Encouraging Spontaneous Communication

Q: How can I help my child communicate better?

  • Play early speech routine games such as “peek-a-boo” Simon says, and hide and seek.
  • Model pretend play with your child (e.g. feed a doll, stir soup) Pair actions with words.
  • Organize toys outside the child’s reach.  Your child will have to request the toy by pointing, requesting, or signing “play.”
  • At meal and snack time, provide your child with two choice to eat or drink.  Model “I want…” Any verbal attempt is reinforced with the desired choice.
  • Rather than giving your child a full serving (e.g. cheerios), give a few at a time,  and ask your child to indicate “more.”
  • Sit with your child on your lap in front of the mirror.  Make silly sounds and faces. When your child says or does something, imitate it immediately.
  • Label everything your child touches and does.
  • Use short phrases to talk about what your doing.  
  • When your child cannot accomplish a task independently, model the phrase “help me.”
  • Hold a toy under your chin when you label the object and ask your child to repeat.
  • When blowing bubbles or rolling a ball, model: “ready, set, go” or “one, two, three.”  
  • Sing familiar songs and leave out the last word to see if your child will finish the phrase.
  • If your child is using single words, repeat back two words (e.g., ball…more ball).
  • Swing your child or blow up a balloon and suddenly stop, waiting for your child to request for “more.”
  • Take turns stacking blocks or blowing bubbles while modeling “my/your turn.”
  • If your child reaches for you to pick her up, ask her to say “up” before picking her up.
  • Hide toys under cups or boxes.  Lift up one at a time and label them.
  • Look at a flip-up book and ask your child to label or point to the pictures.
  • Place toys in a bag and as you take each one out, ask “Is this a….?”
  • Pretend a doll is sleeping.  Say “wake up!” Repeat a few times, put doll to sleep, and wait.
  • Shake a paper bag and say “what’s inside?”  Take out one at a time, labeling each object.
  • When asking questions and your child does not respond, provide choices.
  • Model environmental sounds such as: “vroom, choo-choo, beep beep, honk, ring ring.”
  • Place toy animals in a bag.  As you take each out, model the animal sounds such as: “meow, ruff-ruff, quack, moo, oink.”
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Tongue Thrust

Q: What is a tongue thrust?

A: A tongue thrust occurs when the tongue pushes forward, against the front teeth, causing a reverse swallow.  This habit can cause poor teeth alignment, a lisp, mouth breathing, and jaw misalignment. Because a person swallows 500-1000 times a day, it’s easy to see how improper swallowing can cause a variety of problems.  But it is the resting position of the tongue that does the most damage because it is more constant.

Q:  What causes a tongue thrust?

  • Prolonged pacifier use or digit sucking past 18 months can cause a forward thrusting of the tongue.
  • Enlarged tonsils and adenoids, or allergies.
  • Genetic history.

Q:  My child needs braces.  Will that correct the tongue thrust?

A:  Unfortunately, braces alone will not correct your child’s tongue thrust.  If the child is only fitted with braces, without speech therapy, the constant tongue thrusting will likely reverse the positive effects of braces, especially after they are removed.  However, an orthodontist can place a “tongue crib” in the child’s mouth acting as a tongue anchor; preventing further thrusting. Your orthodontist and speech pathologist must work in unison to reverse the tongue thrust and tongue placement while also improving teeth alignment.   It is best practice to correct the tongue thrust with a speech therapist prior to receiving braces.

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Developmental Verbal Dyspraxia (Apraxia)

What is Apraxia?

  • Developmental Verbal Dyspraxia (DVD) also known as “Apraxia” is the difficulty sequencing, coordinating, and forming sounds into words.  
  • A motor planning delay, characterized by difficulty vocalizing correctly and consistently.
  • Child has difficulty imitating words, but able to say words on his or her own.  
  • The child’s understanding of language is much better than his or her expression.   
  • The child may move the muscles used for speech without making sounds.  
  • Difficulty saying longer words and sentences (e.g., spaghetti, hospital, gymnastics).
  • Limited consonant and vowel sounds.
  • Child uses sounds correctly in some words and not in others.
  • Speech therapy is typically recommended four times per week for 20-30 minute sessions.
  • Progress with therapy is highly irregular, variable, and inconsistent.
  • Therapy involves using multiple approaches including Kauffman and PROMPT
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Developmental Norms for the 24-Month-Old

What can I expect from my 24 month-old child?

  • Says about 100 words and puts two words together: “go car.”
  • Verbally requests wants and needs: “want cookie.”
  • Clearly produces: /p, b, m, n, w, h, y, t, d, t/ with 50% clarity to an unfamiliar listener.
  • Produces early developing pronouns: my, me, I, mine, it, you, your.
  • Points to familiar objects in a picture and names three pictures.
  • Imitates sounds, words, and gestures involving objects (e.g., rolls car).
  • Follows simple two-step related directions.
  • Asks and answers “what” questions with rising intonation.
  • Imitates animal or environmental sounds (e.g. vroom, beep).
  • Imitates a 2-3 word phrase.

