Thursday, April 28, 2011

Child Speech Development: Part 2

In Speech Sounds and Kids: Part 1, I told you all speech sound development in children.  I discussed the order in which kids develop speech sounds, how intelligible (or "understandable") we'd expect kids to be at certain ages, what sounds we expect at each age, and how "syllable shapes" play into the equation of speech sound development. With all that information, you'd think I'd have nothing left to say about speech sounds, right? Wrong. Once you get to know me, you'll realize I always have something else to say (I am a speech therapist after all!).

There is yet another way that speech sound development can be relatively predictable.  As I discussed in Speech Sounds and Kids: Part 1, most children will find the following sounds pretty easy to say: vowels, p, m, h, n, w, b, t, d. Children generally go from not producing these sounds at all to, well, producing them.   There is no real development of these sounds, per se. They're just suddenly there one day.

But what about the other sounds? The one that are harder, like k, g, f, v, "ng" y,  r, l, s, "ch," "sh," j, "th" and "zh"?  Some of these sounds don't develop until kids are into their preschool years. Can you imagine if children just left these sounds out of their speech until they were able to say them? We'd never know what kids were saying at all! And yet by age 3, most children are nearly 80% intelligible (if not more).  How does this happen? It turns out that children make highly predictable and very systematic errors when they are producing these harder speech sounds-- so predicatable and so systematic, in fact, that most adults are able to "decode" their speech without even knowing they are doing it. It's only when speech sound errors deviate from the norm or are very unpredictable that we really struggle to understand kids-- and this is when speech therapy is often needed.

Without further ado, then, here are the some of the most common "phonological processes" (the systematic and predictable speech sound errors made by children) that many children will use as they develop speech.
  • Fronting:  Fronting happens when children produce sounds that should be made in the back of their mouth in the front of their mouth instead.  Make the sounds /k/ and /g/. Feel how the back of your tongue hits the back of roof of your mouth?  Now make the sound /t/ and /d/.  Notice how now it's the front of your tongue that hits the front of roof of your mouth? /k/ and /g/ are made in the back of your mouth while /t/ and /d/ are made in the front.  Kids frequently "front" /k/ and /g/ by substituting /t/ and /d/. Go becomes doe, key is tee, and cookie might be tuhtee.  Fronting usually disappears by the age of three. 
  • Stopping: Stopping occurs when children stop air from moving continuously out their mouths. Make the sound /f/ and keep it going.  Feel how a stream of air flows between your teeth and lips? Now say the /p/ sound. You should notice that there is a small burst of air for the "p" sound rather than a stream of air. You couldn't keep /p/ going if you tried. You can keep the air going, but the /p/ is over with the second you stop the air slightly with your lips and then release it. Stopping occurs when children stop the air from flowing freely. /f/ and /v/ become /p/ and /b/ so that fan becomes "pan" and video becomes "bideo," while /s/ and /z/ become /t/ and /d/ so that sun becomes tun and "zip" becomes "dip."  Stopping also affects the sounds "sh" "ch" and "th." Kids usually stop stopping (ha ha) between the ages of 3.5 and 5, depending on the sound they are trying to stop stopping (okay, now I'm just getting punchy). 
  • Consonant Sequence Reduction (CSR): CSR occurs when children "reduce" (make smaller) a consonant sequence (a series of consonants in a row).  They simply leave out one of the consonants, usually the harder one. Stop becomes top, blue becomes boo, and green becomes geen. This tends to get better around 3.5-4 years of age.
  • Gliding: Gliding occurs when children make "r" and "l" sounds into "w". "Road" becomes "woad" and "lamp" becomes "wamp." I'm not even going to attempt to explain the mechanics behind this one, mainly because I really hate /r/ sounds. I'm a pretty good speech therapist, but the /r/ sound gets me every time.  Anyway. Suffice it to say that this error pattern usually disappears sometime during the school age years (and that if it doesn't, you shouldn't come see me.). 
Whew! If you haven't noticed by now, analyzing speech sound development can get a bit complicated. I listed some of the major patterns young children use, but I certainly didn't list them all. And things get really crazy when a child uses two or more patterns in one single word (and they do, often!).

