Teach a Child to Talk with 5 Strategies from Speech Therapist Laura Mize teachmetotalk

0:00 [Music] hi i'm laura mize pediatric speech language pathologist and welcome to teach me to talks podcast thank you so much for joining me today and thank you so much for subscribing to my youtube channel if you haven't done so already please go ahead and do that all right today's show is something different i want to talk about the top five strategies that i share with parents and these are the things that i teach parents to do first so in some of the show i'm going to be

0:45 talking like i'm talking directly to parents just because i want you to be able to hear that and be able to really own those words and take my words and use them as your own as you are talking with parents and having these conversations that we all need to be having especially right at the beginning and i think the information that i'm going to share with you today is really going to set the stage for success for the widest array of families that we serve with late talking toddlers and preschoolers and of course we're going to tweak these strategies depending on what we see going on with each individual child and there will be some children like who have markers for autism that we're going to emphasize the social things more than we emphasize the talking piece and you'll certainly be able to do that but from my experience and especially at teaching me to talk and the kinds of

1:31 questions and emails that i get from parents these are the things that i think make the most difference for parents right at the very beginning so this podcast is all about parent education and if you're a parent you're certainly going to benefit uh from this information too now therapists let me remind you that you can get uh one hour ce credit for just five dollars in our five dollar ceu program at teach me to talk and this is show 421 if you want to check that out and be sure to claim your credit you'll also get a handout too which i think will be immensely helpful for you in your practice with late talking toddlers and their families so let's go ahead and start moving through these strategies and remember these are the top five things that i try to teach parents from the very beginning just to get us off on

2:16 the right foot when we're first beginning services with their child and in case you're wondering all of these strategies are evidence-based practice which means what they're rooted in science and backed by research so i think that's so important to tell parents so they don't think that you're just sitting there coming up with things to do even based on your own experience they need to know that these are the things that we know that work with late talking toddlers to move them toward understanding and using more language so what's our very first strategy and this is something that i think again just sets the stage for parents and it might not be something that you're accustomed to talking about but i talk about right off the bat that we have to be so intentional with light talking toddlers about teaching them language and we have to really think about maximizing our time together to do

3:03 that so what i say to parents first is you have got to devote some time to this and some effort to this to working with your toddler don't believe the therapists or other professionals that come in and say hey you can just make a tweak here or tweak there and it's going to make a big difference that that simply is not true and we've got to talk to parents about that from the beginning and this is the best time to do it when they are already willing to set up services to schedule these appointments to get their child evaluated and so we need to tell them right off the bat look you're going to have to devote some time to this and you're going to have to change some of the things that you do and why would we say that because if what they were already doing were going to work we wouldn't even be there and so we have

3:48 to again talk to parents at the beginning about making these shifts and making these changes right at the beginning and what i share with with parents from the beginning is that actually the kids who make the most progress are the kids who have parents that really carve out time just one-on-one to work with their children independently and again this may not be a popular thing for you to say working in a state early intervention program they may really want you to tailor all of your strategies to families everyday routines and that's fabulous and i get it when it when a researcher says we have to tie into existing family routines so that they will get the buy-in and so we'll even have a chance and a shot at them wanting to do it that's great and i'm going to talk about that as well and talk about that with

4:35 families as well but the truth is the kids will make faster progress when their parents are fully on board and when they prioritize this and this is what i always say too if at any point during therapy you don't feel like your child is making enough progress time is what we need to do just more time with the strategies more exposure more more effort with with helping them learn how to understand and use words and that already again sets the stage for you as the therapist so that when you're talking about an and a parent is expressing frustration for lack of progress or for how slow things seem to be going i always say remember what we said at the beginning time is what really matters so let's

5:20 think about how we can provide even more intervention and that doesn't necessarily mean me going more or you going more or than them coming to see you more it means that the child just needs more time in general with someone usually his parents implementing these interventions all day every day to make a real big difference you know we can't let the time discussion though scare parents off so we have to really talk about how we can start this at the beginning with just really short bursts and what i try to tell parents is just start with you know 10 minutes here and 10 minutes there and but but we've got to be super super focused and again they need to be uninterrupted which means that neither one of them is looking at a screen

6:07 when we do that we are just ensuring that a child will not continue to pay attention to us and continue to let us share that experience with him so you have to talk about times again even though it's just 10 minutes uh letting yourself or allowing yourself to be distracted during that time and again i tell parents during this 10-minute period you can do almost anything with your child you can certainly do a daily routine and we're going to talk about bath time and meals and those kinds of things but you can also think about things like reading a book together which is so evidence-based if you haven't listened to my other podcasts lately i talk a ton about that two shows ago so i guess it's 419 where i did a whole research show about what research tells us about late talkers and just the data and the statistics and one

6:54 of the most widely recommended and highly researched topics between parent child interaction what always in studies seems to get um just the efficacy is there it's effective is teaching parents how to read books to their children and then really having parents use that time to not only increase their literacy skills but their language skills and so talking with a parent about that you know just with different tweaks that we can do with what their routines are or or if they're not reading we can say you know this is something that really helps your child's language development and again so many times parents don't know how to do these things or don't know how important they that they are to their child's development and that's part of our job to help them understand those things and i did a whole series

