If this is your first visit, I’d like to tell you how I recommend for new moms to navigate the site because I have TONS of info on here that may not be apparent to you with your first click!

The site is organized in chronological order with the newest entries listed first here on the home page. However, most of the best information for parents is in the older articles. What I recommend for first-time visitors is to take a look at the yellow category bar near the top of this page. Find the topic which most interests you. Once you’ve clicked on that section, scroll down to the bottom of the page and select Older Entries. Keep clicking until you’re at the “beginning” of each section, so that you can read the older articles first.

You may want to scroll thru the podcasts too until you find show titles that are most applicable for your child. 

Thanks for stopping by, and I hope you find what you’re looking for to help your baby! If not, leave me a comment with your questions, and I’ll try to point you in the right direction.      

Limited consonant sound use results in unintelligible speech and often indicates a motor speech disorder (apraxia) or phonological disorder. Check out these norms and the list of “red flags” which indicate that speech therapy is likely needed to help your child learn to be understood.

By 18 months -

Child produces 3 to 6 different consonant sounds with each child having a little different consonant inventory.

By 24 months –

Initial Sounds - /p, b, m, t, n, d, h, k, g/

Final Sounds - /p, m, n/

Produces Most Vowel Sounds Correctly and at least 6-8 different consonant sounds.

By 28 months –

Initial Sounds – /d, f/ and “y”

Final Sounds - /s, d, k, f/ and “ng”

By 32 months –

Initial Sounds - /w/

Final Sounds  - /t, b, r/

By 36 months –

Initial Sounds - /s/

Final Sounds - /l, g/ and “er” endings

Child uses at least 9-12 different consonant sounds.

By 40 months –

Initial Sounds - /l, r/

Some consonant blends – bl, br, tr

Final Sounds – /v/ and “sh”   

By 44 months –

Initial Sounds – “sh” and “ch” and fl

Final Sounds – “ch”

By 48 months –

Initial – sp, st, kl

After 48 months –

Initial - /z, v/ and “j”and th”

Final - /z/ and “th” and “j”     

RED FLAGS for CHILD’S ARTICULATION SKILLS that warrant a referral to a speech-language pathologist for evaluation. (Stoel-Gammon 1994).

   Numerous Vowel Errors  -

    Most children have mastered nearly all vowel sounds by age 2. Some errors are still acceptable are age 2, but by age 3, all vowels be mastered (with exception of /r/ vowels).   

   Widespread Deletion of Initial Consonants

    By 2 a child should use at least 3 to 4 different consonant sounds at the beginnings of words.

    By 3 a child should have a large repertoire of initial consonants.

   Substitution of Back Consonants /k/ and /g/ or /h/ for a variety of Consonants  

    This is atypical phonological development and should be targeted even in very young children.

   Deletion of Final Consonants after age 3   

    By 24 months in language delayed children some final consonant deletions are expected, but by 36 months, all children should be producing words with ending consonant sounds.

Again there is variation in individual children, but for the most part, parents should understand close to all of what a child says by age 3, and strangers should understand all of what a child says by age 4, even if errors are still present.       

For more information about how to treat speech sound disorders, check out my DVD Teach Me To Talk with Apraxia and Phonological Disorders. Here’s the link - 

 http://teachmetotalk.com/2009/08/21/teach-me-to-talk-with-apraxia-and-phonological-disorders-dvd-now-available/

Laura,

Hope this helps.  

So?  What does this mean for you if your child has been diagnosed with apraxia?  Children have to practice SPEECH, not movements without any sound or movements with just a sound (such as “p” for /p/) to be able to learn to talk.   

Dr. Lof’s mention of working at the syllable level means that sounds aren’t practiced alone, or in isolation, as your SLP might say.  Most early interventionists and pediatric SLPs use this approach since we work on WORDS in the context of daily activities or play.  Sometimes SLPs (myself included) will cue the sound in isolation, or by itself, to be sure the child is capable of producing the sound as well as to heighten a child’s awareness of the sound. 

Your SLP might also use verbal, visual, or tactile sound cues such saying “Use your popper sound” for /p/ while pointing to her lips, or your “throaty” sound for /k/ while touching under your child’s neck.  Again, this kind of practice should be very limited (no more than a couple of repetitions) and shouldn’t be the focus of the session since we’re talking about toddlers and young preschoolers here!  Individual speech sounds should be placed in words pretty quickly so that the sounds make sense AND so that you don’t lose a child’s attention in this process.  Cognitively, most children aren’t ready for intensely focused sound production practice until after 3.  

Sound practice for children with apraxia isn’t recommended since it’s the SEQUENCING of sounds that usually causes the problems with intelligibility.  He or she may be able to say the sound alone perfectly, but then it falls apart in the word or phrase.  Practicing the individual sound over and over is often pointless since this is not the real problem.        

Let me also reiterate one more HUGE principle that I’ll emphasize yet again.  If your child is really young and his LANGUAGE skills (vocabulary size, phrase length, using words to ask for things and respond to you, etc…) are NOT age-appropriate, all of these speech or sound issues should take a back seat to helping him learn to be an effective communicator.  The time to address all of the specific sound errors is AFTER his language skills are well on their way to matching those of his same-age peers.  Focus on WORDS and COMMUNICATION.  Intelligibility will come, but it won’t matter anyway if he has nothing to say!   Laura      

There’s a whole lot of research in the past few years that tell us that oral motor exercises DON’T work to help children learn to speak more clearly.  Before all of you get fired up and start a campaign to write in to tell me how crazy I am, let’s take a look at what science says……….. 

In his ASHA presentation in November 2006, Dr. Gregory Lof, a PhD level speech-language pathologist from MGH Institute of Health Professions in Boston, titled his work, “Logic, Theory and Evidence Against the Use of Non-Speech Oral Motor Exercises to Change Speech Sound Productions.” 

In real words - he’s saying that common sense tells you that these exercises don’t work to make children  speak more clearly, and then he cites a whole bunch of scientific studies that back him up. 

For those of you who are really confused, he’s defined “non-speech oral motor exercises” as “any technique that does not require the child to produce a speech sound but is used to influence the development of speaking abilities” and “a collection of non-speech methods and procedures that claim to influence tongue, lip, and jaw resting postures, increase strength, improve muscle tone, facilitate range of motion, and develop muscle control.” 

Again, but in English please!  He’s talking about all of those mouth “exercises” or “games” that SLPs tell you to do including blowing, tongue push ups, pucker-smile, tongue wags, big smile, tongue to nose to chin, cheek puffing, blowing kisses, and tongue curling.  

Basically, he’s saying any “game” or “exercise” that you have your child do that DOES NOT INVOLVE him making a speech sound is not going to help him learn to talk.  This means that all the blowing, sucking, tongue exercises, and lip games you’ve been doing will not do one bit of good when it comes to helping him produce clearer speech.  OUCH! 

Now I can’t say that I’m an SLP who has over-relied on this kind of stuff.  I’m a talker, and I push functional communication whether it be with signs or words in play practically every minute of the time I provide direct treatment to a child.  I hardly spend any time doing oral motor stuff in sessions because, frankly, I feel like my time is better spent doing “REAL” therapy stuff, and in my opinion, that’s language-language-language. 

I do not write goals that say, “Johnny will perform 10-15 repetitions of oral motor exercises to improve strength and coordination for intelligible speech.”  I do not make claims that these kinds of activities will “improve muscle tone,” but I know lots of SLPs who do and who base their whole treatment plan around these kinds of goals and strategies for non-verbal children and for children who are struggling with speech intelligibility.   

I’d like to say that I haven’t done lots of oral motor activities in sessions because it didn’t make sense to me clinically.  But the truth is, it’s because I hadn’t found a way to make them fun enough to do on a consistent basis or for any length of time.  Because of this, it never really felt right or worth pursuing for me, or especially for a kid.     

Besides - have you ever really tried to get a 2 or 3 year old to do these kinds of things for more than a minute or two?  You might have an initial novel period where they sit with you and try to do it, but unless you make it super fun and whacky, I’ve found it wasn’t successful for very long.  It’s usually pretty hard for them to do, and again, it’s usually pretty boring. 

