Below is an excerpt from my book Teach Me To Talk: The Therapy Manual.

This is the first response I give to any mom who asks, “What can I do to help my toddler learn more words?”

Teach USABLE Words and Teach by DOING

“The brain learns best through exploration and interaction with real people!”                ~ braininsights.blogspot.com

There’s a very popular article on my website called, “Ditch the Bells, Whistles, Flashing Lights, DVDs, & ABCs!” Among my recommendations, I emphasize the importance of using toys to teach functional vocabulary to toddlers with language delays. Parents, and even some early intervention professionals, often emphasize the WRONG kinds of words. Who cares if a child can count by rote or identify shapes, colors, and letters when he doesn’t understand a simple, real life command like, “Go get your shoes.” 

While children become hyper-focused on these kinds of skills on their own due to their preferences for visual patterns, adults often emphasize these concepts thinking it’s educational. Toy manufacturers have duped parents into believing that these are important academic concepts that must be hammered into our children from infancy.

In our profession, we’ve all encountered children who recognize letters and numbers or even those who could read by the ripe, old age of 2 or 3, but who also struggle to answer simple questions. What good are all of those academic concepts when a child can’t use and understand language in order to get his needs met?

In his books and on his website Dr. James Macdonald, speech-language pathologist, shares his belief that an overemphasis on this kind of academic information shuts down early communicative attempts and drives children away from us.

I believe that teaching these academic concepts by rote memorization is even worse for some children. When a toddler is able to spit out those kinds of words on request, it may actually prevent parents from recognizing the severity of his comprehension issues. How many times have we tried to explain a child’s developmental issue to disbelieving parents (or grandparents) who’ve never considered that a child might have a language comprehension or auditory processing problem because he knows his letters and numbers? Mom and Dad might think the child has an attention problem, a behavioral issue, or even social awkwardness, but all of that “data” masked the fact that the child exhibits a very real communication disorder. They wonder or may even ask you, “How can he have a problem learning language if he can already talk?”

To combat this myth, educate parents and the other professionals you encounter in your practice. Practice what you preach too! Don’t emphasize colors, shapes, letters, and numbers in therapy sessions UNTIL a child’s language skills are functional and near an age-appropriate level. As a rule, I ask parents to wait to talk about these kinds of words until a child is using phrases consistently and has a vocabulary of at least 50 “real” words to ask for what he needs. From a receptive language perspective, this certainly would include being able to understand and follow a variety of directions in every day routines.  

If a child demonstrates a strong preference for these kinds of words, meaning that he uses these words perseveratively or prefers activities with these concepts, I might incorporate his preferences as a way to improve attention and participation. Use them to target more complex auditory processing during games or even in expressive tasks for phrase practice if he’s not able to use other word combinations yet. However, I never teach these concepts formally as a “goal” for very young children, particularly during these early developmental phases. 

What kinds of words should we target? On the next page is a list of the most common words present in the vocabulary of typically developing toddlers according lists compiled from Dr. Rossetti’s work and sources from Nancy Swigert’s Early Intervention Kit.

This list may be helpful for parents during your initial visits when you’re talking about the kinds of words to target in daily routines. Feel free to copy and share the next page with your families. 

TEACHING FIRST WORDS

Naming Words (Nouns) ball, book, choo-choo, train, bike, rain, bubbles, car, truck, boat, plane, baby, bowl, spoon, diaper, sock, shoe, shirt, pants, hat, star, flower, house, tree, brush, towel, bath, chair, table, bed, blanket, light, cookie, cracker, chip, cheese, apple, banana, ice cream, cereal (Cheerios/ “O’s”), candy, milk, juice, water, dog, cat, fish, bird, duck, cow, horse, bunny, bear, pig, lion, elephant, butterfly, bee, frog, alligator, snake   

Names for Favorite People Mama, Dada, names for a child’s siblings, pet names, grandparents & other family members, sitter, and favorite characters such as Elmo, Dora, Diego, etc…

