TREATING RECEPTIVE LANGUAGE DELAYS AT HOME FOR LATE TALKERS

Many times during an initial assessment, when I ask a mom how her late talker understands language, she responds with…

“My child understands everything.”

While this is true for some late talkers, many times a toddler who isn’t saying very much doesn’t understand very much.

I hate it when I’m the first person to point that out to a mom who’s worried about her child.

Here’s the truth:

A child must understand words before we expect him to talk.

A child who doesn’t understand much really can’t (and shouldn’t) say much either.

This incorrect assumption can lead to other problems, such as problems in the “behavioral” realm… A toddler may be described as “bad” or “stubborn” because he isn’t doing what his parents, his daycare teachers, or his grandparents tell him to do.

Here’s what’s really going on in that situation:

He doesn’t follow directions because he doesn’t understand what’s being said. He seems to ignore language because words don’t mean anything to him yet.

When parents understand the connection between receptive language (what a child understands) and expressive language (what a child says), wonderful things can begin to happen!

By changing the focus, parents can make a huge difference in how a child begins to talk by helping a child learn to understand more words.

Several years ago, I wrote a longer post with great background information about receptive language.  It is a lengthier version of the tips I’m going to recommend below. If you want the “meatier” article, click here.

If you recognize that this may be part of what’s going on with your own late talker, let me give you some easy suggestions to get started…

Change What Your Child Hears

During your daily routines at home, pay attention to HOW you’re talking to him. Toddlers with receptive language difficulties often need very specific and focused “teaching” (for lack of a better word) to begin to link words with objects, people, and events.

When parents are resistant to changing the way they talk to a child, I (very gently, of course) remind them that we must change the way we’re talking and interacting with him in order to make a difference. Let’s face it, if the child were going to “pick it up” in daily conversations, it would have already happened, and there wouldn’t be a problem.

Young children with difficulty understanding and processing language need adults who are there to “interpret” the world for them. These toddlers benefit from nurturing parents and teachers who can provide support to help them understand words and begin to make associations throughout the day.

How can you do this for your child?

Practical Ways to Work on Receptive Language at Home

1. Reduce the complexity of what you’re saying.

Use mostly single words and short phrases.

Sometimes this isn’t stated to parents clearly enough. The advice is simply, “Talk to your child.”

This approach doesn’t always work with children with receptive language disorders. Since there’s a problem with your child learning to understand, you must simplify what you’re trying to teach since he’s not getting it the “regular” way.

Perhaps you can relate to this example:  Imagine being dropped off in a country where you understand very little of the native language. You may recognize a few common words or phrases, but you need to find out how to get to the nearest airport to book the next flight home. Because you can say just a few words in that language, the person you’re talking to assumes you “understand everything” and makes no adjustments in how they speak to you. How do you feel? You know you’re in over your head! That’s how it is for a child with a language delay. He understands some of it, but not enough to get him through the day.

Use lots of single words. Use lots of short phrases. Avoid long explanations or questions. When you’re asking your kid with language delays if he wants a cookie, don’t launch into, “Do you want one of these yummy chocolate chip cookies that Mommy just bought at the grocery store?” Hold up the cookie and ask, “Want a cookie?” See the difference?

2. Watch your child and talk about what he’s paying attention to at the moment.

When you’re eating breakfast in the morning and he’s looking at his cereal and milk, use those words and talk about the meal. Don’t discuss what happened at daycare yesterday or grandma’s visit next weekend. Keep it simple and in the here and now so it “makes sense.”

3. Talk directly to him using words he can use.

Kids with language problems need parents who go out of their way to “teach” them the words they need to communicate.

This means that you shouldn’t spend your time talking to a child with baby talk. While we all break into, “Look at mama’s sweet, sweet little, bitty baby girl,” your child needs to hear language she can use.

When a child is having difficulty learning to understand conversations and follow directions, we have to talk directly to them for much of the time we’re together.

Reduce the amount of time spent listening to adult conversation. While we all spend a good deal of time talking to our spouses and older children while a toddler is there, don’t miss opportunities to talk directly to the child using mostly single words and simple sentence structures he can eventually begin to repeat.

4. Give him clues (or “cues” in SLP terms) as to what you’re talking about.

Usually, children with language comprehension delays rely heavily on visual cues since they don’t consistently understand or process words. Point to direct his attention. When practical, show him the object. If you’re using books, point directly to the picture, say its name, and then make a brief comment. Provide other visual cues including gestures such as leading him and moving objects within his line of vision to be sure that he knows what you are talking about.

Because they need visual cues, kids with language delays may depend on your facial expressions to add meaning to your comments. Make your expressions match your words. If you’re upset and he’s about to be in trouble, don’t send mixed messages by continuing to smile as you warn him. He may misread your cues.

When he’s not responding, move closer to him, get down on his level, and touch him to redirect his attention.

Some children respond to clapping or finger-snapping more readily than a word to get his attention. Beware! Don’t overuse this technique, or he may start to tune this out.   Children do this because it’s annoying, not because they don’t understand.