If you are  concerned about your child's speech,don't worry too much about trying to figure out what he's doing. Instead, check out the intelligibility guidelines and speech sound development ages in Speech Sounds and Kids: Part 1; if your child doesn't meet the criteria, it's probably easiest to talk to your pediatrician about a referral to a speech therapist.  If you're just the curious type, though, step back and listen to your little one-- see if you can pick up on any of the above patterns in his speech. If you hear them, consider yourself well on your way to being an amateur speech-language therapist.

    Resource: Clinical Phonology (p. 229), by P. Grunwell, 1987, Gaithersburg, MD: Aspen Systems Corporation

    Monday, April 25, 2011

    Red Flags for Autism in Toddlers

    One of my passions as a pediatric speech-language therapist is helping parents understand the early signs and symptoms of autism.  Autism is a complex disorder that requires systematic and often intense treatment, but there is much hope for children who receive this diagnosis, especially if they are diagnosed a young age and receive treatment early.  Early diagnosis, though, depends on a keen understanding of the early signs and symptoms of autism in toddlers.

    Parents are often told to talk to their pediatrician about autism if their child has not spoken a single word by 15 months, or is not using 50 words and short phrases by 24 months. This is good advice, because delays in verbal communication are part of the diagnosis of an autism spectrum disorder (except in the case of Asperger's Syndrome, but I'll chat about that in another post). However, (note the italics because this is a *really important* however), just because a child is a late talker, one can not assume that the child has autism. Not by a long shot. Many, many children have language delays without having a diagnosis of autism. A delay in language is one indicator of autism, but it is a very broad one.  Luckily, we do have other, much more specific signs and symptoms to look for in toddlers to help us differentiate children with "simple" language delays from children who we may suspect have autism. A significant loss of language, for example, is one red flag.  Here are the others.

    Decreased Use of Gestures and Facial Expressions to Communicate
    Even if they are not yet talking, typically developing toddlers constantly attempt to communicate their needs and interests to the adults in their world. They do so through gestures, facial expressions, and eye contact. Watch as Baby Girl manages to communicate suprise, joy, and love all without saying a word.

    In this video, Baby Girl communicates mainly through facial expressions, and she's very effective in doing so.  By 12 months, children are also really starting to use gestures to communicate with their world.  They wave bye-bye, shake their head no, reach toward things and people they want, give objects to people to get help, show objects to people to share their interest in them, and point out things of interest to those around them. 

    Importantly, typically developing toddlers use their gestures to both indicate what they want and to show others what they find interesting.  They point--not only to things they want to wrap their little hands around, but also to things that they simply want to show their parents. This pointing to get their parents to look at things (technically called proto-declarative pointing)  is an important skill that we really want to see children develop.  It tells us that toddlers want to share their world with the grown-ups in it, something we call joint attention. Joint attention simply means that two people are looking at and sharing an interest in the same thing at the same time. Imagine a child pointing out the window at a dog to get his mom to look at it. His mom looks at the dog and then smiles at the child to share his joy. This child has just used a proto-declarative point as a way of establishing joint attention with his mom (in other words, he used a gesture to get his mom to look at the same thing he was looking at).  Typically developing toddlers do this all the time-- they are constantly trying to get the attention of their parents for a wide variety of reasons.

    Red Flag: Toddlers with autism are less likely to use gestures and facial expressions to communicate with others, less likely to try to get their parents' attention to show them something, and less likely to use a proto-declarative point to share their interest in their world with their loved ones. 

    Decreased Eye Contact
    We expect children to look at their parents often. They start doing this very early on, and continue to develop their use of eye contact as they grow. By 6-12 months, we want toddlers to use what we call gaze shifts. Gaze shifts occur when children look from an object to the face of an adult (often their parent or caregiver) and then back to the object.  Children use gaze shifts to share emotion with others-- for example, a child might be playing with a pop-up toy, find it delightful, look at his parent and smile broadly to share his joy, and go back to playing with that toy.  He's just completed a gaze shift.