Social Function Words more, please, thank you, hi/hello, bye bye, again, sorry, uh-oh, yes/uh-huh/okay, no/uh-uh

Common Action Words (Verbs) eat, drink, go, stop, run, jump, walk, sleep/night night, wash, kiss, open, close, push, pull, fix, broke, play, want, hug, love, hurt, tickle, ”gimme”, all gone, all done, dance, help, fall, shake, see, watch, look, sit, stand (up), throw, catch, blow, cry, throw, swing, slide, climb, ride, rock, ”C’mon”, color/draw      

Location Words (Prepositions) up, down, in, out, off, on, here, there

Descriptive Words (Adjectives/Adverbs) big, little, hot, cold, loud, quiet, yucky, icky, scary, funny, silly, dirty, clean, gentle, wet, soft, fast, slow

Early Pronouns me, mine, my, I, you, it

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Teach New Words By DOING!                                                                                                                               

How do we teach these words to toddlers? Teach by DOING! Use the target word during play or in a common daily routine such as mealtime or dressing. Using pictures or flashcards to teach any new word is NOT recommended as the sole method for teaching children at this developmental level. Toddlers learn best by doing! So…. PLAY! Spend time on the floor with your toddler every day with the goal of teaching him new words.  

Toddlers need to hear and use a new word at least 20 times to really learn it and make it “stick.”

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If you’d like to learn and SEE exactly HOW to do this, check out my DVD Teach Me To Talk. Click here for more information.  

This information is from my book Teach Me To Talk: The Therapy Manual and is copyrighted to www.teachmetotalk.com. For more information about the book, click here.   

All teachmetotalk.com products are available for review and purchase here.

For more ideas to help you teach your child to understand and use language, check out my line of products here at teachmetotalk.com!

Did you make any New Year’s Resolutions? Are any of them related to your work as a therapist in early intervention or a preschool program?

When Kate and I were discussing our last few podcast topics and questions from our regular listeners, I came up with several resolutions which can make us all more effective in our practices.

We’re going to use these resolutions as the basis for the first couple of podcasts for 2012. My weekly show “Teach Me To Talk with Laura and Kate” airs live on Sunday nights at 6 pm Eastern time, and I’d love to have you join us for that discussion. 

If you’ve been a regular listener or reader, these will not be new topics for you. We’ve talked about these issues over and over since our first show aired in August 2008, but often to our surprise and amazement, these same issues keep coming up!   

The list below is based on the common themes that emerge when answering questions from parents and professionals here on the website, talking with callers on the podcast, or the comments I hear when I travel to speak to therapists in my conferences across the USA.

Following these resolutions will reduce many of the common challenges that seem to arise everywhere, whether you do home visits in a city like Chicago, work in a clinic-based practice in southern California, or serve in a preschool setting in rural Tennessee.

See if you recognize yourself in any of these situations: 

1. I will have FUN in my sessions! 

Having fun yourself in therapy almost always ensures that the child you’re seeing is having a good time too.  

Why is FUN more important than almost any other principle when working with young children? Because being FUN often eliminates poor participation, boredom, and even most of the other behavior issues we encounter during therapy sessions. When your little friends are busy having fun, they don’t want to run away, blow you off, or exhibit any of the other less desirable actions toddlers resort to when they’re not having a good time.

To put this a little more bluntly, if you routinely have these kinds of issues with many of the children on your caseload, the problem isn’t with your clients or their families…

Change yourself and you’ll see many of these challenges disappear.  

2. I will be warm, affectionate, and approachable during sessions.

In addition to being fun, establishing a social connection with a child is vital to success in therapy. If you treat children in their homes, this connection must extend to a client’s family too.

Although we’re trained professionals, a cold, aloof, and disengaged demeanor sends the wrong kind of message to a young child and his family. 

