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.      

The sister was so different from most of the toddlers I’ve ever worked with in my career as a pediatric speech-language pathologist. Her parents, both highly educated professionals in the medical field, had managed to teach her not only all of the traditional body parts by the time she was 21 months old, but they had also helped her learn ones I think some full-grown adults might have trouble locating, like her kidneys! Did I mention Dad is a radiologist?

To quote my dearly departed, very Southern grandmother “That’s all well and good.” (Whenever she used this phrase, it was always followed by a ”but….”, and in this case it’s a very big “but.”  BUT this little boy (and any other future siblings) will likely never be able to fill his older sister’s very big shoes.  

That may never be a problem for my little friend, if he continues with his current temperament, because he’s as happy-go-lucky a toddler as I’ve ever seen. It doesn’t bother him to hear “no.”  Actually “no” might be one of his favorite words since he seems to take it as the beginning of his next challenge.  He doesn’t mind if he’s reprimanded and made to sit in a chair or a toy is removed.  He’s happy regardless. He likes it alright when we clap for him after he’s said a new word or completed a request we’ve asked him to do, but so far, approval, or even lack of it, doesn’t seem to motivate him as much as it did with his sister.

Herein lies the problem. This is how his mom and dad have been trained to parent, for 4 1/2 years now, by that older sister who learned to understand words quickly and still does most everything the very first time she’s told. Mom and Dad have learned to use praise to their advantage since this method was so successful with #1. When she was praised for good behavior or for learning a new task, she wanted to do it again and again.  When her parents shoot her a disapproving glance or say her name with a disapppointed tone, she responds.  

When baby brother came along, like most of the other toddlers who’ve been born into this world, it’s not been that easy. He’s not cognitively challenged at all, but as far as language goes and certainly with behavioral directions, you have to tell him more than a time, or even two, in hopes of getting him to respond.

If these parents had had him first, they’d fully be able to appreciate just how easy older sister was, and is, and probably always will be. But this is hard when all you’ve known as a parent is a child of that variety. Little brother looks like he’s much more difficult than he really is.

By comparison he seems like he’s having real learning difficulties, when in fact, he’s likely just demonstrating a different learning style. Although older sister was a late talker, her strength so far seems to be strong auditory learning skills. You tell her, she hears it, she knows it. You read her book, or even 20 books, and she sits for the entire time, very engaged, and very interested in the wonderful explanations her parents give her. She was also very, very responsive. At 21 months she would sit and happily point to any picture her parents asked her to find. This was an enjoyable activity, not only for her, but for her parents.

Not so much for little brother. He won’t sit still for one book, and actually on most days, even half a book! This is especially true when his parents are asking him with questions and expecting the same level and style of participation. It’s not just that he won’t do it, he can’t do it. Not yet anyway.

To me at least part of the ”issue” (and I use this term loosely because this behavior is likely more “typical” than his sister!) for this little boy seems to be that he’s a do-er. This little guy has to feel it, and experience it, and DO it to learn it. Looking at a picture of a ball isn’t nearly as exciting as throwing, and kicking, and catching a real ball. Seeing the picture of a bird isn’t as much fun as watching the real bird fly and land right in front of him when he’s playing outside.

When Mommy or Daddy expect him to sit down and look at the book, he feels like he’s crawling out of his skin! When they start asking all the “Where - Where - Where” questions, he bolts! Without words he’s saying, “Get me outa here!!!”

One thing I recommended last time I was visiting this family was to make a philosophy shift in how we approach helping this little guy. Don’t get me wrong and misunderstand what we’re dealing with here. It’s not that he’s not making progress. In fact, he’s making great progress! In the short time I’ve seen him, he’s progressed from saying no words to using about 40 different words now on his own. He even imitated a few two-word phrases last time I was there. He’s now following simple directions in his daily routines most of, well at least some of, the time. He now plays with me for at least 45 minutes of our hour-long session IF I’ve planned ahead and include lots of FUN and movement-based activities and I’m sure to keep it rolling along so that we’re switching to a new toy when he’s giving me the signals that he’s “all done.” (Meaning he’s saying it, signing it, looking around for, or is getting up to find something else to do!)

I’m talking about how his parents work with him on a daily basis. Again- don’t get me wrong. It’s not just the hour he spends in speech therapy every 2 weeks that’s helped him. It’s how his parents have faithfully carried out recommendations when I’m NOT there that’s made the real difference.

But at this point in therapy, I do want to help them shift not necessarily WHAT they do, and maybe not even HOW they do it, but how they THINK about what they’re doing while they’re working with him.

With this little guy, it may be more helpful for them to think about him learning words from them while they are teaching him, and not necessarily testing him.

By this I mean dropping lots of the direct questions that he’s not responding to just yet. I mean that instead of asking questions to verify that he comprehends, that they do more telling, showing, and helping him learn while they play inside, play outside, eat meals, take a bath, get dressed, go to the store, AND even the dreaded book reading!