7:40 about literacy and language it shows 415 16 and 4 17. so if you haven't checked out those podcasts that'll give you some really good strategies to help parents and if you're a parent listening to help you use books more effectively with your toddler with language delays so parents can read during that those little 10-minute bursts they can play you know which if you follow my work for any amount of time you know that's something that i talk about is just kids learn everything through play and certainly toddlers and when we are teaching toddlers how to play we're working on their language but we're also building the foundational skills for language with teaching them those cognitive concepts that you only learn by doing and certainly every kind of play opportunity with the toddler even if it's just trial and error he's learning he's building his knowledge base and so

8:26 we have to lay your language on that so those things make more sense and so he can talk about the things that he's learning and again so he can link meaning link your words those abstract concepts of your words to that play that he's learning so parents can read a book they can play or the other thing that if you've watched a lot of my videos or have followed my work or have uh some of my therapy manuals that i talk about a lot is playing social games and those are those well-established little routines that have a beginning a middle and an end the child learns and ends the child learns what to anticipate in that little game he likes it he wants to stay with you he's hearing the same words over and over and over and over and repetition is so powerful for helping like talking toddlers again learn to

9:14 what those words mean is they hear them as you use them over and over and over and then how to say those words because they have those opportunities but the context of the little game where you are putting it in something that's just really special that you and your child do together those little routines and when we implement those kinds of things we can see children light up and begin to connect with us and after we have that interaction piece going that's when we know that language learning is most likely to take place and so you've got to set the stage and talk to parents about that and and really talk about how we're going to put all these strategies in daily routines but we're also going to carve out these little special times where you can think about them as just your little at-home therapy program if a parent likes that or you after when you're talking with a parent you'll kind

9:59 of judge what what they expect what they want their time with their child to look like and so talk about these little special play times so back to talking about these little short bursts for many late talking toddlers this will be easy they have really well established listening skills which means they have stronger auditory skills and so they they usually don't have receptive language delays they like playing with toys they're just missing the expressive language piece and so this talking to a parent about saying you know we're just going to do this little short burst of play especially at the beginning and then gradually work up to where you're spending more and more time working on your language strategies together for some parents they'll say hey i can start out with that 15 or 20 minute time

10:44 right now because we're already doing that and that is fantastic when that happens but for many of our other little friends with language delays that if you listen to that show 419 we talked about in the research that even kids who recover from like talking researchers have found that they have naturally or just what they came with just their auditory processing skills are weaker than children who do not have language delays and that makes a lot of sense with how do we learn how to talk we listen we listen to other people say words we listen to other people's conversations we listen when our parents talk directly to us and try to teach us things and again the mode that they're using would be a verbal way of teaching you so those those auditory skills those

11:32 listening skills again and kids that are late talkers even after they catch up they just they came to us wired a little differently with that those skills are weaker and so for those kids and for those parents who again let me say because of the genetics we know with like talking may have some of those uh weaker language skills too so for parents this might even be harder to think about oh 10 minutes that's a long time that's what am i going to do during that time that's my child will never sit with me that long he's way too busy for this and so for some parents we might have to say you know you might have to work up to this and you always reassure them and always say but i'm here to do that i'm going to teach you how to do that we're going to learn some strategies that you didn't

12:17 know before they're going to make this a lot easier so why does all this time matter and again this is a conversation that you need to have with yourself as a therapist or as a professional first before we have it with parents so that you really really understand why you're talking about time and why you want parents to to devote more time to this than they already have in the past and it's not really based on you might be thinking oh this is based on the aba model where it says that kids with autism need 20 to 25 hours a week of engagement to make consistent progress and that is true but did you know that the reason that we have that recommendation just kind of across uh fields here in the fields of education and just a child development or child language development is because

13:03 typically developing children toddlers usually spend about 20 to 25 hours a week with active listening active engagement with other adults in their environments now do they sit down and do it you know like a like a job their job 8 to 12 every morning no it is throughout the day and that is why and it is during daily routines but again remember what we said those kids listen better their their brains are more capable or more um just just they're they're wired again with typically developing children wired again to learn language and so that that's how we have to think about that so hitting that 20 to 25 hour a week mark is what research has

13:49 determined to be the kind of tipping point where kids get enough listening and they get enough engagement and interaction with other people that language starts to really make a turn for the more positive and so again why is that because typically developing children it's not hard to keep their attention and their focus they want to stay with you they want to learn from you again their little ears are more attuned to listening to your words and assigning meaning has not been as difficult for them to say a late talker with a receptive language delay so this is the part we have to change first again it's the amount of time that you spend working on it and it's not easy for a kid or you would have already done it and so we have to really talk with parents about that and one thing i say especially after we've had the 20 to 25 hour a week conversation is that most

14:35 late talkers thankfully respond beautifully with a lot less time than this but we're just going to have to get as much time as we can log more time so that we really kind of know if he starts to make progress keeps on making progress okay that's enough we found the right dosing but if he's not time is what we really really need to focus on and again any time can count if a mom does you know breakfast without a screen and that takes 20 minutes and she's done a lot of the strategies we're going to talk about and then later in the morning she plays a couple of rounds of little social games with them you know that might be 20 minutes for breakfast 20 minutes for that little play period and then let's just say uh you know at lunch they're going to do the same 20 minutes again or or read books right before they go down for nap if you start adding up all these things