    Watch the video of Baby Girl again. This time, check out how she uses gaze shifts to share her joy (and surprise) with us. She alternates between looking up at the TV where the music is coming from, looking at me sitting next to her, and peeking around me to see her brother laughing at her. In doing so, she involves each of us in her joy.

    Toddlers also look at their parents' faces for what is called social referencing. This occurs when young children are unsure of themselves and look to their parents' faces to figure out what to do. If a child was scared of a pop-up toy, for example, he might look to his mother to see her reaction. If she was smiling, he might go back to playing, but if she looked scared, he might crawl over to her for comfort. Amazingly, even very young children use their parents' faces to help them decide what to do.  A classic and fascinating study of social-referencing involved presenting babies with a "virtual cliff" and watching how the babies' reactions to the cliff depended on their mothers' facial expressions. You can check it out here:

    Red Flag: Young toddlers with autism are less likely to look at their parents' faces to share emotions such as joy and less likely to check out their parents' faces to observe the parent's reaction in ambiguous or scary situations.

    Infrequent Social Games and Bids for Attention
    Typically developing young children love to play little social games such as "peek-a-boo" and "hide and seek."  They'll also often repeat their behaviors to get their parents to laugh.  Again, I'll use the video of Baby Girl as an example--she is clearly enjoying the attention she is receiving as she responds to her brother's laughter. As she dances some more, she peeks around to make sure he is still watching.  Although she is enjoying the  music, it is the reaction from her brother that is really making her smile. Her actions are, in part, attempts to get her brother to continue laughing at her.

    Red flag: Children with autism are less likely to engage in  social people games such as peek-a-boo and are less likely to perform for attention and laughter.

    Lack of Pretend Play
    By 12-18 months old, typically developing children are using objects in functional ways. This means that a child this age will use the object for its intended purpose-- he might put a brush to his hair or a toothbrush to his teeth, or he might pretend to drink from a cup or feed his parent with fork. You'll see him start to imitate housework as he uses a washcloth to wipe the table or grabs the broom to sweep the floor. Then, by 18-24 months, children engage in  true pretend play. The toddler will now talk on the phone, fly airplanes, drive cars, give a drink to a baby, put the baby to sleep, and push that baby in a stroller. These pretend play episodes might be very short, but they are still important.  Around 12-18 months, toddlers will also start taking an interest in other young children. Although they won't always play with other young children, they will enjoy playing next to them. 

    Red Flag: Children with autism are less likely to use objects in pretend play and often do not take as much of an interest in other young children. They are also more likely to use the same type of repetitive action with a object or toy over and over (for example, opening a door and shutting it repeatedly) and to get upset if someone interrupts their repetitive play.

    Decreased Response to Adults 
    Babies start to recognize and respond to their name as early as six months;  by 12 months, they respond to their name being called consistently. They also follow an adult's eye gaze when that adult points out something interesting across the room.  

    Red flag: Toddlers with autism are less likely to respond to their names when called.  They're also less likely to be able to follow an adult's point at something across the room.

    Each of the above categories lists a red flag for autism.  However, (here's another really big however), just because a young toddler has one or more of these risk factors, this does not mean he has autism. Autism is a complex diagnosis that can only be diagnosed through careful evaluation by trained professionals. What's more, many of the above categories are very subjective-- it can be really hard to know how often, for example, your child should be looking at your face to share joy. It can be easy to read into something that is really not there. It can be just as easy, though, to ignore the signs that are right in front of you.  If you have any concerns, it is really worth a conversation with your pediatrician. And if you see your child in a number of the above categories, don't hesitate to push for an evaluation by an early intervention professional.  As scary as it might be (and I can only begin to imagine how scary it might feel), you will never do your child wrong by seeking help early.

    Looking for more information on the early signs of Autism?

    Wondering What To Do If You Are Worried About Autism?

    Wondering what the early intervention process will be like? 

    Monday, April 18, 2011

    Pictures, Autism, and Language: Using Pictures to Increase Your Child's Language

    I'm guest-posting again today, this time over at Joy's Autism Blog. Joy is a mom to four beautiful children, one of whom happens to be diagnosed with autism. When she asked me to write a post to help her recognize April as National Autism Awareness Month, I gladly agreed.