With this little guy and with all children like him who are not consistently responding to our barrage of questions, we should tell him more, show him more, and help him to do more rather than just asking him and then expecting him to perform.

This shift in mindset alone can take the pressure off a child who wants to do nothing more than escape. When the pressure is removed with these kinds of kids, wah-lah, they often rise to the occasion and “perform” more than they’d ever do otherwise.

Even if your wah-lah moment with him isn’t that same day or week or month, focusing on the TEACHING part rather than the TESTING will take the pressure off you too. When the focus becomes teaching him instead of measuring what he knows by how he responds, parents can relax and know that just because he’s not demonstrating that he ”gets it” just yet, they are doing what they can to help him learn to understand.  

In real life this looks like parents who go out of their way to label objects, actions, and people they want their child to know. They don’t just provide these words once to twice and then expect their children to know how respond to the questions.  They say these words over and over again, knowing that it may take a while to “see” results.  

In phonological therapy there’s a widely-used method called “recasting.”  Using this technique parents are instructed to say a target word 12-18 times over a few minutes and then repeat that same word 3 or 4 times later in the day in shorter bursts each time, say 4 to 6 repetitions, to help their child “hear” and “process” the word correctly. I’ve started mentioning these numbers to parents I’m seeing now to use with their children with receptive language issues.  By using this number, I hope to give them a way to measure progress, not their child’s, but their own.  If they are repeating a select number of target words this often, then they can feel successful that they are doing ”teaching.” When parents focus on a few words like this several times a day for several weeks, chances are, their children will link meanings to the words and learn to understand, and hopefully, finally demonstrate that they understand. Isn’t that what teaching is all about?

Some parents automatically assume that this is a behavior issue, but often it’s not. Auditory processing disorders make it very difficult for a child to be able to fully understand, process, and then DO what you’ve asked him to do.

The purpose of this article is not to explain auditory processing disorders, but rather give you ideas of how you can work to improve your child’s ability to understand and process directions at home.     

As always, since I’m a pediatric SLP, I target these skills in play. Here are a few of my favorite ideas -

Use a child’s strengths or interests to develop “games” that will keep him with you long enough to learn how to listen, understand and follow-through. If he likes colors, set up a game so that he has to listen to what color of some object you’ll tell him to “get” and then “do” something with to complete the task. If he loves animals, set up a zoo game and give him different directions for various animals to do at the zoo. If his passion is his prized set of Cars vehicles, have him “do” different things you suggest with Lightning McQueen and all the other ones (but you’ll have to learn the names first!)

Get it? Take what he loves and then figure out a way to weasle in “therapy” with him during play.

If you’re the “need to HEAR it to understand it” kind of person, listen to episode #21 of my podcast Teach Me To Talk with Laura and Kate. It’s called Let’s Play! If you can’t take our banter about toys for the full hour, forward on toward the end when I’m talking about how I use puzzles in sessions with children who need work on this.

If you’re the “need to SEE it to understand it” kind of person, take a look at the last video clip in the article “Best DVD for Receptive Language Therapy at Home.”  If it’s not still posted a few articles below this one on the home page, then look for it in the DVD category.                  

If you’re the “need to see it and DIGEST it to understand it” kind of person, get the DVD Teach Me To Listen and Obey 2! You’ll see this clip plus others AND get to hear an explanation of the theory behind these activites and difficulties as well (but in plain English so you’ll be able to understand and apply it!).    

Whatever your style - I hope these ideas will help you to work on these skills during play at home. Language processing is critical to future academic success. It’s that important!

Maybe everyone around you, even your pediatrician, is telling you that everything’s fine. But you can’t get past that nagging feeling that something’s not quite right. 

You know he should be doing more by now, but how can you help him? Everything you’re trying isn’t working.       

As a parent, there’s nothing more frustrating than watching your toddler not be able to do things as well as other children his own age.  While friends’ and relatives’ toddlers are showing off the new tricks they’ve learned, your child continues to be in his own little world, locked away from others when they try to talk to him.   

DOES YOUR CHILD SEEM TO TUNE YOU OUT? DOES HE HAVE A DIFFICULT TIME OBEYING YOUR COMMANDS? 

You can’t help but feeling embarrassed, or jealous, or even angry.

Why YOUR child? Why does it have to be so hard for him and for YOU?  

IS YOUR CHILD A LATE TALKER TOO?

You just want him to be able to tell you what she wants, or even to be able to call you ”Mama,” or whisper back, “I love you too.”   

The truth is….a child must understand words before we expect him to talk, and certainly before we expect him to obey.    

Many times late talking is also due to underlying difficulty comprehending language. He can’t talk yet because words don’t mean anything to him yet.

A child must understand words before he begins to use those words to communicate.   