Some kids need picture schedules to help them know what to expect next. Many preschools use these kinds of systems to provide additional support. Take digital pictures and put them in a small album or post them on the refrigerator to “show” him things he doesn’t understand in daily routines.

5. Repeat directions when he doesn’t seem to understand.

Toddlers with language delays need extra repetitions of information to be able to process what’s been said. Resist the urge to think and say, “I’ve already told you once (or twice).” Repetition helps his little brain to learn.

6. Break commands into smaller chunks of information.

Until he’s following directions consistently, limit yourself to simple commands with one piece of information.  Use “Go get your cup,” rather than “Take your cup to the sink.”

Once he’s gotten the hang of familiar directions, then work on adding more parts. “Get your shoes and bring them to Mommy.”

7. Reword what he doesn’t understand.

When you’re getting that look (like “Huh?”) or if he’s tuning you out, try using other words. If you’re saying, “Our family is going to church now. We have to get ready to leave,” and he’s not looking, you might try calling his name and saying, “It’s time to go bye-bye.” Pause. “Come here.”

8. Give him frequent opportunities to demonstrate that he understands.

Consistently ask him, “Show me the ____, ” and “Where’s the _______?” If he’s not pointing yet, encourage him to look around to find what you’ve asked him to locate. Other activities you can include in your daily routines:

• Have him point to pictures in books. Focus on the names of objects & actions. “Where’s the dog?” and “Show me who is sleeping.”
• Once he’s mastered basics names for objects and common actions, up the ante. Teach object use/function with words such as, “Which one is for riding? Which one goes on your feet? Which one do you use to drink? Which one says moo?” Help him identify parts of an object rather than the whole picture – “Find the door of the house, the wheel of the car, the dog’s foot, etc…”
• Retrieve objects on requests. Have him get items or put away specific toys on request.  “Get your ball,” or “Bring me your puzzle.”
• Have her perform familiar tasks related to daily routines. Toddlers can get diapers or wipes before changing time, throw things in the trash, put their own cups in the sink, take off their own shoes and socks, close a door, wipe off a high chair tray, pet the dog, and help you clean up toys by placing them in a basket. Involving them regularly in these kinds of activities increases their opportunities to follow directions (and help you out!)
• During playtime give short directions and help him perform the action. For example, “Put ball in,” and then help him do it.
• When you’re playing with puzzles, hold up a piece and label it with a single word as he completes the puzzle. When he is finished, have him retrieve the puzzle pieces one at a time by asking, “Give me the ________.”
• When dressing, tell her to put her arm in the sleeve or her leg in her pants. Hold up a sock and shoe and ask her to, “Get the sock.”
• When he’s seated near a toy, hold out your hand and say, “Give me the _____.”
• Place several items related to your play in front of her and ask, “Where’s the ______.”
• In the bathtub or during diaper changes, ask him to point to body parts, and help him follow through.
• During playtime ask her to give her baby doll a drink or put her baby down to sleep.

9. To build compliance with everyday tasks, try telling him to do things that he’s already about to do.

For example, if he’s headed for a ball, say, “Get the ball.” If he’s reaching for a book, say, “Read your book.” A child may not yet be following directions because you asked him, but using this method gives toddlers a way to “get in the habit” of doing what Mommy says.

10. Insist that he follow directions by providing physical assistance as necessary.

Once you’ve given him a verbal direction and repeated it once or twice, help (or make) the child complete the request. Repeat the direction so he can link the activity with the words.

11. Pause frequently when you are talking to him to give him time to process what you’ve said.

This is hard for chatty parents, me included! Give him enough time to think during your conversations. You may have to purposefully (but silently) count to 5 before moving on to your next point, or before you repeat yourself to be sure he’s had time to respond.

12. Have fun too!

Make some directions fun too, such as “Come here so I can tickle/hold/kiss you.”

Teach games like, “Gimme 5,” so that everything isn’t about behavioral compliance!

13. Lastly, but probably the most important, be very consistent with realistic behavioral expectations.

Children with difficulty understanding the language need the same rules day-in and day-out that are easy to remember and follow. They need to be able to count on consistent routines.

If your child’s ability to understand language is much lower than his chronological age, you’re going to need to keep that in mind when determining behavioral standards and even disciplinary methods. For example, time out is recommended for children who are 2 and older. If your child is 26 months old, but his comprehension is at the 16-month level, time out is not an appropriate choice for him.

Some parents disagree with this and think that this is how you “teach” a child to obey.  Believe me, though, you’re fighting an uphill battle. This would be like trying to teach a 3-year-old to tie shoes or jump a full-size hurdle. He’s just not ready yet. Use the same discretion when determining what is and isn’t appropriate behavior based on a child’s ability to understand.

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If you’re a therapist and need some new ideas for developing comprehensive treatment plans with a heavier focus on receptive language, that’s my specialty!! Check out Teach Me To Talk: The Therapy Manual. In this post, you’ll see a description of that book and my other manuals for pediatric SLPs!