15:21 you can get to two hours pretty easily in the course of a day and so talk to a parent about that and say you know that's 14 hours and you haven't even really done anything different yet that's fantastic and so talk with parents about how they can really log that time and this is the thing i always say no matter how behind a child is that amount of time is going to make a huge difference and even children with significant delays in language can make a cover a lot of ground make a lot of progress in that amount of time so carve out some special time together one on one every single day and make your everyday routines count too by using the strategies that we're going to continue to talk about all right let's move forward with strategy number two this is really important because now we're addressing how a parent talks so the second

16:07 strategy for helping a late talking toddler is to simplify what they hear so that means we have to look at changing the way that we talk to a child and a child what a child hears the language that he hears other people say has a direct a just a direct connection to his ability to learn how to talk and so when we talk to parents about that sometimes they don't make that connection clearly enough sometimes parents think that just a child flipping through a book is a language activity but we have to say unless he's hearing the right words and again we know that your child has a language delay so something there's something amiss here so you talk with them about specifically changing the kinds of language that their child hears uh and we've already talked about

16:54 that that why that research has really told us that and research has really taught us that that we've got to simplify and we've got to again make it easier and then we have to do it for more time so this is even more important to simplify what we say to a late talking toddler when there are receptive language issues too now you can't just say as you already know receptive language issues to parents they have no idea what you're talking about so you really got to talk about things like how he understands language how he processes the the directions that you give him and again you can't measure that without really looking at what a child can actually do so here's what i say i talk with them and say how well is your child doing these kinds of things and if he's over 18 months old he should be following simple familiar

17:40 commands and daily routines really really consistently so things like go get your shoes bring me your cup throw your diaper away where's your ball or even things in daily routines like let's go get a snack where he would know that that means go to the kitchen or let's go take a bath and he would know that that means go to your bathroom and so when a kid isn't understanding those kinds of directions well enough that's why he's not talking and so we have to really talk with parents about the simplification process for those kids is even more important because again they're not able to pick out all the words from the blah blah they're not able to hear you say a long long paragraph and know what they should say from that and so that's that's true for a kid with an expressive delay so then when we layer a

18:27 receptive delay on top of that meaning that a kid doesn't link meaning and he just he not only can he not pick out the important words when he can he doesn't even know what it means and so we have to help parents not miss this now if you are a therapist and if you have worked for more than a week or two you've already had experience with this because you've probably asked a parent how much how well does your child understand language or how much does your child understand and what do do they all say nearly every parent will say he understands everything and then you start to assess him and you've spent some time with him and then you realize nothing could be further from the truth and so you have to kind of get you have to realize that when you hear that from a parent you need a follow-up question right away don't don't naturally assume that they are equating what you know to be true

19:14 about receptive language with what they are saying he understands everything means and so you've got to take it a step further and say how well does he follow directions because you will have parents who say he understands everything and then act like well no he he never does anything i say and so you've got to help them see that disconnect we can only count or measure language comprehension by what a child actually does when he hears a verbal command and so lots of times there's just a strong chance that a parent has overestimated what their child who's not talking has been able to understand and so i talked with parents about kind of testing that on a daily basis and and giving them those little commands that we already talked about and seeing how well they do that without hand gestures because all

20:01 of us most of us talk with our hands and so we're saying go get your cup go bring me your cup see your cop right there and so we're given that visual cue when a lot of times if uh kids with we talked about those weaker auditory systems they come to rely on visual cues and so they depend on you pointing and so sometimes when we talk to parents about taking those visual cues away they realize how much their child doesn't understand and then you have to say as a therapist but i want you to still keep doing that because that helps your child follow those directions and understand what he's doing so particularly when we see this with a parent we have to say you know here's the good news in this we know what the problem is when a kid doesn't talk very or doesn't understand very much he's not going to talk very

20:46 much so we've got to back up and help him learn how to understand words and how do we do this we're not going to take a lot of time right here to talk about your receptive language strategies because i've done a lot of podcasts about this but you can just search receptive language at teach me to talk or even on our at our youtube channel on our page just search uh receptive language or help my child listen or this is what you could also search tell them show them help them and those are the cues that i use and that really encompasses your verbal cues would tell them your visual cues would show them and your physical cues with helping and so that's what we do anytime we want a child to follow directions we tell them what to do we show them what to do by pointing by holding up the item and then if he still doesn't do it we take his little hands

21:32 we walk him over there and we help him do it and so tell him show him help him it's really really important it's a great great cue for parents the other thing we do for kids with receptive language delays meaning they don't follow a lot of directions is we want parents to teach them to do their part in everyday routines and this helps the child not be able to do that passive just kind of go from one thing to the next and parents don't always understand that either and we have to really really talk about this with parents and say you know we want to give your child a part of every little thing that you do at home and so with diaper changes his part might be what throwing away the diaper when a snack his part is maybe taking his cup from the kitchen over to where he's going to

