I’m working with a great family right now. My little friend in this family is a darling boy who will be 2 in April, and he’s a total handful! He’s so unlike his older very compliant, very praise-driven sister, who I also had the privilege of working with a few years ago.
The sister was so different from most of the toddlers I’ve ever worked with in my career as a pediatric speech-language pathologist. Her parents, both highly educated professionals in the medical field, had managed to teach her not only all of the traditional body parts by the time she was 21 months old, but they had also helped her learn ones I think some full-grown adults might have trouble locating, like her kidneys! Did I mention Dad is a radiologist ?
To quote my dearly departed, very Southern grandmother “That’s all well and good.” (Whenever she used this phrase, it was always followed by a “but….”, and in this case it’s a very big “but.” BUT this little boy (and any other future siblings) will likely never be able to fill his older sister’s very big shoes.
That may never be a problem for my little friend, if he continues with his current temperament, because he’s as happy-go-lucky a toddler as I’ve ever seen. It doesn’t bother him to hear “no.” Actually “no” might be one of his favorite words since he seems to take it as the beginning of his next challenge. He doesn’t mind if he’s reprimanded and made to sit in a chair or a toy is removed. He’s happy regardless. He likes it alright when we clap for him after he’s said a new word or completed a request we’ve asked him to do, but so far, approval, or even lack of it, doesn’t seem to motivate him as much as it did with his sister.
Herein lies the problem. This is how his mom and dad have been trained to parent, for 4 1/2 years now, by that older sister who learned to understand words quickly and still does most everything the very first time she’s told. Mom and Dad have learned to use praise to their advantage since this method was so successful with #1. When she was praised for good behavior or for learning a new task, she wanted to do it again and again. When her parents shoot her a disapproving glance or say her name with a disappointed tone, she responds.
When baby brother came along, like most of the other toddlers who’ve been born into this world, it’s not been that easy. He’s not cognitively challenged at all, but as far as language goes and certainly with behavioral directions, you have to tell him more than a time, or even two, in hopes of getting him to respond.
If these parents had had him first, they’d fully be able to appreciate just how easy older sister was, and is, and probably always will be. But this is hard when all you’ve known as a parent is a child of that variety. Little brother looks like he’s much more difficult than he really is.
By comparison he seems like he’s having real learning difficulties, when in fact, he’s likely just demonstrating a different learning style. Although older sister was a late talker, her strength so far seems to be strong auditory learning skills. You tell her, she hears it, she knows it. You read her book, or even 20 books, and she sits for the entire time, very engaged, and very interested in the wonderful explanations her parents give her. She was also very, very responsive. At 21 months she would sit and happily point to any picture her parents asked her to find. This was an enjoyable activity, not only for her, but for her parents.
Not so much for little brother. He won’t sit still for one book, and actually on most days, even half a book! This is especially true when his parents are asking him with questions and expecting the same level and style of participation. It’s not just that he won’t do it, he can’t do it. Not yet anyway.
To me at least part of the “issue” (and I use this term loosely because this behavior?is likely more “typical” than his sister!) for this little boy seems to be that he’s a do-er. This little guy has to feel it, and experience it, and DO it to learn it. Looking at a picture of a ball isn’t nearly as exciting as throwing, and kicking, and catching a real ball. Seeing the picture of a bird isn’t as much fun as watching the real bird fly and land right in front of him when he’s playing outside.
When Mommy or Daddy expect him to sit down and look at the book, he feels like he’s crawling out of his skin! When they start asking all the “Where – Where – Where” questions, he bolts! Without words he’s saying, “Get me outa here!!!”
One thing I recommended last time I was visiting this family was to make a philosophy shift in how we approach helping this little guy. Don’t get me wrong and misunderstand what we’re dealing with here. It’s not that he’s not making progress. In fact, he’s making great progress! In the short time I’ve seen him, he’s progressed from saying no words to using about 40 different words now on his own. He even imitated a few two-word phrases last time I was there. He’s now following simple directions in his daily routines most of, well at least some of, the time. He now plays with me for at least 45 minutes of our hour-long session IF I’ve planned ahead and include lots of FUN and movement-based activities and I’m sure to keep it rolling along so that we’re switching to a new toy when he’s giving me the signals that he’s “all done.” (Meaning he’s saying it, signing it, looking around for, or is getting up to find something else to do!)
I’m talking about how his parents work with him on a daily basis. Again- don’t get me wrong. It’s not just the hour he spends in speech therapy every 2 weeks that’s helped him. It’s how his parents have faithfully carried out recommendations when I’m NOT there that’s made the real difference.
But at this point in therapy, I do want to help them shift not necessarily WHAT they do, and maybe not even HOW they do it, but how they THINK about what they’re doing while they’re working with him.
With this little guy, it may be more helpful for them to think about him learning words from them while they are teaching him, and not necessarily testing him.
By this I mean dropping lots of the direct questions that he’s not responding to just yet. I mean that instead of asking questions to verify that he comprehends, that they do more telling, showing, and helping him learn while they play inside, play outside, eat meals, take a bath, get dressed, go to the store, AND even the dreaded book reading!
With this little guy and with all children like him who are not consistently responding to our barrage of questions, we should tell him more, show him more, and help him to do more rather than just asking him and then expecting him to perform.
This shift in mindset alone can take the pressure off a child who wants to do nothing more than escape. When the pressure is removed with these kinds of kids, wah-lah, they often rise to the occasion and “perform” more than they’d ever do otherwise.
Even if your wah-lah moment with him isn’t that same day or week or month, focusing on the TEACHING part rather than the TESTING will take the pressure off you too. When the focus becomes teaching him instead of measuring what he knows by how he responds, parents can relax and know that just because he’s not demonstrating that he “gets it” just yet, they are doing what they can to help him learn to understand.
In real life this looks like parents who go out of their way to label objects, actions, and people they want their child to know. They don’t just provide these words once to twice and then expect their children to know how respond to the questions. They say these words over and over again, knowing that it may take a while to “see” results.
In phonological therapy there’s a widely-used method called “recasting.” Using this technique parents are instructed to say a target word 12-18 times over a few minutes and then repeat that same word 3 or 4 times later in the day in shorter bursts each time, say 4 to 6 repetitions, to help their child “hear” and “process” the word correctly. I’ve started mentioning these numbers to parents I’m seeing now to use with their children with receptive language issues. By using this number, I hope to give them a way to measure progress, not their child’s, but their own. If they are repeating a select number of target words this often, then they can feel successful that they are doing “teaching.” When parents focus on a few words like this several times a day for several weeks, chances are, their children will link meanings to the words and learn to understand, and hopefully, finally demonstrate that they understand. Isn’t that what teaching is all about?