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Language issues

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Julie Loe

Question:

My 19 month old daughter does not talk. She nods and shakes her head when asked questions and will say MaMa or DaDa if there is no other way to get our attention. She can moo, bzzz, and bark. Often, if you try to get her to say something she turns away and refuses to respond or will shake her head no. My pediatrician has recommended that she see a speech pathologist, but my husband and other family members insist that this is not necessary, She will talk when she is ready. Does she have a problem? Would a speech pathologist help?

Answer

There is no harm in having a trained pediatric speech pathologist do an assessment.

I commend you see a pediatrician for his recommendation. Too often parents are told to "just wait". Waiting is lost time in any child’s life. Time that can never be regained.

At 18 months children should be using 20-30 words, pointing to at least 4 body parts, shaking head "no", imitate 3 animal sounds, ask for "more, food, drink, and what’s that" and find familiar objects not in sight.

Children "should" have up to 500 words at the age of 2 years, be putting 2-3 words together, uses I and you, follow simple directions, point to pictures in books, understand prepositions such as "in, on, under" , and point to 7 body parts. A "red flag" at age two is when a child has less than 50 words and is not putting 2 words together.

The lack of language or the ability to communicate can impact other developmental areas, such as cognitive and social emotional skills. The inability to clearly communicate needs and wants can also lead to increased frustration and behavioral outbursts.

There are many ways to build communication in children.

If you have any concerns at all, what better news could you get than to be told everything is fine from the professional? But if she needs speech therapy , now is the time to begin!!

Language facilitation Techniques*

Follow the child’s lead
Try getting on the floor with your child to increase eye contact and proximity to one another.
Remain silent and wait for the child to initiate some behavior then respond
Establish a joint reference of attention
Establish a mutual focus of attention on an object, action, or person in the room.
Direct the child’s attention to your face by putting an object between you or up near your face
Follow the child’s line of regard
Respond to and encourage the child’s communication attempts
Notice the child’s verbal and nonverbal signals:
How do they use their gestures, eye gaze, head turns, points, frowns, smiles, body shifts, and vocalizations to initiate, maintain, and terminate the interaction?
Attribute meaning to the child’s vocalizations or body signals. For example, the child says: "Dada" and points. You say, "You want daddy to get the ball!"
Self talk
Talking aloud to ourselves and verbalizing what we. are seeing, hearing, touching, doing, or feeling in that moment. There is no expectation on the adult’s part for the child to listen or respond to this talk. It merely provides a model of the act of expressing oneself.
Verbally state the dynamic actions (I have a cup, I drink water, oh-oh it’s spilling!).
Parallel talk
Talk aloud about what the child is seeing, hearing, touching, doing, or feeling.
Talk about or imitate (with another set of objects) the actions with objects that the child is focused on.
The child selects what is interesting to them.
No demands are placed on the child to respond.
As the utterances you produce are highly related to the child’s own interests, there is a greater probability that the child will join into the interaction either verbally or nonverbally.
Verbally state the dynamic actions (You have a cup, Your thirsty, oh- oh its spilling!).
Expansions
The child’s self-initiated utterances can be responded to and expanded.
Repeat the child’s utterance but expand it with more words, new word endings and related concepts. For example, the child says, "Baby sleep." You expand with: "The baby is sleeping," or "Yes, baby is asleep."

*Adapted from Language Intervention with Young Children, Mark Fey 1986 and Transactional Approach to Early Language Training, McLean & Snyder-McLean 1978

For more information on language development the following resources are available:

The New Language of Toys, Teaching Communication Skills to Children by S. Schwartz Ph.D, & J. Heller Miller M.Ed.
Talking Together: A parents guide to the Development, Enrichment, and Problems of Speech and Language, K.F. Schetz. & S. K. Cassell, Pocohontas Press Inc, Blacksburg VA
Hearing Equals Behavior by Guy Berard (Very popular with parents )
Voices by Oliver Sacks. While this book is technically on deafness, it has a lot of wonderful writing on language acquisition. Oliver Sacks is the neurologist who wrote Awakenings.
Childhood Speech, Language, and Listening Problems: What Every Parent Should Know by Patricia McAleer Hamaguchi
In association with Amazon.com. Available now at Amazon.com.
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Last modified: January 26, 2013