BUT I have routinely recommended, out of some kind of SLP obligation, at least in my initial assessments, that mom and dad do these kinds of things with my little clients as part of ”homework.”  I have even recommended these kinds of things for kids without low muscle tone or who don’t have sensory issues that are negatively affecting feeding.  Why?  Because it’s somehow ingrained in how we’ve been trained as SLPs.  There are whole catalogues, entire textbooks, countless treatment manuals, and week-end long continuing education courses devoted to telling us how effective these are and how to do these.         

As a matter of fact, Dr. Lof cited that 85% of SLPs in America who were surveyed said they use non-speech oral motor exercises to change speech sound production.  Results were the same for Canadian SLPs.  He cited other interesting statistics including the most frequently used exercises, the reported benefits, and  the diagnoses of children when these kinds of exercises were used.  

I will tell you that every “diagnosis” for kids I see were on that list including dysarthria (which is unintelligible speech due to low muscle tone), childhood apraxia of speech, structural anomalies (probably cleft lip/palate but not specified), Down Syndrome, enrollment in early intervention, late talker diagnosis, phonological impairment, hearing impairment, and functional misarticulations (meaning sound substitutions).  This tells us that MOST  SLPs are recommending this kind of task for MOST clients that they see - even toddlers enrolled in early intervention programs.     

His conclusion, again based on a number of studies, was that it’s not appropriate for any of them.  Double OUCH! 

Again, I don’t feel too badly on a personal level since I haven’t used them all that much, but I feel super sad about all of the therapists who have and mostly for the moms they’ve convinced to try to do it.   

In this presentation, he also dissected most arguments for using oral motor exercises including that children must first learn to produce isolated movements before they can use a speech sound, that you have to build up articulatory strength when a child has low tone, that these exercises “warm up” the mouth before talking, and that you have to have adequate coordination in non-speech exercises before you talk. He debunked every one of these very persuasive arguments for non-speech exercises with 10 different studies that prove otherwise.  His conclusion was that no research supports the use of these for any reason when improving speech is the goal.  Triple OUCH!   

His bottom line was this -

“If clinicians want speech to improve, they must work on speech, and not on things that LOOK like they are working on speech.” (GOOD!  To learn to talk, you must focus on talking and not blowing, wagging, puffing, etc…!)

“Phonetic placement cues that have been used in traditional speech therapy are NOT the same as non-speech oral motor exercises.”  (GOOD!  This means you can and should still give your child verbal, visual, and tactile cues about placement of his tongue or lips to help him make a speech sound correctly.  The difference here is that you’re actually working on SPEECH and not just a movement.)

“Non-speech Oral Motor Exercises are a procedure and not a goal.  The goal of speech therapy is NOT to produce a tongue wag, to have strong articulators, to puff out the cheeks, etc… Rather the goal is to produce intelligible speech.”  (GOOD!  Goals must have speech and language outcomes.  That’s a big duh to me, but again, these never made much sense to me anyway.) 

“Speech is special and unlike other motor movements.”  (GOOD!  He means that using these kinds of exercises to improve feeding do not necessarily correlate to the same movements needed for speech.  He cites studies that prove that same function/same structure argument doesn’t hold water.  He also means that working on a particular oral exercise like lifting your tongue up and down 10 times in a row may not translate into a kid being able to lift up his tongue to produce a sound like /l/ when saying a word or in a phrase.  No kiddin’!  I gave up that kind of assumption early into my 2nd year of work when this rarely produced results!)

This last one really gives a kick in the seat of the pants to SLPs who depend on oral motor exercises as a staple in their treatment plans - 

“Following the guidelines of evidence-based practice, evidence needs to guild treatment decisions.” (Here’s his parting blow - ) “PARENTS NEED TO BE INFORMED THAT NON-SPEECH ORAL MOTOR EXERCISES HAVE NOT BEEN SHOWN TO BE EFFECTIVE AND THEIR USE MUST BE CONSIDERED EXPERIMENTAL.”  (Emphasis was mine, not his.)

My bottom line is this - I won’t be recommending or doing these in therapy anymore for kids whose focus is speech and language, and now not just because young children don’t like them and won’t do them, but because science tells me not to bother.  Whew!  Laura

Here’s the original article’s reference for those of you who want to read it yourself - 

http://www.speech-language-therapy.com/Lof-2006-ASHA-06-Handout.pdf

Other articles from experts who’ve looked at the same issues & reached the same conclusion -

Caroline Bowen - http://www.speech-language-therapy.com/cb-oct2005OMT-ACQ.pdf

From the Apraxia Kids Site -

http://www.apraxia-kids.org/site/c.chKMI0PIIsE/b.980831/apps/s/content.asp?ct=464461

In the spirit of fairness, here are articles that disagree with Dr. Lof’s findings -

http://www.speech-language-therapy.com/oral-motor-TT-bathel.pdf

http://www.speech-language-therapy.com/williamsetalACQ2006.pdf

One more thing - Another SLP also cited Dr. Lof’s article and arrived at this conclusion which I also agree with -

“Oral Motor therapy does have its uses. While it is ineffective for improving speech production it is effective for treating many issues related to feeding. And that is an important distinction. If your child is drooling, or unable to move food around with his tongue and chew, Oral Motor Therapy can be very effective if provided by a competent therapist.”   http://www.speechlanguagefeeding.com/Newsletter.html

This is a mom who’s poured out her blood, sweat, and tears over the last several months to do anything she can to pull him into interacting with her, and now that he is, she’s elated.  But …. she still doesn’t hear that magical word, that word we all wait with baited breath to hear from our sweet, little babies - “Mama.”

On our show today, we gave Annette a couple of different ways to work on how to help him learn to call her Mama, but before we get into that, let’s review what could be going on. (Let me say that I didn’t explore all of these with Annette on air, and I haven’t had the pleasure of meeting her cute little boy, so I don’t know with any certainty why her particular son isn’t doing this yet.  However, it is not uncommon for children with language delays to struggle with learning to say “Mama” for several different reasons.  I’m going to discuss the possibilities of why he’s not doing it yet, and hopefully give you some ideas so that you can work on these at home with your child who may not yet be saying this wonderful word.   

Possibility #1 - Conceptually he has not made the connection between this particular word and his actual mother. 

Sometimes it’s because this word has not been presented to him in the same way that he learns all of his other words.  Since his mother is likely doing most of the teaching, it’s hard for her to label herself in a way that makes sense to him.  When she’s teaching him names for other things, she’s repeating the word many times, holding up the object , or pointing to it so he gets what she’s talking about.  She may even have him “ask” for it so that she knows he’s made the connection between the word and the actual object or event.  This is kinda’ hard to do with yourself!  Even though a mother is likely saying “mama” in context all day long (”Give it to Mama.”  “Do you want Mama?”  “Where’s Mama - Here I am!”), it’s just not the same for him as when his primary language labeler says it, shows it, and does it in the way that she teaches everything else. 

Solution - Use very specific activities to teach him to conceptualize or learn this as your label/name.  Ideas you can try at home: 

1.  Play the “Mama “game.  

Just like you’ve tried to teach him “Dada” or any other name by constantly labeling that person,  you’re going to have to get someone to play with you to label you as “Mama.”  The most success I’ve had with this is by placing the child in a confined area, say the crib, or behind a gate, or in a room with a closed door and me.  Mom hides outside the room, behind the door, or bends down below the crib so that the child can’t see her.  Then I model calling, “Mama.  Mama.  Maaaaaaamaaaaaaaaa”  several times using an exaggerated, playful, and animated tone of voice.   After doing this several times, Mama excitedly jumps out from her hiding place with a big smile and shouts, ”Mama!”  We all laugh and smile and hug and tickle so that it’s very clear that this is a fun game that we all want to play again.  Then we play it again.  And again.  And again, until I think he’s ready to begin to try to imitate “Mama” when I model this.  If he even hints that he’s trying to say this on his own, I ask Mom to pop up with the biggest reaction she can muster so that he links his action (saying the word) with her return.  Older siblings are GREAT at playing this game with younger brothers and sisters.  The act of having someone else “call” you and label you as “mama” sometimes helps a child solidfy this concept. 

2.  Play the “name” game for everyone at home.

I usually recommend that families do this at dinner or at another time when everyone in your family is seated and isn’t distracted.  (Meaning no TV or other playful activity going on!)  Start with the “name” your child most easily understands or says and ask, “Where’s ______?”  Build up the anticipation by asking it several times.  Hold your hands out and look around expectantly.  Wait for your child to look at the person, point, say the name himself, or somehow indicate where the person is.  Even if he doesn’t, have everyone  excitedly point, look, and shout the person’s name.  Have the person named hold up their arms or clap or do something to indicate that he or she is the person named.  Laugh, giggle, smile, hug, and make this a total riot for your toddler.  Repeat it for every member of your family, but especially have someone else ask, “Where’s Mama” so he doesn’t hear that label from you. 