Think back to some of your own favorite doctors, teachers, or other service professionals such as your hairdresser, or the best servers in restaurants, or cashiers at the grocery store. What do all of those people, regardless of their job titles, have in common?

Without exception they execute their jobs with a high level of proficiency, yet they are friendly, easy to talk to, and make you feel welcomed and important.

Our little clients and their parents should feel that way about their child’s therapists. Often times an early intervention therapist is the only professional young clients and parents see on a regular basis, so taking the time to establish a very natural, unforced rapport is important. 

3. I will stop blaming parents for developmental issues!

Many professionals begin and end discussions about their clients with comments about a child’s environment or family’s lifestyle. 

There are certainly cases of severe neglect and abuse when we’d rather a child we’re seeing live anywhere but where he is. When substance abuse has occurred prenatally, this parental choice has determined the course of a child’s development, but I’m not talking about these kinds of horrific situations.

I’m thinking of cases when a therapist talking to a colleague says things like, “I think so much of this child’s issue is related to parenting,” or “If that mom weren’t so ___________, (fill in the blank with any number of descriptors), this child wouldn’t be so far behind.”

The truth is most of the delays and disorders we see with our clients in the USA can more likely be attributed to neurological or biological differences than where the child lives or who the child lives with.  

While parenting certainly plays a part in who all of us end up to be, it is often NOT the chief reason for a child’s developmental delays and disorders.

Haven’t you seen siblings of clients who are developing within normal limits or even thriving? These kids live in the same homes, have the same parents, and usually live by the same rules, or even lack thereof! Despite what can be described as lackluster or non-stimulating environments, these brothers and sisters seem to be coming along just fine. In these situations, nature must be the difference, not nurture.

Before dismissing a child’s struggles as something a parent did or didn’t do, examine the true causes, especially before passing judgment on a parent.  

While environment does play a huge role in helping a child improve, it often didn’t create the difficulty in and of itself. Even if a mom had been more responsive, or established a better routine, or enforced a stricter parenting style, or read to her baby more, or blah, blah, blah, there STILL would have been a developmental delay or disorder because that’s how the child came into this world. Perhaps there would have been a milder version of the same problem, but what a parent did or didn’t do would not have totally eliminated the issue.     

Making a parent feel guilty about a problem they can’t control and didn’t cause doesn’t help anyone.

4. I will stop blaming behavior for developmental issues!

Of all the “themes” that have emerged throughout my career and certainly over the website and on the podcast during the last 4 years, this one is the most pervasive and in my opinion, the most damaging.

Late talking is NOT due to behavior or personality traits.   

When I say that to most adults, they seem to understand and agree with me, yet go on to explain how their child is not talking because he’s lazy, or stubborn, or bad.

I am constantly amazed at well-educated adults, even therapists, who seemingly believe these kinds of false and dangerous statements. Every time we nod our heads or sigh when a parent tells us these kinds of things, we reinforce this serious untruth.  

Late talking is not a choice a toddler purposefully makes. That diagnosis is called selective mutism and necessitates that a child is using normal language consistently in at least one setting. Late talking toddlers do not have expressive skills that fall within the range of normal anytime, anywhere. If so, why would that child be on your caseload? 

When kids can talk, they do talk. I call this philosophy “Can’t Vs. Won’t,” and I talk about it often here on the website, on the podcast, and in my books and DVDs. Check those out to help yourself and parents make this important philosophical shift.   

5. I will develop tunnel vision (when needed) to decide how I can best help my client & family.

Many of the questions we’re getting from therapists lately take more time to explain a client’s complicated medical or social history rather providing information related to a child’s development or his progress in therapy.

In these situations sometimes the therapists seem to be using most of their time and mental energy to search for a diagnosis or seek treatment options that are beyond their scope of practice rather than doing what they are there to do which is to address a child’s communication needs.  