ARE YOU DISCOURAGED WHEN YOU TRY TO DISCIPLINE YOUR YOUNG CHILD?  IS SHE  DIFFICULT TO HANDLE?   

Are you becoming agitated and irritable when your child won’t listen? When you’re out, are others noticing her behavior? 

Many times a child is called “stubborn” or “bad,” when there IS a real problem.  Many teachers or even parents label a young child as “difficult” or as a behavior problem when the real problem is, he doesn’t understand and process language as well as other children his age.

This happens often when children achieve their milestones on the late end of the expected developmental ranges. And this is always true for kids who have been diagnosed with developmental delays and other issues such as autism spectrum disorder, sensory processing disorder, Down Syndrome, cerebral palsy, or who were premature.

Because of these delays, whether mild or severe, all of these children have trouble understanding what’s expected of them.

This makes it even more difficult to know how to discipline them or even what’s appropriate to try.      

The good news is …. 

There are lots of very practical ways to work on these skills at home.

You can learn simple, but effective strategies for improving the way a child understands language so that he can begin to obey.   

There’s finally a DVD series that will teach you EXACTLY how to help your child learn to understand your words and learn to obey your instructions. 

It’s called Teach Me To Listen and Obey, and it was developed by Laura Mize, pediatric speech-language pathologist and author of the website teachmetotalk.com.

There’s so much information that it’s been split it into a 2 part DVD series to address specific developmental phases and disciplinary approaches for both toddlers and preschoolers.

Both DVDs focus on helping parents, and even professionals, teach receptive language skills, or improving the way a child understands and comprehends language. 

Teach Me To Listen and Obey takes the camera inside real therapy sessions with children just like yours. Whatever stage you child is at - whether you’re just wondering if there’s a problem and want to try to address it at home, or if you’ve already seen a professional and your child has been diagnosed with a developmental issue - you’ll see all kinds of children with various abilities and at different stages.

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Here’s a sneak peek…. 

Clip from Teach Me To Listen and Obey 2………….

Teach Me To Listen and Obey 1 is a packed hour-long DVD that teaches parents how to help younger toddlers, and even older preschool children with developmental delays, learn to understand words and follow basic directions.  

Teach Me To Listen and Obey 2 is a full two hours long and is for parents of older toddlers and young preschoolers ages 2 to 4 who need help learning to understand many different kinds of words so that they can follow more complex commands and begin to consistently obey.  Watch more……

Buy the entire set and you’ll get a full 3 hours of instruction to help you teach your child to understand new words, consistently follow your directions, AND you’ll learn what to do about it when this doesn’t happen.

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See more from the discipline section of Teach Me To Listen and Obey 2…..

It’s hard to discipline ANY toddler, but when you’re considering your options for a toddler with developmental delays, it’s especially challenging. 

In Teach Me To Listen and Obey 2, you’ll review the techniques recommended by behavior experts, and then you’ll see actual demonstrations of how to handle common behavior problems such as:

• Difficulty with transitions
• Throwing things
• Melt-downs and tantrums
• Difficulty paying attention and staying on task
• Refusing to do what you’ve asked 

There’s even an entire section on how to use time out for toddlers with developmental challenges.

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If your child is not learning to understand new words and does not follow your directions, you need to change your approach.

Learn what works to be able to teach your toddler or preschooler to listen and obey. 

A lot of the time, it’s not what you do, but HOW you do it. Teach Me To Listen and Obey 1 and 2 will show you how to teach your child in an easy, step-by-step format, that you can easily implement at home.  

Read what a few parents and professionals who previewed the project during the editing process said:

“ 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. ” 

“The discipline information alone would be worth the money to buy the whole set.”

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

“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.”

“This is the BEST DVD I’ve ever seen for teaching a parent how to work on receptive language at home.”

Another parent’s comments:

Dear Laura,
 
Four months ago I noticed my daughter didn’t talk as well as other childrend her age.  After visiting our local school district for a speech eval, I was sent home and told she was fine and would have a “word burst” any day now.  I wasn’t comfortable with the “wait and see” idea, so I turned to the internet and THANKFULLY found your website.  From your site alone, I was able to educate myself and understand my daughter’s problem was a language issue, and she was way over due for her “word burst.”  It prompted me to get an assessment with a private SLP, and we then found she does have a moderate expressive language delay that is not going to correct itself!
 
Even though my daughter scored normally on her receptive language test, I saw the signs you listed that may still point to a receptive language issue,  specifically not being able to answer simple questions or follow simple commands, using lots of jargon, etc.  I deceided to get Teach Me to Listen and Obey 2 to get some ideas to work with her at home.  As expected, it gave me many great game ideas.  Infact, my daughter found your voice so engaging, she kept coming into the room to view the video with me.  I could tell she really wanted to play the games!  But perhaps the most valuable thing your video taught me was that raising a child with a language delay is different and it’s hard!  My daughter and I are both frustrated all the time, so it’s my job to keep it together and to fill in the communication gaps.  I needed to be reminded of that, and I am a better parent today because of it.  Thank you so much for your wonderful website and videos.  Thank you, thank you!
 
