This week’s podcast is responding to an SLP’s email with a very, very common scenario for those of us who work in early intervention. If you’re a therapist, I’m sure you’ll recognize these circumstances!
I work a lot with children under 3 (ASD& late talkers). I keep running into the same problem. I start with Hanen and parent education regarding same. Parents generally like the social interaction it can bring. Then I work on imitation skills with toy’s or motor movements. I also work on task completion.
AFTER this I get stuck. Parents want therapy weekly/ every second week. Kids are often saying a few words, but we seem to be doing the same things going nowhere. During Hanen kids play with same toys often silent despite my efforts (playing own agenda). Kids won’t imitate words and parents are frustrated as they have heard their child say the word in the past.
Usually lack of motivators and parent reluctance rules out PECS.
I would be so grateful for any advice or product recommendations for this dilemma. I am beginning to lose faith at this stage.
Listen for my ideas below:
Written summary of recommendations:
Keep teaching social games! Don’t settle for just a few routines. I don’t stop until a child has 10 to 15 games that he plays with me and his parents regularly. When this is the ONLY strategy that seems to be working (for example, a child’s only real engagement with you is during these games), I add even more. On the show I recounted a story 10 years ago (probably longer) when I sat in an IEP meeting and came up with 50 little games/routines we used with a child BECAUSE THAT’S THE ONLY TIME HE REALLY RESPONDED TO AND INCLUDED OTHER PEOPLE! If you need some new ideas for social games or have difficulty teaching and using games effectively, I can help you! Check out my book Teach Me To Play WITH You.
Be sure you’re using lots and lots of verbal routines. The first words many late talkers use consistently are often in the context of verbal routines. For toddlers with ASD or red flags for autism, the chances of hearing any purposeful words increase significantly with verbal routines because of the predictability and repetitiveness of the words they’re hearing. That’s their learning strength so of course it works! For more information about verbal routines, check out my one-hour online video Creating Verbal Routines, the therapy manual Building Verbal Imitation Skills in Toddlers, or my CE course Steps to Building Verbal Imitation Skills in Toddlers.
Intentionally include those infrequent “pop out words” (words parents have heard a child say a few times then never again) in your activities. Ask parents what words a child has said occasionally and then think of ways to purposefully facilitate these words. Scroll back up the show link and listen for examples!
If you’re hearing NO single words, back up to play sounds. “Real” words are too hard for some late talkers. If a toddler already uses sound effects like animal sounds or car noises or first words like “Whee!” or “Uh oh,” he’s telling you that he can be successful at this level. Read this post for ideas.
Make yourself a necessary part of the play with kids like this so they don’t shut you out. For example, play with toys they can’t operate by themselves like wind up toys, toys with levers, balloons, bubbles, anything that requires an adult. Or dole out the necessary pieces for the toys they like (Legos, puzzles, Potato Head, even a pile of cars or plastic animals) one piece at a time. Even if they’re not talking, they’re still interacting and this will build the foundation for language. There’s a wonderful section in my therapy manual Let’s Talk About Talking with specific instructions for doing this.
Double down on receptive language! When toddlers understand more words, they’re much more likely to use more words – particularly when there are delays or gaps in their receptive language skills as we note in many toddlers with red flags for autism. By gaps, I mean splinter skills, as in a child understands and loves higher level concepts like colors or numbers, but does not follow simple, functional directions such as “Go get your shoes” or “Bring me the book.” On the show, I discussed how I work this in to play with toddlers. For example, you’ll get them to follow fun directions as you play or even read a book together. Instead of just playing with a toy or labeling the pictures, get them to DO something. You can SEE examples of how this looks in my DVDs Teach Me To Listen and Obey. There’s a huge section on therapy techniques for targeting receptive language delays in my course Early Speech-Language Development: Taking Theory to the Floor.
Identify other prelinguistic skills that are weak or missing and target those. That’s the topic of my therapy manual Let’s Talk About Talking. If you’d like a sneak peak of those skills and beginning strategies, you can get a copy here on the site at this link, BUT you’ll need a password available to email subscribers. Sign up and get it!
Hope those ideas help!!