Possibility #2 - He is a visual learner and needs a new method of presentation for this word to make sense and ”sink in.”

Some kids learn almost everything they know visually, by seeing it, and not auditorily, just from hearing it.   That’s what makes it so difficult for kids like this to learn language since language is an auditory communication system.  These are the kids who like to look at pictures in books, and these are the kids who LOVE television and videos.  Use this to your advantage.  

Solution - Teach him visually.  

Make a ”Mama Movie.”  Have your husband,  a grandparent, an older sibling, or your best friend come and shoot some footage of you in some very focused activities so he can learn to label you as ”Mama.”  This has been a huge success every time I’ve used it. 

Try to shoot the beginning shots with as plain a background as possible.  Try to look as “normal” as possible.  If you usually wear sweat pants and have your hair in a pony tail, don’t doll up for this movie.  Your kid may not recognize you!   

Begin by standing right there in living color, looking right into the camera and saying “Mama.”  Smile.  Pause.  Say it again.  Wave.  Say it again.  Blow kisses or do any other action your child might associate with you.  Say Mama in this way 5 or 6 different times with huge pauses in between so that your child can begin to imitate and say “mama” himself during these pauses.  Then have your person behind the camera say it a few times in imitation of you, or after you say “Mama” again several times.  This will help your child begin to imitate this word.

After a few rounds of this, turn the camera off and reposition yourself behind a door or or couch or counter.  Then have the person filming turn the camera back on focused on your hiding place.  Have the other person ask,  “Where’s Mama?  Mama.  Mama!”  Jump out from behind the obstacle in a very animated and playful way and say, “Mama” with as much warmth and excitement as you can muster.  Again have your camera person say, “Mama! Mama!”  Repeat this several different times in several different locations.  Don’t forget to use pauses so that your child can being to imitate the word “mama” at the appropriate times.    

Sometimes families have added other statements such as, “There she is!”  But I think it’s most effective to limit the word to “Mama” so that there’s no doubt what you want your child to learn to say. 

You can repeat this with other family members too.  But again, if “Mama” is the goal, don’t make it more complicated than it needs to be!        

Once your child can do this, move on to the Mama games listed above in #1 or reenact some of your “hiding” places from the movie in real-life too.   

For kids who love books, make your very own Mama photo album.  Have someone take lots of current digital pictures of you.  You’ll need new ones, not ones from 20 pounds ago, or when your hair was longer or blonder, or any other pre-mom photos since we all know how different you look now that you’re sleep-deprived and exhausted from chasing a toddler!  It’s so hard for most moms to come up with several pictures since we are usually the ones behind the camera! Take several new ones, and again in your “normal” everyday Mom attire.  Try to get lots of close ups with few background distractions too.  

Buy a small, cheap album from the Dollar store and place the pictures inside.  Don’t spend lots of money on the album or buy a nice one that you’ll use as a keepsake, because my hope is that your child will love it so much that he’s going to want to carry it around with him all of the time.  You’ll be less likely to let him do it if it’s expensive or pretty, and you’ll find yourself getting too upset if he tears it, chews it, whirls it at the dog, or flips the pictures with his dirty, little hands.  Help him look at it and say “Mama” about 150 times with as few other words as you can force yourself to do.  Point to yourself.  Say it again and wait, wait, wait for him to say it back to you.  Have other people look at it with him too.  Try to use this during times when he is calm and more likely to look at it for more than a second or two.  Right before nap or bedtime is a good idea, or when he’s strapped into his car seat, or sitting in the waiting room at the pediatrician’s office when you need a quiet activity.     

Possibility #3 - For whatever reason, he can’t say the sound /m/ and/or sequence it with a vowel yet to form the word “Mama.”  

This could be a physiological issue - he has low muscle tone so he can’t get his lips consistently closed to form the speech sound /m/.  (Look for lip closure at other times.  It actually takes very little lip “strength” to close your lips to produce an intelligible /m/ sound, so if he can do it when he’s not talking, low tone is not a significant factor for him.)

This could be a sensory issue - Some kids don’t like the feeling of their lips being together to vibrate for /m/.  These are the kids who may refuse lots of foods, hate having their faces washed, or flip out when you try to brush their teeth.  They truly are HYPERSENSITIVE in and around their mouths or possibly all over their bodies.     

Then there’s the other extreme.  HYPOSENSITIVE - These kids have so little awareness of their mouths that they don’t even know “how” to make an /m/ sound.  Usually there are other indicators such as profuse drooling after age 2 since they don’t routinely close their mouths (usually mouth breathers from a sensory perspective OR because they have so many allergy/respiratory issues that they HAVE to mouth breathe!).  This may be a kid who constantly places toys or other things in his mouth.  Or it may be a kid who overstuffs his mouth with food to the point that he gags.  He lacks the normal sensations in his mouth.  He literally does not “feel” things normally.       

This could also be a coordination, or motor planning and sound sequencing issue.  He may even be able to use an /m/ sound alone, but not necessarily combined with the ‘a’ for Mama.

Solution - Work on the /m/sound.  

My favorite way to get this sound is by doing ”mmm, mmm, mmm, mmm, mmm” with foods he loves.  Exaggerate it.  Shake your shoulders when you do it.  Make it so silly and captivating that he’s going to want to try to imitate you.   

While earlier in my career I may have tried chapstick or lip gloss on your lips and then hers (or his!) and again exaggerated rubbing my lips together to increase sensory awareness of his lips, now we know that that’s more likely to promote tongue protrusion since the child will only want to lick that yummy stuff right off his lips! Some SLPs like vibrating toys or textured spoons, but I’ve even stopped doing all fo this.  

You MAY even try helping him get his lips closed by placing your index finger above his top lip and your thumb below his bottom lip and helping him close his lips, but if he’s negative or over-reactive to this very hands-on approach, stop. Don’t overdo this method because then you’ll ruin it for the both of you! 

One little guy I have right now is responding very well to the verbal cue, “Hide your lips” to produce an /m/ sound when he watches me model this sound.   

When he can do “m”, or even if he can’t, keep modeling “mama” in speech often so he begins to imitate it, even if it’s not in context, or purposeful just yet. 

———————————————————————————

I hope these ideas help your child begin to say this magic word!  AND you have to promise NOT to complain when he says it so much in a few years that it makes you crazy, but that’s a whole different post!!!  Laura

Maybe the “experts” tell you everything’s fine. But you can’t get past that nagging feeling that things should be getting better. And they just…aren’t.

As a parent, there’s nothing more frustrating than watching your precious baby struggle to learn to communicate. While friends’ and relatives’ toddlers are all saying “Mama” and “ball” and even forming simple sentences, your child can only cry in frustration, locked away from the world of words that should to be opening up for her.

You can’t help feeling embarrassed, or jealous, or even angry. Why YOUR child? Why does it have to be so hard?

You would give anything for your baby to be able to ask for help when he needs it, or tell you he loves you when he snuggles close.

Everyone tells you, “Oh, she’ll talk when she’s ready.” Even the pediatrician insists there’s nothing seriously wrong. But you KNOW your child. You know she WANTS to communicate. You see her trying. You know she’s ready now.

But no matter how hard you try to help her, the words don’t come.

Maybe your child is seeing a speech therapist. But it’s hard when the techniques the therapist tells you to use at home are too hard and too complicated for you – let alone your toddler!

I want to tell you right now, the problem is not you.

And it’s not your child.

The problem is simply that you don’t have the simple, easy to understand tools you need to help your child communicate.

Until now.

Right now, TODAY, there IS something you can do. Without letting another painful, frustrating, heartbreaking day go by.

BECAUSE FINALLY, THERE’S AN EASY, FUN, NO-TEARS METHOD THAT’S PROVEN TO HELP TEACH YOUR TODDLER TO TALK.

It’s called Teach Me To Talk, and take it from a mother who’s been there – it’s just amazing.
The Teach Me To Talk DVD is packed with strategies that will unlock that beautiful voice your child has locked away inside. And best of all, these strategies are PROVEN to be simple to learn, easy to apply, and best of all, successful in teaching young children to talk.