While we want to be mindful of all the challenges a child faces, and we certainly want to point parents in the right direction by referring to other disciplines and professionals, searching for answers to these complex diagnostic issues can distract you from your real purpose. Honestly, the outcome won’t change or affect what we will do for a child during treatment sessions.

That’s a fancy way of saying, “The diagnosis doesn’t matter.”

As pediatric speech-language pathologists and other early interventionists, we really don’t treat a specific diagnosis. As a child’s SLP or Developmental Therapist, do you really treat Down Syndrome, Autism Spectrum Disorder, cerebral palsy, or any other medical diagnosis? Nope.

What do you treat? You treat the developmental deficits in a child’s receptive and expressive speech- language skills.

From the most practical standpoint then, in reality, it doesn’t matter if a child has a diagnosis or doesn’t because you are assessing and providing intervention for what skills he needs help to develop and master.

A diagnosis is often much better from a reimbursement perspective and it can help a child receive more services. A diagnosis may provide prognostic information about a child’s long-term outcome, but thankfully, often it does not. A diagnosis will certainly help explain the “why’s” to parents.

But the bottom line is this: when you’re doing a great job clinically, a specific diagnosis won’t significantly alter your treatment plan or therapy strategies.   

Don’t let finding a diagnosis consume your therapy time with a child or his family. Your primary role is to provide intervention and address issues that you can help make better.

6. I will work the hierarchy for treatment with toddlers!

If you’re not sure what I’m talking about here, have I got a show, a website, and a book for you!

In a nutshell, many times we don’t see progress with young children on our caseloads because we’re working on the wrong goals or targeting skills in the wrong sequence.

Every week on the podcast “Teach Me To Talk with Laura and Kate,” we discuss (at length and ad nauseam) ways to prioritize your treatment goals and therapy strategies for toddlers with developmental communication delays and disorders. You can listen to the most current show by clicking the white arrow in the blue box with the blogtalkradio icon in the right side column on this page. You can listen to the last several shows by clicking on the show number listed in the light blue boxes below the blogtalkradio icon. For a list of all previous shows, click the blogtalkradio icon, and you will be redirected to the blogtalkradio site where the archives are located. Scroll down to find topics that interest you. You can also download the show FREE from iTunes and listen on your iPod or iPhone. If you’re a podcast novice, click here for detailed instructions for how to access and download shows to your iPod or iPhone.   

For a full explanation of my treatment hierarchy, please consult my book Teach Me To Talk: The Therapy Manual. Click this link for more information.  

Well, that’s the list of resolutions and those are my initial comments, but I’m sure I’ll have plenty more to say in the upcoming weeks on the podcast.

I’d love to hear your comments too! Leave those here for me on the website. Please know that all comments are moderated, or approved, before they appear here on the website or else the site would be overrun with irrelevant ads or worse. When I’m extremely busy, it may take several days for your comment to appear and a few more days for a response from me.   

Or better yet, call us! Our favorite shows are when we have real live people call us and talk to us on the podcast! For details about participating in the show, email me at Laura@teachmetotalk.com. 

teachmetotalk.com is so pleased to present…

Teach Me To Talk:

From Signs to Sounds to Words

From Laura Mize, pediatric speech-language pathologist and founder of teachmetotalk.com, comes a NEW DVD designed specifically for toddlers, their parents, and the professionals who work with them.

Using toddler-themed play activities, each scene was deliberately engineered to facilitate gestures, sounds, simple sign language, and early words.  

Often toddlers lack the ability to imitate, to attend to language, and to link meanings to words. Many times these are contributing factors for why a child is not yet talking. This DVD shows simple, repetitive, and FUN play routines which are successful in helping young children acquire these critical, prerequisite skills.

Laura demonstrates techniques from her hierarchy of imitation that she teaches to therapists in seminars throughout the country and in her best-selling therapy manuals and DVDs.

These sequential steps help toddlers begin to imitate actions, simple gestures, easy sign language, and then finally, progress to repeating sounds and early word approximations.   

