Written by Donna Davies, Speech Language Pathologist
Donna Davies is a Pediatric Speech-Language Pathologist with over 30 years of experience. She owns Dragonfly Therapy Services, a private S-LP clinic specializing in early language delays, speech sound disorders and persistent sound errors in older children. Recently, she has added Orofacial Myology to her skill set.
Is your child struggling to talk? Does your child say only a few words, say only “uh uh,” or point at what he wants? Have you tried all the tips and strategies you’ve found online and nothing seems to be working? Do you feel like you never really know how to combine all the strategies to effect a change? In this article, a Speech-Language Pathologist (SLP) with over 30 years of experience shares her step-by-step plan for parents to follow to help their child “get the words going.” By following these steps, parents will learn strategies to change how they communicate with their child creating better opportunities for imitation and paving the way for words to emerge.
1. Stop asking questions
Asking questions is the number one roadblock to helping a child with few to no words, but question-asking is hard-wired into the communication mindset of a parent. Eighty percent of what an adult says to a child is a question!
Asking questions and having our child answer is a way that we can ensure our child is learning. For example, when we say, “Where’s the monkey?” and our child points to the monkey, we know he understands. When we say, “What is this called?” and our child answers, “Monkey,” we know he has the word. We also use questions for clarification and validation. When we ask, “Do you want the monkey?” or “Is that the monkey?” your child’s yes/no answer clarifies his request or validates what you already know to be true. These examples are valid reasons to ask the question, but question-asking is a receptive language activity focusing on how a child understands the language.
Most children, even those with few words, typically understand more than they can express. A child with few to no words can often answer yes/no questions as he can point, nod or say yes or no. However, questions fall short when used as a strategy to help a child who is struggling to make sounds and words build his expressive language (using words and sentences). For a child with few to no words, questions create frustration, or at the very least only reinforce your child’s ability to nod or say yes or no. A child cannot get their wants and needs met if he only can say “yes or no.”
Picture this scenario, a parent takes her 3-year-old child to an SLP because the child only has a handful of words that sound like “mom, dad, baby, no and puppy.” During this visit, the SLP observes the parent and child playing with an animal puzzle and typically hears the parent say something like: “Do you want the monkey piece?” “What is this called?” “Tell Mommy what this is.” “Where does the monkey go?” “What does a monkey say?” “What color is the monkey?” “What does a monkey eat?” “Put the monkey there.”
This barrage of rapid-fire questions is a common way parents engage with their child; possibly more so when their child is not following an expected developmental path.
The problem with rapid-fire questions is that they happen quickly, with one question asked immediately after the other, leaving no opportunity for the child to respond to the first question even if he could.
In the above scenario, the parent reported their child only has 5 words yet the parent bombarded him with questions that required him to answer with words he doesn’t say. Asking a child to answer questions that require him to say words he is not yet using sets him up for failure and frustration. The strategy of not asking questions is often difficult for parents to learn, but it is the first step in changing how they talk with their child that in turn creates better opportunities for the child to respond.
2. Create opportunities to communicate
We want our children to use words to ask for things, make comments, and share their thoughts and ideas. For this to happen, they must have many opportunities to hear and try words when ready. As you’ve learned, questions don’t allow opportunities for a child to hear the “target” word because the question expects the “target” word as the answer but your child doesn’t use that word. If your child does not have the word to answer your question, why are you asking him the question?
To help a child who is struggling to learn words, parents must learn to stop asking questions. Then, they must learn to replace questions with a single word or make a statement. The goal of replacing questions (that your child cannot answer) with a single word is to provide opportunities for your child to hear a word many times so he can attempt it when he is ready.
Thinking about a really common question such as “Do you want water?”, can you predict what a child who does not say “water” will do when asked this question? He will likely nod yes/no, say yes/no or he might just make a grabbing motion if you are holding the water. What he will not do is say “water” because he does not have that word. To turn this common interaction into an opportunity to communicate, replace “Do you want water?” with “water?” By just saying “water?” you reduce a 4-word sentence to the “target word” or the one word you want your child to hear, to focus on and hopefully imitate.
Questions can be replaced with statements too; that is discussed more in Step 3. However, when providing opportunities for a child to just try a sound, a syllable or a word, providing just a single word, or “target word” is preferable. It is important to remember that when we use a single word in place of a question, we naturally use a rising intonation at the end of the word. As a result, a child may unintentionally interpret the word as a question and respond with a nod or say yes or no.
