Archive for the ‘Language Delays’ Category

Asking Questions

Asking questions can be a tough task for a child with speech defects or language delays. Especially when it comes to the order of the words. Grammatically, they may be behind in what truly counts as a good question.

Carrie Clark explains “For many children with language delays, asking questions appropriately can be very confusing to figure out. As adults, we change the word order of a sentence when asking questions. For example, instead of saying “you do have three apples”, we would ask a question as “do you have three apples?” Often, children with language delays will miss this subtle word order shift and will simply ask the question without changing the word order. When they are asking questions, it may sound like “I can have one?” or “you are eating cookies?”. This can make their message difficult to follow and, if they don’t get the right intonational patterns, you may not even know that they’re asking questions at all.”

Carrie gives us three steps to think about when teaching our children about question-asking:

  • Step 1: Collecting an Inventory of Incorrect Question Structures – What type of questions is your child having trouble with? Yes/no questions? “What” questions? Take time to see where the break down occurs.
  • Step 2: Imitating and Practicing Correct Question Structures – Play a game or come up with an activity to work not he types of questions they are having problems with. This will give your child the opportunity to ask the question many times to get lots of practice!
  • Step 3: Correct in Conversation – Practicing question asking in a structured setting is different then asking then in conversation. After practicing the questions in an activity, when you child goes to apply them conversationally, make sure to correct them if they use it incorrectly, or let them know when they used it correctly to reinforce correct usage!

Posted by on May 15th, 2014 Comments Off on Asking Questions


Choosing an AAC Method

To follow up on the previous post, after deciding that your child could indeed benefit from an aided Augmentative and Alternative Communication (AAC) device, how does one know which one to pick?

There is quite a multitude of AAC devices and methods out there. Choosing one for your child can be overwhelming. However, many therapy programs will provide some kind of AAC assessment to see which modes of communication will work best for your child (even if that means trying out two or three different methods before figuring out the right one).  Most insurance companies even allow a trial period with certain electronic devices to see how it can create the most effective and functional communication for the child. Or maybe the therapist will recommend a picture board with 2-4 pictures for selection to get basic wants and needs met, depending on the child’s level of functioning (and you could even make it yourself).

It is very important to consider the child and their needs. For example, is the program/method easy navigate/use? Can you adjust the size of the keys/pictures for visual impairments? Is the device portable and easy to carry? Can I build in words for spontaneous speech? Is the device for temporary or long term use?

According to “AAC Connecting Young Kids,” it is most important to give the child the quickest and most effective way to communicate at that period in time. As the child grows into adolescence and adulthood, AAC methods can be adjusted to tailor their current needs.  It is also crucial that therapists, parents, and caregivers all know how to use the AAC device and how to implement it into every aspect of the child’s routine. Consistency really does make a difference in the use of an AAC method. Using in only at school, for example, will not benefit the child when they are trying to communicate in another setting.

Here at CLASS Inc., we do AAC evaluations for children who could potentially benefit from using them. We have multiple devices available for the client to trial during each activity (DynaVox, PRC Vantage, iPad with Proloquo2Go, iPad with GoTalkNow). During the evaluation, we tailor all activities we use to the client’s age and cognitive level. A clinician directly models each device for the client, prior to introducing the device into a chosen activity. We require the client to trial all four devices/software. Towards the end of an evaluation, if there is a device that the client clearly uses more efficiently and effectively, we spend the last 10+ minutes focusing on that single device to make sure it is the best choice for the client’s communication goals (i.e. to repair conversational breakdowns; sole communication through a device; can the device/software grow with the client’s skills as they grow…).

Remember, it is important to give children with expressive language disorders a proper, functional, and effective way to communicate!!

Click here for more information about AAC methods:

Posted by on January 25th, 2014 Comments Off on Choosing an AAC Method


Game Play Can Improve Language, Attention, Cognition and Social Skills

Children with language delays, attention deficits, social skill chalenges and/or sensory integration disorders frequently have poorly developed play skills.  When skillfully presented, game play  is particularly beneficial in improving all of these issues.  I use this term, “skillfully presented”, to mean thoughtful selection and presentation of the game.  The game must be enticing, but not over-stimulating; age-appropriate, but also at a cognitive and/or linguistic level in concert with  your child’s skills, short enough to allow for completion, but long enough to stretch attention spans, and have clear rules that provide structure and predictability, with enough flexibility  to allow for unrehearsed social exchanges.

