Speech and Language Milestones: 30-36 Month Development

We’re continuing our discussion of typical language development and red flags for communication difficulties for children ages birth to 5! Below you will find a list of age-appropriate speech and language skills for children ages 30- to 36-months. If you have questions or concerns about your child’s speech and language development, feel free to contact us at info@playworkschicago.com or 773-332-9439 to set up an evaluation.

Stay tuned: “Speech and Language Milestones: Ages 3 to 5” is up next!

Autumn Smith, MS, CCC-SLP
Director of Speech-Language Services

Typical Speech-Language Development (24-30 months) & Red Flags for Communication Difficulties

Children vary in their development of speech and language, however they follow a natural progression for mastery of speech and language skills. The table below outlines speech and language skills that are typically developed between 24-30 months of age as well as red flags for communication difficulties. If you are concerned about your child’s speech and language development, it is recommended that you consult with a speech-language pathologist or your child’s pediatrician.

Coming up next: Typical Speech-Language Development (30-36 months) and Red Flags for Communication Difficulties. If you have questions or concerns about your child’s speech and language development, please feel free to contact us at info@playworkschicago.com or (773) 332-9439.

Claire Kakenmaster, MS, CCC-SLP

Typical Speech-Language Development (0-24 months) & Red Flags for Communication Difficulties

Children experience so much growth with regard to speech and language in this relatively short amount of time. It can be difficult to know what is expected and when. Use the chart below as a guideline to review your child’s progress or to see what skills might appear next!  If your child presents with red flags for communication difficulties, it is recommended that you seek guidance from a speech-language pathologist or your child’s pediatrician.

For those of you with children over 2 years of age, stay tuned! And as always, feel free to contact us with any questions or concerns regarding your child’s development.

Ana Thrall, MS, CF-SLP

Let’s Talk Screen Time!

Let’s Talk Screen Time!

How it may affect your toddler’s speech and language development:

https://digitalpublishing2015.wordpress.com/2015/01/11/technology-educating-todays-digital-native-children/

Screens are nearly impossible to avoid in our daily lives, from televisions, phones, tablets and even screens in cars and emerging in public transportation. New research by the Hospital for Sick Children in Ontario launched research findings indicating that children under the age of two spend an average of 28 minutes daily with a handheld device. Strikingly, every 30-minute increase in daily screen time was linked to a 49% increase in expressive language delays (using sounds and words to communicate). The study did not find a link between screen time and social or gesture communication skills.

This new research is just the beginning of more research to come, but supports the American Academy of Pediatrics’ recommendation of limited screen time for toddlers:

  • For children younger than 18 months, avoid use of screen media other than video-chatting.
  • Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they’re seeing.
  • For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs.
  • For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.

While the research is out, it can be difficult to avoid screens in our daily life. Here are some tips to make screen time more beneficial for you and your toddler.

  • Pick age-appropriate apps or programs. Apps or programs built around daily routines of grooming, playing and eating are easy for toddlers to relate to!
  • Play and/or watch together! Make this a special time with your toddler and practice stopping the screen to talk about what is happening and how that might relate to your life.
  • Set a timer. It is easy to get caught up in an activity, set a timer for a clear expectation for you and your child to know screen time is over.
  • Take videos and pictures of activities you and your child play together, look back at the pictures and talk about the activity!
  • Designate non-screen time into your day. The vast majority of your child’s day should be spent interacting with toys, peers, and caregivers to build cognitive, problem solving, positive social-emotional, gross motor, fine motor, and speech and language skills

Jessie Delos Reyes, MA, CCC-SLP

Full research details:

http://www.cnn.com/2017/05/04/health/babies-screen-time-speech-delays-study/index.html

https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/american-academy-of-pediatrics-announces-new-recommendations-for-childrens-media-use.aspx

“What is auditory processing? Does that mean my child can’t hear?”

“I think my child has a hearing problem. They don’t always follow directions and often need me to repeat things.”