22:18 sit down and eat his little snack in front of his tv or whatever he's going to do and so you look at your daily routines everyday routine and you come up with a job and then for the receptive language part the parent has to give the child that command so they have to say what it is so after diaper change they have to say go throw it away let's go throw your diaper away and again you're gonna have to take a child and do this show him help in part two if this is not something that a child has done before but it's a wonderful wonderful way to work in those receptive language commands those things that that parents of kids with typically developing language are already doing all day every day and they may not even really realize they're doing it they just think they're parenting but a lot of our little uh parents with our little guys who have

23:04 receptive language delays don't do these things and we don't know about it until we're talking to them about their daily routines so let me give you some other examples when a cub is empty a child's little job could be that he goes to you know toss it over the edge there into the sink before leaving the house we could ask a child to go get her shoes or her backpack or whatever her coat whatever she's going to need for that outing when it's time to get out of the bathtub the child's job you might say let's clean up clean up your toys come on clean up and their little job might be to put them in the basket that you use to drain the bathtub toys or to throw them out over the side of the bathtub if mom just lets them dry there on the floor whatever it is whatever little command you can come up with it might be leaving the room and you let a child turn off the lights now will that

23:50 turn into an obsessive compulsive kind of fixation for a child probably but you're teaching them how to do what you say and how to understand what those words mean as a way to again just expand that child's ability to understand words one of my favorite ways to do this is if a child has a favorite routine it's that a child has to get something to uh start that routine or to to signal the beginning of that routine so if a child likes to snuggle with his mom on uh the couch with a blanket his little job might be go get the blanket so we can snuggle let's snuggle go get your blanket or if a child likes to read it would be go get your book go find your book and again mom has to be really diligent about giving these little

24:35 commands and letting letting the child do that helping going showing and helping too so that that can be part of a routine and then once the child masters that first little direction then you add a second job in a routine or you add more routines where you have one or two little jobs and so you want to do this and really really build this up and this parents love this advice don't think that you're asking them again this would be where you really mixing something and melding it into their existing routines this is something that they really like when they start to see their child respond and they say gosh he's really doing it now those little things we talked about last week those four little jobs he said you know we came up together that we wanted him to do this after after meals and do this at bath time and she'll say you know he's doing that great he's doing that great and so see

25:22 then there's so much motivation there and so you'll know that with a parent when they're doing that because they get so excited and then you say hey you know what you are making it more and more likely that he is just going to be able to talk a lot sooner than if we were not working on these things because you're really setting a stage for that and you're really helping him understand what words mean so always bring it back to that now these kinds of little commands are so important to me because one i know that if a parent is really intentionally working on these things and their child isn't making any progress we've got more of a problem with cognition and we're going to have to really kind of take a step back and look at that cognitive development and look at where that child is and know that most of our time shouldn't be spent in speech therapy on talking it should be spent in really

26:09 laying the foundation for talking or really getting that receptive language piece and that cognitive piece just just as as built up as we can we and again sometimes we think or parents will say you know i just i'm not just not doing it i'm just not working with him like i should and so you'll know that too you'll say these parents have a lot on their plate we need to simplify for the parents and you really again talk about um what you can do to make that easier for them for kids like this too we can't we have to practice what we preach so even in sessions if you are talking with a parent really hitting home about receptive language receptive language receptive language but you are focused only on your expressive goals during sessions you are being a hypocrite and so you've got to go back and really

26:54 work on the receptive language piece too so talk with parents about you know oh and you know in this therapy activity that we're doing right now with this puzzle we're not even going to ask him to say anything we're just going to focus on how well he understands this so we're going to give him some little directions and you can certainly do this every single time every single toy you can work in receptive language with clean up time and so let's go back to your puzzle example so if you've done the puzzle and then to clean that up you can say to a child where's the boat clean up the boat and you can have him throw the puzzle piece in a bag that you have or a basket or anything that you've designated as your clean up material or your clean up container and so you do that you really you really model that working on receptive language and you always like we said tie it back to we are setting the stage for him to

27:41 talk now because he understands more language and we say you know once your child understands more we know he's going to be able to say more and we say things too like kids anytime there's a problem with understanding language they're going to talk late and they're going to talk less and so we tell parents and we say you know the only way we're going to get there with him talking is to help him understand more and more words and so a lot of times with parents too when we say these things when we talk about following directions or even talking we'll we'll say that and they'll say well it's not that he can't do at large it's just that he won't do it and they try to label everything his behavior and so if you have a parent who's saying things like he's so lazy he's so stubborn you know you know right then that if you're not prepared to do it when they first say it you know you better address this and get yourself a

28:27 little script before you meet with that family again and say you know i want to go back to talking about this it's not that your child can't talk it's not that your child can't follow directions or i mean it is that your child can't talk it is that your child can't follow directions it's not that he won't do it and so you say it's not that he won't do it it's that he can't do it and you help them make that really really important shift and that really really important distinction because we treat kids differently when we know something is a developmental issue versus a behavioral issue when it's behavior what do we want to do we want to punish it we want to control it you might not even say punish it but we want to reward it if it's good but usually it's that negative part is that we want to extinguish it we want to get rid of it and so you have to talk with parents about that and say that's