    I was first introduced to autism spectrum disorders more then ten years ago in the form of a little boy with Asperger's Syndrome; he stole my heart and made me want to know so much more about the way he saw the world. Since that time, I've worked with countless families of children with autism. Their strength and dedication to their children never fail to amaze me.

    The post I wrote for Joy's Autism Blog is about using pictures to help children with autism learn to use generative, creative language in the place of echolalia. You can find it here. Look for another post from me later this month about the early signs and symptoms of autism--information that is crucial for every parent of young children to have. Until then, enjoy poking around Joy's blog; she writes about her experiences as a mom, links up to other blogs and online resources about autism, and is just generally pretty darn cool.

    Thursday, April 14, 2011

    The Changing Face of Early Intervention

    I'm excited to be a guest blogger over at ASHA today.  ASHA is an acronym for the American Speech-Language-Hearing-Association, which is the national organization that represents and coordinates nearly 128,000 of us speech-language therapists, audiologists, and speech-language-hearing scientists. I'm pretty sure that only a few of us actually read the blog but hey, it's fun to post over there anyway. 

    In my post, I talk about the changes that are occurring in our early intervention program. Before you check it out, let me set the stage just a bit. I've been working with kids under the age of 3 in our early intervention program for over ten years now, and for the majority of those years, I did therapy in one way.  I brought toys into a child's home, sat on the floor, and worked my "magic" with the child.  At the end of the session, I'd give his parents suggestions for doing what I just did and be on my merry way. I'd come back the next week, repeat the process, give out some new suggestions, and feel pretty good about the work I'd done.  And it worked...pretty well, most of the time, anyway.

    Over the past year, though, our state's Birth-to-Three program has encouraged us to look at our practices and think about how we could take them to a deeper level.  They asked us to explore new ways to work within all kinds of family routines (not just play), to look carefully at how adults learn, to find ways to teach families (not just children, but families), to carefully and systematically give our knowledge about child development away to parents, and to help parents explore ways to integrate this knowledge into their daily routines. In short, we were asked to work with parents just as much as (if not more than) we worked directly with the child. These new-fangled ideas came out of research indicating that parents are much more powerful in their young child's life than are therapists and that our biggest source of power in early intervention comes not from working only with the child, but in truly partnering with that child's parents.

    To be honest, it's been a challenging year. It wasn't easy to look at what I had been doing for ten years and realize that maybe, just maybe, I could have been doing it better. It elicited all kinds of emotions and reactions and feelings. It was--and continues to be--hard to step outside my comfort zone. And it was--and continues to be-- even harder to do this alongside my peers, each of whom are having their own varied and highly individual reactions to the challenging work that has been placed in front of us.

    And yet for all the challenges this year has brought along with it, there have also been hints of excitement, and inspiration, and understanding, and growth. This, then, is what my post is about. You can find it here.

    Wondering what the process of getting into early intervention is like? 

    Wednesday, April 13, 2011

    Moo Baa La: How Animal Sounds Can Help Your Child Talk

    As a pediatric speech-language therapist, I often spend my days mooing. And baaing, too.  Although it might seem strange, there's a reason that I do this, and it's not the one you might first suspect.  Yes, children like animal sounds and yes, it can be fun to get children smiling by making silly sounds that don't normally come out of adult mouths. But there's more than that. The secret behind animal sounds is simple: most animal sounds are easy for kids to make. Combine that with the fact that young children are often fascinated by animals and you've got an easy way into helping children produce some of their first "words."

    Yesterday, I wrote a post about speech sound development in children.  In it, I discussed which speech sounds are easiest for young children (vowels, p, m, h, n, w, b, t, d) and which syllable shapes tend to come first in speech development (CV = consonant-vowel).  Combine the two and you get...animal sounds! Moo. Baa. Neigh. Meow.  All easy, all fun, and all powerful ways to help a young child start talking.