Interested in seeing the Teach Me To Talk techniques in action? Here’s a quick preview of the Six Essential Strategies you’ll learn — and a glimpse of the first technique you’ll see:

What makes Teach Me To Talk different?

It was developed by Laura Mize, a pediatric speech-language pathologist who has literally spent thousands of hours and 15 years on the floor, helping toddlers just like yours and mine learn to communicate.

Laura has read stacks and stacks of research on the subject of delayed speech in children. She’s attended more professional courses than you can count. She’s taken the best of the best from all the “experts” in language development.

And she’s condensed all those years of learning and experience and trial and error into a single DVD, with the six most simple, most practical, MOST EFFECTIVE strategies to get your child talking. And best of all, you can start using them the minute you start watching the DVD.

“Thank you so much for this DVD! Our 3 and a half year old son has apraxia and only has 10-12 clear words. When I first started watching this DVD, I wondered if I could ever be that animated. About 5 minutes into the DVD, my son walked into the room and was instantly fascinated. He sat with me and watched the rest with me! His reaction was truly amazing, and our speech therapy will never be the same again! The most amazing thing to me, though, was how my son interacted with you! During the 90 minute video he “got” two new words: choo choo and boom. He also tried to say “pull” and “barn,” and learned the sign for fish. Twice he signed “give me” and then touched a toy you were playing with, and every time you tried to get a child to say a word he knows, he would say it with you.” Robyn, mother from Wyoming

How wonderful would it feel to hear your child say “Mama?”

You’ve been waiting for that moment since he was born and you first held him in your arms. But as the months have dragged by, you may have started to lose hope that you will ever communicate with your baby – to hear what he wants, what he needs, what he feels.

And even if your toddler can say a few words, is it taking longer for her to communicate than other children her age? Are you constantly trying to interpret what you think she might be saying, or asking for?

Maybe both of you are ending up in tears.

“[When I watched the DVD] I felt like I was reliving my son’s life for the past 1 1/2 years now. It was a little sad in some ways, but on the other hand if I concentrate on where he is now and how far he’s come, it’s positive…..” Holly, mother from New Hampshire

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The Secret is Simple…Change Your Approach!

Of course you’ve been trying to teach your child to talk. It’s what parents do. But if what you’re doing hasn’t been working, the solution is simple.

Change your approach.

If you’re like me, you’re probably wondering what that can possibly mean when you’ve tried EVERYTHING. The problem is, you’ve probably tried without really knowing what to do, or how to do it.

This DVD will change everything. Because a lot of the time, it’s not what you do, but HOW you do it. Teach Me To Talk will lay out step by step, in easy-to-follow terms, exactly what you can and should be doing to help your baby learn to talk.

“I know for a fact that Laura’s approach really does work because I’ve been using it for years myself! Don’t be afraid to copy exactly what she says, how and when she says it! It is not hard and can become second nature to you, just as it has to me. By implementing her approach, you will set the stage for both you and your child to be successful!” Kate, Developmental Interventionist, Kentucky

If your child has a language delay, no doubt you’ve heard it all. There’s always the well-meaning friend who tells you “Boys talk later than girls.” Or the mother-in-law who tells you to “Wait and see” (while you worry what she’s saying about your parenting skills behind your back).

The fact is, the most critical time for language development in a child is from birth through age three. So if you feel in your heart that something’s not right, you’re probably on to something. You know your child.

Most parents of children with language delays regret that they waited to do something. The good news is, YOU DON’T HAVE TO WAIT ANY LONGER.

Teach Me To Talk will show you a better, easier way to do things. Things you can do RIGHT NOW, at home, that will help your child learn to talk. It’s all about learning a new and better way of working with your child.

After all, as a parent, you are the most important teacher your child will ever have.

“Just wanted to let you know how thrilled I am with your video. I just received it five days ago and I’ve watched it every morning to gear up for working with my daughter each day and I have to tell you what a difference it has made! My daughter has been in therapy for a year and a half (she’s 31 months) and she would often run from me during our “play” sessions…finally, after only five days, she is starting to think that her mommy is fun during playtime! Thank you for giving me a way to really connect with my daughter on a new level. This video is priceless.” Helen

“I do think the video will be very helpful for parents with late talkers. The ideas are great, and you really do show them how to do the things you are talking about which is very important…..” Holly, mother from New Hampshire

Secrets Your Speech Therapist Hasn’t Told You (or might not even know!!!!)

“Even when weekly therapy reports indicated a great deal of progress, we weren’t always seeing that progress at home. The Teach Me To Talk DVD has dramatically changed the number of words we hear. Seeing the techniques you use, and seeing how easy they are to incorporate in to our daily routines has been a blessing. I can get so many words and even phrases out of my both my toddlers by incorporating playfulness in to our daily activities. As a working mom, I’ve always felt as if I’m not as active in my children’s therapy as I should be. You DVD is finally helping me make that connection. Thank you so much for such a fantastic tool!” Stephanie, Mother from Kentucky

Speech therapy is a specialized skill – that’s why speech therapists charge hundreds – even thousands — of dollars for their services. But the very same techniques they use can be SIMPLIFIED, so that you can use them at home.

Teach Me To Talk will teach YOU how to use the very best, most effective techniques speech therapists charge hundreds of dollars for. Watch and learn as these techniques are explained in plain language so that you can use them at home. Then, see each technique in action.

And you won’t just see how it works with one child, but with 20 different toddlers, all with different personalities and challenges. You’ll be amazed and inspired by their progress as each and every one of them learns to talk – just like your child can with the Teach Me To Talk DVD.

“The DVD brought tears to my eyes (not your goal I’m sure, but there you go!). Each strategy you used - reminded me of my child. It is amazing how simple techniques (most of which we take for granted) can help a non-verbal child become verbal. Another thing I learned from my experience with being a mom, a pediatrician, having your guidance and the DVD - is that language, talking, speech, and articulation involve SO many other aspects of development.” Ranjana, pediatrician and mom from Ohio

If your child is a late talker, you’ve probably read dozens of parenting books and looked for advice on the internet. But when you apply it to YOUR child, it doesn’t always make sense.

Do you try to do what the “experts” say, but find it just doesn’t work with your child?

The secret isn’t just knowing WHAT to do, but WHY you need to do it, and better yet, seeing exactly HOW to do it. Teach Me To Talk unlocks those secrets.

“The DVD was quite different from what I expected - in a good way. I hardly expected to see so much one-on-one with the kids, and it was great!” Kristyn, mother from New Hampshire
”The DVD is great! I wish I had had this when we first started down the path with Gabe who has been diagnosed with apraxia.” Julie, mother from Illinois

View It — Then Do It!

You don’t have to read another book. You don’t have to make time for a class. All you need is a TV and a DVD player – you can watch and learn at your own pace, in your own time, in your own home.

And your child can be right there with you while you learn!

“I recently watched a DVD that has been advertised on this site called Teach Me to Talk, by Laura Mize, Pediatric Speech-Language Pathologist. The DVD was 90 minutes long and taught six strategies to teach your child to talk.

It is aimed at toddlers who are delayed in speech…..which is how I will use it. It has tons of video of the speech therapist actually working with children! This was so informative. Laura Mize explains what she is doing while showing actual video of her working with children with delays! These are things you can incorporate in every day interaction with your child. I finished watching the video feeling like I could really teach my child to talk!

From the time I first learned Sophie had autism, I have wanted to see what a speech therapist actually did while working with a child. I desperately want to homeschool Sophie, but until now I have been in the dark about what the experts do to get children to talk. Now I have video examples to work with.

I watch this video with my 3 children in the room, and my daughter Sophie, was actually playing along with the video! I highly recommend this video for anyone who has a child with delayed speech. It is worth every penny.”      Sarah, mother and author of the website www.wakingsophie.com

Teach Me To Talk takes the camera INSIDE therapy sessions with children just like yours. Whatever stage your child is at – if you’re just wondering if there’s a problem, if you’ve already seen a professional or if your child is currently in speech therapy – you’ll see all kinds of children in all kinds of situations.

So you’ll discover the very best techniques to use with YOUR child.

”Seeing these tips ‘in action’ was very beneficial. When you have a child that is language delayed, you want to do as much at home as you can - after all, our children are at home most of all! And this DVD helped me do that.” Kristyn, mother from New Hampshire

All of this…for only $39.99???

