AAC Myth Busting

Augmentative and Alternative Communication, or AAC, is instrumental for effective, efficient, and successful communication, especially for those with communication and speech disorders. Myths surrounding AAC can prevent families, individuals, and even some therapists from supporting AAC usage. Here are some of the top myths about AAC and why these myths are indeed, just myths.

Myth: Use of AAC discourages or hinders verbal speech production

Perpetrators of this myth believe that AAC will cause individuals to lose interest in talking or that they will only want to use AAC to communicate. Research studies show that AAC does not have a negative impact on verbal language (Millar et. al, 2006). Rather, AAC can actually support and encourage verbal language development. AAC is also beneficial for all-around development, as it supports expressive language skills, receptive language skills, literacy skills, play skills, social and pragmatic skills, behavioral skills, and frustration tolerance (Light et al., 2003; Millar et al., 2006).

Myth: AAC is only for pre-verbal or non-verbal individuals

Although AAC is extremely beneficial for those who do not speak, it is not exclusively reserved for these individuals. The term “augmentative” (the first “A” in AAC) refers to the use of communication systems to supplement speech. If an individual has limited verbal speech or demonstrates decreased understandability, AAC can help them effectively communicate. For example, people with motor-speech disorders often demonstrate decreased understandability due to muscle weakness, muscle incoordination, and/or planning/sequencing difficulties of the muscles involved in speech production. Even though these individuals have the ability to speak, they benefit from AAC to supplement their message when they cannot be understood or when they do not have the capability to produce the desired message. “Alternative” (the second “A” in AAC) refers to the use of systems by individuals with no-verbal communication.

Even individuals with intact verbal communication skills use AAC on a daily basis, as AAC emcompasses all of the ways that we communicate outside of talking. Use of facial expressions, body language, texting, emailing, gestures (e.g, waving, holding a finger up to the lips to indicate “shhh”), holding up objects, pointing to pictures, and writing are just a few examples of everyday AAC systems.

 

 

Myth: Children must reach a certain age or have certain prerequisite skills to use AAC

There is no evidence to suggest that children must be a certain chronological age to use AAC. Rather, introducing AAC during infancy and toddlerhood can have a positive impact on a child’s brain development. The National Scientific Council on the Developing Child (2007) reported that enriching experiences during infancy and toddlerhood (such as using AAC) establishes foundations for later brain development, which helps improve a way a child thinks and regulates emotions.

There is also no evidence that children need certain prerequisite skills to use AAC. In the past, children with cognitive or sensorimotor impairments were often excluded from AAC usage due to absent foundational skills. However, children with cognitive and sensimotor impairments have been shown to effectively implement and use AAC, provided individualized support. Further, implementing AAC with children with cognitive or sensorimotor deficits can have a positive impact on their global development (Ganz et al., 2011; Ganz & Simpson, 2018; Kasari et al., 2014; O’Neill, Light, & Pope, 2018; Romski et al., 2010; Walker & Snell, 2013). AAC can also enable children to demonstrate their cognitive abilities, especially in those who do not yet speak or have a reliable way to communicate. 

In short, no matter a child’s age or ability level, AAC promotes brain development and provides a way for a child to improve in a variety of developmental areas.

 

 

Myth: You must have good motor skills to use a speech-generating AAC device.

As stated above, there are no prerequisites for using AAC. Just as there are many different types of AAC systems, there are also a variety of ways to activate these systems. For individuals with significant motor impairments, eye gaze technology (using equipment to track eye movements) and switch scanning (activating a switch using a specific body part) are two of the most widely used access options. One of the most famous scientists of the 21st century, Dr. Stephen Hawking, lost voluntary muscle control throughout the majority of his body due to ALS. He activated his AAC speech-generating device using his thumb, then a switch mounted to his glasses, which picked up on small movements in his cheeks and face (DO-IT, 2021). Recently, researchers have helped completely paralyzed individuals activate AAC systems using just their breath and have even successfully found a way to activate devices using just the brain (Elsahar et. al., 2018; Moses et. al., 2021)

Individuals with vision, hearing, and other physical impairments are also able to access and use AAC systems, provided appropriate equipment and support. A team of professionals (occupational therapist, physical therapist, audiologist, vision specialists, etc.) should collaborate to help determine the best activation method for AAC based on an individual’s strengths and needs.

 

Myth: Children should start with low-tech AAC before moving on to high-tech AAC

Children do not have to demonstrate competence with a low-tech AAC system before moving toward a high-tech AAC system. (Don’t know the difference between low-tech and high-tech? Check out the previous blog post for more information!)