29:12 not what's going on here that's not my take on this knowing all i know about language development that's that's not what's happening with your baby he doesn't understand words yet and we've got to get him to understand words and when he does you will see you will believe me at that point because when he understands more he's going to do more and when he understands more he's going to say more so help parents with that now i call this little talk my camp versus won't talk i started writing about this way back in 2008 when we launched teach me to talk lots of other therapists have borrowed my words which is fine i wish they'd give me credit but it's fine but go back and and look at some of those articles that teach me to talk with can't versus swamp because it is a huge shift that if you're a professional and you haven't made that shift that's something you need to do today

29:57 so that you again you're not mislabeling these things or helping helping a parent just really solidify their belief that their child is stubborn and that's why they're not talking and so really help parents get through that and move through that so either way when we when we have a kid that we're working on let's look at this when we have a kid that we are again thinking that it's just he won't talk not that he can't talk again we could be so authority authoritative we could be so just overbearing with that kid and then what happens you end up in a power struggle especially with the parents who want to quote unquote punish bad behavior that's what they're doing about talking they're like you got to say it or you can't get it you know when they're holding the milk up and no wonder their kids you know thralling around on the floor and

30:44 flailing around on the floor because he's upset he knows he can't do it and so we have to really help parents do that they're on the other hand you have parents that are so passive about their child not talking you just won't do it and they've kind of given up and you need to energize those parents and say no no he can't do it you're going to be able to teach him how to do it that's what this therapy is for and again you give them energy so they're not just so passive about it either way we've got to change parents whether it's thinking about following directions so they can understand more words and then say more words or talking we have to move parents from who won't do it too he can't do it all right so let's go back to our strategy of simplification so what are we doing here we are going to simplify what we're saying so that we can give

31:31 lots of single words and single words too we're going to repeat those keywords and help kids pull that those keywords out of all that blah blah and then we're going to again be sure that they are linking that meaning and repeating it enough so that they know what to say after that so simplification usually means saying less so let me give you an example and this is an example i've used for a long long time so let's say that you want to give your child a treat that you got the day before at the grocery store and so you might say something like sweetie look my mommy god i got this tree for you yesterday at the grocery store remember you were with me it was after we dropped your sister off at ballet but before we picked your brother up from soccer and i just know you're gonna love this and we just go on and on and on and on and on and if this is a

32:17 cookie that we have gotten from the grocery store did we even say the word cookie in that example no and so that's what a lot of chatty parents are doing they hear just talk to your child talk to your child talk to your child and they don't realize again because like talkers have kind of that natural pre-decision predisposition to not processing and understanding words as quickly as their typically developing counterparts we don't know that and so we don't give them their keywords and we don't repeat like they should so that's certainly something instead of that example i gave you it would be much more effective to say cookie want a cookie look cookie and offering it that way because we've modeled the keyword three times we've slowed it way down we've

33:02 taken all that other extraneous junk out of there that is important for a child to be able to understand more and more language but at the same time if he's not talking we know we have to modify it and when you give a parent an example like that they can see the difference and it kind of takes the pressure off too because they know they've just got to get the key word and they've got to repeat it and the other thing they need to do is really put it at the ends of phrases so want a cookie would be better than having cookie in the middle or cookie at the beginning so talk with them about that now therapists call this modeling you know what it's called as a professional but you need to be sure your parents understand what that means that i like calling it simplification we're going to use lots of single words those keywords we're going to repeat those keywords a lot because kids have

33:49 to hear them over and over and over before they understand them and then before they say them and then we're going to put those keywords at the ends of phrases and we'll continue to talk about that more as we move through the strategies all right the third strategy that we want to use to help a late talker that we're going to teach his parents it might be something he's not already doing yet we're going to teach moms and dads to respond to and repeat every single noise their child makes now will they do it every single time no but can we get them doing it more consistently yes and why is this possible and you may be like me and not have valued reciprocal imitation as much as you should have as a therapist and again if you're a parent reciprocal imitation just means that you you want

34:35 that child to imitate you so that he can learn how to talk but before that he you might have to imitate him and again i just read a piece of research if you'll go back and listen to that show 419 that talked about what they they took a set of kids at two a set of toddlers who were classified as language delayed and then they reassessed those kids at four and one of the factors that well let me just give you both the factors the two factors that that made a difference with between kids who had a language delay at two and who made enough progress to no longer have meet the diagnostic criteria for language delay at four they didn't have the comprehension delays at 20 months all right great we talked about that they didn't have as much ground to cover they already understood what words

35:20 meant so then they could just focus on talking but the second part was their parents were good at imitating any non-words the child said so non-words what are nine words it's when they just babble or when they just say uh when you think they're talking about something and then you repeat that to them and then you assign meaning and so they found a link there one of the things that study talked about something i mentioned before too that i want to mention it is again because we know light talking can be genetic that sometimes parents again as adults continue to have those those auditory processing skills where they their their auditory discrimination skills aren't as great so if their kid says aga they may have a hard time saying aga because they didn't really understand they can't make it make sense it's a

36:06 non-word so they don't want to do it and so again a parent might miss that a child saying a god a god and he might be trying to say dog i mean it might sort of be on enough so that we rose-colored glasses therapist people who can kind of make a word out of anything we might get it and sometimes parents can do that again to a fault where they're just interpreting everything is purposeful but it's really not but here the the theory is that all words start as non-words and so when a parent gets good at repeating a child what they're saying they're focused on that child they're tuned into what they're saying and they're more likely to try to shape that word now as therapists we are very very uh familiar with the word shaping and so we have to uh talk about that though in a way that a parent will understand it

