep, drink, jump, open, push)
- Early pronouns (such as me, mine, my, I, you)
- Prepositions/location words (such as in, out, off, on, up, down, here, there)
- Negation (such as no and then later contractions including don’t, can’t)
- Adjectives & adverbs/descriptive words (such as big, hot, fast, yucky)
Be sure you are introducing and teaching words from these different categories so that your child has broad vocabulary base in order to make phrases.
3. Your child needs to be able to sequence two syllables together.
If your child routinely reduces multisyllabic words to one syllable, such as “ma” for Mama, “bu” for bubble, “Mo” for Elmo, he needs more practice with sequencing syllables first before trying to learn phrases.
Work on this by practicing words with reduplicated or repetitive patterns since this is the easiest and earliest form noted in typically developing language. For example, all the “early” words - Mama, Dada, bye-bye, baba (for bottle), and night-night. Try to target words with sounds he already tries to say.
Don’t forget animal sounds since these are more fun to practice such as moo-moo, baa-baa, neigh-neigh, quack-quack, woof-woof, etc…
Use clapping or patting the floor to help him “feel” both parts of the word. You can model this and wait for him to imitate, or use hand-over-hand assistance to make him do this. This technique is very helpful for children with motor planning problems (apraxia). The motor movements actually help them produce the word. (That’s why signing is so effective too!)
4. Your child needs to be able to say several different types of syllable structures.
This is going to be a little technical to explain, so hang in there with me. Toddlers with typically developing speech and language skills usually learn to say words with various patterns and syllable structures. For example, a toddler who can say Mama, up, no, hot, and open is using 5 different kinds of consonant (C) and vowel (V) combinations.
“Mama” is CVCV.
“Up” is VC.
“No” is CV.
“Hot” is CVC.
“Open” is VCVC if he says “open” or VCV if he says “opu” (a typical way babies say “open.)
If your child can only use one or two syllable types, he is not going to be able to say lots of different phrases. Even if he tries, you may not be able to understand him because it will be “off-target.”
Analyze the kinds of syllable structures your child says by carefully listening to how he says the words. (A word of caution here - new talkers do not need to be constantly corrected for their first word attempts. Do not take this as a license to overcorrect. This should be a process of analysis, not an opportunity to prematurely begin work on articulation!)
Note if most of his words are the same patterns. This is common for children who are late talkers and especially those with apraxia, phonological disorders, dysarthria, or whatever else you want to call it.
If most words are the same pattern, you’re going to have to work on introducing new syllable structures. This requires some thought and careful planning. If you’re not naturally good at it, call in a speech-language pathologist to give you some assistance. (Another word of caution - Your child may not be able to do this without special coaching, and you may not be able to teach him. Don’t despair if you can’t get him to pronounce a new pattern. I had to go to college for 6 years to learn how to do it!)
For children who did not babble or produce jargon (saying short syllable strings with inflection similar to adult speech), this step may be unrealistic for a while, since difficulties with verbal sequencing is likely the reason he is talking late. Some therapists try to teach kids to babble or jargon by modeling this for them. I must confess that I am horrible at this!
Instead, I sing to them using very familiar songs. Singing is the best way to practice sequencing because we get help from the melodic (The technical term is “prosodic”) qualities of speech. Remember all the advice about using a “sing-song” kind of voice from the What Works article? It’s the same idea. I encourage kids to sing by “bouncing” or dancing during singing. Sometimes I just hum the song to get them going. Or you could use a single syllable he can say and repeat it to the tune of a familiar song. There’s more about the benefits of singing later in this article.
5. Your child needs to hear a variety of two-word phrases before he is able to imitate them.
What can you do to work on this at home? Frequently model short two-word phrases during the day. Try to vary your categories too. (See #2 above if you’ve forgotten this already!) Don’t get stuck always modeling, “Noun + Verb.” “Mommy sees.” “Blocks fall.” “(Name) eats.”
Vary the way you model phrases.
- Verb + Noun - “Read book,” or “Eat cookie.”
- Pronoun + Verb - “I run.”
- Pronoun + Noun - “My shoe,” or “You(r) turn.”
- Adjective + Noun - “Yucky milk.”
- Noun + Preposition - “Arm in.”
Expand his single words to phrases and repeat these to him.
- When he says, “Car” to ask for a car, model, “Want car.”
- When he sees a car and is labeling “car,” model, “There’s car.”
- When he’s making the car move, model, “Go car.”
- When you are playing cars with him, take it from him and teasingly model, “My car.”
Remember that lots of the language directed to a late-talking toddler should be at or just above his expressive language level. For new talkers, you should be using mostly single words and short, two-word phrase utterances when you’re talking directly to them in play and in daily routines.
6. Your child should be able to imitate two-word phrases before he can consistently produce them on his own.
(Okay - here’s another disclaimer. Sometimes kids with apraxia can say phrases on their own initially better than they can imitate them due to the difficulty with imitating anything, especially a challenging sound sequence, which usually includes phrases.)
Teach phrase patterns so he has a model of what words to combine. Use predictable patterns for extra practice since motor planning will be easier if one word is changed.
The ones I start with first are:
More + (Noun he says frequently) (Noun he says frequently) + please
More + please Bye-bye + (Name/noun he says frequently)
If your child has used sign language, it may be helpful to model the sign as you are saying the word.
Even if your child has “dropped” signs in lieu of words, you may want to pull them out again as a strategy to help him “motor plan” for phrases.