    Once you realize the power of animal sounds, it's easy to integrate them into your day to help your little one start mooing, too. You can simply make the sound when you see an animal.  You can say the word, too, of course (Cow! Moo!  The sillier you make the sound, the better!). Do this while looking at books, coloring pictures, watching TV, or just playing around. If you have little animal toy figures around the house, you can pair your actions with words by making the animal walk while saying the animal sound repeatedly.   Your child is likely to follow both your actions and your words when you put them both together. You might also want to learn the sign for each animal and do the sign while you say the sound-- again, the power lies in giving your child both an action to imitate and a sound that goes with it.

    What's more, animal sounds are readily present in a number of repetitive books and songs. Old MacDonald, of course, is an oldy (pardon the pun) but a goody. And Sandra Boynton has a great book entitled Moo Baa La La La that many kids love to read.

    Although animals sounds might not seem like actual words, they can help children learn to associate a simple sound with an actual object or picture. Because the sounds are easy to say, children are more likely to imitate them. This success, in turn, helps them make the jump to 'real' words.  So don't hold back: moo, baa, and neigh away!

    Tuesday, April 12, 2011

    Child Speech Sound Development: Part 1

    Many parents wonder when their child is going to utter his first word.  They await the moment eagerly and with great anticipation. Then, when the momentous occasion is finally reached, it is duly noted in the baby book and celebrations are had. A few months go by, the child starts talking more and more, and suddenly a new question moves to the top of the pile: When, exactly, should I actually be able to understand my child?!?

    This is not an uncommon question, especially in the world of toddlers and preschoolers.  Children start using spoken language (words and short sentences) long before they are actually able to produce all the speech sounds for the words and sentences that they want to say. There are roughly 45 speech sounds in the English language. This confuses people sometimes, because there are 26 letters in the alphabet we use to write words down. But remember that one alphabet letter (or "grapheme") can stand for a number of different speech sounds (or "phonemes").  Take the letter "c" for example--in words such as "cat," it makes a /k/ sound, but in words such as "face," it makes a /s/ sound.  So, while there are 26 letters in our written alphabet, there are 45 sounds in our spoken words. And, even at the age of three, the great majority of children are still working on producing at least 18 of those speech sounds.

    Speech sound development is predictable, in that it typically unfolds in a somewhat similar way across children. Most children, for example will make a /w/ sound for /r/ for a long time--this is fully expected and of no concern.  Ironically, speech sound development is also quite variable, in that some children produce words clear as day from almost the moment they start talking while others take much longer to produce speech sounds clearly. As a speech therapist, it's my job to help figure out when a child's speech is so distinctly different from normal that the child would benefit from therapy. It's not always easy--and even as speech therapists, we don't always agree! There are some general guidelines, though, that can be helpful to share with parents of young children who are worried about their child's speech. And that, my friends, is what I'm going to share with you today. 

    Intelligibility is a fancy word that simply means "how much of a child's speech is understood."  The general guidelines for intelligibility in young children are as follows:
    •  A 2 year old is usually understood by others about 50% of the time
    •  A 3 year old is usually understood by others about 75% of the time
    •  A 4 year old is usually understood by others nearly 100% of the time
    Speech Sounds
    Children usually develop certain speech sounds first. Then, as they grow, they learn to produce new speech sounds along the way.  Here's a general picture of which sounds are easy, which are harder, and which are the hardest:

    • Easy speech sounds: Vowels, p, m, h, n, w, b, t, d
    • Harder speech sounds:  k, g, f, v, "ng" (as in ring), and y (as in "yellow")
    • Hardest speech sounds: r, l, s, "ch," "sh," j, "th" and "zh" (as in the end of the word "garage")

    To find out what ages kids usually develop these speech sounds, you can take a peek at this:

    Speech Sound Development Chart (developed by Eric Sander in 1972).  

    It's not perfect, and there is disagreement in the field of speech therapy about how accurate it is, but it's a great guideline for helping you to get a basic picture of when speech sounds are usually produced accurately. The beginning of each black bar represents the age at which 50% of children produce the sound correctly, while the end of each black bar represents the age at which 90% of children produce the sound correctly. As speech therapists, we generally don't get too excited about a certain speech sound error until a child isn't producing it when 80-90% of his peers are.