There is a common misconception among the families in the speech and hearing world that a child who presents with an auditory processing disorder can’t hear or that a child who has difficulty answering questions or following directions has a hearing impairment.  While the term may sound confusing as both issues concern the auditory system, they are in fact very different from one another. Below are some fast facts on what auditory processing is and is not.

What it is/may present with:

  • Auditory processing disorders are conditions where children have difficulty processing the meaning of the sounds they hear.
  • A disconnect between what the ear hears and the brain processes
  • A breakdown in receiving, remembering, understanding, and then utilizing auditory information
  • The inability to interpret, organize, or analyze what they’ve heard.
  • May have difficulty following directions, especially more than one direction/step at a time
  • May often need information repeated/rephrased
  • May need extra pause time for processing before responding
  • May look confused, give a blank stare, or often ask “huh?” or “what?”
  • Appear easily distracted or bored, especially when conversations/activities don’t include visuals
  • May become upset, angry, or frightened by loud noises and noisy environments
  • Increased difficulty understanding speech in noisy environments
  • Display poor memory for words and numbers
  • May have difficulty with complex language such as word problems, riddles and jokes, or a long story
  • Struggle to hear the difference in similar sounding words
  • Have difficulty paying attention for appropriate amounts of time
  • Have difficulty expressing complex speech
  • Struggle with language skills, including reading/reading comprehension, spelling, vocabulary, and understanding information presented verbally

What it is not:

  • A hearing impairment; all the parts of the hearing pathway are working well.
  • ADHD, Dyslexia, or Sensory Processing (although many children with these disorders struggle with auditory issues as well)
  • Not the result of more global deficits such as autism, intellectual disabilities, attention deficits, or similar impairments.
  • Not defiance or laziness in a child
  • It is not rare-research suggests it is in 2-7 percent of U.S. children
  • Not a lack of intelligence

Diagnosing either hearing loss or APD requires a multidisciplinary team:

  • A pediatric ear, nose, and throat (ENT) doctor will assess any medical problems with the hearing pathway (e.g. ear infection, fluid in the ears, etc.)
  • An audiologist will test hearing sensitivity to determine if there is a hearing loss and administer the series of tests that will determine if APD is present.
  • The speech language pathologist (SLP) will test developmental milestones in speech and written language.
  • The teacher or an educational expert will look at/identify academic difficulties (as well as implement modifications to the classroom after diagnosis)
  • psychologist will evaluate cognitive functioning.

Things to remember:

  • Even if your child has multiple symptoms of APD, only careful and accurate diagnosis can determine if APD is actually present.
  • Although a multidisciplinary team approach is important in fully understanding all difficulties/aspects associated with APD, the diagnosis of APD can only be made by an audiologist.
  • Treatment of APD is highly individualized. There is no one treatment approach that is appropriate for all children with APD.

For further information, call us at PlayWorks Therapy, Inc. for a language evaluation or ongoing therapy after your child has been diagnosed!

Therese Schmidt, MS, CCC-SLP

Using Mr. Potato Head to Practice Speech and Language Skills

Mr. Potato head is a versatile toy that can be used to target many speech and language skills.

The following are concepts that can be targeted while playing with your child:

  1. Identifying body parts: Ask your child to find Mr. Potato Head’s eyes or his nose. If they have trouble doing this you can narrow down their options by giving them a choice of two. You can then ask them to find their own eyes, nose, etc.
  2. Requesting more: Before handing your child another piece, have them request “more” at their current level (i.e. eye contact, pointing, signing, or verbally.)
  3. Following directions: Practice following directions by asking your child to hand you Mr. Potato’s hat, hands, etc. Make sure that they know which part you are referring to so that they do not have increased difficulty following the direction. You can also have them perform an action before receiving a new piece. For example, ask your child to clap their hands and reward them by giving them a new piece.
  4. Teaching Action words: Teach action words through Mr. Potato Head such as running, jumping, sleeping, eating, waving, etc. You can model and label the action for your child and then have them practice.
  5. Pretend play: Perform routines with Mr. Potato Head such as eating breakfast, taking a bath, or getting ready for bed.
  6. Early location concepts: You can hide pieces around the room and ask your child to find the piece on the table, in the shoe, or under the chair. If they are not at this level yet you can model for them (i.e. “look! His nose is on the chair”.)