Since every child has different needs, strengths, skills, environments, and support systems, AAC should be selected based on those criteria, rather than a one-size-fits-all approach or progression. Further, since communication is most effective when it is multimodal, a combination of unaided systems, as well as aided low-tech and high-tech systems can be used in conjunction with one another to help provide the best functional communication outcomes.

A speech-language pathologist, as well as other healthcare professionals, can assist in the assessment, recommendation, and trialing of a variety of systems and modalities to determine the best fit for an individual. Even if a system is successful, modifications to the system or a replacement of the system may be necessary based on progress, changes, personal preferences, and other developmental factors. Flexibility, collaboration, and consistency is necessary for effective AAC interventions.

 

Questions or concerns?

If you have questions or concerns about your child’s communication skills, please contact us at info@playworkschicago.com or (773) 332-9493. The Speech-Language Pathology team and the Assistive Technology team are available to provide individualized AAC recommendations based on your child’s needs.

 

Nicole Sherlock, MA, CCC-SLP

Speech-language pathologist

Assistive Technology Co-Coordinator

 

Common myths about AAC (augmentative & alternative communication). Common myths about AAC (Augmentative & Alternative Communication) – Tobii Dynavox. (n.d.). https://www.tobiidynavox.com/learn/what-is-aac/common-questions/. 

Elsahar, Y., Bouazza-Marouf, K., Kerr, D., Gaur, A., Kaushik, V., & Hu, S. (2018). Breathing Pattern Interpretation as an Alternative and Effective Voice Communication Solution. Biosensors, 8(2), 48. https://doi.org/10.3390/bios8020048

Ganz, J.B., Earles-Vollrath, T.L., Mason, R.A., Rispoli, M.J., Heath, A.K., & Parker, R.I. (2011). An aggregate study of single-case research involving aided AAC: Participant characteristics of individuals with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 1500–1509. doi:10.1016/j.rasd.2011.02.011

Ganz, J., & Simpson, R. (2018). Interventions for individuals with autism spectrum disorder and complex communication needs. Baltimore, MD: Paul H. Brookes.

Kasari, C., Kaiser, A., Goods, K., Nietfeld, J., Mathy, P., Landa, R., … Almirall, D. (2014). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 635–646. doi:10.1016/j.jaac.2014.01.019

Light, J. C., Beukelman, D. R., & Reichle, J. (2003). Communicative competence for individuals who use AAC: From research to effective practice. Brookes Publishing.

Millar, D.C., Light, J.C., & Schlosser, R.W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech, Language, and Hearing Research, 49(2), 248–264.

Neuroprosthesis for Decoding Speech in a Paralyzed Person with Anarthria. Moses DA, Metzger SL, Liu JR, Anumanchipalli GK, Makin JG, Sun PF, Chartier J, Dougherty ME, Liu PM, Abrams GM, Tu-Chan A, Ganguly K, Chang EF. N Engl J Med. 2021 Jul 15;385(3):217-227. doi: 10.1056/NEJMoa2027540. PMID: 34260835.

National Scientific Council on the Developing Child (2007). The Timing and Quality of Early Experiences Combine to Shape Brain Architecture: Working Paper #5. http://www.developingchild.net

O’Neill, T., Light, J., & Pope, L. (2018). Effects of interventions that include aided AAC input on the communication of individuals with complex communication needs: A meta-analysis. Journal of Speech Language and Hearing Research, 61, 1743–1765. doi:10.1044/2018_jslhr-l-17- 0132

Romski, M., & Sevcik, R. (2005). Augmentative Communication and Early Intervention. Infants & Young Children, 18(3), 174–185. https://doi.org/https://depts.washington.edu/isei/iyc/romski_18_3.pdf 

Romski, M., Sevcik, R., Adamson, L., Cheslock, M., Smith, A., Barker, R., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53, 350–364. doi:10.1044/1092-4388(2009/08-0156)

University of Washington. (2021, April 9). Dr. Stephen Hawking: A Case Study on Using Technology to Communicate with the World | DO-IT. DO-IT: Disabilities, Opportunities, Internetworking, and Technology. https://www.washington.edu/doit/dr-stephen-hawking-case-study-using-technology-communicate-world

Myth: Young Children Must Wait Until They Can Use AAC. Tobii Dynavox (n.d.).

http://tdvox.web-downloads.s3.amazonaws.com/MyTobiiDynavox/Pathways_SCF_Myth-Young%20Children%20Must%20Wait%20Until%20They%20Can%20Use%20AAC_v1-0_en-US_WEB.pdf

Photo by Volodymyr Hryshchenko on Unsplash

Photo by Stephen Andrews on Unsplash

Photo by Palle Knudsen on Unsplash

What’s Inside the Mystery Box?!