    Syllable Shapes
    Finally, any discussion of speech sounds is incomplete without talking just a bit about how children use those sounds in what we call "syllable shapes."  Syllable shapes refer to the way that we put consonants and vowels together to make words. This can get a bit tricky to think about, because most of us are used to thinking about how we put alphabet letters together to spell words, rather than how we put sounds together to say them.  A full discussion of this is too complex (and way too boring) to get into here, so I'll just ask that you remember that, for the purpose of this post, we are talking about sounds, not letters. Okay? Okay.

    When we shorthand syllable shapes, we write C for consonant and V for vowel (easy enough, right?).  So a "CV" word would be "me".  One consonant + one vowel.  A CVC word would be "mom." Got it? Good.
    Here, then, is what we know about the development of syllable shapes:

    • Easiest Syllable Shapes: V-V (uh oh), CV (me), VC (up), CVC with the same consonant (mom) and CVCV with the same consonant (daddy).
    •  Harder Syllable Shapes: CVC with different consonants (pat), CVCV with different consonants (tummy), and CVCVCV words (banana)
    • Hardest Syllable Shapes:   Words with two or three consonants in a row (black, street) and long words (dictionary).

    Combine all that together, and you'll start to find the words that are easy for children (me, boo, bye, mama, dada, up), a bit harder (hat, pony), harder still (dog, kitty, goat), and the hardest (Gregory, licorice, motorcycle). When we speech therapists work with children with speech sound difficulties, we often start with the sounds that are the easiest and put them into the easiest syllable shapes...and then we go from there up, up, up the ladder of speech sound development.

    Whew. With all that information, isn't it amazing that our kids ever get it right? Luckily, most of them do, with very little help from us at all. And if they don't? That's what speech-language therapists are for! :)

    Looking for more information on speech sound development?

    Thursday, April 7, 2011

    I Was So Mad: An Activity for Social Emotional Development

    My son and I read I Was So Mad by Mercer Mayer the other night.  It was a spontaneous book choice on his part, but as we read it, I realized that we had happened upon a great opportunity to enhance his social-emotional development. Social-emotional development refers to a child's ability to manage his emotions, skillfully negotiate with friends and family, and understand who he is and how he relates to the world. It emerges over time as children grow from feisty self-centered toddlers into (sometimes) empathetic, (more) cooperative school-agers.  Although the concept of social-emotional development is complex and multi-faceted, a large part of it involves being able to identify and work with the multitude of emotions that we all face as a part of being human.

    As my son and I read I Was So Mad, we used it as a springboard to talk about the emotion of being, well, MAD. We talked about the things that make us feel angry and described  how our bodies feel when we start to get mad (I, for one, start to clench my jaw a wee bit too tightly). We discussed the idea that it's okay to feel angry--everyone does!--but that some of the things people do when they are mad are not okay. Then we talked about all the things we can do to help our bodies calm down when we are mad so that we make good choices along the way. Finally, we made our own "mad" book: one page included drawings of things that make us angry, another was comprised of pictures we drew of ourselves feeling mad, and yet another depicted the variety of ways we could calm down when our bodies were starting to feel angry and out of control.

    Activities like this can help your child start to recognize and label the emotions that creep around inside him every day. Emotions can be especially confusing to children with language delays or diagnoses such as autism, but all children benefit from being gently guided through the overwhelming and sometimes bewildering emotions that often seem to come out of nowhere.  Describing how emotions make our bodies feel and drawing pictures of what this looks like makes the squishy concept of emotions much more concrete--and less scary-- to young children. Brainstorming ideas to help calm our bodies down and drawing pictures of those ideas helps children recognize that they have a choice in actions when they are angry, even if they doesn't have a choice in what they are feeling. Putting it all together into a book gives children something tangible to return to time and time again as their ability to manage their emotions unfolds over time. All together, activities such as these nudge your child a bit further down that long and bumpy road of social-emotional development. And that's good for everyone.  :)

