Have you ever wondered if a child is “just a late talker” or if there’s a larger problem?
Research reveals that there are several risk factors that let us know that a child’s late talking is likely a part of a child’s developmental differences, rather than the only issue. I’ve started a series of articles to address this concern. In this post, we’re addressing the fourth red flag:
Limited Use of Gestures
What are gestures?
Gestures are actions or body movements we use to share a message to others.
This nonverbal method of communicating is important because it signals that a child understands that he can convey his idea to you by doing something. He’s becoming symbolic, meaning that he can perform actions that represent his intentions and thoughts. For example, when a child reaches for something, it means, “Give me that!” When he waves, he’s essentially saying, “One of us is leaving. See ya’.”
Other common gestures used by toddlers include pointing, showing, giving, clapping and shaking your head.
Why are gestures important for language development?
Gestures are an important marker for language development and a precursor to words. Typically developing toddlers begin to use gestures just before they learn to talk. Many times, a baby will make sounds intentionally and begin to produce a few early word approximations as he’s using a gesture. For instance, you may hear him grunt as he raises his arms to be picked up.
Speech-language pathologists think about gesture use as an early part of expressive language development. We place just as much importance on a child’s ability to use gestures as we do on her ability to produce sounds. Gestures are a “sign” that a toddler’s language skills are progressing.
When we see a lag in a baby’s ability to use and understand gestures, we suspect that he or she will be a late talker. Research confirms that a toddler’s ability use gestures at 18 months can predict her language skills at 36 months.
Signs of Difficulty with Gestures
Babies who are typically developing begin to use gestures between 9 and 10 months and add on average two new gestures every month. Experts, namely speech-language pathologist Dr. Amy Wetherby, tell us that a child should be using at least 16 gestures by 16 months. When a child isn’t using at least a couple of gestures by the first birthday, it’s a red flag.
Diagnostic Implications for Limited Use of Gestures
Toddlers who don’t understand and use gestures have difficulty with the nonverbal aspects of communication. Many times this difficulty is linked to limited engagement and interaction with others. Current research tells us that early, intentional gesture use is so important for social skill and language development that any toddler who isn’t using gestures should be screened for autism.
Children with cognitive delays also have a hard time learning to use gestures. They may not understand what a specific movement can mean to others and may not have learned to imitate others’ actions.
A child with motor and muscle tone issues, such as cerebral palsy, will likely have difficulty using gestures because any kind of physical movement is challenging.
On the other hand, when a nonverbal toddler is using a variety of gestures to communicate, we don’t worry as much. We know that their expressive skills are developing, even if words aren’t!
Ways to Improve a Child’s Ability to Use Gestures
There are lots of things you can do to help a toddler learn to use gestures. First, model gestures yourself. The easiest way to remind yourself to do this is to talk with your hands! Be active and animated when you’re talking, playing, and taking care of a child. Point out things you want as you’re retrieving them and to direct a child’s attention toward something interesting. Shake your head as you say “yes” or “no.” Wave and blow kisses to people when you’re coming and going.
Get those little hands moving with lots of intentional practice! Teach a child to give high 5’s and a big thumbs up. Clap when something exciting is happening and to cheer successes. Play games and sing songs that involve familiar hand motions. Try “If You’re Happy and You Know It” and “Patty Cake.” Move on to new actions such as “Itsy Bitsy Spider” and “Wheels on the Bus.”
Recommendations for Parents
The most important recommendation I can make for parents of a child who is struggling with understanding and using gestures is to pursue professional assistance. Begin by discussing the concerns with your pediatrician or another healthcare professional. Ask for a referral to a speech-language pathologist or state early intervention program to evaluate your child’s overall language skills. If your doctor dismisses your concerns, get another opinion! You know your child better than anyone else ever will and if you’re feeling uneasy about your child’s development, trust your instincts!
Early intervention is especially critical for a child who is not trying to communicate by using gestures. As I’ve said in other posts in this series, maturity alone does not usually resolve these kinds of issues. By this I mean that a child won’t “grow out of it.” Intervention is absolutely necessary! In early toddlerhood and throughout the preschool years, I believe that specialized developmental therapy services are critical. This period is when we can make the MOST difference in a child’s outcome. It’s when developing brains are most “ready” for growth.
