 By Kate Eichstadt M.S. CCC-SLP
"How many words does your child have?" While it may seem like a harmless question, this question can bring on a range of emotions. What if your child doesn't have any words, what does that mean? Maybe your child has words, but doesn't use them very often or isn't combining words yet. What even counts as a word for our young toddlers? As parents or caregivers, you might be thinking "Should I be worried? Will my child ever talk? What can I do?" This is going to sound funny coming from a speech-language pathologist, but my first suggestion to families is "Let's not focus so much on talking right now, let's focus on all the wonderful things your child IS doing and let's focus on language and communication."
Language is a developmental process we are entitled to as humans. Language development or language acquisition is a part of development for ALL kids regardless of whether or not they have a disability. Language is about much more than talking or using words.
Did you know that within the last twenty years, researchers have discovered there are two different ways that humans acquire language? Typically, we think about children developing language through analytic processing where the child analyzes and breaks down adults' longer utterances into single words, eventually combining the words into phrases and sentences. Another style of processing is called gestalt processing. Kids who acquire language through gestalt processing learn language in a completely different way than analytic processors. Kids who use gestalt processing learn whole units or chunks of language. Gestalt processors are typically lifting strings of language from a variety of sources such as songs, TV programs, jingles, or language they hear during their daily routines. We call this lifting of language, echolalia, which may be immediate or delayed, and sometimes even used in a completely different context than the original utterance. You might wonder if a child is repeating whole gestalts from TV shows or songs, does that language have meaning or function? What if the child is using the gestalt outside the context it originated? The answer is a resounding YES. Echolalia serves many functions including requesting, commenting, affirming, protesting, labeling or just providing information. What we often see in Early Intervention with our young gestalt processors is that these very young children might not be able to put all the sounds together to make these gestalts intelligible. You might hear your child using what sounds like conversational gibberish, the tune of a familiar song, or maybe even just a single sound that has a hint of a familiar prosody. In other words, you might think your child has no words when in fact they are already trying to use sentences!
When a child is not yet using words to communicate there are several strategies you can use to figure out your child's learning style and to facilitate language development and overall communication. There is so much more to language development than the spoken word. Early Intervention principles of following your child's lead and understanding your child's strengths are a great starting point, and I am going to outline some specific strategies to get you started:
1) Observe your child in play:
- Start by observing what your child enjoys playing with (might not be toys!) Notice how your child interacts with the toy/object.
- Keep in mind that there is no right or wrong way to play, and do not panic if your child engages with a toy in unexpected ways.
- Make note of preferred toys or materials, and how your child plays with those toys/objects. What is your child noticing? How is your child exploring?
2) Join your child in play:
- Play side by side- go ahead and take a turn! Do what your child is doing, even if your child isn't playing with the toy in an expected way. You will get your child's attention and validate their play style.
- Try not to jump too many levels ahead in play style.
- You can add steps or model something new with a toy if your child is interested and ready. Try combining toys in new ways, like loading blocks into a truck or building a tower and having the truck knock it down.
3) Model language: say it the way your child would if they could
- Avoid asking questions-this is the most challenging strategy I suggest to parents, but the most important. We want to interact with our little ones, so we tend to ask questions to engage: "What do you have?" "Is that your truck?" "What color is it?" Questions require quite a bit of processing, and we want to take the pressure off and decrease their cognitive load SO instead I want you to MODEL and say the words for them.
- Add context to single words instead of labeling: "It's a truck!" "It's a big truck." "Wow, the truck is fast!" "Here we go!"
- Say it for your child-use first person (avoid "you" for now): Watch your child's nonverbal language and add words. If your child reaches for their milk say "I'm thirsty" "milk" then give them the milk "Mmmm, drinking milk." "It's so good." When they put the milk down because they are finished you can say "All done milk" or if they hand it to you and want more you can say "More milk." "Still thirsty." Talk about the steps you use to get the milk "Lid off, pour the milk, time to drink." You have just made a language routine!