Teresa G

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Use the following guidelines to determine which DVD is most appropriate for your child:  

Teach Me To Listen and Obey 1 is for parents of a child who:

• Can’t follow simple directions
• Doesn’t consistently respond to his or her name
• Won’t participate in simple games or play with an adult
• Needs help understanding very basic concepts like learning the names of familiar objects and people, pointing to body parts, or completing early requests such as, “Wave bye-bye,” or “Give me a kiss.”
• Demonstrates developmental and receptive language skills below the 24 month level

Even if you feel your child is older and past the “baby” stage, if he is not consistently following simple directions or paying attention when you talk to him, you need to begin here.

In Teach Me To Listen and Obey 1, you’ll learn what things your child must do first so that he can begin to understand words. You’ll also learn the background information you need to decide if there’s a real problem.  This includes the definition of receptive language, the early signs and symptoms of a receptive language disorder, and you’ll see a review the basic receptive language milestones for toddlers and preschool children between 1 and 4.

You’ll learn 3 simple ways to cue your child, and you’ll be able to use these techniques during play and during your daily routines at home to provide a strong foundation for comprehension and communication skills.  

Teach Me To Listen and Obey 2 is for parents of a child who:

• Gets “lost” when trying to follow more complicated commands
• Needs help expanding his vocabulary to understand many different kinds of words
• May understand basic directions, but won’t follow through with what you’ve asked her to do
• Has reached a developmental and receptive language age-equivalency of at least 24 months, but is still behind his peers who are 2, 3, or 4
• Is ready to move on to higher-level language skills, but you’re not sure how to teach these or you don’t know what should come next

During Teach Me To Listen and Obey 2 you’ll see demonstrations of teaching children how to understand the major language comprehension milestones for children ages 2 to 4. This includes learning to understand verbs, prepositions, adjectives, pronouns, and other concepts such as size, categories, parts of an object, object functions, quantity, and making inferences.

You’ll also find out what’s NOT important to teach your child at this phase of language development so that you can use your time efficiently and wisely.  

You’ll learn how to design  “games” for teaching young children to listen and follow directions, and you’ll get ideas for involving siblings at home.  Here’s an example……….   

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SPECIAL OFFER

Teach Me To Listen and Obey 1 and Teach Me To Listen and Obey 2 are now available for $39.99 EACH. 

When you buy now during this introductory offer, use the coupon code INTRO and get $10.00 off each DVD with FREE USPS First Class Shipping!  

For a limited time, you can get an even better deal!

Buy both DVDs, and get the entire set for $55.00.  That’s more than 20% or $15.00 off the regular price!  

Use the coupon code INTRO SET during the Google Checkout Process, and you’ll receive this special offer!

Buy the entire set, you’ll get 3 full hours of instruction to help you teach your child to understand new words, follow your directions, and learn to obey. Order yours now! 

The DVDs Teach Me To Listen and Obey 1 and 2 are NOW available for a special pre-sale offer with an anticipated shipping date of on or before January 5, 2009.

I’m so excited to FINALLY get to offer this DVD series for helping young children learn to understand language. By the time we were done filming, there was so much information that we decided to split it into a 2 part series so that we could address specific developmental phases and disciplinary approaches for both toddlers and preschoolers.    

Part 1 focuses on teaching younger toddlers ages 1 to 2, and part 2 is for parents of older toddlers and young preschoolers ages 2 to 4. Both DVDs focus on helping parents and professionals teach receptive language skills, or improving the way a child understands and comprehends language. 

A child must understand words before we expect him to talk, and certainly before we expect him to obey.    

Many parents and teachers label a young child as “difficult” or as a behavior problem when the real problem is, he or she doesn’t understand and process language as well as other children his age.  This is always true for kids with developmental delays and other diagnoses such as autism spectrum disorder, sensory processing disorder, Down Syndrome, cerebral palsy, or prematurity. Because of these delays, all of these children have difficulty understanding what’s expected of them.

Many times late talking is also due to underlying difficulty with receptive language. A child must understand words before he begins to use those words to communicate.   

 It’s hard to discipline ANY toddler, but when you’re considering your options for a toddler with developmental delays, it’s especially challenging.  Both DVDs explain appropriate disciplinary methods for parents of young children with problems learning to understand language, listen, and obey.     

The good news is that there are lots of very practical ways to work on these skills at home. Teach Me To Listen and Obey 1 and 2 show parents simple, but effective strategies for improving the way a child understands language and then can begin to obey.   