Katie Dabkowski M.S., CF-SLP

Spring Break Speech and Language Opportunities

As spring break approaches, parents frequently ask what they can do on their various trips so their children don’t fall behind and they can help maintain progress in speech. Without their house full of toys, they are often at a loss on how to play and incorporate speech and language practice. The short answer is, pretty much everything involves language and ordinary activities can easily be turned into a targeted speech and language opportunity! With a new environment, it can present lots of new opportunities for increasing vocabulary and new ways to use language they already have.  No matter where you find yourself, from airplanes to hotel rooms, beaches to mountains, there are lots of opportunities to talk with your kiddo. Here are some specific examples:   

  • Identifying/Labeling: There are bound to be a lot of familiar as well as new and exciting things to see wherever you go. Depending on your kiddo’s goals, give them specific things to look for and identify or have them label things they see for you to look for. Make an “I Spy” game out of it for some back and forth fun that can be played in the airplane/car or exploring the new scenery.
  • Imitating actions: This can be a great opportunity for teaching new verbs. Have your kiddo imitate your actions and then see if they can identify/use them when they come up again. Whether it be swimming or building sand castles, hiking/climbing mountains, riding new rides, or even licking an ice cream cone, there are countless activities they will engage in that will present opportunities for practicing language.
  • Follow directions: Whether you’re doing it intentionally for language practice or simply trying to keep everyone together at a theme park, there will likely be novel directions given (and hopefully followed!) wherever you go. Take this opportunity to practice directions at whatever level your kiddo is practicing/performing (i.e. simple commands, one-step directions, two-step related or unrelated directions, etc.) Remember to use language at their level and one level above to ensure they understand and can be successful. Make a game out of it to make it fun while they’re still practicing goals!
  • Use your imagination! Whatever the trip entails, there are always ways to encourage language. Don’t forget to label what else you see throughout your trip to give them a language model of these new and exciting things in their environment!

Therese Schmidt, MS, CCC-SLP

Using Play-Doh to Target Early Language Skills

One of my favorite toys that I like to use in therapy sessions is Play-Doh. The possibilities are endless and kids tend to have so much fun! The following are several goals that can be targeted while playing with Play-Doh with your children:

1) Imitation of Play Actions: Typically, kids learn to imitate our actions before they learn to imitate our sounds and words.  You can use Play-Doh to target this early imitation skill! Demonstrate different actions with the Play-Doh and praise any attempt your child makes to do what you do. Examples include squishing, rolling, making a ball, dropping, patting, etc. You can also bring in other props such as a rolling pin and cookie cutter to make different shapes. You could also incorporate other toys such as cars and have the cars roll over the Play-Doh, run into the Play-Doh, etc. You could even pretend that the Play-Doh is a car or a train and make it move across the table. Again, the point here is for your child to attempt to imitate what you do with the Play-Doh so praise them for all attempts!

2) Requesting via signs or words: My favorite requests to use in sessions include “more” and “help”. Encourage your child to request at their current level.  If they are able to verbally request encourage them to use their words. If they are currently able to sign that is great too! Even if they are just reaching for more Play-Doh you can model the word and honor their request. To target “help” give your child a closed container of Play-Doh and encourage them to ask for help before you open the container for them. To target “more”, give them a small piece at a time and encourage them to request “more”.

3) Teaching Action Words: Model action words while playing with the Play-Doh. My favorites include open (while opening the container), take out, roll, smash, drop, squish, cut, push, put in, close (while closing the lid), etc. Any word that you can think of to model with the Play-Doh would be great to use here!

4) Following one step directions: Tell your child what to do with the Play-Doh and see if they can follow without a model. If they do not understand the direction, model for them and then ask them to do it again without the model. You can get silly with this and ask them to put the Play-Doh on their head or nose. You could also give your kids directions to make your own recipe!