It can be expensive teaching your child to communicate.

Conferences that teach parents and therapists cost hundreds of dollars – and take up hours and hours of time.

But the Teach Me To Talk DVD has all the information you need for only $39.99. That’s less than 1/3 the cost of a typical one-day training conference.

And the Teach Me To Talk DVD is packed full of ideas and tips you can use all day, every day as your child learns to communicate. Plus, it’s yours to keep and watch over and over again until you master the techniques.

“I have worked with quite a few speech therapists in my practice as a developmental interventionist. In ten years, I’ve only worked with one that was universally appreciated by parents and young children alike! Thanks to this DVD, you no longer have to live in our county to benefit from Laura Mize’s unique and effective approach. For a minimal investment, she comes live to your living room to demonstrate her highly successful approach to speech and language therapy.” Kate, Developmental Interventionist, Kentucky

To order, click this link.

To order directly through PayPal, click below:  

Teach Me To Talk the DVD is now available for an introductory offer of $39.99 plus shipping and handling. This is for a limited time only! Order yours now!  

          
  “A lot of the therapy techniques that you use, some and or all of his therapists have used EXCEPT for a few things. First, your enthusiasm it’s AWESOME!!!!! I have never seen any of my son’s therapists be so upbeat and fun as you were in your video. I wish they had been because I know my son would respond so well to that in therapy. Any time I play with him at home and do some of the things you do with your kids, like tickling them and just being ’silly,’ his whole frame of mind changes and I can usually get him to try whatever it is again at least one more time.” Holly, mother from New Hampshire

Watch how you can learn sign language to help teach your child to communicate.

“I also like the emphasis put on signing with your child. I was very hesitant to do this with my son at first, I was afraid it would hurt his speech development, but it helped him learn that he has to do something to get something, now anytime I hear someone say they are hesitant about signing, I pipe up and tell them to please consider it. What a great DVD! It will be a huge help to other parents like me!” Julie, mother from Illinois

Teach Me To Talk the DVD is now available for an introductory offer of $39.99 plus shipping and handling. This is for a limited time only! Order yours now!

Get The Must-Have Speech Therapy DVD Recommended For Both Parents and Professionals!

The Teach Me To Talk DVD was especially designed for parents. But the techniques used are equally beneficial for professionals. Anyone who works with young children can learn from these PROVEN, EFFECTIVE techniques, including speech-language pathologists, developmental interventionists, occupational therapists, service coordinators, family therapists, and preschool teachers.

“I think this DVD is a tremendous & invaluable guidance tool for parents, preschool teachers, caregivers, and other therapists (speech, occupational, developmental, etc) and should be used as an accessory aid for anyone involved in early childhood development.” Ranjana, pediatrician and mother, Ohio

”Teach Me to Talk is an easy to watch DVD that empowers parents and caregivers with the “how to” skills to not only promote speech development, but also PLAY. As an occupational therapist, I believe that play is an important “job” for a child, but it requires more interaction from a parent than just watching a child play. Finally, parents have a visual tool that teaches them how to interact and play with their child so that he or she will not only learn to talk but will be on the road to reaching their optimal potential! The techniques are easy to implement, and you will discover playing with your child is actually fun!” Carey White, OTR/L, Occupational Therapist

The Teach Me To Talk program is so effective, university speech pathology programs are already ordering this DVD to train their new grad students! Several state early intervention agencies are also purchasing Teach Me To Talk for their loan libraries to make these proven techniques available to parents and therapists.

Why? Because the experts know—Teach Me To Talk does exactly what it says it does.

”This is an excellent training DVD for parents of late talkers. The strategies that Laura teaches are the same ones she used when working with my son, who has apraxia of speech. My son made incredible progress working with Laura. These strategies are very effective and easy to apply to a variety of speech and Ianguage disorders. I wish all speech therapists possessed this level of knowledge and skill. As a Speech-Language Pathologist, I would recommend this DVD to my parents of late talkers. As a Mom of a late talker, I would recommend this DVD to all speech therapists working with children.” Laurie Felty, Speech-Language Pathologist

“I just finished your DVD. It was great! I really got into it and actually found myself taking notes! As a PSC (early intervention service coordinator) it was helpful to see the speech therapy in motion so I can answer some questions from parents. As an OT is was refreshing to see some OT techniques embedded into the speech therapy activities.” Cindy, Louisville, KY

”Thank you so much for allowing me to preview your DVD! I will put these techniques into practice myself on Monday morning with my clients! They’re not going to recognize me anymore! I learned so much from watching you provide therapy, and I will never use those same approaches again. This DVD has rekindled my excitement for pediatric speech therapy. I can’t wait for next week to come so I can try them out! One more thing - Why didn’t they teach me this in grad school? Thanks again!” Penelope, Speech-Language Pathologist, Kansas

Even experienced therapists struggle with the challenge of providing therapy that’s developmentally-appropriate for toddlers.

One on hand, it needs to be entertaining enough to hold their attention. But on the other hand, it needs to provide real growth and learning opportunities in order to be “therapeutic.” Teach Me To Talk effortlessly combines the two, illustrating WHAT to do and HOW to do it in a wide range of situations.

”What I especially loved was that it wasn’t just clips of the PERFECT session; you showed us what to do when a kid turned away, or lost interest, or was more difficult to engage (for instance, touching the child or changing their position). Let’s face it, sometimes kids have their own agenda!” Kristyn, mother of a child with apraxia, New Hampshire

The 1 ½ hour Teach Me To Talk DVD is packed with plenty of “HOW TO” examples you can begin using right away with clients in your practice. Learn how to make therapy FUN, how to keep a busy toddler’s attention, and how to select successful and age-appropriate techniques that will lead to SUCCESS for you and your clients.

You’ll see toys that are “winners” with children at various developmental levels from 12-36 months old, watching the kids in action and seeing how the toys work.

“Just watching how my son interacted with the DVD made me a believer in how engaged he will become once it stops being “work” and begins being fun.” Robyn, mother of a 3 year old with a language delay and apraxia, Wyoming

You’ll learn how to use play and food as THE focus for therapy — not just the reward at the end of the session!

“The whole idea of using food during speech is awesome. I will usually reward him with something after therapy especially if his self esteem is a little low that day or he’s just having an off day, but I never thought of buying something to use when working with him, nor have any of his therapists used food ….” Holly, mother of a 3 year old with apraxia, New Hampshire

Teach Me To Talk is packed with essential, must-have tips to make your sessions more natural, more kid-friendly, and most importantly, more effective.

“If you are the parent of a young child who has been in speech therapy, you may have already learned the hard way that children don’t necessarily respond to all speech therapists efforts to “teach them to talk”. Despite being well intentioned, far too many speech therapists attempt to implement the same strategies that they use with school- age children or mistakenly believe that young children “choose” not to talk. As a result, young children are frequently frustrated by inappropriate techniques or by speech therapists who have even more “attitude” than they do.” Kate, Developmental Interventionist, Kentucky

Of course, there are plenty of things that just DON’T work with toddlers – and you’ll learn what those are too! Watch here as Teach Me To Talk illustrates a classic example of one of the most common mistakes parents and professionals make when trying to teach a toddler to communicate:

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Teach Me To Talk the DVD is now available for an introductory offer of $39.99 plus shipping and handling. This is for a limited time only! Click here to order.  

More feedback….

“I also liked the tips in the “withholding” section. A lot of times, we Moms are instructed to do so (by putting toys out of reach and such), but sometimes it is difficult to judge just how much is too much or how long is too long. You gave easy to understand tip to follow. How to push just far enough to elicit a response, but not so far as to discourage language, or cause too much frustration.” Kristyn, mom from New Hampshire

”I love the part about not ruining the interaction and to keep it going with humor…this is SO important. I can’t tell you how many times I probably lost Gabe in the process of working with him because it was too drill like. The withholding concept is explained perfectly. It was never explained to me as well as you did, I failed to keep it playful and as a result totally killed the communication with Gabe. As you say in the DVD, you will miss the effectiveness and the child won’t learn anything…I plan on trying to keep things much more playful with him from now on when it comes to withholding.” Julie, Mom from Illinois

If you’ve been struggling to help a late talker learn to communicate, there’s no need to wait another day to hear those precious words. Order Teach Me To Talk today – and you’ll be on your way to a healthier, happier relationship with your child tomorrow.