By watching along with the child, adults will see the same kinds of play routines used in speech therapy sessions with late talking toddlers. Instructions for parents and professionals are provided in an introductory section. Suggestions are shown as graphics on the screen during the DVD so that an adult will know exactly what to do with the child as they watch and play together.

The research and science behind the strategies are fully explained in a special tutorial section which will benefit both parents and professionals such as speech-language pathologists, developmental interventionists, occupational therapists, and other early intervention specialists.  

Every minute of this DVD was planned using the following research study criteria cited to make viewing more relevant for very young children:  

• Slower paced to provide extra time for a young brain to process new information

• One setting with no confusing changes in time or place

• Toddler-friendly camera shots with no quick cut-aways or rapid picture changes

• Singing and a melodic speaking pattern which is more effective in helping a toddler attend to spoken language

• Key concepts and vocabulary are repeated to help a young child understand and remember new words

• Focus is on a real person providing simple narration during play rather than objects shown with little or no language content

• Instructions are provided right on the screen so that an adult can change the child’s experience from passive to active participation

Additionally, parents will benefit from new ideas to work on language at home.

Learn more than 20 different early signs!

Laura teaches sign language during play with developmentally appropriate toys. The signs are repeated in context along with cues for parents to teach the child to use the sign too!

Enjoy simple (but CUTE) language-based songs and play routines toddlers love!

These songs and routines can be effortlessly incorporated into your daily routines at home to work on language all the time!

Therapists will benefit by:

• Observing a seasoned clinician putting theory into practice with Verbal Routines easily adapted for your own therapy sessions with your youngest clients

• Learning the Hierarchy of Vocal Imitation

• Hearing the family-friendly explanations provided during the tutorial section

• Obtaining a new tool for caregiver education sure to enhance carry-over

• Receiving a reference list for recommendedreading and resources to improve your own clinical practice

Anticipated release dates for Teach Me To Talk: From Signs to Sounds to Words is anticipated in early 2012.   

  

  

  

The truth is when kids can talk, they do talk.  It makes life so much easier for them, and for you!  Once they figure that out and come together cognitively (understand language), neurologically (can plan and send the message they want to convey), and physiologically (the complex processes that are physically required to produce sound), they do learn to speak.      

Sometimes parents think that because a child can say a few words, he can say any word.  They think he is somehow “holding out on them” when he’s “refusing” to say new words.  Children at age 2 or 3 are not capable of the advanced cognitive reasoning that must occur for this kind of mental manipulation.  Please don’t convince yourself otherwise.  Some parents would rather see their children as “bad” vs. having a true developmental problem, and I am always confused by this approach.    

This is also certainly not true with new talkers, and especially not children with specific verbal motor planning issues.  They are not “not talking” because they “choose” not to talk.  If this were the case, they would be diagnosed with selective mutism, and this is very, very rare.  

When a kid defaults to the same word over and over in lieu of using new ones, motor planning problems (apraxia) are usually found to be the underlying reason.   They are neurologically “looping” a word they can say.  Default is an accurate choice of word here, because that’s what’s happened.  They can’t say the new word.  This is very different from they won’t say it. 

Making a distinction between can’t and won’t is very different, and I BEG moms of children that I see as clients to change the way they think about this.  Without even meaning to, we often treat children differently when we view developmental issues as behavioral (”He just won’t do!) vs. a  true challenge for them. 

When we look at a kid as he can’t do it (YET!), we try to help them and look for a solution.  Often times when we think something is he won’t do it, we throw up our hands and walk away, or push and push and push to get OUR way so that it becomes a power struggle rather than finding strategies that will help this child learn to imitate and say words.

When I get a kid like this on my caseload, I keep things super fun so they WANT to participate.  I model, model, model lots of single words without lots of pressure to “perform,” give lots of choices so that they are somewhat forced to respond, and I always teach signs. 

These strategies, along with changing a parents’ mindset, really can make the difference with a kid who seems like he won’t talk.    