    Tuesday, April 5, 2011

    Child Language Development: What to Expect at 18-24 months

    Your baby has hit 18 months! All of a sudden, she's grown from a sweet little baby into an independent, active toddler who likes to push her limits. She makes you laugh, she makes you cry, and she surely makes you wonder what on earth she's up to each minute of the day. As your toddler uses her developing motor and cognitive skills to explore her new world, she'll also continues to explore the world of words. During this stage of language development, she'll stun you with her swift language growth, make you smile with her attempts at new words, and teach you to be careful of what you say, for fear that she'll say it right back to you!
    Up until now, your toddler has been using mainly single words. She's probably picked up one or two words a week, with no real urgency or speed.  Somewhere between 18 and 24 months, though, she'll reach a magical turning point. When she's got about 50 words in her vocabulary, she'll start putting two words together into short sentences. And with those two milestones in place, she'll enter what we call a language explosion.  We're not sure exactly how children are able to accomplish this feat, but we do know this: once they hit this language explosion, they gain words so swiftly that by the time they hit their second birthday, most children have hundreds and hundreds of words in their vocabulary and are putting those words into a wide variety of two and three-word sentences. It's truly a sight to behold.

    Even though your little one is saying lots more words, her speech may still be pretty hard to understand. As her parent, you probably understand a lot of what she says, mainly because you know her so well that you can predict what it is she wants before she even tries to tell you. Others, though, might only understand her about 50% of the time. Be assured that this is very normal. Your toddler is still learning how to produce speech sounds and the vast majority of her words are simplified versions of grown-up words. By 2 years old, you can expect your toddler to produce most vowels and the consonant sounds b,p,t,d,n,m,h,and w well when she is saying short, little words that start and end with a single consonant (mom, dad, pat, hot). She can also say words that have two short syllables (e.g., baby). She'll probably change all other words and sounds to make them fit into her speech abilities- so "blanket" might become "baytee," bubble might be "buboh" and "grandma" might be "dama." Worry not--this is a very normal part of child development!

    At 2 years, your little one continues to understand more than she can say. She's begun what many language experts call the fast mapping stage of language development, where she can learn what a word means after hearing it as little as one time. Can you imagine, as an adult, being able to learn language so quickly?  We'd all be multi-lingual! By 24 months, children understand thousands of words, can point out a wide variety of pictures in books and can show off a number of different body parts.  Importantly, they can now follow directions that they wouldn't normally see someone do, such as "put the block on your head!" This shows us that they are truly understanding the words in a sentence, rather than just guessing at what is being asked based on what they've seen happen throughout their day.

    As your child's little brain continues to develop during these months, you'll see her begin to problem-solve in new ways.  Suddenly, you might see her push a chair (or a cooler!) over to a counter (or a sink!) that she wants to climb on. Although this can make parenting a bit, um, challenging, it is a skill that I'm always excited to see develop. It tells us that your child is learning to use objects as tools that can help her get what she wants.  In a similar way, words become her tools for getting her needs met around the house!

    Your little one's play, gestures, and social skills continue to develop as well.  She'll get your attention by pointing at and labeling things that interest her with increasing frequency. You'll also notice her doing more and more pretend play-- she'll pretend to do things like cooking food, pushing a stroller, flying an airplane, and playing a musical instrument.  She'll use two toys together in play-- for example, she might put a blanket on a baby when putting the baby to sleep.  She might also enjoy helping you clean up (take advantage of this while it lasts!), and will notice if toys are broken and try to fix them on her own. Finally, you'll notice that she's started to take an interest in other children; although she's not quite ready to play interactively with other children, she'll start to really enjoy playing next to them (something we call parallel play)

    Your little one will develop fast and furiously during this period of child development. By the end of it, she'll have become her own little person, bursting with thoughts and ideas that she wants to share with you.  Stand back, watch it happen, and rediscover the world right along with her.

    Looking for more information on speech and language development?

    Looking for strategies and activities to use at this age?

    Monday, April 4, 2011

    Baby Steps For Baby Signs 2: How to Get Your Child To Sign

    So you're thinking about using baby signs with your little one, eh?  Let's assume that you've already learned how baby signs can be helpful for language development and you've done your research to find out how to select the signs to use with your child. You're armed and ready. The next step is to apply all that knowledge as you teach your baby to sign along with you. Although this can seem like an overwhelming task, a few simple tips will get you well on your way.

