In this week’s podcast, listen as I help an SLP problem solve goals and strategies for a toddler with a short attention span who is not yet imitating any sounds or words. Here’s her original email to me and then a summary of the areas we discussed:
First of all I have to tell you I love your show! I listen to it between visits in the car. I’m an SLP working in pediatric home health and I have a lot of early intervention kiddos. I’m contacting you because I would love advice with one of my 2 year olds. He has many red flags for autism but is not yet diagnosed. He is 2.5 now and will be going to preschool soon. He has no words yet but babbles a lot. I haven’t been able to get him to imitate sounds yet even though we have been practicing this for months in many different fun ways. I can make him smile and laugh but he is VERY busy! He climbs all over the couch, climbs up into his tall high chair and climbs along the window sill. It is difficult to keep his attention but that is the area in which he has improved the most.
Do you have any advice for kiddos who get stuck in the action imitation phase for awhile but won’t yet imitate noises? He imitates actions fairly consistently but when I’m not there mom says he just takes her hands and pulls her towards what he wants. I have been trying sign with him for awhile and there doesn’t seem to be much follow through with mom even though I encourage it weekly. He sometimes will give his hands to me to make the sign for him but he will not yet initiate the sign and he has been in this stage for months now as well. I’d love to hear your advice! Thanks for listening!
AREAS OF FOCUS
Additional Ways to Improve Attention
Continue to do what he likes! Think about what’s worked to help him learn to stay with you. Ask yourself, “How do I keep his attention now?” “What gives me the results I want to see?” Do more of that!
Since social games with touch work for him, think of new games with those same components or add a new part to existing routines. Don’t make it too complicated which could drive him away! Just one little part.
Other ideas for improving attention from Let’s Talk About Talking that we didn’t get to discuss on the show:
Obstacle Courses to teach more purposeful and directed routines (from skill #4 on page 126)
Adapt a “move – sit – move – sit” schedule so that you’re up and moving to fulfill that need and then increase the likelihood that he’ll sit down for toys he likes and understands (from skill #4 on page 114)
Calm Down Play Sequence when it’s super hard to help him settle and participate (from skill #4 on page 127)
Use the “one more rule” to extend every play activity (from skill #4 on page 117)
Finish strong by adding clean up routines to most of your play routines and even daily routines (from skill #4 on page 118)
For getting him to pay better attention during brand new activities, try the placemat method (from skill #4 on page 122)
Begin easy with back and forth trading games (from skill #3 on page 94)
Review the Prerequisites for Using Signs to determine what’s missing since this has been hard for him
- are aware of you and focus on you when you talk to them (the social piece).
- understand the back and forth piece of communicating—meaning they listen to you and then respond (the turn taking piece).
- can imitate other body movements like clapping, banging on a table, waving, and doing hand motions in songs (the imitation piece).
- are beginning to link meaning to your words (the receptive language piece).
Work on those areas that are still weaker for him – turn taking, imitating, and of course, receptive language! Find ideas for improving his ability to understand early words and follow directions in skill #7 beginning on page 187.
Since signs are hard, consider PECS if it’s practical. There’s a longer discussion about the practical considerations for this child and family on the show!
What sounds does he already make? Think about to make these vocalizations more purposeful and tie them to his existing routines.
On the show, we discussed using his babbling to move toward word approximations for “go” and “more” since he says “guh” and “muh” more consistently. Verbal routines are an important step to helping late talkers use more words. Find out more about that in Building Verbal Imitation in Toddlers.
Other ideas for vocalizing are in skill #8 in Let’s Talk About Talking!
Based on what he can’t do yet, imitating sounds may not be realistic yet. Back up to imitating body movements and gestures. Encourage mom to build in opportunities to repeat her actions during daily routines like meal time and bath time. For example, start simple with things like patting your hands on the side of the tub or wall, clapping, pushing toys off the side of the tub, etc…
Look at the ideas in skill #9 beginning on page 241 from Let’s Talk About Talking. There are other great ideas easy for families to incorporate in the hand outs at the back of the book!