- Stretch your words: Kids pay attention to the words if you stretch them or even use a sing-song voice. "That's a BIG tower!" "Wheeee, ALL the way DOWN!
- Use sound effects: animal sounds, vehicle sounds, any environmental sounds and add context. "Glug glug, the fish is swimming" "Zoom! The car is fast!" "Whoosh! It's a waterfall!"
- Use descriptive praise, avoid "good job!" When your child does something you are excited about this is another opportunity to provide rich language input. "Wow, great cleaning up!" "Look at that big tower!" "Puzzle piece in!" Your tone of voice lets your child know you are excited and happy for them, but you also give them specific language input at the same time.
- Expand your child's utterances. For analytical processors you will want to add a word or two to your child's utterances. For gestalt processors you will pay attention to your child's whole chunks of language and when you notice they are starting to understand small chunks within the whole you can help model new combinations using what your child already says. (eg. "Let's get out of here" + "I want some more" = "Let's get some more" or "I want out of here")
- Sing songs-you can use songs with movement or make up songs to go with your daily routines (getting dressed song, washing hands song, brushing teeth song etc.)
4) Bringing all the steps together
- Observe your child in play--what are your child's strengths?
- Join your child in play. Start with 15 minutes of on the floor playtime with your child and add to that time when you can.
- The more you imitate your child's actions and sounds the more your child will want to imitate you back.
- Reduce questions and offer rich language models. You can do this during playtime and daily routines.
- Listen to your child's sounds and jargon/babble, your child might be trying to tell you something!
- Honor any and all attempts at communication.
- Have FUN!!!
For more information on gestalt language development check out these resources:
About the Author:
Kate Eichstadt has been a certified clinical speech-language-pathologist for 20 years and founded Empowered Therapies in the North Shore suburbs of Chicago. Kate has been doing Early Intervention in Illinois since 2004. Kate also worked for Rush University on clinical research in Fragile X Syndrome using a parent coaching model via telethealth from 2017-2021. In March 2020 Kate worked with the New York City Department of Education to get their therapists up and running on telehealth during the Covid-19 pandemic and in March 2021 she was invited to be a guest speaker for the 31st Oyer Lecture at Michigan State University. Kate has been on both sides of Early Intervention, as a therapist and as a parent!
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By: Wendy Deters MS, CCC/SLP, LSLS Cert AVEd EI/ School Professional Development Coordinator
Hearing loss occurs in 2.2 of every 1,000 live births. For us in Illinois that means about 300 babies are diagnosed with hearing loss each year. Hearing loss can occur by itself and it can be present with a number of syndromes and other medical conditions. Severity can range from minimal to profound and it can effect one or both ears. Regardless of the type or degree of hearing loss, children are at risk for communication delays. As EI providers, we have an amazing opportunity to work with families when their child is in the critical language period and take advantage of their growing brains.
It can be overwhelming for families and for providers who do not specialize in hearing loss to tackle this complex need since it varies so much from child to child. The best advice I have for everyone is to use each other! Having a good team of: Developmental Therapists, Hearing, Speech Language Pathologists, Audiologists, ENT’s, and others is crucial. Here are five other tips for working with children with hearing loss as well as some great resources:
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Communicate frequently with the child’s Audiologist. Understanding the child’s access to sound with and without their devices will help you understand how best to facilitate their communication skills.
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Have open conversations with families about what they wish for their child’s communication development. Parents have a choice in how they wish to communicate with their child and should be informed about their options. They should also know that these choices may change over time and that there are many resources and people they
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Expect children and families to work towards wearing their devices as consistently as possible throughout their day. In order for hearing aids and cochlear implants to do their jobs they have to be on and working. Listen to families and validate their struggles so you can work together to move forward towards full time device use.
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Help families connect with other families of children with hearing loss. Illinois Guide By Your Side is an amazing program that connects families of children with hearing loss. DTH’s can also be excellent resource when it comes to connecting families.
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Use your team and resources to learn more about listening skill development. Here are some great resources to get you started.