Use the following guidelines to determine which DVD is most appropriate for your child:  

Teach Me To Listen and Obey 1 is for parents of a child who:

• Can’t follow simple directions
• Doesn’t consistently respond to his or her name
• Won’t participate in simple games or play with an adult
• Needs help understanding very basic concepts like learning the names of familiar objects and people, pointing to body parts, or completing early requests such as, “Wave bye-bye,” or “Give me a kiss.”
• Demonstrates developmental and receptive language skills below the 24 month level
• Even if you feel your child is older and past the “baby” stage, if he is not consistently following simple directions or paying attention when you talk to him, you need to begin here.

In Teach Me To Listen and Obey 1, you’ll learn the definition of receptive language, be able to recognize the early signs and symptoms of a receptive language disorder, and review the basic receptive language milestones for toddlers and preschool children between 1 and 4.

You’ll learn 3 different ways to cue your child and be able to use these techniques during play and during your daily routines at home to provide a strong foundation for comprehension and communication skills.  

Teach Me To Listen and Obey 2 is for parents of a child who:

• Gets “lost” when trying to follow more complicated commands
• Needs help expanding his vocabulary to understand many different kinds of words
• May understand basic directions, but won’t follow through with what you’ve asked her to do
• Has reached a developmental and receptive language age-equivalency of at least 24 months, but is still behind his peers who are 2, 3, or 4
• Is ready to move on to higher-level language skills, but you’re not sure how to teach these or you don’t know what should come next
• CONSISTENTLY follows simple directions, enjoys playing with you, and pays attention when you are talking to him. If he can’t do all of these things yet, back and begin with Teach Me To Listen and Obey 1, even if your child is older.

During Teach Me To Listen and Obey 2 you’ll see demonstrations of teaching children how to understand all of the major receptive language milestones for children ages 2 to 4. This includes learning to understand verbs, prepositions, adjectives, pronouns, and other concepts such as size, categories, and making inferences. You’ll also find out what’s NOT important to teach your child at this phase of language development so that you can use your time efficiently and wisely.   

I’ll show you my best “games” for teaching young children to listen and follow directions and give you ideas for involving siblings at home.

We’ll also tackle discipline! Teach Me To Listen and Obey 2 will help parents and professionals understand developmentally-appropriate disciplinary strategies for young children ages 2 to 4 who are struggling to learn language. First we’ll review the recommended techniques, and then you’ll see actual demonstrations of how to handle common behavior problems such as difficulty with transitions, throwing things, melt-downs and tantrums, difficulty paying attention and staying on task, or refusing to do what you’ve asked.   

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But there’s one catch. During the Google checkout process, you’ll need to enter the coupon code to match your order.

1 DVD (either part 1 or part 2)                                                                    PRESALE1            

Both DVDs  (Parts 1 & 2)                                                                             PRESALE2

Both DVDs (Parts 1 and 2) PLUS my first DVD Teach Me To Talk                PRESALE3

If you’ve already ordered our 1^st DVD Teach Me To Talk, check your e-mail for an even better discount!  If you did not receive your offer yet, let us know at Johnny@teachmetotalk.com.

HURRY - Order yours now! This is a limited time offer! When the ad starts running on other sites, this sale will end. Don’t miss out on this special discount only for regular readers of teachmetotalk.com!  

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A mom e-mailed me this question this weekend, and I thought I’d include it here since I haven’t written about this anywhere else on the site.  

“Hi Laura! I have a question for you.  Gabe has recently started saying “you want…”  instead of “I want…”  When we model “I” for him, he will correct himself.  He also doesn’t always do it, maybe 50% of the time.  Do you think this could be echolalia, pronoun reversal, or just SO much therapy.  For a long time when ever he would say “I want…” we would always respond with “OH, YOU want …”  I read on your website that echolalia is a normal part of language development.  Since Gabe has language skills that are far behind his age, would echolalia be just cropping up now?  Should I just model, model, model to help resolve this?  Thank you!  Julie”

Oh….. the dreaded I/you problem has reared it’s ugly head, huh?  This is my take on this issue from just knowing a little bit about Gabe’s background, but keep in mind that since I haven’t seen him, this is my best guess. 

It’s likely not echolalia since he doesn’t do other “echolalic” things typically associated with echolalia such as quoting previous conversations or shows he’s watched verbatim, and since he has lots of spontaneous language already. 

I think he’s just trying really hard to learn how to use the pronouns “I” and “you.”  Lots of children have difficulty with this, at least for a little while until they sort it all out, even kids with typically developing language, and especially children with language delays. 

It is sometimes really difficult to teach this difference too, because when you’re talking to kids, you naturally refer to them as “you,” so in turn, the child begins to imitate this.  A classic example that I hear constantly is when a child says to his mom, “Hold you,” when he wants to be held because of the thousands of times his mom has said to him, “Do you want me to hold you?” 