Parents of a child with any kind of language delay will benefit dramatically from having a professional or team of professionals teach them ways to successfully address their own child’s needs at home. Therapy doesn’t need to be a once or twice a week thing when a child attends therapy or goes to preschool. By working with therapists and teachers who have had experience treating other children with similar backgrounds, you’ll be able to trust that you’re doing everything you can to help.
In summary, a toddler who doesn’t use gestures may have difficulty acquiring a broad range of developmental skills including learning how to talk. These challenges may overlap into additional areas of development including a child’s fine motor skills. Assistance when the child is young can be highly successful for significantly improving, and in some cases, even eliminating these problems.
If you’re a parent, I hope that this information will help you understand what may be going on with your own child.
If you’re a therapist, this is the kind of information that doctors and other professionals may not be sharing with parents of a child with a language delay. It’s up to us to help families understand the depth of a child’s issues and provide hope that therapy, along with consistent parental commitment, can make a huge difference!
Keep watching for additional posts in this series! Next we’ll discuss pretend play.
Product Recommendations from teachmetotalk.com for Helping Toddlers with Language Delays
Toddlers who don’t understand and use gestures will have difficulty learning to understand and use language. My best resources for parents include:
Teach Me To Play WITH You is my first book written for both parents and professionals. In this therapy manual, you’ll learn my best tips for helping a toddler learn how to consistently interact with you during fun games and social routines. It can be the starting point for therapy for any child who isn’t using gestures because you’ll learn how to teach hand motions in songs and fingerplays. Each activity is written in a “homework format” with step-by-step instructions and goals that are clearly delineated. Parents who use this method rave about how quickly they noticed changes in their toddler once they implemented these methods.
Teach Me To Talk the DVD focuses on expressive language or what a child says. In this DVD, you’ll see the 6 beginning strategies I teach parents of late talkers. The DVD is filled with video clips of children with a wide range of abilities from 12 months to 3 years. It’s a great starting place for most parents (and therapists!) who want to learn real life ways to work with a toddler with language delays. There’s a section about teaching beginning sign language, the natural extension of gestures for late talkers.
If you’re more of a reader, the therapy manual Building Verbal Imitation Skills in Toddlers has an entire chapter on teaching gestures – especially when that has not come naturally – for the child or you! If you like an organized, easy to follow approach, get this book!
If you want detailed goal lists for both receptive and expressive language matched with activities to use with toddlers and preschoolers, take a look my book at Teach Me To Talk: The Therapy Manual. There are specific activities for teaching gestures and a great chart to use to help parents remember to include gestures in every day routines. This book was written for speech-language pathologists, but many parents use it as their basis for “at home” therapy.
For therapists (and ULTRA committed parents who are working with their children intensely or parents who don’t have access to services and need professional-level information), my CE courses that best address early language skills (including gestures) are:
Is It Autism? Recognizing and Treating Toddlers and Preschoolers with Red Flags for ASD is a course on DVD. Part One entails a comprehensive look at the diagnostic criteria for autism so it takes some of the guesswork out of this process. If you’re a professional and find yourself wondering if a child would or wouldn’t get an ASD diagnosis, this course is for you! Part Two is all about intervention. You’ll learn the most effective treatment strategies and approaches to jumpstart progress in a toddler with red flags for autism.
Early Speech-Language Development: Taking Theory to the Floor. In this comprehensive 12-hour course on DVD, all areas of language development (social, receptive, expressive, and intelligibility) are addressed. There’s a discussion about the importance of gestures and strategies for improving early language skills.
Steps to Building Verbal Imitation in Toddlers is a course that outlines how to move a nonverbal child toward using words and phrases in a sequential, step by step approach. It includes an entire section (it’s Level Two) on teaching gestures.
All courses are approved for ASHA credit for speech-language pathologists (and if you’re in IL, it’s preapproved for EI credit!) with a certificate of completion for other therapists to use toward licensure or certification requirements.
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Links to Milestones
Follow these informative links to the Center for Disease Control website with lists of skills and pictures to show you what’s normal for a child’s age range. Remember that most babies will have easily achieved the skills listed there – meaning that the standards listed are set at a minimal level to account for a wide range of “normal.” (In other words, the bar is pretty low.) If a child hasn’t met all the skills on these lists or especially exhibits the concerns in the bottom “Act Early” boxes, there is a definite reason to speak to your child’s doctor or healthcare professional.
Here’s a link to a FANTASTIC resource outlining the importance of gestures by Dr. Amy Wetherby.
Photo credit: slate.com