The possibilities are endless so have fun with it!

Resources: Laura Mize, Teach Me To Talk

Katie Dabkowski, MS, CF-SLP

Early Pronouns: When They Should Be Acquired and How to Teach Them

Your child’s pronoun usage can be very difficult to understand and even more difficult to teach! Many parents – and therapists alike–  struggle teaching this concept to their little ones. First, you need to have a basic understanding of when each pronoun should be acquired. This way, you’ll know what is appropriate to teach and what isn’t! The research varies slightly with regard to pronoun acquisition; however, all research agrees that I and it are the first to emerge, followed by you.

Approximate Age of Acquisition:

12-26 months – I, it

27-30 months – me, my, mine, you

31-34 months – your, she, he, yours, we

35-40 months – they, us, her, his, them, her

41-46 months – its, our, him, myself, yourself, ours, their, theirs

47+ months – herself, himself, itself, ourselves, yourselves, themselves

Sources: Adapted from Haas & Owens (1985); Huxley (1970); Morehead & Ingram (1973); Waterman & Schatz (1982); and Wells (1985).

Now for the tricky part – teaching pronouns! Many children with language delays, auditory processing issues and echolalia struggle with correct pronoun use. Yet, parents often don’t understand how to practice the skill at home and facilitate generalization. Pronouns by nature are ABSTRACT, and therefore, difficult to “see” or conceptualize, thus difficult to teach to children.

Here are a few tips and activities for targeting pronouns with your toddler at home:

  • Use GesturesAlways pair pronouns with gestures! This provides a great non-verbal cue for the child to understand who you are referring to and what each pronoun represents. Point to yourself for “I” and tap your child’s chest for “you.” When you are modeling what, you want your child to say, take his/her hand and use it to pat their own chest for “I” or “my.”
    • Raise your intonation to emphasize the pronoun as you gesture to help the child make the connection
  • Modeling – Providing frequent models is important! Often times, parents and therapists simplify language and use proper nouns instead of pronouns. For example, “Mommy is eating” or “Ms. Lisa is going bye-bye.” This strategy is great for babies who are not talking or who are just learning to talk because it improves understanding and attaches meaning to the words. However, once your child is talking, it is important for them to hear you modeling the correct pronouns! For example, “I am eating” and “I am going bye-bye.”
    • Don’t worry if you forget! Simply follow-up with an emphasized model: “Mommy is eating. I am hungry.”
  • One at a time – Focus on just one pronoun at time. This can be challenging because it is natural to want to use them together. “I have blue and you have green.” Although, it may seem helpful, it can actually be quite confusing for your little one!
    • It takes time and maybe a slow process. That is okay!
  • Prompt with how the child should say it – Rather than saying, “Do you need me to help you?” prompt your child with a model of what he/she should be saying. So, for example, you would simply model, “Help me.”
    • This can be challenging because our tendency is to prompt with phrases such as, “you say” or “tell me,” which may only lead to more confusion and repetition of the wrong pronoun!
  • Look for opportunities in everyday play and routines – pronouns are best taught during normal play and interactions. Model, gesture/point and emphasize the pronoun by raising pitch, intonation and volume. Provide lots of opportunities for repetition and practice!
    • “Mine” – If your child produces the /m/ sound, mine is a great place to start! Model the word as you hold a toy (or part of a toy). Be sure to keep it light and fun and always give the object right back! It’s important for your toddler to know that you are not there to take their toy. You are simply being playful and having fun (while teaching a pronoun).
      • Tip: Do not do this with your child’s favorite toy. They will not like you saying, “mine” and will likely become very upset. If you see that your child is getting frustrated or upset, stop working on it and try again later!
    • “Me” – Look at family pictures (printed or on your cell phone) and ask, “Whose that?” Model, “me” while pointing to a picture of yourself and tapping your own chest. Model “me” again and use hand-over-hand assistance to help your child touch his/her own chest.
      • Selfies – Children love phones and they especially love taking pictures on phones. Take a few “selfies” with your child for extra engagement, motivation and fun, then use the pictures to model me!
    • “I”
      • Choosing items – Lay a few objects out in front of the child and say, “I want banana” or “I want car” as you take the object. Exaggerate “I” as you take the item.
      • Snack time – Ask, “Who wants ____?” Help your child touch their own chest while modeling “I do! I do!”
      • Actions – Use actions to practice the pronoun “I.” Children love gross-motor and movement activities and this is the perfect opportunity! Pair “I” with simple actions (i.e. I run, I jump, I hop, I sleep, I laugh, I cry, etc.) as you act out the action. For example, “I laugh” and then crack-up laughing or “I cry” and pretend to cry. Have fun and get into it! The more you are enjoying it, the more your child will too.
    • “You”
      • Playful commands and help scenarios. Create “you do it” situations where you need to ask your child for their help.
        • Roll a toy car under the table and say, “Oh no! Oh no! You get it.”
        • Wrap a toy in Play-Doh or putty a say, “Oh no! Stuck! You do! You!”
        • Think of the key phrases, “You do,” “You go,” “You get,” “You eat,” etc.
      • My” vs. “Your”
        • Practice with clothing, body parts or food. “My pants” and “Your pants” while gesturing.