The most successful thing I’ve done to teach this is by giving LOTS of visual cues with pointing as I say the word.  The best way I’ve found is to play the whole “YOU do it game.”   When I want a child to do something, point to the child and emphasize “you,” such as “YOU do it.  No YOU.  No YOU.” (I think a little clip of this was in Teach Me To Talk - The DVD), and then I point to me when I say “I.”  

Sometimes say, “I, Laura, want the ………..”  or “I, Laura, see the …….”  I wouldn’t recommend doing the reverse for “You, Gabe” since children I’m trying to help with this who do the same thing he’s doing often seem to further link “ YOU” with their own names and think this is how they should refer to themselves.   

 Another game to play is to have snacks or some little thing that he will want to ask for over and over again.  Involve at least 1 other “asker” besides him. The giver of the treats should say, “Who wants ….?”  The other receiver should model, “I do! I do!” or “I want…..”  Have the model point to her/him self to give the visual cue. 

If toddlers don’t get “I” this way, I go ahead and point to my “eye” to cue them, but I’m sure lots of SLPs would hate this idea!  It works though since it makes that word a little more concrete than abstract in their little minds.    

I usually have the giver (the mom in therapy sessions since I am playing the kid to part model it for the child to imitate) say, “Here you go.” or “You want….”  but again, I probably wouldn’t add the “you” part for him for him until he’s really mastered the “I” part, which may take a couple of weeks of consistently playing this a few times a day every day.        

I have a little section about teaching pronouns on my new DVD Teach Me To Listen and Obey which should be out later this month.  You may want to check this out if he’s still having difficulty learning to understand more complicated words like pronouns, verbs, descriptive words, and other 2-3 year-old language concepts.     

If you think this is hard, wait until you start trying to teach “he” and “she” and “him” and “her” ……………….

Hope these ideas help!   Laura

 1.  Minimize the distractions from other people for your child, especially during initial sessions. 

This means don’t have grandparents or your best friend or the neighbor’s children over until your child has established relationships with her therapists.  It’s much easier to keep a new client’s attention if the stressors are limited in the beginning. Grandparents can come to watch AFTER your therapist has a good read on your child, and after she already loves her and wants to play.

2.  Turn the TV off before she gets there! 

It’s hard to start a fun session when your child is having a melt-down because Dora or Super Why has been abruptly turned off. 

3.  Put the pacy and cups away.

This is unless you’re working on feeding, oral motor with a straw cup, or your kid absolutely, positively has to have the pacifier to regulate.  Your therapist may want you to keep the pacy available, but she should NOT have to be the one to have to pry it from your child’s mouth!  It makes her the bad guy, and that’s really a mom’s job.

4.  Do a “warm up” before she comes. 

Act excited before she gets there telling your child, “________ is coming to play!”  Do a movement activity like swinging or jumping on the bed or couch or running laps 5 minutes before she’s due (or in my case, 5 minutes after I’m due since I consistently run 10-15 minutes late!)   This serves to pep up kids who need to kick it up a notch to talk.  More often, it calms down really active kids who have a hard time engaging and attending.

5.  Follow your therapist’s lead with participating in the session. 

I LOVE for moms to sit and actually play with us, unless mom is so chatty that I can’t get a word in edge-wise or a mom that subconsciously sabotages techniques by answering for her child, is too quick to jump in to rescue her child (a little bit of frustration is sometimes good thing), a mom who is too mean, or a mom who justifies every little negative thing that he may do (He’s tired today because he went to bed late, so no wonder he can’t do what you’re asking…).  

Do chime in and tell her why you think something may be going badly (i.e. “This is his 2nd day of antiobiotics for an ear infection.” or  “He was up 7 times during the night.”), but don’t tie her hands or so lower the expectations that she ends up wondering why you didn’t call to reschedule if he’s truly having such a bad day.  

If your child is clingy to you and won’t interact or play with your therapist, make yourself present, but not quite as available.  For instance, casually check your e-mail from across the room or stand up and dust so he can’t sit in your lap.  Be there so he’s not stressed, but don’t coddle him unless he really needs it.  If in doubt, ask your therapist what she’d like you to do.

Read your child’s cues, BUT remember that challenging your child may be just what he needs.  Don’t feel threatened if she’s not doing it exactly as you would.  She’s there to teach you NEW stuff.    

6.  Cancel if you know you’re not going to get anything accomplished, and please cancel if anyone at home has an illness that’s contagious.  

I can’t tell you how many times I’ve picked up a child and felt him burning up with a fever or sat while mom changed dirty diaper after dirty diaper and thought…. I hope I’m not going to catch this and take it on to my next 4 clients or home to my own children!  Speech therapy is important, but it’s not an emergency!  It’s okay to miss a session when your child is not going to benefit anyway.  This might also include the day you’re leaving on vacation and the house is a disaster or when the water heater has broken and the repairman is going to be going in and out of the front door 50 times.        