Child’s Voice is happy to be a resource for other EI providers, we have a great network of DTH’s and SLP’s who work with children with hearing loss both on our own staff and as independent providers. Best wishes to you all!
Resources:
https://www.ilhandsandvoices.org/
https://www.hearingfirst.org/
https://successforkidswithhearingloss.com/
https://www.nad.org/resources/early-intervention-for-infants-and-toddlers/information-for-parents/
https://childsvoice.org/
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About the Author:
Wendy is the EI/ School Professional Development Coordinator at Child’s Voice. Wendy provides initial AT and ST evaluations and therapy services for children in the Early Intervention program. She also supports the EI Staff, coordinates the Toddler Program, and facilitates professional development in the school. Wendy is a licensed Speech Language Pathologist and Listening and Spoken Language Therapist. She is also an adjunct assistant professor at Midwestern University.
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Video Link:
5 Simple Tips for Improving Your Child's Language Development - YouTube
About Paula Acuña:
Paula Acuña, M.A., CCC-SLP is a licensed bilingual (English-Spanish) speech-language pathologist and resident of Wilmette. Ms. Paula, SLP Bilingual Speech + Language Services offers comprehensive bilingual evaluations, treatment, consultation, and training to meet diverse client needs. Paul is personally dedicated to providing effective, individualized intervention to support children, adults and their families via in-home, on-site and telehealth services.
What is a Parent Liaison?
A Parent Liaison is familiar with the challenges and questions families face helping their children reach their full potential because she also has a child with special needs. Empowering parents with knowledge from a variety of resources related to individual family needs and encouraging parent to parent connections for family support are the primary roles of a Parent Liaison. The goal is to become part of the IFSP team providing valuable information to families when requested, planning play groups throughout the Lake County area and promoting the family perspective within the Early Intervention Program. There are no additional fees for Parent Liaison services.
Meet your Parent Liaison: Kayla Olson
My journey as a parent of a special needs child began just after my son’s first birthday. We noticed he was not meeting his speech milestones and we were unable to gain his attention for sitting activities. We debated he may be behind due to the pandemic and not being able to socialize as much as if there was not a pandemic. We felt it wouldn’t hurt getting him screened by Early Intervention. During the screening process I noticed there were so many questions regarding him “spinning” and “running in circles” and not much discussion regarding his speech. After services began and we meet with our therapy team is was discussed my son has Sensory Processing Disorder and speech delay. As this was a diagnosis, I knew nothing about at the time, I was scared, but open to learning on how to support my son with this new information given by our Early Intervention team. After several months working with our Early Intervention team we decided to complete a Medical Diagnostic in October 2021. After our consultation with the physician our son was diagnosed with Autism. I am grateful to our Early Intervention who ensured we had the "tools" to advocate for our son needs to meet his highest potential in every setting.
I am very excited to support you, services coordinators and providers in my new role. I look forward to talking with you about questions/concerns or requests you may have including, but not limited the following list.
Here are some of the ways I can help you as Parent Liaison:
- Share information about support groups in the area and online that fit your specific needs
- Provide requested information about resources for additional therapies, park district classes, library programs and/or fun family friendly activities in the area
- Answer questions about Individual Education Plans (IEP) and 504 plans
- Provide a list day care centers/preschools that fit family needs
- Attend IFSP, 6-month review, transition and IEP meetings if requested
- Connect families with children with the same diagnosis
- Connect you with agencies that aid with grocery, clothing and housing needs
- Provide information about Respite care in the area
- Plan and invite all families to private EI playgroup/field trips in the area
- Send useful information about developmental activities, play groups, family friendly events and more out to you 4 times a year (This is the first addition from me!)
- Just listen when you need to talk with someone who has been through similar circumstances
- Talk about how EI can help with experiences you are facing
How can I contact the Parent Liaison?
- Contact your Service Coordinator (SC) with any requests or concerns, then the SC will provide me with information needed to contact you with a phone call or email.
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