Regardless of whether your child interprets the single word as a question, you will use his response to verify that he does or does not want water. If he does indeed want the water you will say “water” again, but this time you will slow the word down by saying it sing-song like “waah-deerr”. You will also exaggerate your mouth movements, particularly on the vowels to really show how your lips round for the /w/, your mouth opens wide for the “ah” and then closes for the /d/ and “er”. By slowing down and exaggerating the movements of the word you’d like your child to say, you provide the best opportunity for him to imitate. From your model, he can try “wa”, “wah-wah”, “wah-uh” or “wahduh” and all of these attempts count as a word!
It takes a lot of practice to replace questions with a single word. To begin, listen to yourself as you talk with your child. Note when you ask a question. Become aware of how often you do this. Once you are catching yourself asking questions, begin asking yourself, “How can I say this as a single word?” When you hear yourself asking, “Do you?”, “What is?”, “Tell me what?”, “What are you?”, “Where is the?”, etc., stop and ask yourself, “Can I say this question in a single word that will create an opportunity for my child to try the word?”
For example:
Change “Do you want a cookie? to “cookie?”
Change “What is this called? To the name of the item – shoe, spoon, boat.
Change “Where is the ball? To the location word – under, behind, on.
Change “What are you doing?” to the action word – jumping, laughing, rolling.
Change “Who is this?” to the person – daddy, mommy, grandma.
3. Self-talk and parallel talk
When you have a “conversation” with your child and bombard him with rapid-fire questions you are not having a conversation! You are doing all the talking, but in a way that does not create opportunities for your child to respond to you or to try words. A conversation with a young child with few to no words involves commenting on what you think he is interested in; giving him time to respond (however that may look or sound like) and then replying to his attempt to communicate. It is a game of making a serve and waiting for a return.
Being responsive to your child is one part of a conversational exchange. But, for a child who is not routinely responding back, reducing or eliminating questions helps you naturally do 2 of the most common strategies used in speech-language therapy – self-talk and parallel talk. These strategies simplify your “serves” and create opportunities for your child to make a communicative return. Neither Step involves asking questions but both increase your responsiveness to your child’s communicative attempts.
Self-talk is you “narrating” what you are doing. You are simply talking out loud; giving a play-by-play of what you are doing. “I’m putting the cow on the barn roof. That’s silly to have a cow on the roof. Oh, no the cow fell off.”
Parallel talk means you are “narrating” what your child is doing, what you think he is interested in, and what you think has caught his attention. You are giving your child the words for things he sees, hears, touches feels and tastes. “That’s a big cookie. I see chocolate chips. MMMM, yummy cookie. Wow, you took a big bite. Num, num. I think you like that cookie.”
To narrate for your child, you need to be engaged in an activity together. You need to be watchful of what his body language, gestures and sounds might be telling you so you make your serve back to him count.
Self-talk and parallel talk give you practice in changing questions you hear yourself saying to statements. For example: “Are you building a tower?” can be “You are building a tall tower.” “Is your car going fast?” can be “Wow your car is fast.” “Do you see the puppy?” can be “I see a puppy outside. Hi Puppy.” Can I open that for you?” can be “I can help you open the bin.”
4. No pressure, no expectation
No pressure, no expectation means exactly what it says. When your child feels no pressure to communicate and feels safe knowing that you will do the talking, he will stay and play for longer periods. When your child plays with you for longer periods, you get more opportunities to model words and sentences than when he leaves the play because the communication demands are too great and he feels too much pressure to have to talk.
When you change questions to single words, use self-talk and parallel talk, you do so knowing that it will take time for your child to imitate you. Your job is to provide the words and share experiences but not to pressure your child to imitate you or have any expectation that he will. Additionally, parents must remember not to expect their child’s first attempts at words to be perfect or pressure him to say more than he is. His first attempts at words are the best that he can do. No matter when a child starts to talk, word approximations always come first.
Word approximations simply mean that the word your child said does not sound like the word you said. The approximation may have some of the sounds and vowels you used, but often sounds are missing, different ones are substituted and the vowels may sound wrong. For example, your child might say “da” for “car”, “do” for “go”, or “muhdee” for “monkey”. Or, he may just imitate back the intonation of the word with the vowels only so “Open” is “oh-eh”, “monkey” is “uh-ee” and “again” is “a-eh.” These are all examples of word approximations.
This step is a perfect time for parents to hone their skills of watching, waiting and listening closely. Watch and observe what your child is interested in so you can meet him at his level; wait for him to respond when you serve him an opportunity and then listen closely or watch for a response. If you expect to hear the word as you know it should be said, or if you are only expecting a word and you miss his subtle communicative gesture you will not hear his first attempt at words or see how he tried to engage with you.