This is also true for when Dad is home with the flu.  He’s touched doorknobs.  He’s sneezed out his germs into the air.  Cancel or at least call and warn her! 

 7.  Handle your child’s major behavioral issues, but not the minor ones. 

I’d rather ignore little infringements than get off on the wrong foot with a kid.  I almost always use gentle redirection in sessions rather than “disciplinary” stuff like time out or even verbal corrections.  However, if your child is truly being horrible (i.e., purposefully throwing toys at your therapist, hitting, biting, destroying her toys, or hurting your other children), step in and parent.  If you’re not sure how to handle these behaviors and also need coaching in this area, ask her to model what she would do for discipline in that situation.           

One other pet peeve I have is parents who are constantly chiming in, “Tell her thank you,” “Say please or you can’t have it, ” “Say MISS Laura,” or using other politeness or verbal cues that are irritating for a non-talker and for me when we’re just trying to get ANY word!  Ditch the etiquette lessons until he can communicate! 

8.  Don’t save all of your questions for the last minute.  

I routinely ask moms how the week is gone, if they have any questions, etc… at the beginning of the session.  Answering questions is what your therapist is there for, so don’t save a bombshell bit of information or a long question until she’s about to walk out the door.  It’s not fair to her other families who may be waiting 20 minutes for their appointment because she feels like she must answer your question before she leaves.  If it’s a complicated issue she may need to think about, leave her a voice mail or shoot her an e-mail a day or two before she comes so she can be prepared with a credible answer.        

9.  Be respectful of her schedule.  

Schedule all of your other appointments around your therapy time.  You wouldn’t call your pediatrician’s office and say, “I’d like to come in on Tuesday at 10.”  You take what they give you.  While it’s important for therapists to be flexible and respectful of your schedule, you may not be able to dictate exactly when you want her to come.  If a therapist has a good reputation, she is going to be busy.  If she’s busy, you’re going to need to take what appointment you can get, within reason of course.  I am very careful to tell parents that I don’t want to come at the worst possible time of the day, but if you have to push lunch back a little and put your child down 30 minutes earlier for a nap so that your great therapist can come for an afternoon appointment, so be it.  Not every client can be seen at 10:00 am on Wednesday.  Be flexible. 

10.  Help your child love therapy.

Sometimes parents subconsciously sabotage their child’s good relationship with a therapist out of well, jealousy, or mistrust, or any other number of unproductive emotions.  You need your child to love, or at least like, okay at least tolerate, his therapist.  Stay positive, even when it may be off to a rocky start.  Don’t characterize the session as “work.”  Don’t say dumb things like, “Do you want _____ to go home?” Don’t ask him, “Do you want to play with her today” when the answer may be no.  Expect that he and you are going to benefit tremendously from each session, and do everything you can to make it happen.  

If your child hates therapy, consider switching approaches, times of the day, settings, or as a last resort, therapists.  Unfortunately, there are good and bad SLPs just like there are good and bad hairdressers, car mechanics, preachers, cashiers, and math teachers.  Find a good match for your child so he can get the help he needs.  

I love the beginning quote so much that I’d like to share it here:

“Not all children with delayed speech are “little Einsteins” or garden variety “late bloomers.” Some have a speech-language disorder that will persist unless warning signs are recognized and intervention comes early.”

She also includes a set of risk factors for pediatricians (and parents) to look for which might also inhibit language development: 

• Family history, such as a strong heritability factor. There’s a higher risk of continued delay if one of a toddler’s parents or siblings had long-term language and learning difficulties.
• Otitis media with effusion causing a fluctuating hearing loss during the period of speech development. (This means frequent ear infections.  If your child has had several, and especially if he’s had to have tubes during infancy or toddlerhood, this could be a major contributing factor to his speech-language delay.)   
• Low socioeconomic status and educational level. These families are more likely to have a child with a poor outcome.
• Parental characteristics that may inhibit speech, including the way parents interact with the child. Parents need to follow a child’s lead and provide a language model using simplified speech. Use of “parentese,” the way that many parents instinctively talk to infants in a high-pitched, sing-song voice, actually fosters language development by attracting the infant’s attention and resembling the pitch of the sounds he makes.
• Missed language explosion. Most children experience a vocabulary spurt around the age of 18 months, but late talkers don’t. Some late talkers have an “explosion” of speech later—between 24 and 30 months. If a child has not had a vocabulary spurt by 30 months, he is at considerable risk of continued language delay.