The  most effective ways that I have found to encourage speech, language, social and cognitive development through game play all rely on adapting the game in such a way as to maintain engagement.  Once you have engagement, you can then teach your target skills.

  1. Tap into special interests:  Is your child a fan of Star Wars, Legos or Superheros?  Is she head over heals for Strawberry Shortcake or horses?  How about a passion for trains, Harry Potter, anything blue?  Use what they are interested in to draw them into a game.  I once had a client who was obsessed with clocks.  I put clocks on trains, made board game squares into clocks and the pawns became Grandfather Clocks, I used a clock for a target instead of a dart board, played Go Fish with clocks, etc.  One he learned the rules of those games, I was then able to transition away from clocks to more traditional formats.  Before long, he was playing all kinds of games with the other students in his private school classroom.
  2. Simplify!  Reduce the number of pieces, colors, turns required, etc.  For example, you can play Jenga with 10 blocks instead of the entire box, memory with 6 pairs instead of 12, Candyland with a board that you have drawn that is shorter and only has spaces of three colors and no special characters, require everyone to take only 3 turns and then end the game.  Anything that will reduce the number of things that your child needs to attend to, remember, process or do will make it easier for him to attend to, and enjoy the game.  For example, think about how  much more complicated it is to play a game with 4 people versus just 2.  Instead of having to track  red, blue, yellow and green pawns, he only has to track red and blue.  Instead of having to wait for three other people to take their turns, he only has to wait for you.  Instead of having to look from person, to person, to person, he only has to look at you.
  3. Introduce games when your child is calm.  After having had a nap, snack and/or a good dose of rough and tumble play is a much better time to bring out a sedentary game that demands focus, language processing and social referencing.  Don’t try to play “one quick game” just before bed, or while waiting for dinner to finish up.  If your child is rested,  has a full stomach and is well organized, he will be much more able to engage and have a positive experience.  The more positive experiences that your child has, the more he will want to play.
  4. Maximize positioning.   Make sure that your child is comfortable.  Perhaps sitting in a chair with solid support, or on a bean bag where he is cushioned, or under a weighted lap pillow- where ever your child has shown you to be the most calm and happy is a good place to begin.  Then, sit ACROSS from your child so that he can easily see your face, reference you and watch your actions.

Posted by on December 5th, 2012 Comments Off on Game Play Can Improve Language, Attention, Cognition and Social Skills


App Update

Whew!  This new onslaught of Apps for our profession is both sensational and overwhelming at the same time!  I thought you might find it useful to have a regular update, a few at a time, on some of the Apps that we like at CLASS, Inc.

1. “Things That Go Together”- this is an app that works on associations and starts out with two pictured associations on a page and moves to six or more to a page.

2. “ABA What Doesn’t Belong“- this app works on spotting the difference between four pictured objects per page. The objects may differ from colors to categories each item is associated with.

3. “Sentence Maker”– this app is great for teaching the beginning concepts of sentence structure. Each sentence has a picture representation. The sentence from two to six words and you place the correct word in the blanks to make a complete sentence.

4. “Grammaropolis”– this is a great app to work on grammar. It’s decided into categories of nouns, verbs, adjectives, adverbs, pronouns, conjunctions, and interjections. Each category has quizzes books and videos for that part of grammar. It’s very comprehensive!

5. Spellmania”– this app works like a spelling game show and makes spelling really fun and challenging. As you progress in levels, you are given a certain amount of time in which you are suppose to spell the word correctly.

Posted by on November 26th, 2012 No Comments


Is My Child a “Late Talker”? How Do I Know?

“He’s a boy…boys talk later than girls.”  “She is the baby of the family and her older brothers are just talking for her.”   “My brother didn’t talk until he was five.”   “Einstein didn’t talk until he was five.”  “Wait until he is three and then we will see how he is doing.”   These are just a few of the many responses that parent receive from well intentioned friends, family and doctors when parents confess that they are worried that their child is not talking as much and/or as clearly as he or she should be for his/her age.  In most cases, a  parent’s “gut feeling” is correct.  Why wait and see what might happen when you can get an evaluation today from a professional who is trained to identify children who have communication delays?  While it is true that each child develops at his or her own pace, there are certain milestones that should be attained by specific ages.  Children who are behind in meeting those benchmarks can often quickly catch up with some speech therapy.  Speech therapy is fun, and can’t hurt, so why do parents often wait and worry?  Usually because we parents don’t want our children to be “behind” and silently hope that they will just catch up.  While some do, many won’t.