Let’s make a mystery box!

It’s no mystery that families and children been spending more time at home than ever before. When we are constantly surrounded by the same scenery, including the same toys and games, it can be difficult to brainstorm ways to mix it up (without constantly rushing to the store or clicking ‘buy now’ on Amazon).

As a pediatric therapist, I am always seeking new ways to turn every day household items into fun, motivating, and enriching toys. I’ve found that some of the best toys are not ‘toys’ at all. One of my favorite non-traditional toys is a do-it-yourself mystery container/box!

This language-rich activity is appropriate for children at every developmental stage AND it only requires a few common household items. There are endless outcomes, variations, and possibilities with this activity!

Materials

  • An empty box or container (plastic flower pot, clean mini trashcan, big bowl, toy bin)
  • A short sleeve t-shirt
  • A rubber band to secure the t-shirt (optional)
  • Small items from around your home

Directions

  1. Collect the materials
  2. Pull the t-shirt over the top of the box/container, so that one of the sleeves lines up with the top or opening of the container.
  3. (Optional) Secure the t-shirt onto the box/container with a rubber band
  4. Place objects from around your home into the mystery box/container through the sleeve hole at the top. Choose objects that are safe to the touch- avoid sharp/pointed items.
  5. Take turns reaching inside of the mystery box. Encourage your child to use his or her hands (or even feet!) to feel the objects in the box/container. Ask your child to pull the objects out. *BONUS: Create a silly song to sing while you pull objects out! This song is to the tune of “Mary Had a Little Lamb”

What’s inside the mystery box?

Mystery box, mystery box

What’s inside the mystery box?

I wonder what we’ll find!

 

How to target speech, language, and social development during this activity:

  • Play ‘peek-a-boo’ with objects in the box! After modeling this phrase a few times, pause and wait for your child to fill-in-the-blank. Encourage your child fill-in-the-blank with the object label by modeling the phrase “It’s….a…”. Pause, look expectantly at your child, and wait for him/her to fill-in the blank.
  • Increase your child’s eye contact and joint attention by holding the box and objects by your face! Tickle your child with the objects or place box on your head to increase shared attention.
  • Encourage your child to follow 1-2 step directions (grab the bear, then put it in the box; pull a soft toy out of the box). If your child needs extra support, provide a model or use gestural cues to show your child how to follow the direction
  • Model grammatically correct phrases and sentences throughout the activity. Label and describe what you feel, see, and hear. Incorporate different word types into your models, including:
    • Exclamations (uh oh, wow, ooooh!)
    • Object names (box, bear, shoe, stick, spoon, playdoh)
    • Pronouns (my, your, his, hers)
    • Action words (shake, pull, feel, reach)
    • Location words (in, out, under, up, down)
    • Descriptive words (big, little, hard, soft, squishy, smooth, bumpy)
  • Practice turn-taking by taking turns reaching inside of the mystery box. Identify whose turn it is by pointing and/or using turn-taking language (It’s my turn! Now, it’s your turn!). Encourage your child to wait and watch while you take a turn.
  • If your child is working on specific speech sounds, place objects in your mystery box/container that contain the target speech sound in the object label. Each time your child pulls an object out, you can practice the target word 5x together! For example, if your child is working on the “b” sound at the beginning of words, you can include objects such as a ball, bird, balloon, bib, baby, bell, banana, etc.
  • Ask your child to guess what objects are inside based on what he/she feels! Once the objects are out of the box, compare and contrast how the objects feel and look. Make a list of similarities and differences between the objects.
  • Sort the objects into categories based on color, shape, size, or object function (things you eat, things you wear, animals, vehicles, etc.)

Not only is this activity great for building language, but it also targets many occupational therapy skills, such as the ability to discriminate and identify objects based on touch without the use of vision, increasing focus and attention on the hands and the sensory system, and increasing impulse control (as your child has to wait until he/she finds the right objects, via touch, before pulling it out of the box).

 

Questions or concerns?

If you have questions or concerns about your child’s speech, language, and/or play skills please contact us at info@playworkschicago.com or 773-332-9439.

Nicole Sherlock, MA, CCC-SLP
Speech-Language Pathologist
Photo Credit: Nicole Sherlock

Employee Spotlight: Kelsey Martin, CCC-SLP

What do you love most about working for PlayWorks Therapy?

My favorite part about working for PlayWorks Therapy is being surrounded by such an amazing support system. I truly view all of my coworkers at PlayWorks not only as colleagues, but friends as well! I have grown so much as a therapist due to the collaborative environment that this company creates, and I especially love how easy it is to bounce ideas off of one another to provide our clients with the best therapy possible.