36:52 and so let me give you an example so let's let's use that example we already started with started with let's say that the kid looks at a dog and says uh or a guy or duh or something that a parent thinks well that might be dog because one of those sounds is in there and he's looking at the dog and so what do you do you say you repeat them if they said ah you say yes ah dog you're trying to say dog that's a dog ah dog whatever they have to do to kind of get it there and so help parents get in the habit of that and so for parents again living in this technology driven everybody has a dd because of all the screens we're attached to all day and all the alert bells that are constantly going off and so when we talk about to a parent you

37:38 need to repeat everything or most of what your child says that also gets them to tune in and really again help them kind of disconnect and know how important that is and so it's also a good strategy here when parents are doing a lot of that reciprocal imitation we don't always want the kid to try to say what he said we don't always try to get that expressive in there but i have found when i'm modeling this for a parent or when a kid just does it in therapy and he picks up something let's say that he picked up my glass here my yeti here and he wants a drink and he goes ah and you say oh you want a drink or cup i would probably go with cup i would try to match them out of their cup oh you want my cup you want a drink from my cup laura's cup and so you're modeling in

38:25 and then before you give them the drink you say yes you can have it it's uh or what do you want you wanna and you are setting up that that carrier phrase so to speak but really that fill in the blank or completion method that we're gonna talk a lot about in a minute with verbal routines but you're setting that up and a lot of kids will then repeat their word that they try to say for that if they said uh when i'm saying it's uh and they say ah again for cup and you're realizing yes that is what he's trying to say and so uh this may be a tad a little bit of a reach from that study that we just talked about but our point is that we want reciprocal imitation well established in our families because it really helps them pay attention to what their kid is trying to say and it gives us something to shape if we already know that a kid is trying to do

39:12 that and we're going to recognize that he has a lot more word attempts than we may have thought that he previously had and so we want a kid to learn how to imitate us which we're going to talk a lot about in the next strategies one way we can get there is by imitating him and so be sure that the parents that you're working with understand reciprocal imitation and that you're able to model that strategy for them all right let's move on now we're going to talk about strategy number four instead of focusing on a child to say words we're going to focus on something that's easier for a child so we're going to teach a child to use play sounds and what i usually how i usually say this to parents is hey before a kid starts to talk he has got to get noisy

39:58 and i'm hearing your child say a little bit but he's still pretty quiet so we've got to get some noise and then what i say about that is and you know what he's not really ready for words yet there's some things that come before words that i think that are going to work a lot better for your child and i think this we need to meet him where he is right here and i'm hearing him say a lot more sounds so this is what we're going to focus on instead of less words and i say less words more noise and so that's what we have to help parents understand lots of times and if you'll think about this as a therapist when we first get a child when they first come to us for their assessment or evaluation sometimes they'll already have a little

40:43 handful of words and sometimes they're real functional words like mama or baba but sometimes late talkers come to us and pardon me with just words like uh oh or words like animal sounds or a little noise he'll make he'll do like a little er and you'll you might not even know what he's saying and you'll say to mom what's that and she'll say he wants a car that's what he says for car and so they adopt their little sounds to be meaningful so that's why when a lot of kids start to identify animals they'll call their animal the the sound that it makes instead of so instead of calling a cow a cow they'll call the cow a moo and when you have this kind of thing with a kid and instead of really trying to change all that to a real word at the

41:29 beginning if they're like talker we need to go with that we need to maximize that and so again we start at a level that's a lot easier for a child with the language delay and so i'm not meaning that we're going to do individual phone names if you're an slp and i might you might think that i'm meaning that we're going to teach a sound in isolation you know we're going to really get it going right here and say watch me now say pop we're not we're not doing anything like that with a light talker we know that we cannot worry about that articulation and again if you're a therapist i know you've probably already broken that association in your mind but uh sometimes our therapists in other fields haven't our deep friends that are dis or developmental interventionist or preschool teachers or certainly parents sometimes they really think oh i better start with the sound

42:15 so i better teach my child the alphabet and how to produce every sound and then he's going to be able to say words talk to parents about no our beginning our our basic unit of meaning here is still that word and we have to do that with late talkers we can clean up those specific sounds later but they've got to be talking first before we do that so what i'm talking about here would be like like i said before more like sound effects or those exclamatory words like uh oh and wow and we and oh boy you know even if they're or it's even more than one word even a little phrase a holistic phrase and so we want to meet kids where they are and get them saying words that are a lot easier most of the time they are easier uh phonetically or phonemically when we

43:01 look at them their sounds or even how we would transcribe that it's an easier pronunciation it's certainly more novel which makes these kinds of sounds so fun for toddlers to try and if you'll think about it too uh in a typically developing babies repertoire there between six months it starts kind of with a fake cough you know they're trying to get your attention and they learn that that's real funny and so they'll play a little game with you and our late talkers sometimes don't do that with with just those noisy kinds of sounds and so if we're working with child and a family that they haven't done that i i say this is what i say i say we've got to go back and pick that up we've got to get that little vocal play stage going and you might have thought that he babbled and then he stopped or you you know whatever you're saying to the parent you know you told