It is difficult to predict which children will catch up on their own.  What follows is a list of  identified “red flags” or “risk factors”  that, when  present, indicate that a child is unlikely to attain speech and language milestones without professional speech therapy support:

  • Family has a history of speech or language delays
  • Frequent ear infections
  • Limited babbling as an infant
  • Produces few consonant sounds
  • Does not imitate sounds or words
  • Does not point
  • Has limited eye contact
  • Uses only a few gestures to communicate
  • Speaks with mostly nouns or just a few words
  • Appears to have a hard time following directions
  • Does very little pretend play
  • Has a hard time being understood by people other than family

The best course of action is, if you have a nagging worry, consult a speech language pathologist.  Many offer free consultations.  Wouldn’t it be great to have your mind put to rest?  If there is a delay, the sooner that your child receives help, the faster he will catch up.  Bottom line:  asking for help from a certified speech language pathologist is the way to go!

Posted by on November 20th, 2012 Comments Off on Is My Child a “Late Talker”? How Do I Know?


Successful School Meeting!

My client’s father sits across the table from six school professionals. The principal, psychologist, teacher, para, special education director and OT have all gathered together for this morning progress meeting. I am there as my client’s private SLP. Despite the lack of balance in representation, my client’s father reaches deep into his heart,  graciously praising the school team for their care, interest and ongoing hard work with his son. He knows, he says, that his non-verbal and often self-injurious pre-teen is not easy to work with and that the rewards are in the smallest of gains. I gaze around the table at the individual faces of this large school team and see them lift with gratitude at the father’s words;  even if they don’t always know what to do, they always have his son’t best interests at heart.

My client’s father then outlines what he wants school’s next steps to be in educating his son. As I once again glance  at the faces of those six professionals, I notice a hardening of their features and slight glare in their eyes. I am unsure if my client’s father notices this or not.  Many things are discussed over the next hour. Most of them are trivial.  My client’s father politely, yet relentlessly, returns to his requests.  Words are tossed back and forth between the large team of six to the small team of one. The most solid ideas to foster educational progress are those spoken by  my client’s father. It is crystal clear that he has thought long and hard about the current needs of his son and how to overcome them. The school staff really has no option; they are wonderful, loving, highly-educated folks with the best of intentions. But, they aren’t Dad. There is no way that they can possibly have the depth of understanding about this young man that Dad does, and he doesn’t expect them to.  What  he does expect them to do is use his wisdom to teach his son. They understand this.  They also realize that his ideas really are what is best for his son at this moment in time.  They tweak a few ideas to better fit my client’s school day.  A  plan is developed.  I take one final look around the room and see smiles, glowing eyes and postures indicative of mutual respect.  This was a successful  meeting.

Posted by on November 5th, 2012 Comments Off on Successful School Meeting!


Will Ear Infections Affect My Child’s Speech and Language


They certainly can.  Ear infections, (otitis media), can create a temporary hearing loss, resulting in the child missing language or confusing what he/she has heard.  The reason that young children have more ear infections than older children is that young children have small ear tubes.  In fact, up to 80% of children under age three have had at least one ear infection, and often more. Most of the time, the fluid in the ears is not infected (Otitis Media with effusion) and clears itself out within 30 days.  When the fluid in the ear is not infected, there are usually no symptoms except that the child has allergies or a head cold.  When the fluid becomes infected, (Acute Otitis Media),  your child may experience a fever, tug at their ears, be irritable, complain about ear pain or have trouble sleeping. Antibiotics are often prescribed to clear the infection.

The preschool years are an important time for speech and language development. If your child is hearing “muffled speech” because of ear infections, it will be difficult for him or her to learn to speak.  A speech and language delay requiring treatment may result.  To avoid this, close attention to ear infections is recommended;  check with your child’s doctor if you suspect that your child has an ear infection.  If you have any concerns about your child’s speech and language development, seek the advice of a speech-language pathologist.

Posted by on November 2nd, 2012 Comments Off on Will Ear Infections Affect My Child’s Speech and Language


Fantasy & Pretend Play Boost Cooperation Skills

Pretend Play teaches kids how to cooperate better with their peers. Dramatic play, whether it’s pirates, house, school or super-heros actually refines children’s social and communication skills. This summer, consider putting together a dress up treasure box filled with creative castoffs, set your kids loose and let their social communication skills blossom!