Teach Me To Talk the DVD is available NOW for an introductory offer of $39.99 plus shipping and handling. This is for a limited time only! Order yours now! Click here or order via PayPal below.

Read more feedback from parents and SLPs alike -

“As members of the medical community and parents of two toddlers who experienced speech delay, we can personally attest to the value and effectiveness of Laura’s instructional video, “Teach Me to Talk.”  The teaching points reinforced throughout the DVD are parent friendly, reproducible, and easy to follow.  Laura repeatedly demonstrates simple and effective techniques that promote language skills, while at the same time emphasizing a fun and engaging environment for both parent and child.”  Jane Rice, RN and Michael Rice, MD

“ Hi Laura. I just finished watching your DVD and am so impressed You really did a terrific job putting everything into “parent-friendly” language, and your examples are super. Thanks so much for doing this. I look forward to sharing it with the parents in our practice. By the way, I am working on a 3rd edition for my “Childhood Speech, Language & Listening Problems: What Every Parent Should Know” book, and I will definitely include your DVD and website. You have so much great information on there.” Patti Hamaguchi, Speech-Language Pathologist and Director, Hamaguchi & Associates, Cupertino, CA  

“I have been a Speech and Language Pathologist for 12 years, and I have worked in the early intervention for the last 2 years.  In my quest to provide the best services I could for the children I worked with, I scoured the internet looking for therapy tips.  I hit a gold mine when I found Laura Mize’s Teach Me to Talk website.  Her website has wonderfully informative articles, but being the visual person that I am, it was even more helpful to see her therapy techniques in action.  The Teach Me to Talk DVD is a valuable tool for anyone looking for hands on ideas to help develop speech and language skills for toddlers, and it is an especially valuable tool for those in the profession.  No matter if you are a seasoned pro or a grad student; you will surely find many helpful tips and ideas to make the most of your therapy sessions with toddlers.  The DVD does a great job of putting the information into very simple and easy to understand steps.  I also found it helpful that Laura did not just show the sessions where “everything” goes perfect, because in the real therapy world it often does not.  Her DVD includes several clips that show you how to playfully re-direct those “little angels” when they might not be at their “toddler best.”  This is really a wonderful tool, and I will be recommending the DVD not only to my early intervention parents, but also to the other early intervention speech therapist I know.”  Yvonne Smith, Speech and Language Pathologist MS, CCC-SLP, Sacramento, California

“The DVD was quite different from what I expected - in a good way. I hardly expected to see so much one-on-one with the kids, and it was great!”
–Kristyn, mother from New Hampshire

“The DVD brought tears to my eyes (not your goal I’m sure, but there you go!). Each strategy you used - reminded me of my child. It is amazing how simple techniques (most of which we take for granted) can help a non-verbal child become verbal. Another thing I learned from my experience with being a mom, a pediatrician, having your guidance and the DVD - is that language, talking, speech, and articulation involve SO many other aspects of development.”
–Ranjana, pediatrician and mom from Ohio

“Just wanted to let you know how thrilled I am with your video. I just received it five days ago and I’ve watched it every morning to gear up for working with my daughter each day and I have to tell you what a difference it has made! My daughter has been in therapy for a year and a half (she’s 31 months) and she would often run from me during our “play” sessions…finally, after only five days, she is starting to think that her mommy is fun during playtime! Thank you for giving me a way to really connect with my daughter on a new level. This video is priceless.” 
–Helen

“Even when weekly therapy reports indicated a great deal of progress, we weren’t always seeing that progress at home. The Teach Me To Talk DVD has dramatically changed the number of words we hear. Seeing the techniques you use, and seeing how easy they are to incorporate in to our daily routines has been a blessing. I can get so many words and even phrases out of both my toddlers by incorporating playfulness in to our daily activities. As a working mom, I’ve always felt as if I’m not as active in my children’s therapy as I should be. You DVD is finally helping me make that connection. Thank you so much for such a fantastic tool!” 
–Stephanie, Mother from Kentucky

” I loved your first DVD Teach Me To Talk, but I think I enjoyed Teach Me To Listen and Obey even more! The way you presented the information made it very easy to understand. My child does have some difficulty understanding what’s said to him, but I never thought it could be the reason he doesn’t seem to listen to me. Thank you for letting me watch this because now I know how to help him better. ” —–Andrea, Mother from Chicago, Illinois

“The discipline information alone would be worth the money to buy the whole set.”  Kathleen, mother of son with speech delay from Florida  

“As a father, I want my son to mind me. Until I watched your video I didn’t realize that he didn’t understand words. Thank you for showing me that.” Jason, Father from New Jersey

“This is a great DVD set for teaching parents how to view receptive language delays. I’m a developmental therapist, and I learned several new things that I will be thinking about as I work with my clients in my state’s program.”  Margaret, therapist from Pennsylvania

To order and see other products from teachmetotalk.com, click here.  

While regular readers of this site know that my philosophy is language-language-language, there is a place for “no pressure practice” for toddlers, even while your main focus is improving receptive and expressive language skills. Once language is at an age-appropriate level, or your child is preschool-aged (over 3), then you can begin sound practice as your main focus for speech therapy.

Here are the links -

http://mommyspeechtherapy.com/?cat=23     for /t/ and /d/

http://mommyspeechtherapy.com/?cat=22      for /k/ and /g/

She didn’t include tips for /p, b, m/, the earliest developing consonant sounds that I focus on all day, every day, so I’ll try to write these myself soon, unless she does all the hard work and beats me to it!  Laura 

When I’m in a social setting and people find out that I’m a pediatric speech-language pathologist, I get lots of questions about using pacifiers, sippy cups, and if they affect speech development in babies and toddlers.   

Let’s tackle the sippy cup question first.  ”Sippy cup mouth,” or a huge open bite, is quite common.  Don’t mistake the word “common” for “normal.”  When children have an open bite they have a gap between their upper and lower teeth when closing the top and bottom teeth together.  Many times this dental malocclusion can be linked to prolonged sippy cup use.  By prolonged I mean carrying a cup around all day and sleeping with one at night, or using this kind of cup exclusively after age 2 or 3.  It can be worse if your child is using a sippy cup AND taking a pacifier because there’s something in his mouth essentially all of the time.     

If your child is using a lisp as a toddler or preschooler, it’s likely he has an open bite.  An approximation for the sound /s/ is very common in this age group, with or without an open bite.  As children get closer to age 5, their /s/ should sound adult-like.  If this doesn’t occur by age 5, children may need speech therapy to help learn a more mature production pattern for /s/.  This is usually the only negative effect on speech development.              

Although it’s messier than a sippy cup, your child should learn to drink from a straw by age 2 and an open cup before age 2 1/2 to 3.  This takes a commitment from parents because it requires more supervision and clean up than using a no-spill cup.  Not too long ago, we didn’t even have sippy cups, besides the slotted top kind from Tupperware.  Actually that cup could still be a nice transition between sippy cups and an open cup.  The skills to drink from a slotted opening are more mature than the sucking pattern required for the no-spill sippy cups. 

Moving to a more complex cup is a great way to work on oral motor coordination than any set of “oral motor exercises.”  This drinking practice is very functional, meaning that your child would have built-in opportunities to “practice” many times a day, rather than setting aside time to do special oral motor tasks.

Introduce the new cups (straw, slotted, or open) when he’s seated at a table, outside, or on a tile kitchen floor.  Save the sippy cups only for times when making a mess is a big deal such as in the car, when he’s on carpet, or in any other place that would be a major hassle to clean.         

Your child should NEVER go to bed with a sippy cup or bottle, no matter how convenient it is to help him to sleep.  Leaving the cup or bottle between your teeth while sleeping is what leads to the open space AND tooth decay, especially if you’re using milk or juice.  I’ve known several two-year-olds who have had to see a dentist due to a mouth full of greying teeth.  Not a pretty site.  If you can’t kick this habit just yet, at least switch to water in the cup at bedtime. 

Straw drinking is wonderful for oral motor coordination and sensory skill development.  Drinking  a cold, thick liquid from a crazy straw is just about the best way to improve tongue, lip, and cheek strength and coordination all in one!  Look in the toddler dishes/utensils section of the major retailers for the many version of these cups, or save and use the plastic ones you get at sit-down restaurants.  Sports water bottles are also a good option.    