43:47 me that he babbled and then he kind of got quieter we got to go back and pick that up so we got to make him noisier and i tell parents listen this is a lot easier than teaching him how to babble and some therapists really do talk about babbling and we'll really model that and really try to get that going with the kid but i think these play sounds are an easier way to do it especially with a toddler who is more likely to be able to imitate these things because they're fun and because they're meaningful we start to assign meaning and then recognize that and so that's why i like using these little examples so we let me give you some more things to do so let's go back to our our farm animal example because animal sounds are so easy for parents to under uh kind of get this or even with vehicles play with those things in a session with a parent and say you know we're still going to talk we're still

44:33 going to say oh look here's our car you know ready set go you know we're still saying ready set go but we are we are interjecting all of these little sounds in there and again you would do it in context it wouldn't sound as fake and as i did it then you're going to do it with the car and so it's going to sound a lot better but you say to a parent i just i want to focus on how you and i right here together how many different sounds we can come up with and you might say to a parent listen we don't want 35 different sounds we only want you know maybe five new little sounds here but we want to come up with a lot of sound effects that we can use in play rather than all these words and so just walk through them with that you know sit down with their toys sit down with what their child likes to play if he loves thomas the train and

45:18 mom has been saying thomas it's thomas look thomas say thomas with no success you've got to really back that up so you could say you know let's just say things like or let's say when the train crashes into another train we're just going to go oh you know and just give her all kinds of sounds and if you get really smart about it as an slp and you can sit there and say kind of think well how have i heard this child vocalized what kinds of sounds has he made as he's vocalizing here and you might even be able to sit there and be so on the ball that you're thinking he's got some bilabials in his or even in his little vocabulary here let me come up with some play sounds that have some bilabials because i know that he can do

46:05 it and think about that you know think about those kinds of things and think about how you can share that with a parent and say hey he's got some you know he says mama all the time and so when we're playing with this car you know let's try to just say um you know let's try to get that m or let's say b b because that little b is made at the same place in his mouth as that m and so i think he's got a pretty good shot at being able to say that word and so put on you know put on your thinking caps here use your clinical skills and your analysis here with the sounds that a child can say and come up with some sounds that you can have a parent do that with and really really hit home the fact that your child isn't successful with familiar words yet that's fantastic we know that we are we are going to adjust for that so we're

46:50 going to pull back and focus more on sound effects which we call play sounds and talk about how to do that and also get parents doing that in their daily routines and so when you're looking at a child's favorite toys and favorite activities include those little daily routines and introduce even some little routines yourself you know say oh let me teach you a trick after he does after he takes a drink does he say ah you know and if my if a mom says no teach him that trick or she says well he's done it a couple times say that'd be great you know you realize you're practicing a you're practicing an h sound and you're getting him ready to do it and he he's going to learn how to do his part in conversation so you know he's going to take the drink and his little job here is to go and you're going to clap for him and you're going to cheer for him so you're going to reward him and reinforce that

47:36 attempt and so talk about that say in the bathtub when that water is running or when you're washing him off let's see if we can get just kind of a shh let's see if he can do that kind of little sound and so give them just some really specific things to work on you are going to get a ton of information from a parent after that a ton of information about that child's uh repertoire of the sounds that he can say when he's adding new little play sounds there and so it's just a wonderful wonderful strategy if you're not already using it if you have my book building verbal limitations skills and toddlers you'll know that this is a whole step a whole level that we teach kids way back here with level four and you know we always talk about words are way

48:21 up here at level seven and so we've got to get kids back here doing these easier earlier things and so you'll certainly want to do that too so i wanted to mention that to you in case you have that book and you can use that resource all right let's move on to the fourth strategy for helping the late talker and that's making it as easy as possible to use real words now we talked about play sounds and how we have to introduce more play sounds because the child is not able yet pardon me to use single words simple familiar single words and so now what we're going to do we're going to make it just a little harder than the play sounds but not quite as hard as him imitating a word on request for us so we're going to take his familiar words and we're going to tie it to make it highly predictable

49:07 and make it super familiar meaning that we're going to say it over and over and over and over and over until that child begins to recognize the word and eventually say the word himself and so what how do we do this this is how we use verbal routines now if you follow my work you know what a verbal routine is it's when we say the same things at the same time with the same words in the same way however i have said it when you've heard it before it's that we do the same the same the same the same the same and so this will make it easier for a child to talk because again he's going to hear it but then we're going to take these really super familiar words that you have said over and over and over and over and that we want him to say but he only is going to say it right now we know because of what we know about

49:53 language development and neurological uh how this how all these words come into being we're going to make it automatic and so if you'll think back to your adult neuro patients those of you who are slps that went to grad school we know that when a person loses language because of their because of an assault to their brain to their neurological system like a stroke or like a head injury when they've lost language the number one strategy that we need do as slps to get it back is automatic speech so we start out with things like counting with things like singing familiar songs that they know if they went to church we sing hymns if they were in the military or patriotic we we sing patriotic songs you know we pull we sing just highly familiar songs if they like country music and their wife says gosh he used to sing you know