Posted by on June 28th, 2011 No Comments


Developmental Milestones

This is a nice little article from Parents Magazine this month about developmental milestones:

( — Although your baby won’t say much during her first year of life (at least not in words you understand), her language skills begin to grow the minute she’s born. Here’s how the process unfolds:

Age: Birth to three months

What your baby does: Your little sweetie is learning about voices by listening to yours. The coos and gurgles that emerge at the end of this period are her first attempts at imitating the sounds you make.

How to help: Sing and talk to your baby often, but also keep other distracting background noises (the TV, radio) to a minimum so she can hear and focus on the sounds she’s working on.

Age: Three to six months

What your baby does: Your child is beginning to notice how people converse with each other, and wants to join in on the dialogue.

How to help: When you talk to him, pause after saying something (“Would you like to play with this pretty red rattle?”) so he has a chance to respond in his own language. If he tries to make the same sound as you, repeat the word for him.

Age: Six to nine months

What your baby does: The vocalizations your baby makes are be- ginning to sound more like words now — baba and dada, for instance. She’ll also express emotion in response to the tone of your voice, smiling if you are talking happily, showing distress if you are yelling or expressing anger.

How to help: Talk her through her days: “Where did the puppy go? Oh, look, here’s the puppy on the sofa,” labeling and showing her what you’re referring to as much as possible. Use a mirror to show her who she is: “Who’s that little girl? It’s Rachel!”

Age: Nine to twelve months

What your baby does: His receptive language skills are exploding now; that is, he knows what you’re referring to even though he can’t repeat the words himself. He may scamper to the high chair if you say it’s time to eat, or look around for a toy when you ask him where a favorite plaything is.

How to help: Begin to label body parts (“nose,” “eyes,” “tummy,” “toes”), spend more time reading books together and talking about the pictures, and teach interactions such as waving bye-bye and blowing kisses.

Age: Twelve to fifteen months

What your baby does: Here come the words. Though the number an individual baby can say varies greatly at this stage — from one or two to a dozen or more — you can expect your child’s spoken vocabulary to pick up speed during this period. Even when he can’t say something, he knows how to tell you what he wants through gestures.

How to help: Continue to label for your child, but also use more simple sentences so he can hear how to string words together. Respond enthusiastically at each new word development or attempt at communication.

please see for more information

Posted by on February 8th, 2011 No Comments


Using Messy Play to Boost Language

Paint, play dough, mud, sand, paper mache, water, shaving cream, cookie dough, slime, pudding, glue….the opportunities are endless, and oh, so messy, and oh, such rich language building experiences!

With messy play, the play can be without rules and expectations.  This opens the creative doors to imagination, investigation, exploration, ,experimentation and inspiration.  If we provide children with descriptions of the materials and the actions while they are actively absorbed in explorative sensory experiences, the language is instantly meaningful in a vibrant, salient way that it just isn’t if we use the same words without connection to these rich sensory moments.  Suddenly, the abstract words that make up descriptions of tastes, sounds, feelings and actions are no longer abstract; they are connected to something tangible.

Messy play also increases problem solving and the ability to ask questions.  As children become engaged in maniulating the material, the try new and different things, or try old things in new ways.  They ask themselves questions, such as, “I wonder what will happen if ….” and “How can a make it do…..”.  They ask adults questions like, “How does it do that?” and, “What do you think I’m going to do next?”.

Messy play is wonder play, but for some children it can be a bit daunting to experience novel sensory stimuli.  Children are ususally most comfortable playing with dry textures first, such as rocks, marbles, beans, ceral or shredded paper.  Once they are enjoying these  hard, dry textures, children a ready to explore the properties of soft textures including play dough, squishy balls, wet sand and cooked spaghetti.  The last texture to introduce is material that is both soft adn wet.  This includes items such as fingerpaint, glue, mud, shaving cream, pudding, cooked squash or sponges in water.

“Press, stomp, squeeze, pull, squish, squash, ooze, slurp, slimy, sticky, gooey, slippery, shiny, swirling, dribbling”….such rich vocabulary words from Messy Play.  Go For It!

Posted by on January 12th, 2011 No Comments