Now let’s tackle pacifiers.  For some toddlers, pacifiers are not an issue since they never took one in the first place or easily gave it up as an infant.  Sometimes not taking a pacifier hasn’t necessarily been a good thing either, since a child may not have found a successful way to self-soothe.  Sucking is a very good way to regulate an out-of-control infant and toddler. 

Many babies find their thumbs during this phase.  While some parents and even experts prefer this habit, I think it’s a lot more difficult to kick, even for 6 and 7 year olds, because you can never  truly get rid of it.       

For some babies and toddlers (and their parents!), pacifiers are essential and even recommended.  For babies with significant oral motor issues, learning to suck a pacifier and keep it in their mouths is a milestone.  For cranky babies and toddlers with sensory integration differences, using a pacifier to soothe is the only thing that helps them calm.    

Most children should be able to give up the pacifier between age 2 1/2 to 3, or at least relegate this for sleeping or calming only.  Walking around all day with a pacifier in your mouth is not recommended as kids move closer to age 3, but not because it keeps you from talking.  It makes you look like a big ol’ baby, but that’s another issue in and of itself, and one I’m not going to tackle today!           

I think it’s a myth that pacifiers prevent children from talking.  Most kids try to talk with it in their mouths and then take it out if their parents insist that they don’t understand them.  If your toddler is not talking, is over age 2, and is addicted to his pacifier, try to limit the pacifier to naps, bedtime, and when he really needs it to calm down.  You can monitor to see if having an open mouth during waking hours will help him vocalize more.  In nearly every child I’ve seen in my whole career, the lack of language is the reason the kid isn’t talking, not because he takes a pacifier.   

Some SLPs disagree with this and insist that a toddler be weaned as soon as they begin therapy.  I usually advise parents to keep the pacifier until we find other ways to help a kid self-soothe.  I think taking away the only method some kids have for calming down is too traumatic when they are also struggling to learn to communicate.  I am not into torture, not for the kids I see, and especially not for their parents!    

I will add that I don’t let children keep pacifiers in when I’m in their homes seeing them for therapy unless they are falling apart without it.  Many children I see work so hard during treatment that they need it to calm down after we’re finished, and I think this is alright. 

Parents of children with sensory issues tell me that they need the pacifier for times when no other option works to wind down a jacked-up toddler or end a tantrum.  If your toddler, even at 3, still needs the pacifier to help calm his sensory system, keep it and don’t feel guilty.  As a mom, I’m just fine with that.  As a therapist, I’m fine with it too, but I’d like to see them learn to self-soothe in other more mature ways as they turn 3, and especially by 4, if at all possible. 

Options that I’ve seen work are finding a special blanket, stuffed animal, or doll.  You are still transferring dependence to an object, but usually one that won’t hurt your teeth, or cause grandma and the neighbors to raise an eyebrow or make those nasty, condescending comments that cause us all to cringe.                                       

Kicking these habits aren’t easy, but it’s all part of growing up, for your baby and you!    

However, your child’s ability to hear can become compromised during infancy and toddlerhood by the presence of fluid in his or her middle ear.  Fluid is most often present during an ear infection, but fluid can also be present without any other symptoms. 

When a toddler has fluid in his ears, he does not hear words and sounds normally.  Speech sounds muffled, like he’s swimming underwater.  He may know that someone is talking to him, but have no clue what they are saying.  Can you imagine the challenge that presents when a toddler is trying to follow your verbal directions, much less learn to talk?          

Maintaining the ability to hear consistently is the key to learning how to understand and use words.  Parents should judiciously monitor hearing ability in children, especially those with frequent ear infections.  I am not one to overuse antibiotics, but if your child’s pediatrician is very laid back about the presence of fluid and treating ear infections AND your child is not learning language, you should consider taking a more aggressive approach.  Begin by asking for a referral to have your child’s hearing tested.  

The professional who is best qualified to test hearing in babies, toddlers, and preschoolers is a pediatric audiologist.  This person has at minimum a masters degree, but most often a doctorate in audiology.  You can usually find them in private practice in the yellow pages, at an ENT’s office, or in a children’s hospital.    

Many parents wonder how a toddler’s hearing can be accurately assessed.  Listed below are very basic explanations of the procedures that are most often used:

1.  Tympanograms - This test is performed by inserting probes that are like ear plugs into the ear test to measure middle ear function and detect the presence of any fluid in the middle ear.  Some kids hate it, especially those who are touch-defensive or who’ve had bad experiences with doctors checking their chronically infected ears.  Most don’t mind.  Parent holds you while audiologist does the test one ear at a time.

2.  Sound Field/Booth Testing - Toddler sits with mom or dad inside a dark “booth” or room.  When the audiologist plays the tone, the baby looks toward the speaker and an animal/light/some kind of visual spectacle lights up to “train” a kid to look toward what he hears.  It works remarkably well for alert and responsive children.  I have had lots of children on my caseload “fail” the test because they weren’t reliably responsive.  When that happens, the audiologist recommends ….

3.  An  ABR - Auditory Brain Stem Response Test - This test is usually performed in a hospital setting because it requires anesthesia so that the brain’s response to sound can be measured.  It’s scary for parents because of their child being “put to sleep,” but the test is accurate because the kid doesn’t have to “participate.”

4.  Referral to an ENT (Ear Nose & Throat Doctor) - If your child has had chronic ear infections, he may need tubes put in his ears to keep the fluid from staying lodged in his middle ear.  This procedure is done as an outpatient in a children’s hospital and does require anesthesia since it is surgery.  Most parents reports that it’s a very quick process with their children back home and playing within a couple of hours.  Most of the time tubes stay in place for a year or two and then fall out on their own.  You’ll know when the tubes are working because you’ll sometimes notice the drainage leaking out, but this is a good thing because it’s not keeping him from hearing.  This is the best treatment for a language or speech delayed child with chronically infected ears.  If he can hear, there’s a much better chance he’s going to learn to understand, talk, and be understood.          

 —————————————————————————————————————————————–Hearing loss should always be ruled out as a reason for speech-language delay.  Most of the time, it’s not the problem, but I’d hate to be the parent or therapist that missed hearing loss!  For many children with mild to moderate losses and no other issues, pop the hearing aids in and go!  I’m not minimizing the plight of hearing impaired children, but it’s sometimes easier to treat (relatively speaking of course) than lots of other things that could be a reason for a language delay or disorder, particularly if the loss is not severe, and there are no other issues.             I must also add that even minimal hearing loss that goes untreated can end up to be a “big deal.”  Children with even mild hearing losses at high frequencies have difficulty learning the high frequency consonants such as /s/.  In English the sound /s/ carries so much meaning.  It changes verb tenses, makes nouns plurals, and adds possessives. Make sure your child can hear consistently!  Aggressively monitor his or hear ability to hear by being aware of middle ear fluid.  Many times fluid remains in a child’s ear after a cold or allergy episode.  Be consistent with your follow-up appointments at the pediatrician and ENT. 

Bottom line - If a child can’t hear or understand, he is not going to talk.         

“Isn’t it normal not to understand what my two year old is saying?”  The answer to that is both yes and no.  Here are the norms. 

Parents should understand at least 50% of what a toddler is saying by their second birthday.  By age 3, parents should understand most (90%) of what a child is saying.  By age 4, strangers should understand most (90%) of what a child says. 

For those of you who aren’t familiar with typical speech sound development, let’s begin with a quick review of the basics.  

Babies begin to use vowel sounds to coo during the first months of life.  Then babies begin to add consonant sounds and combine them with vowels to begin babbling between 7-9 months.  Babbling is using a string of consonant-vowel syllables.  Most early babbling includes reduplicated or repeated syllables (”mamamama”).  Near the end of the first year or shortly after, many babies begin to use approximate real words.  They also become more sophisticated in their babbling and can sequence syllables with different consonant-vowel combinations.          

Bilabials, or lips sounds, /p, b, m/, are usually the first consonants to emerge.  (FYI - This is the reason that ”Mama” and “Papa” are universal parent names!)  Other consonant sounds such as /n, h, w/ are also “early” developing consonant sounds.  Most children, or 75%, have mastered using these consonant sounds and all vowel sounds in words by their second birthdays.  Consonant sounds that generally emerge before and around age two-and-a-half are /t, d, k, g/ and “ng” and /s/ at the ends of words.  Some sources report that /f/ also emerges around 2 1/2;  some cite between 3 and 4 years.  Later developing consonant sounds that emerge during the preschool years are /r, l, z, v/ and  “ch, sh, j.”  The sound “th” is usually the last consonant sound mastered after age 5.          