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For more about this topic and to find ways to help your child, please see the full listing of our products here.     

The book is divided into 2 parts.  

Part I includes the background information to make sure you understand WHY you’re doing what you do in sessions! You’ll learn the overall philosophy, rationale, and treatment hierarchy recommended for successful language therapy with toddlers for the developmental areas of social, cognitive, and both receptive and expressive language skills.

Part II outlines a comprehensive list of therapy goals with highly detailed  instructions for targeting each milestone in sessions with a variety of activity ideas. Specific recommendations are provided to help you tie each goal to realistic and practical carry-over “homework” for parents and caregivers.     

The last two chapters contain activity recommendations based on the KINDS of play we use in therapy and when/why to use those categories and then finally a few problem solving examples to help pull together all of the information.

The regular price is $54.00 for customers who live in the USA. Save more when you purchase this in addition to other products!

To order from our store at teachmetotalk.com, click here. This link processes orders in the USA and around the world using credit cards or your PayPal account.

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Making it through circle time at preschool or daycare is often a challenge for toddlers with developmental delays.  Here are hints for teachers, therapists, and parents who are looking for ways to make young children more successful during this schedule standard. 

Promote Participation and Attention at Circle Time by:

1.  Using developmentally-appropriate activities.

Too often I go into toddler classrooms to work with a child who is language-delayed and having difficulty participating in the circle time routine, and I cringe at what the teacher is trying to pass off as an activity interesting enough to hold the attention of 10 two-year-olds.  

HINT - HINT - If 8 of the 10 children are not able to participate and pay attention, you’re doing the wrong kind of activity!  

Naming flashcards, reciting the alphabet, days of the week, or months of the year, and saying the Pledge are NOT appropriate for this age group! For 4 & 5-year-olds yes (well, maybe), but 2- and 3-year-olds, forget it!

What activities are developmentally-appropriate for younger children? 

• Sing simple songs with hand motions, or better yet, songs with lots of whole body activities (think Hokey-Pokey, London Bridge, If You’re Happy and You Know It, Itsy Bitsy Spider, The Wheels on the Bus, etc…)  Try to mix 1 or 2 old favorites with one newer song that’s related to your weekly/monthly theme.  Sing the same songs for a week or two to build familiarity, then move on to new ones to match your theme.  
• SHORT Flannel Board Stories or SHORT Stories told with Props  OR 
• VERY SHORT stories from books with lots of pictures related to your theme read with LOTS of enthusiasm.  By short, I mean 2 minutes tops!  By enthusiasm, I mean using your voice and your facial expressions to convey the meanings of the words.  This is sooooo important for children with language delays who may not understand all of the words, but can follow the plot pretty well if you’re giving them other visual and verbal cues to help them.     
• Include only activities that the children obviously enjoy.  If you’re losin’ ‘em, lose the activity!
• Build routines into circle time such as singing the same opening or closing song so that children know what to expect. 

My favorite opening circle time song for toddlers is letting the children take turns hiding under a blanket and singing:

“Where, oh where, oh where is (child’s name)?,

Where, oh where, oh where is (child’s name)? ,  

Where, oh where, oh where is (child’s name)?,

Where can (name) be?” 

Then help the child uncover and everyone says, “Boo.”  This has been a big hit with every class I’ve ever introduced it to from about 15 months all the way through 3 year olds.  It also helps children learn their friends’ names.   

2.  Making the length of circle time match your group’s attention span.

In the beginning of the year, circle time may need to only be 5 minutes long and then expand to no more than 10 minutes for 2 year olds and 15 minutes for 3 year olds.  Why?  Because you may lose the attention of even the best-behaved and brightest young children after this amount of time.  Very complaint children may still remain seated longer than this, but if they’re not actively participating and learning during this time, why bother?

