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1. Comment by Ana on 28 January 2012:

   Hi Laura

   I am a mother of a 29 month old son. My parents used to take care of my son. Currently my son has been attending school for about four weeks. I am concerned about my sons speech. He is a child that learns songs quickly, he knows some of the alphabets, he counts 1-20, he knows shapes. I feel like its my fault that my son is not expressing his wants and needs as per his age using two word phrases. He will go to the refrigerator, get yogurt, come to me and say mami yogurt, I ask him do you want me to open the yogurt? yeap he says. My main concern is that he is not speaking to the fullest.
2. 

   Comment by Laura on 1 February 2012:

   Hi Ana.

   Yes, you should be concerned. The milestones we use for language are normed with both boys and girls so believing that boys won’t achieve them by the ages listed is a serious, serious misjudgment for any parent or professional. The milestones we use are also not listed as a milestone until 90% of all children have achieved the skill meaning that it’s the very bottom of the range of normal. By 30 months old children (Boys too!) to be using short phrases consistently to communicate their wants and needs.

   Based on what you reported, he is using some phrases, so your job now is to help him use phrases more consistently. I’d do that by modeling what he should say when he’s requesting nonverbally, and then have him imitate BEFORE he you give him what he needs. In the example with the yogurt, you would say, “Open yogurt” or “Help me please.” If he doesn’t imitate, give him more direct cues like “Say open please” or “Tell me what you want me to do.”

   I just posted an article on the website with a vocabulary list for toddlers. Make sure he understands and says those words. Nearly all of those are completely functional, meaning that he needs to use those words to request, label, and respond to you during conversations. I’d stop the push on the academic words. That recommendation rings true for the kids you see at work too. Toddlers should NOT focus on colors, ABCs, shapes, etc… UNTIL their language skills are age-appropriate and until they are good communicators in every day routines. I hope this recommendation makes sense to you.
   Here’s the link to the article for reference:

   http://teachmetotalk.com/2012/01/26/what-can-i-do-to-help-my-toddler-learn-more-words/

   You also may want to check out my DVDs and therapy manuals for specific HOW TO advice not only to help your little guy, but your clients too.

   One more thing that may be helpful is listening to my show. Every week on Sundays at 6 pm I do an hour long show about all things therapy related. You can listen from the website live or anytime after. You can listen to the old shows too.

   In answer to your last question, I’d probably go ahead and have him assessed, but he may not be far enough behind to qualify for your state early intervention program. You may have to go the private route. Good luck to you and him! Laura
3. 

   Comment by Mark on 16 February 2012:

   Hi Laura,

   My son will be turning 4 in May. He is currently enrolled in Pre-school and is also seeing an OT and a Speech Therepist after being diagnosed with Sensory Disorder. He has made much improvements in the past year, learning to recite the alphabet, count to 100, as well as sing and play songs on the piano. He repeats many words but does not initiate conversations. He will say “I want juice” or “I want cookies”, but usualy only when asked. Occasionally, he will ask by himself, but not often. My concerns are his lack of communication with us. He is able to say colors and shapes and recognizes family members, but he can not carry a conversation with us. I will ask him “How was school today?” and he will not answer me. While his eye-contact has improved, it is not consistent. He does not always respond to his name. He walks on his toes and does not sit still for too long. He is always full of energy, running and jumping. I was wondering what more we can do for him to get him to catch up in his development. I feel like he wants to talk to us, but just does not know how. Please help.

   Thank you,
   Mark
4. 

   Comment by Laura on 16 February 2012:

   Mark - Of course I haven’t seen him to know exactly what’s going on, but based on what you’ve said about him, there are red flags beyond a sensory disorder. His lack of initiation is a HUGE concern, and it sounds like he only uses language he’s learned in rote. I would stop the focus on academic skills and concentrate on helping him learn to use functional language. Although learning those kinds of things seem to be his strength, and you can certainly use those things for practice with auditory processing, it should not be the focus for your work with him at home or in therapy.

   Play based therapy activities should include strategies to help him learn to request and initiate spontaneously. Sabotage activities and withholding are great for this IF you’re sure he knows and can say the word - meaning that he’s labeled that item on his on. For example, teasingly eat cookies in front of him and don’t offer him one until he asks. Shake the juice container and pour yourself a drink, but wait for him to initiate before offering this to him. Prompt and cue him by saying, “This juice is so good! MMMMMM!” but don’t offer him a drink until he initiates. Withhold for 3-5 prompts before giving him the drink anyway, but if’s not upset and he doesn’t seem to care, wait until he asks for it. If he’s crying or frustrated, of course you’ll give it to him anyway because to not do that or to withhold beyond 3-5 times is just plain mean, and I’m not into that! If you need more help to learn how to withhold and sabotage, there are section you can watch on my DVD Teach Me To Talk and instructions in my book Teach Me To Talk: The Therapy Manual. It sounds like you could use the other ideas too to know how to work with him at home beyond what he’s getting in therapy.

   You may also want to have some very frank conversations with your therapists about what else is going on with him and what else you can do to help since they work with him and I haven’t. Good luck to you! Laura

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