What is your favorite children’s book?

My favorite children’s book would have to be “If You Give a Mouse a Cookie.” I adored this book as a child and appreciate it now as a therapist because the illustrations and plot allow for tons of language opportunities!

What do you enjoy most about living in Chicago?

My favorite part about living in Chicago is having so many family and friends nearby. I grew up in a suburb outside of the city and earned both of my degrees in the Midwest, so many of the people that I love most happen to be here too! I also love the fact that there is always something to do in Chicago, whether it be a sporting event, concert, outdoor activity by the lake, or a street festival to check out!

What is your favorite childhood memory?

It’s hard to pick just one, but I hold my memories of Christmas Eve at my grandparents’ house are very close to my heart. My entire extended family is OBSESSED with the holidays and spreading Christmas cheer, so I vividly remember how excited I always was to spend time with my grandparents, aunts and uncles, cousins, and sisters singing Christmas songs, wearing matching pajamas, and of course, eating lots of cookies. It’s been pretty amazing to see how our traditions have continued over the years as new family members have been welcomed, too!

Mountain or beach vacation?

I think I’d have to say both… I would probably pick the beach in the summer and mountains in the winter, as I love soaking up the sun and being by the water, but also am a huge fan of skiing!

Share a proud “therapy moment” with one of your clients.

One of my absolute favorite parts about working with children is that every accomplishment, no matter how big or small, is celebrated and cherished. One moment that I remember specifically was when one of my clients on the autism spectrum looked me directly in the eye and said, “bye-bye Kelsey!” Not only had he never said my name before, but I was so unbelievably proud to see this little guy initiate such an awesome social interaction!

What is your hometown?

Prospect Heights, Illinois.

What do you like to do in your free time?

In my free time, I love to spend time with my friends and family, run along the lake or attend a yoga class, cross restaurants off my extensive bucket list of places to try, and support all of my favorite Chicago sports teams! I also love to sing and play guitar, as well as sing karaoke with friends on the weekend!

Fun fact about yourself?

Speaking of singing, I once sang the National Anthem to open a Bret Michaels concert in 2013! I got to hang out with Bret for a little after the show and take some pictures, too!

Favorite therapy toy?

My favorite therapy toy, without a doubt, is my sock monkey ball popper. Not only do kids of all ages find it extremely entertaining, but it’s an amazing facilitator for language, such as asking for help and more, working on directions (up vs. down), working on body parts, and more!

Kelsey Martin, MS, CCC-SLP
Speech-Language Pathologist

Picture Exchange Communication System: Is PECS appropriate for my child?

When people think of communication, they often think of verbal communication. However, communication is not limited to one modality. In fact, communication can occur through a variety of modalities: verbal exchanges, written exchanges, facial expressions, gestures, sign language, etc. Picture exchange is another modality through which people can communicate. To capitalize upon this modality, Picture Exchange Communication System, or PECS, was created as a leading therapeutic technique for children who cannot yet verbally communicate.

As a pediatric speech-language pathologist, I often come across the question from parents, “Is PECS appropriate for my child?” Let’s dive into what PECS is, how it works, and for whom it may be appropriate.

What is PECS?

Picture Exchange Communication System (PECS) is a form of augmentative and alternative communication (AAC) that allows people to communicate using pictures. Although PECS contains a formal protocol that systematically moves through six phases of communicative exchanges, the method of picture exchange can be modified to meet the needs and skill level of the child.

How does PECS work?

  • Children using PECS are first taught a cause-effect relationship between pictures and communication. In other words, they learn that when you give a picture, you receive something in exchange.
  • Children are then taught to use pictures to communicate with different people across a variety of environments.
  • After the basic communicative exchange is established, the child learns to discriminate between multiple pictures in order to request specific objects or activities.
  • Pictures can then be combined to communicate phrases and sentences of increasing complexity, such as “I want ___.”

Who benefits from PECS?

PECS is often recommended for children who do not yet have a means of verbal communication. For PECS to be effective, however, the child must be motivated to communicate, as PECS relies upon the child initiating communication exchanges by giving pictures to another person. PECS also requires that child must have the cognitive skills to understand the cause-effect relationship between giving a picture and getting something in return. Therefore, a child who does not yet understand the cause-effect nature of a basic communicative exchange would be an inappropriate candidate for PECS until this skill emerges.