3.  Scheduling circle time AFTER a gross motor activity.

So many preschools schedule circle time for the very first activity of the day.  This is GREAT IF your children have been given the opportunity to run, jump, kick, catch, throw, and play rambunctiously for the first 10 or 15 minutes they have been in the classroom, but often this is not the case. 

If you don’t have the luxury of planning your own schedule or the facilities to do this, then always begin circle time with a 2 minute dance to “get the wiggles out.”  Or you could have the kids ”march” around the room or “hop like bunnies” to pick up and put away toys before beginning circle time.    

Many teachers are afraid to do this thinking that it will hype the kids up.  Actually, it’s the opposite.  After kids spend some time moving around, their little brains and bodies are more ready to attend.

I love it when circle time is after children have been outside or have had gym time.  Not only have kids gotten to move around, they’ve also walked to and from the other location between activities.

4.  Providing better seating arrangements for younger children.

Toddlers need to know where and how to sit for circle time.  Using an arrangement that promotes visual boundaries is the best way to make sure children stay where they should, instead of wandering around the room or invading the space of their friends.      

Many programs use colored shapes taped to the floor as a guide, but often times the shapes are too small to serve as a boundary for where sprawling legs and wiggly feet should stay. I prefer carpet squares or bean bags.  Toddlers with sensory processing disorders will also get a “sensory bump” from using either of these since it provides much more tactile feedback than sitting on floor.       

I know storage is a problem for some facilities, but most every room has an empty corner.  If you have the children retrieve them from a stack in a corner as the beginning activity for circle time and then stack them back in the corner when you’re finished, you’ve also provided a movement activity PLUS established another “routine” for your classroom.  You’ve also extended circle time by at least 5-10 minutes for children with even very limited attention spans since most 2 year olds can be taught to get and return their carpet square or bean bag just by following the examples of other children.                 

I place mimimally verbal children and highly distracted children directly across from the teacher so that they can SEE what’s going on.  I also like to place less verbal children between other more verbal kids so that they hear better language “models” BEFORE it’s their turn to respond if we’re going around the circle to answer a question, and so that they can see a peer seated next to them who is (hopefully) on track.  

5.  Giving kids who can’t participate yet enough support to make them successful, AND a way out. 

If the length of your circle time is too long for him, a child could be allowed to sit for the first song/activity of circle time, then be allowed to go to a quiet or calming spot (definitely better than time out for not participating OR disrupting the activity fo the rest of the group!)  You could gradually extend it so he sits thru the first 2 activities, then he can opt out.  Still make the child return for the clean up part if you are putting carpets away since I know from personal experience that most all children CAN learn to do this part. 

One other way to help a young child learn to sit and attend is to provide “fidget toys” so that they can get some tactile feedback while being expected to continue to sit.  You can provide small squishy toys (think small koosh balls, smushy or stretchy animal toys, or even a Hot Wheels car).  You may want to buy several options and put them in a special box so that once a child is sitting he can choose from the box every day. 

You can gradually extend the time so that the child has to sit for a minute or two BEFORE he gets the toy in circle time, then he can sit and “fidget” through the next little portion of circle time.  When he gets up, the toy has to go back in the box. This works well for kids who are tactile or visual seekers because they want to sit to get the ”treat.”  If you know there’s something he loves, try to find it in a little toy appropriate for holding during this time, and I’d give it only during this time for him. 

Other items that work great for me when I lead this activity are attaching ribbons to the edges of the carpet squares.  I also purchase and wear cheap bracelets that I can give to a kid during circle time if he needs it, or let him “fiddle” with it while he sits in my lap. 

I do think it’s okay to hold a child who needs it through circle time, either while I’m seated on the floor or even between my legs if I’m fortunate enough to get a chair! Some teachers balk at this saying it’s not fair to hold one and not all of them, but rarely will you have more than one or two who need to be held until he can do the routine (unless it’s a special needs classroom).  Use the laps of other staff members too!  If you have a kid who really needs the support, recruit a volunteer to be there specifically for circle time.           