Learning takes time, so being persistent and consistent is the motto for this step. Most children who are slow to talk will begin to imitate in time. For some children, they imitate a word the first time these strategies are tried. For others, it’s after a word is modelled 100 times or even 1000 times. It takes a typically developing child 12 to 18 months to start to use words so give your child the time he needs to learn.
5. “The rule of 3”
The Rule of 3 is the golden rule for how many times you offer a model before you give. It is easily remembered as “model, model, give”. This rule offers a no-pressure, no-expectation way to offer opportunities for your child to try a word. Your child will quickly learn that even though you are going to model a word 3 times, he will still get the desired object even if he doesn’t say a word. This sounds like you are just giving in to your child. What you are doing is giving your child lots of opportunities to just try without expectation or pressure that he will say anything. As the words come, and his vocabulary grows, different strategies come into play that will address spontaneous use of words and putting words together.
Putting it altogether
You’ve learned how using questions with a child who has few to no words is a roadblock to communication as questions create frustration. You’ve learned that you can change a question to a single word and that single words provide opportunities to communicate. You’ve learned that when you eliminate questions you naturally begin to do “self-talk” and “parallel talk” and that this style of communication increases positive serves and returns by reducing pressure and expectation. The Rule of 3 helps you create multiple opportunities to communicate during activities. These are the 5 steps you need to help your child start making sounds, syllables, and words.
Let’s explore how these 5 steps, when used together, can be a real game changer in how you communicate with your child; changing frustrating and unproductive interactions into incredible communicative opportunities that may lead to first words or new words.
Your child says, “Uh, uh,” as he points at the bubbles. You interpret his gesture to mean “I want to blow bubbles” so you don’t ask “Do you want the bubbles?” because you know the answer. Instead, you use the single word “bubbles” and the Rule of 3 (model, model, give) to create opportunity.
For Model 1 you say “bubbles?” Your child nods yes. For Model 2 you make the word sing-song and say “buh-uh-bles.” Again, your child nods yes as he reaches for the bubbles. For Model 3 you say “buh-uh-bles” again but this time you “give” and narrate by saying “I see you reaching for the bubbles. You want Mommy to blow the bubbles.” As you are narrating, you open the bottle and change to self-talk. You say, “I am opening the bubbles. I am going to blow big bubbles. Oh, look at the bubbles going up high. Pop the bubbles. Pop, pop, pop.”
You opened the bubbles and blew bubbles even though your child did not say “bubbles” because you had no pressure and no expectation that he was going to say “bubbles.” You were not expecting anything more than “uh”, a head nod, a reach or even silence. You just wanted your child to hear the word “bubbles” multiple times.
Keep the exchange going and maximize the opportunities to communicate by doing something you’ve not done before. Put the lid back on the bottle of bubbles and repeat the interaction described many times. After you model bubbles 2, 4 or even 10 times you may hear your child say “buh” “buh buh” or “buhbo” and now you have heard your child’s first approximation of bubbles!
By employing these steps, you reduce the pressure and frustration that questions put on your child, you create multiple opportunities for your child to hear and try a word when he is ready. But don’t stop here. Create more opportunities to communicate by using the Rule of 3 to mark each step of the process of getting ready to blow bubbles. Model “open” when the lid needs to come off; “out” for when the wand needs to be pulled out and then “blow” for when you are ready to blow the bubbles. These strategies have helped you create the opportunity for your child to try, when he is ready, the words “bubbles, open, out and blow” and move beyond “uh uh.”
Make communication your superpower
Are you ready to make changes in how you communicate with your child that will make changes in how he communicates? I can help you make communication your Superpower. Get in touch today and let’s book your free 30-minute mini-session. Regardless of where you are, if this article’s topic resonates with you, please don’t delay and seek a referral with your local Speech-Language Pathologist.
Donna Davies, Speech Language Pathologist
Donna has helped hundreds of children say their first words, overcome their speech sound delay and when others had given up, helped young adolescents master the /r/ sound. After a long career in health, Donna established a private practice focused on what she loves most, speech sound disorders and early language delay. Donna’s style of not “just doing therapy”, but rather empowering parents to develop the skills they need to help their child at home through personalized coaching, teaching and mentoring makes her approach unique. Donna has won the award for Best Speech Pathologist for 2 consecutive years in the city where she lives. She proudly holds 5-star ratings from the families of the children she has had the privilege of helping become talkers, and talkers that can be understood.