    Show Off Your Stuff
    As you may have guessed, your first step is to show your baby the signs that you think would help him communicate with you.  Every time you show him the sign, also say the word. You can start doing this any time, but your baby is probably most likely to pay attention to what you are doing around 6-8 months.  If you do start signing at this age, though, know that your baby might not sign back at you immediately. Take heart and know that your baby *is* watching, you, however. Soon enough, he'll start signing back-- and all that signing you did with him as a baby will have laid the groundwork for what is to come.

    Around 11-12 months, children reach a new stage of development that turns them into little imitators. Watch your little one carefully for this important sign of readiness, as you don't want to frustrate her by expecting her to imitate your signs when she's just not yet able to. When you see her start imitate your actions more often, you'll know she's ready to start imitating your signs, too.  At this point, you can use a new strategy to help her understand how to use her signs. The strategy is called communication temptations, and it goes a little something like this:

    1. Get your toddler involved in something she loves (bubbles, snack time, tickles)
    2. Give her just a bit (blow the bubbles one time, give her a few goldfish, tickle her just a bit)
    3. Show her the sign and say the word
    4. Wait just a bit
    5. Continue the activity (blow the bubbles again, give her a few more goldfish, tickle her again)
    6. Repeat

    Do this consistently, and your toddler will probably start imitating you right after you do the sign. Once this has happened, keep using communication temptations and then wait for a minute before you show her the sign. She might just do it on her own! 

    Give Her A Hand
    Your child might start imitating signs all on her own, especially if you use communication temptations with her on a regular basis.  If she doesn't, though, you can give her an extra boost by taking her hands and helping her do the sign when you expect her to use it.  Do it quickly, keep it fun, and then give her what she wants. Be careful though: some independent toddlers will resist this....and that's okay. Don't push too hard, or you'll both end up frustrated and discouraged. If your toddler doesn't want you to help her do the sign, go back to just showing her the signs when she wants something or sees something interesting. She'll get it eventually.

    Don't Expect Perfection
    Young children aren't able to move their hands like we can, especially when they are first learning to sign.  At first, accept anything that looks even close to the sign you are trying to teach her.  Many children, for example, will just clap when they are first trying to sign "more."  This is totally fine-- encourage all your child's attempts to use a sign. Remember, the goal is communication, not perfect signing!  Accept her attempt and then continue showing her how to do the sign the right way. In time, she'll come to do the same.

    Books and Movies
    Some children like learning signs from books or movies that are focused on teaching signs. While I don't typically use these to teach signs to the kids I work with, many parents have told me that this was the way they taught their little one to use signs.  If you want to go this route, you might check into Baby Einstein's My First Signs DVD or a toddler book such as Baby Signs by Joy Allen.

    Have Fun
    Last, but certainly never least, make sure you have lots and lots of fun. This is a time for you and your baby to love and laugh and grow together. Enjoy it!

    Looking for more information on Baby Signs?

    Find out how using baby signs helps your child develop language here.
    Learn how to select which signs to use with your baby here

    Saturday, April 2, 2011

    Blog Party What Now?

    Being somewhat new to this whole blogging thing, I'm also rather unsophisticated in my understanding of things like memes, blog hops, and twitter parties (heck, I'm still figuring out what Twitter really is, much less how to how to party over there).  I don't know that I'll ever figure it out completely, but I what I do know is this: As a pediatric speech therapist, I've got a lot of really good information to share with parents who want to know more about their child's speech and language. I'm building this site to do just that-- to provide accurate information about speech and language development, share proven strategies you can use to enhance your child's speech, provide ideas for fun activities to build language, guide you through the steps to take if you are concerned about your child's development, and give you a place to ask questions to someone who spends her days working to help children develop speech and language.

    I'd love to make this information available to lots of parents, and the Ultimate Blog Party being hosted by 5 Minutes for Mom seems like a really great way to do that.  That being said, this will be one of the very few times that I post something like this on my site-- I really want the site to be mainly about speech and language for those of you who come here for that reason.  But for those of you who have come here to party, welcome! And party on.