Another way I use signs at this level is for me to sign the word, but not say it, as a cue to help the child know what to say. If he can’t do it with this no verbal cue, I mouth or even whisper the word. Sometimes kids can even say a phrase in unison with me, but not repeat it. If your child is interrupting you while you are modeling, he’s indicating that this technique will work for him, especially if he’s doesn’t “finish” the phrase without you.
One mistake many people (including therapists) make when practicing phrases is to break up the phrase into single words. For example, they have the child repeat, “more,” then “milk.” This is okay for one time or perhaps two, but please resist the urge to split up phrases every time you practice! This defeats your purpose! Model the phrase with the words together. You already know he can say single words. You’re working on phrases!
If a child keeps repeating the first or second word as the phrase, such as “ball ball” for cheese ball, he is having difficulty with motor planning. Keep using these strategies. He needs them!
Another thing I do is to model the phrase using a sing-song tone of voice. Again, this helps with motor planning/programming because of the rhythm and prosodic (melodic) qualities. Your kid won’t sound like this forever, but doing this now may give him a shot at being able to produce phrases sooner.
When he’s imitating those well, move on to other patterns including:
Hi + Name/Noun Night-night + Name/Noun
(For you purists out there, “good night” is usually too hard!)
When he’s doing these well, I listen for words he says frequently to model and prompt as phrases.
If he says, “go” and “choo-choo,” I model the phrase both ways to see what’s easier for him to imitate, “Go choo-choo,” or “Choo-choo go.” I always keep these kinds of “probes” in context too. Don’t sit down with your word list while he’s having a snack and try to see what he can imitate. Keep it real!
7. Some kids need an “in-between” step when making the leap from single words to two-word phrases.
Some kids need that extra practice with sequencing before they are able to try phrases. I like to use the same word for this kind of practice. Use words in a repetitive pattern like “up, up, up.” Location words/prepositions and verbs/action words usually lend themselves better to this kind of practice. Try, “Walk, walk, walk,” as you’re walking or making an animal walk in play. Try, “Down, down, down” when you’re going doing the stairs.
Another way I practice is to label pictures in a book or toys placed in a line on the floor sequentially. (This is a great way to work in a language focus for kids who line up all their toys!) Start with all of the same kinds of objects. For example, if he’s lined up all his trains, point to each one and say, “Choo-choo, choo-choo, choo-choo.”
Instead of counting objects or pictures of like items, I practice labeling them. For example, in a counting book with a picture of a group of dogs, I point to each one and say, “Dog, dog, dog.”
I also practice with different pictures or objects in play when a child’s sequencing is better. Try to stick with words she can already say. For example, when playing with dolls, place a few items in a row and label, “Baby, milk, sock.” Pause between words, but not for too long or you’ll defeat the purpose of practicing to improve sequencing.
8. Take advantage of “automatic” speech.
When something is familiar to us, it becomes “automatic.” When you’ve heard something over and over again, your brain “recognizes” and “predicts” the next part. Use this with your child.
One way to practice this is with books with repetitive themes. Look for ones with a tag line that’s repeated over and over. Again, make sure this makes sense to your toddler.
Another way to practice this is by singing familiar songs. When your child has heard a song many times, his brain begins to expect what comes next. You can use this to get new words by singing a line from the song and pausing for him to complete the next word. Toddlers usually do this best when you leave the blank at the end of the phrase. For example, sing, “Row, row, row your” and wait for your child to sing, “Boat.” This works best when it’s an age-appropriate word. The next line in this song illustrates my point. “Gently down the _______.” I don’t know a two-year old with typically developing language skills who says, “Stream” in everyday conversation. Be sure you’re using common sense in choosing which words you expect him to say.
When you’re singing, be sure to slow down the rate so he has time to catch up. This is the main reason you should sing, and not rely on CDs. You can control the speed! Some children’s CDs and toys sing so fast that I can’t even keep up.
Don’t forget to try other familiar sequential phrases such as, “Ready,” and pause for him to say,
“Set - Go.” Or “1″ and wait for him to say, “2 - 3.” Make up your own cute phrases at home during daily routines and say them over and over so your toddler expects what’s coming next. We had lots of these in our house (and still do!)
9. Try wholistic phrases if your toddler is really struggling.
As a rule, I don’t model lots of these unless I don’t think I can get phrases any other way. Sometimes children with apraxia can imitate or “pop out” a holistic phrase and then it becomes part of their core vocabulary. Good ones to try are:
I did it I got it There it is Here you go See ya Where (did it) go?
Right there Right here That one This one No way! Oh man!
I also try funny, novel sequences such as, “Oooh - Yuck,” “Uh-oh Spaghettios,” or “Oopsy daisy” to help move sequencing along if I’m not having any luck with more traditional combinations.
10. Listen for any “pop out” phrases and try to elicit them again in similar situations.
Pay attention to any “accidental” phrase he might use and try to get your little guy to say it again. You may have to set up the same situation later to see if lightning will strike twice. Remember that repetition is what increases the strength of your child’s brain’s motor pathways or connections for speech. Do all you can to help your child be able to say the phrase again, without lots of obvious pressure. Sometimes the more you push, the harder it is for him! Set up the situation and wait (and hope and pray!)
Hope these ideas help at home! If you need clarification, please feel free to leave a question or comment! I love to hear from you! Laura
EDIT TO ADD -
11. Try carrier phrases.
Use simple phrases with the same words at the beginning so that your toddler only has to “plan” to change one word at a time. For example,
There’s a ___________.
That’s a ____________.
I see a _____________.
I want _____________.
I like ______________.
Give me ____________.