 She also includes information I’ve cited in other places on the site with the signs that a child should get an early speech-language assessment including:  

One major review in the speech pathology literature paints a profile of toddlers 18 to 24 months old who are at risk of persistence of language impairment at 36 to 48 months and who should receive early intervention.⁶ The greater the number of warning signs a child exhibits (especially the closer he gets to 3 years of age), the greater the need for early assessment. Those signs include⁶:

• little sound play or babbling as an infant, with limited number of consonant sounds and, possibly, vowel distortions as a toddler
• poor verbal imitation skills; reliance on direct model and prompting
• immature play skills; little pretend play
• interactions with adults more than peers
• few communicative gestures (the late bloomer who caught up with his peers within a year used significantly more gestures than the child who had persistent delay)
• impaired social skills or behavior problems
• small vocabulary for age; less diverse verb repertoires
• comprehension delay of six months or greater relative to chronologic age

This might also be a great resource for your pediatrician, especially if he or she is of the “wait and see” variety.  Printing this article and taking it with you to an appointment might be a great way to start (or re-start) a conversation about your concern with your child’s language skills. 

 You can read the full article at this link.
    

Not only does this little girl have delays in English, but she is not imitating or spontaneously saying words in ANY language.  She’s not doing much better understanding language either.  She doesn’t consistently follow many directions, no matter what language her parents use.    

To her credit she is beginning to use some early gestures such as pointing and waving bye.  Hmmmm….. could it be because these are the only consistent means of communicating in all of her languages?     

I think the parents’ intentions were good.  They wanted to expose their child to all of their languages hoping she’d become fluent in all of them.  As educated parents, they have read that the best time to learn language is before age 3, so they have bombarded her from birth. 

Her mother was careful to tell me that she talks to her daughter in her own native language most of the time and adds English words to label familiar objects.  Her father does the same in his language and with English.  In addition, the little girl loves television, and most of the shows she watches are American.  They asked, “Shouldn’t this be enough to learn English?”  My answer is obviously, “No.”  If it were, she would have picked it up by now. 

The mother cited that she learned English as a school-age child and knew that she didn’t want to wait that long to teach her English, but she also didn’t want her to have difficulty communicating with her grandparents and extended families during their yearly visits back home.  She added that many of her friends advised learning only native languages at home and saving English for when she’s older and going to school. 

The mother also was worried that their relatives might think they were neglecting their duty to continue to pass along their heritages.  While I understand the concern, I can’t help but wonder, would you rather have upset grandparents who think you’re not doing a good enough job (and by the way, doesn’t that happen to most of us anyway?), or a daughter who can understand and use words to communicate in her home where she spends 11 months out of the year?        

Now the question becomes, would this child have a language delay if her parents had chosen one primary language from the beginning?  We’ll never know.  She may have struggled with only English.  Her system may have been compromised by who-knows-what that would have made learning any language difficult.  Or not.  We truly won’t know.  

What I do know is that she is struggling now.  Because of her challenges with language, she is at huge risk for cognitive and academic issues as well if things don’t improve for her and soon.  Waiting to learn English in school is really not an option for parents who want their children to excel academically.  Let’s not even talk about how she’ll do socially with no verbal way to initiate or respond to new classmates!           

For her parents as well as all multilingual families I see, my number recommendation is to pick one primary language and stick to it.  If your child is struggling to learn language, doesn’t it make sense that he’s more likely to succeed if he’s learning just one?  That doesn’t necessarily mean that you won’t get to teach him other languages later.  It means that we need to increase his odds of doing better right now.  One language is easier to master than two (or three!).   

Families who have chosen to fore-go their initial plans of raising a bilingual or trilingual child are often targeted by their friends or families.  They are told that the SLP is trying to sabotage their child’s development or “doesn’t know everything” about language.  Families also cite the research that tells us that bilingual children achieve milestones later.  What they don’t say is that this research is relevant to expressive language, or what a child can say.  It doesn’t address children who don’t understand or process verbal language.  This indicates a larger problem than late talking.      

While it is true that SLPs don’t know everything, we can certainly predict that a child who isn’t communicating well verbally by kindergarten is going to have an uphill battle learning to read and write.  All of the academic concepts we learn, even math, are based on language.  It’s a fact.  The teacher talks to teach; kids listen to learn.  It’s a mostly verbal system.    

Educators who recommend teaching your baby several languages at once are not considering the effects on a child with language processing issues.  While in theory it is a good idea to teach languages during this optimal learning time, it has done damage to children who weren’t old enough to be identified yet as language delayed or disordered.  We don’t which kids are going to thrive with this approach and which ones are going to fail. 

Granted it’s not a parents’ “fault,” but at the first sign of difficulty, I’d advise them to reevaluate their decision to teach multiple languages.  If a child is having difficulty learning to understand and use language, I think it just makes sense to let him master (that is, catch up to his age level) in one language before moving on to another one.  Then he’ll have a point of reference for “learning” the new one, and you’ll know you’ve done everything you can to help him learn to communicate his wants and needs in a consistent way that he and you understand.  Isn’t that ultimately what all of us who love a child with language-delays want and hope for?      

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.