How Can I help my 24-Month-Old?

  1. Label everything you see and talk about what you’re doing.
  2. Provide two choices and ask your child to request one, modeling “I want + object.
  3. Speak in simple, 2-3 word phrases with your child.
  4. Participate in “mommy and me” classes and park play dates.
  5. Imitate everything your child says and imitate their play.
  6. Look at picture books every day, perhaps as part of a bedtime ritual.

  7. Expand what the child says (e.g., If he says, “More juice,” you say, “Want more juice”? Okay, here’s more orange juice”).

  8. Hold a preferred object under your chin and label the object.

  9. Sing to your child and constantly talk about what you’re doing and seeing.

  10. Expose your child to many new experiences and talk about them before, during, and after the event.

  11. Help your child learn new words in a meaningful way by experiencing object in a variety of ways (seeing, touching, tasting, smelling, hearing).

  12. If your child leads you to a desired object, ask him/her to point and “use your words.”    

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Developmental Norms of the 5-Year Old Child


What can I expect from my 5 year old?

  • Stabilization of most sounds including: /v, s, z, sh, ch, l, r, j/ with 90% clarity.
  • Understands opposites including left/right.
  • Talks about their day at school and has a simple conversation with adults.
  • Asks and answers how and when questions.
  • Uses adjectives to describe an object and adverbs to describe an action.
  • Uses yesterday, today, and tomorrow and understands time concepts.
  • Starts to bargain, negotiate, and compromise with adults.
  • Uses prepositions including: through, nearest, corner, middle.
  • Names ordinal numbers such as: first, second, third.
  • Uses irregular plurals (feet, mice) and irregular past tense verbs (ran, slept).
  • Uses complete, compound, logical sentences that are easy to understand.
  • Able to describe the category, function, and parts of an object.


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Developmental Norms of the 3-4 Year-Old Child

What can I expect from my 3-year-old?

  • Expressive vocabulary of 350 words; Puts 3-4 words together with 80% clarity.
  • Understands quantity concepts: more, less, empty, a lot, big, tall.
  • Understands directions: up/down, in/our, on/off, in front/behind, under/over, next to.
  • Identifies all colors and shapes.
  • Separates from primary caregivers easily.
  • Follows an unrelated two-step direction (e.g. touch your nose and pick up the bear).
  • Follows a three step direction: “Go upstairs, get our shoes, and bring them down.”
  • Asks and Answers questions such as: what, where, who, why and “yes/no” questions.
  • Talks about a recent experience and has a simple conversation.
  • Adult like speech with 80% clarity; Words are no longer simplified.
  • Clearly produces /p, b, m, t, d, k, g, n, w, , w, f, ing/ in sentences.

What can I expect from my 4-year-old?

  • Has a 2500 expressive word vocabulary.
  • Initiates, maintains, and takes turns in conversations with adults.
  • Most sounds are produced clearly: /v, s, z, sh, ch, l, r, j/ with about 90% clarity.
  • Follows three-step directions without cues.
  • Uses 4-5 word sentences and says imaginary sentences (e.g., What if…I hope).
  • Uses words to invite others to play.
  • Understands time concepts: first, then, days of the week, months of the year.
  • Asks and answers advanced questions including: why, how, and when.
  • Asks “Do you want to…?” “Are we going to…?” “Can you…?”
  • Understands non-literal language such as idioms, jokes, humor.
  • Uses could, would, might, maybe, should in speech.
  • Tells what common objects are made of and their function.
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My Child has Difficulty with Social Skills…What do I do?

Pragmatics (social skills) is the effective and appropriate communication in relation to varying social and situational contexts, intent, and conversational rules.  Pragmatic delays may also affect academic performance. In the classroom, your child may not demonstrate his true ability if he does not ask/answer questions, ask for help, sustain attention, provide eye contact, or follow directions.  In social situations, a child’s pragmatic social skills is reflected in her ability to comment, initiate, maintain, and take turns in conversation, ask/answer questions, greet others, request, and direct others verbally.

How can I help my child?

  • At dinner, play “pass the question game.”  Whomever is holding an object (e.g., ketchup bottle) asks a question to the person next to him or her and passes the object around until everyone has a chance to ask and answer the question.
  • When your child is talking, model ways to politely interrupt by saying “excuse me” or “May I please interrupt?”
  • Model polite ways to order such as “May I please have…?”
  • Model bridging phrases to change topics: “Bye the way” “Speaking of…” “On a different subject” “That reminds me of..”
  • Ask your child if he can be flexible and talk about multiple solutions to a problem.
  • Discuss how to greet a parent when entering and exiting their house: “Hello Mrs. X”
  • Model flexible language such as: “No big deal, Let’s trade, Maybe next time, Let’s compromise.”
  • Ask your child to rate a problem as “big” or “small” and how they can calm down (e.g., going to a safe place, breathing, walking away, drawing, whistling, and singing.)
  • Model questions rather than demands: “Could you please…”
  • Play the “social fake” game at dinner.  Each person talks about something while everyone else shows interest (e.g., smiling, nodding, eye contact).  Whomever maintains the “social fake” for the longest time, wins the game.
  • Expose your child to many different types of social experiences and play dates.
  • Tell your child that he can talk to you about anything that’s bothering him.
  • Be specific with your questions: “What was the silliest thing that happened at school today?”