Another thing I have done if I have a child with behavioral issues (rather than truly sensory ones) who won’t sit is to give everyone who is sitting a treat like a Skittle (or even a sucker if I think I need a “bigger” incentive) or let everyone who is sitting have a special turn doing something I know this kid likes to do.  Some teachers ”stamp” kid’s hands or give stickers for this too, but I usually see children who need more of a prize than that!  I am pretty generous with this initially.  I go ahead and give a child like this the prize too to get him “hooked” into doing this even if he initially he just comes over and sits and waits for the prize while the other kids are getting theirs.  Then I might up the ante and remind him that he has to sit through the most of the closing song to get the prize, then all of the closing song, etc…  (Often these are the children who get up after the opener, then they come back for the closer.) 

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You really can use these activities to “shape” behaviors for circle time, but gradually over several days, weeks, or even months, depending on how well you pick your reinforcers, how entrenched the child’s behavior is, OR how his little sensory system is affected.  It will likely not happen in a week unless your issues are pretty mild, but it can happen over time for most children.

Be sure to leave a comment if you have other great circle time ideas to share!  Laura    

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?

I have a question about pointing and grunting in a 19 month old….and signs of speech/language development. I was always told this was a good sign that child is going to start using speech and language skills. But there is a mom that says it is a bad thing. If you have any info…. that would be awesome.

My response -

About pointing and grunting - it IS a good thing in that it signifies that a child has the “intent” to communicate, which as you know, is a challenge for kids on the spectrum. When a professional is looking to diagnose autism, we look for pragmatics, or how a child is using gestures or words to communicate his needs. 

Pointing and grunting are very early expressive and pragmatic language skills we would want to see in a baby or toddler who is just beginning to realize the need to communicate.  Most developmental language checklists cite this skill at the 12-15 month level.  In many typically developing children, these skills emerge even earlier.

The mom may be recognizing that these skills are emerging later than we would hope, or that a child who began to use these earlier hasn’t matured 

and progressed to more complex gestures, and more importantly words.  A child who is 19 months old should be imitating familiar words frequently throughout the day and using a minimum of 10-15 words independently.  Again, many typically developing children use well beyond this number of words. 

The mom may also be looking at the pointing and grunting from this negative perspective that real words aren’t coming in yet.  However, I view these as a compensation method for an older toddler  who “gets” that he has to do something to get something, but he’s not ready or able to talk just yet.  

Now if the child is grunting without joint attention (for example - without eye contact and that nice looking back and forth between what he wants and his mother), or he’s using another gesture, such as taking his mom’s hands to open a top, or leading her to the kitchen without any other indication of joint attention, then it does usually indicate that although the child understands on some level that these adult hands are useful, he’s sometimes still not getting the “bigger picture” of  reciprocal back and forth communication. 

That being said, I’d rather a child be a pointer and grunter any day over NOTHING! At least then you’ve got a pretty good starting point to build the foundation for communication - both verbal and non-verbal!

Funny you should ask this question since “pragmatic” language skills in kids with autism  was the topic of my podcast last week. You can listen to show #20 for more information. 

Mom’s reply to me -

Thank you for the response.  I guess I look at it from a point of view as an mom of an autistic child.  He did not point or grunt.  He would walk into the kitchen and just stand infront of the fridge.  He would bring us books and place our hand on it…but he didn’t really look at us.  As he got older and we used PECS, he would drag us to the fridge and point to what he wanted….but again…there wasn’t much back and forth there.  Now there is….he even turns my face towards him sometimes.

My final answer is this… 

Because pointing and grunting demonstrate an intent to communicate, I’d say they are (mostly) a “good” thing.  But I would hope to move that intent to more complex forms of communication - higher level gesturing, back and forth turn-taking, and finally words.  But let me say it again in case you missed it the first time - I’d rather have pointing and grunting than nothing!!!     

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