Jargon emerges in most children between 12-18 months.  Jargon is defined as unintelligible strings of sounds that mimic adult speech.  Some parents refer to this as ”gibberish.”  Sometimes parents get upset when they hear their children using lots of jargon.  Actually jargon is an indicator that a child is learning to sequence sounds and is trying to copy conversational speech.   However, in the absence of other “real” words, it can be unsettling for some parents. 

Many parents ask, “How should I respond if I don’t know what he’s saying?”  My advice is to reword what you think he intended to say to ask for clarification.  Hopefully, he’ll try to correct you if your guess was wrong.  Other advice is to encourage your child to SHOW you what he wants or is talking about.  If your child becomes overly frustrated when you don’t understand, you may be able to slide by with nodding or offering a general comment such as, “Oh!”  However, if your child is adamant about telling you something or asking you for things you don’t understand, “faking it” may not work.  

This is one reason I love signs or even pictures, especially for difficult words your child asks for routinely that you never get on his first (or seventh) attempt.  If he keeps asking you for something and you finally “get it,” store a mental “audio clip” of the word, or take a picture of the object so you can use it to help the next time.                  

Being understood is an important part of communicating.  But let me interject a word of caution.  Until a child’s language skills, that is the number of words he’s using and how he combines those words into phrases and sentences, are at or near an age-appropriate level, intelligibility should not be the sole focus for speech-language therapy OR for parents at home.  Overcorrecting a 1 or 2 year old child’s speech errors can lead to frustration and a shut down of progress faster than anything else you can do to a new talker.

What should you do when your child mispronounces a word?  Model the word correctly and move on.  Your child asks, “Tootie.”  You say, “Cookie?  You want a cookie?  Here you go!”  

Actually, before you start to work on specific consonant sound errors, there are other more important factors you should consider to make your child easier to understand.  

First Targets for Intelligible Speech in Toddlers 

1.  Is my child using the correct number of syllables in a word?

Consider the child who says “ba” for ball, balloon, and blanket.  You’re going to be able to understand him better if he is able to use “ba” for ball, “ba oo” for balloon, or “bwa ee” for blanket.  Even though these words aren’t “perfect,” you’ll probably be able to figure out what he wants more easily than if all the words sounded the same.    

If he’s leaving off syllables (not just individual sounds, but entire syllables), start here first. 

Tips for working on syllables - clap or pat the floor as you say the word to help him hear and feel the difference.  Try words with repetitive patterns (reduplicated syllables) such as bye-bye, Mama, Dada, boo-boo, Bubu (for bubble or brother), and nana (for banana or grandma).  Some kids get so into this that they “double” everything - dog-dog, car-car, etc…  It’s cute at first, but be careful, or you’ll have to fix that later!   

2.  Is my child using correct vowel sounds in words?

As stated previously, most children with typically developing communication skills use vowel sounds correctly by age 2.  If your child is substituting vowel sounds or leaving off vowel sounds in words, this can be an indicator of motor planning problems, or apraxia. 

Work on vowel sounds by exaggerating them in words, and using new ones alone as “sound effects” in play.  For example, if your child can’t say an “ee” such as “green,” “baby,” or “whee,” pretend to be scared during play and let out a big “eeeeeeeeeeeee.”  This is also one of the vowel sounds that you can “help” him learn by pulling out both corners of his mouth into a smile.  “Cheese” is usually an effective cue not only for picture taking, but learning this vowel sound.

Other vowel sounds you can provide a tactile (touch) cue are “ah” by pulling his chin down with your finger and “oo” by pulling in her cheeks to help her round her lips. 

I use lots of animal sounds to work on vowels and really exaggerate the vowel sound.  Think - mooooo, baaa-baaa, meee-ooooow, woooof-wooof, etc….          

3.  Can my child use 2 different vowel sounds in words, or does he always copy the first sound for the next syllable?

Learning to “change” the vowel sound for a new syllable in a word is especially difficult for some toddlers.  You may continue to hear him say “Coo coo” for cookie, “o po” for open, or “ca ca” for cracker.  Work to help him hear and say those differences.  Again modeling exaggerated vowels is the best way to do this. 

Your child’s SLP may be able to help you come up with “modifications” of particular words that may not be completely correct, but sound “closer” to the intended word.  For example, for a child who can’t say “cracker,” you may teach “ca uh” as an in-between more intelligible version of the word.  (Some children have difficulty using different consonant sounds in words until age 2 1/2, but most have mastered this by age 3.)            

4.  Is my child learning consonant sounds in the beginnings of words and syllables?

Usually beginning consonant sounds come first, but in some children, they continue to omit beginning sounds while adding some ending consonant sounds.  It is very difficult to understand children who use words and phrases with predominantly vowel sounds.  I have several children doing this at any given time on my caseload.  Children who are using mostly vowels absolutely need speech therapy to help them learn to use more consonant sounds. 

Your SLP will be able to teach you and your child “cues” to help him learn additional sounds.  If you’re working on this at home, you can try the following ”tricks.”

Many experts “name” the sounds for young children rather than calling them by the letter.  For example, /m/ can be called a “motor” sound, or a ”yummy” sound.  A /p/ can be called a “popper” sound or “lip” sound.  These names can be found in many early articulation books, or better yet, talk with your child’s speech pathologist.

If you’ve heard your child use consonant sounds at the beginning of one word, or even in a word you couldn’t understand, using these sounds that he can already produce in at least one context is generally easier than teaching new sounds.          

5.  Is my child using ending consonant sounds?

This is the question about articulation that I’m asked the most.  Final consonant deletion occurs in many children until 2 1/2 to 3 years of age.  Easiest ones to work on include /p/ and /t/, both unvoiced consonants.  If your child is producing /k/, you may also try this sound.  The voiced consonant sounds /b, d, g/ should not be early final sound targets because your child may end up adding a vowel sound at the ends of words such as “bug -u” or “bed-a” in an effort to produce this sound.  Once your child is using unvoiced sounds, the voiced sounds should emerge on their own. 

I also work on /s/ since this final sound carries so much grammatical information.  For example, children need final /s/ to make words plural such as “cats” and “books.”  Using plurals is a language concept that emerges around age 2 1/2, so /s/ is an important sound. 

Many children begin using /s/ as a lisp.  Although it’s an incorrect way to produce /s/, it’s very common until age 4 or so.  You can target this by telling your child to “hide his tongue behind his teeth” or to say “smile and hide your tongue.”                   

Other Hot Topics Related to Oral Motor and Articulation Issues - Pacifiers and Sippy Cups 

If your child is using a lisp, it may also be an indicator that he’s developing an open bite, that is there’s a gap between his upper and lower teeth.  This can be attributed to prolonged use of sippy cups or pacifiers.  Although it’s messy, your child should switch to an open cup or straw when he’s at the table or in another place that you can clean up easily.  Save the sippy cups for the car. 

Your child should NEVER go to bed with a sippy cup or bottle, no matter how convenient it is to help him to sleep.  Leaving the cup or bottle between your teeth while sleeping is what leads to the open space AND tooth decay, especially if you’re using milk or juice.  I’ve known several two-year-olds who have gone to see a dentist before age 3 with a mouth full of little black teeth.  Not a pretty site.  If you can’t kick this habit just yet, at least switch to water. 

Straw drinking is great for oral motor and sensory skill development.  Look in the toddler dishes/utensils section of the major retailers for many options for these cups.  Sports water bottles are also a good option.    

I think it’s okay to use a pacifier for sleeping until age 2 1/2 to 3, but excessive use during the day is not recommended if your child can calm down without it.  If your child has sensory issues and using sucking to help him regulate, keep the pacy without feeling guilty.  

It’s a myth that pacifiers prevent children from talking.  Most kids try to talk with it in their mouths and then take it out if their parents insist that they don’t understand them.  If your toddler is addicted, try to limit it to naps, bedtime, and when he really needs it to see if having an open mouth will help him vocalize more.  I don’t let children keep pacifiers in when I’m in their homes seeing them for therapy unless they are falling apart without it.  Many children I see work so hard during treatment that they need it to calm down after we’re finished.  Many parents of children I see need them to have it for times when no other option works to wind down a jacked-up toddler and end a tantrum.  As a mom, I’m just fine with that.                       

If you have other questions, please feel free to post a comment.  Laura