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Speech and Language of the 6-Year Old

Speech and Language of the 6-Year-Old

At 6 years of age, your child…

Has correct articulation of most sounds in conversation to an unfamiliar listener.

May still have difficulties with clusters such as /spl/, or /tr/.

Uses adult-like grammar and understands the meanings of most sentences.

Names days of the week and months of the year in order and counts to 30.

Predicts the next sequence of events and tells a 4- to 5-part story.

Tells month and day of birthday, name, age, address and distinguishes left and right.

Knows most opposites and the meaning of through, away, toward, and from.

Knows time based concepts including: today, yesterday, and tomorrow.

Asks many questions including: “why,” “what,” and “how” questions.

Is beginning to read simple words like cat, the, and ball.

Is starting to recognize that individual letters in words represent different sounds

that form words when put together (for example, c-a-t for “cat”).

You can stimulate your 6-year-old child’s speech and language if you…

Spend quiet time each day when only the two of you carry on a conversation.

Have your child read simple, repetitive, and familiar books to you (i.e., Brown

Bear Brown Bear) and read new and more advanced books to him or her.

Help your child write his or her own story-picture book.

Play games with your child that involve reasoning and conversation (i.e., 20 questions and Headbands).

Allow your child to cook and bake using a child’s cookbook with simple step-by-step instructions and pictures.

Let your child watch special children’s videos or television shows and have him or her retell the story.

Have your child contribute to family discussions that involve decision making and personal opinions (i.e., peak and pit/high and low of the day).

Use more advanced words in your own vocabulary and define them to your child.

Tell a short story to your child and let him or her finish the ending.

Have your child “write” new words and sentences each day with chalk, or a marker on a dry-erase board.

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If You Think Your Child Stutters

If You Think Your Child Stutters

You should take your child to a speech-language pathologist if he or she…

Shows frustration or embarrassment when speaking.

Others seem impatient with your child’s speech.

Exhibits facial grimaces or bodily tension when attempting to speak.

Stutters with considerable tension and effort throughout the day.

Avoids stuttering by changing word and using extra sounds to get started.

Stutters on more than 10% of his or her speech.

Avoids going to new places for fear of speaking to strangers.

Stutters 6 months or longer.

You can help your child during this time if you…

Allow your child to finish his/her words without interrupting.

Maintain eye contact, stay calm, and try to avoid showing concern or worry.

Model slow, unhurried speech, with many pauses, so your child feels relaxed.

Avoid finishing sentences and filling in words for your child.

Avoid comments such as “slow down,” “take a breath” or “relax.”

Ensure that your child is getting proper rest, diet, and exercise.  

Try not to change your child’s handedness.

Be calm in your discipline and avoid asking your child to “perform” for others.

Ask close ended questions rather than open ended “WH” questions.

Wait a few seconds before responding to your child.

Siblings must never interrupt the child during a stuttering moment.

Reassure your child using comments such as: “Many people get stuck on words…it’s okay,” or “I know it’s hard to talk sometimes; let’s sit down together and talk.”

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Developmental Norms of the 2.5 year old child

Speech and Language of the 2 ½ year old

At age 2 ½ years, you child…

Uses about 450 words.

Gives first name and holds up fingers to tell age.

Uses past tense, plurals, and combines nouns and verbs.

Understands simple time concepts, such as “last night” and “tomorrow.”

Refers to self as “me” rather than by name.

Tries to get adult attention (for example, “watch me”).

Likes to hear the same story repeated.                                                             

Uses “no” “not” and “yes” in speech.

Talks to other children as well as adults.

Begins to control behavior verbally rather than just physically.

Answers “what” and “where” questions.

Can name common pictures and objects he/she sees regularly.

Uses short sentences to announce what he or she has done (i.e., “Me do it,” or Me want to jump”).

Knows the words big and little.

You can stimulate your 2 ½ year-old child’s speech and language if you.

If your child leads you to a desired object, ask him/her to point and “use your words.”       

Listen attentively as your child answers simple questions.

Imitate everything your child says and copy their play.

Read books every day, perhaps as part of a bedtime ritual.

Talk to your child a little beyond his or her level of language production.  For example, if your child is saying one word, model two words.

Expand what the child says (for example, if he says, “More juice,” you say, “Want more juice”? Okay, here’s more orange juice”).

Hold a preferred object under your chin and label the object.

Sing to your child and constantly talk about what you’re doing and seeing.

Expose your child to many new experiences and talk about them before, during, and after the event.

Help your child learn new words in a meaningful way by experiencing object in a variety of ways (seeing, touching, tasting, smelling, hearing).

Have your child deliver simple messages for you (i.e., Tell Daddy that dinner is ready).

Show the child you understand what he or she says by answering, smiling, and nodding your head.

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