50:38 this straight song all the time we sing george strait right we get it back for them the same theory can also be applied to our late talkers we've got to make it so automatic the only way we do that is with time it's with saying the same things over and over and over and over and over so let's talk about what some common familiar verbal routines are it would be things like ready set go one two three anything that a child can learns and can kind of and this is a neurological principle too it's called backward chaining kids learn from the back to the beginning from the end to the beginning and so we know this and so we set up our verbal routines things that we want to eventually have a child say

51:23 so that we're putting those key words like we said at the beginning when we were talking about simplification we're putting those keywords at the ends of phrases so to say go at the beginning when we want to teach the word go to a kid who's not talking at all we know okay i can probably get it in ready set go and so we come up with all kinds of little routines to to work on that and to have a kid learn that and know so his little brain predicts what's going to come next and so that's the kind of thing we need to do and so again we talk about with parents the songs that they sing the books that they read the things that their family says over and over and over again those are the things that a child is more likely to be able to say before we even get to him imitating other kinds of

52:10 words and again our point here is to make those words become automatic and so it's the predictability and it's the repetitiveness and again remember what we said at the beginning when i was talking about time and i said when when a parent seems distressed about their child isn't making enough progress i always say it's time we have to put in the time he's got to have the time and i don't mean time like his little system has to catch up he'll talk when he's ready i don't mean that i mean time as in we've got to do the strategies we have to give them the opportunity we have to set the stage we have to build a foundation and so it's the same thing here with verbal routines when we get that little pump primed enough

52:56 kids do talk they do and so we've got to be predictive predictable and we've got to be repetitive and so that's again what verbal routines help us really do with kids the routine becomes familiar the child begins to participate link meaning and then he begins to say the word himself so let's talk about an example so we already talked about ready set go let's do one two three because a lot of parents like to count and they'll start to work on things like counting and saying letters and numbers and shapes and all that and we're not necessarily talking about any of that you know until a child has a lot of words we don't need to worry about teaching that but something like one two three could be the start of so many fun little routines so let's just say that your child likes uh to be thrown up in the air and so you could

53:41 start to count you know before you do it you can pick him up and you're gonna say okay let's play i'm gonna throw you up are you ready let's say it one two three and then you throw them up or throw them in the pool or throw them on the couch or however you want to do it so three kind of becomes that little uh word that automatic speech that he's going to try to complete and so you tell the parent you're going to play it this way over and over and over and over and over but then you're going to stop and you're going to use a technique that we called expectant waiting where you pause just long enough for a child to fill in that word and so because you have said one two three 250 times before you expect him to say it his

54:27 little brain expects that and he he's gonna he's waiting for you to say three so if you set it up again where you've played this a lot and then you do your same thing oh i'm going to throw you up let's play are you ready are you ready come on here we go one two and you pause there and you wait and you give him the tell me face and i wish i'd made that up but i read it from a blogger from a long time ago who doesn't even have her blog anymore but that tell me face where you were looking at him with wide eyes and kind of an open mouth and you're leaning forward and all of your body language screams it's your turn to talk and so we pause right there for them to

55:13 fill in that word and so this is a highly highly highly effective strategy does it work for every single child right away no why because you've got to get time you've got to teach them that routine so let's say let's do let's do something let's do another another example let's do ring around the rosies that's one of my favorite games with toddlers with kids in general but really with toddlers because we're working on that social interaction piece where they're learning we're going to play together you're going to stay with me you're going to look at me you can't play this game by yourself and i can't play this game by myself so we have to play it together and so for bringing around the rosies that we're holding their hands and we're singing ring around walking in a circle so let's set it up in case you don't know that game so we hold hands we

55:59 i do the ready set go with the beginning of this game because i or if they're doing one two three we'll do one two three but you do your little ready set go ready set go ring around the rosie's pocket full of posies ashes ashes we all fall down and so we do that and so again you can tell by my singing voice you do not have to have a perfect singing voice you can have key changes all through your songs with toddlers they don't care and so you've set that up though you've played that little game and so your little all fall down so you're gonna at the end you're gonna play that game you're gonna play ring around the rosies a lot but when you think your kid knows it and loves it when his eyes are twinkling when you're playing when he plays with you when he

56:45 grabs your hand to pull you up to play again you know this is a great game for them after a while you'll pause there for the the second part ashes ashes we all fall and again pause there to see if he's going to fill him down but it doesn't work unless he's heard it enough so i hope that that strategy will help you too you've got to choose a few verbal routines to get late talkers going have moms say those routines a lot and and don't just have it tied to they only say ready set go when they play chase they can say ready set go when they play with their racetrack with cars or when even when they're getting ready to open the door to go outside or when they're ready to turn the water on in the bathtub you know you can use ready set

57:31 go all day uh just think about how you can blend these kinds of things in especially if they're not like a game like ringing around the roses where it's tied to just playing that game but think about that with parents and this is part of their little 10-minute burst that they're going to do you're giving them concrete specific things that they can do in those little 10-minute periods that they're going to try to intersperse throughout their whole day so those verbal routines really really are effective but you've got to teach them do it a lot you've got to put the time piece in then you have to teach them how to do that pause there with that expectant weighting so that those those are the strategies i teach most often those five strategies so let's review number one what are we going to do we're going to devote more time to working on language and so how do we do that we don't scare parents with this we don't maybe not beat them

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