Resources: Laura Mize, Teach Me to Talk

Kelly Fridholm, M.C.D., CCC-SLP

How can I encourage my son/daughter to practice their “speech homework” outside of therapy?

If your child receives therapy for their articulation or phonological skills (i.e. how they produce specific sounds), intervention focuses on repeated practice of the target sounds at different levels. Your therapist structures the session to be highly motivating and engaging for your child so that they are motivated to participate in the repetitive nature of the task. Additionally, your therapist most likely assigns homework to work on in between sessions to help with generalization of your child’s articulation skills—but here’s where the challenge lies! Most kiddos are reluctant to practice their ‘speech homework’ outside of therapy because it is challenging and because it is not the most exciting work. However, daily practice of articulation skills is necessary for both acquisition and maintenance of these age-appropriate articulation skills. Here are a few tips and activities to encourage your child’s home practice:

  • Choose the same time each day to practice—on the way to school, after dinner, right before bed, etc. Creating a routine makes it easier to incorporate practice into daily life.
  • Set attainable goals—45 minutes of articulation practice per day is not going to fit into your daily routine, and it doesn’t have to! 10 to 15 minutes of directed practice per day is all you need to ensure that your child does not lose the progress that he/she has made in therapy.
  • Provide the correct cues for target sounds—Your therapist will create articulation goals based on your child’s current level of functioning. Talk with your therapist to determine if your child is working on targets at the syllable/word/phrase/sentence level and support their production of target sounds at that level.
  • Make practice fun! – Articulation homework does not have to be ‘drill’ work; you can use your child’s speech targets in a variety of fun activities, such as:
    • Sound scavenger hunt
      • Cut out pictures of your child’s target sounds and hide them around the house. Go on a scavenger hunt to find the missing words!
    • I-Spy
      • Try to find objects that start with the target sound while in the car, on a walk, looking through books, etc.
    • Adapt age-appropriate crafts
      • Making a spider for Halloween? Cut out 8 target words/pictures and attach to the spider’s legs
      • Winter crafts? Make a penguin out of an old Kleenex box and ‘feed’ it your target words
      • Jewelry? Put one bead on each target word and practice the word before adding the bead to your bracelet/necklace
    • Snack time!
      • Cover target words/pictures with one piece of a favored snack (cheerios, popcorn, fruit loops, nuts, raisins, cheddar bunnies, etc.); practice each word 3 times before eating the snack
    • Do-A-Dot
      • Say target words for X-number of dots per page

 

**Remember to consult your speech-language pathologist to make sure you are providing the appropriate level of prompting for your child’s goals

Autumn Smith, MS, CCC-SLP
Assistant Director of Speech-Language Services