Myths Debunked

  • PECS is only for people who won’t learn to talk: The use of PECS does not imply that the child will never learn to use verbal language. In fact, the use of PECS can facilitate verbal communication by providing children with an outlet to reduce frustration and establish early communication skills.
  • PECS is only for people with Autism: PECS is frequently recommended for children with Autism Spectrum Disorder due to deficits in expressive language and social communication. However, recommendations of PECS should be child-specific and may or may not be appropriate for any child who does not have a means of verbal communication.
  • PECS only targets requesting: As a child moves through the PECS hierarchy, they can learn to use pictures for different functions, including requesting, answering questions, and ultimately, commenting independently. PECS involves high priority vocabulary to teach children that they can expand their expressive vocabulary to meet their wants and needs.

Questions or concerns?

If you have questions or concerns about whether PECS is appropriate for your child, please contact us at info@playworkschicago.com or 773-332-9439.

Jill Teitelbaum, MS, CF-SLP
Speech-Language Pathologist

References:

Bondy, A. (2001). PECS: Potential benefits and risks. The Behavior Analyst Today2(2), 127.

Vicker, B. (2002). What is the Picture Exchange communication System or PECS?.

Photo Credit: sitemaker.umich.edu

The Importance of Promoting Early Literacy Skills

Literacy skills develop from language skills and language skills begin to develop as soon as your child is born. Your baby begins communicating through eye contact, smiling, crying, facial expressions, and gestures and relies on your response with words and attention to lay the foundation for language and literacy development. Your child’s brain develops the most during those early years, and frequent exposure to language and reading will help build your child’s vocabulary, comprehension, story-telling, reading, and writing skills.

Why is Early Literacy Development Important?
Research shows that babies and toddlers who participate in literacy activities with their caregivers are more likely to develop a sustained interest in reading and writing. Developing an interest in reading and writing early on will have a positive impact on your child’s academic readiness.

Literacy, which is the ability to read and write, is comprised of a variety of skills including letter recognition, phonemic awareness, use and understanding of vocabulary, and story comprehension. These skills begin to develop within the first year of life. For example, when your child is six to twelve months old they may begin to grasp books or pat pictures they are interested in. At twelve to twenty-four months your child may begin to turn board book pages, give a book to you to read to them, and point to and name objects in pictures. Between the ages of two and three your child may start to scribble, request the same story over and over, and begin to complete sentences or rhymes in stories that are familiar. As a parent or caregiver, you can provide your child with positive early literacy experiences, which will lay the foundation for language, reading, and writing skills to develop.

Tips For Promoting Early Literacy Skills:
1. Have fun while reading! If your child is engaged and enjoying themselves, they are learning. You can use silly voices and actions while reading your child a story. This will promote positive feelings towards reading for your child.
2. Talk about the pictures. Rather than reading the words on each page, try talking about the pictures. Point to the objects and actions in the pictures as you describe them so that your child will begin to make connections between the words you are saying and what they see. Eventually you can ask them to describe the pictures themselves.
3. Let your child interact with books. Let your child hold the book and turn the pages even if you need to help them do this. Remember that it is okay to skip pages and to talk about pictures rather than read all of the words.
4. Make books and stories a part of your daily routine. Have books in your car, sing songs and nursery rhymes during mealtimes or play, and make time to look at books before naps and bedtime. Provide your child with frequent opportunities to engage with books and story time.

Early Literacy Skills Are Developed Through Early Experiences:
Remember that early language and literacy skills are learned through every day experiences with you and your child. Through playing, talking, singing, and reading together, your child is developing early language and literacy skills. While your baby or toddler may not be ready to read or write yet, exposing your child to frequent opportunities to interact with books and tell stories will help to develop your child’s vocabulary, comprehension, story-telling, reading, and writing skills. Remember, it is never too early instill a love for learning and reading in your child!

Questions or concerns?
If you have questions or concerns about your child’s early literacy skills, please contact us at info@playworkschicago.com or 773-332-9439.

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Photo Credit: Child, Fun, Family, Love via Pixabay.com

Eating Habits- Picky or Problematic?

Is my child simply a picky eater? Or should I be more concerned?

Many children go through a phase of picky eating, some longer than others, that is not usually cause for concern. Some days it seems impossible to get them to eat anything other than goldfish or cake pops, and vegetables aren’t even up for discussion! However, some children demonstrate behaviors that may indicate a feeding problem or disorder. These difficulties may present as sensory challenges, such as only eating brown, crunchy foods, or as oral-motor challenges, such as excessive drooling or food falling out of their mouth while eating.

The following is a list of red flags that may tell you if your child would benefit from the support of a feeding specialist:

Children develop feeding challenges as a result of negative associations with eating. These associations may be caused by various medical or sensory complications, such as sensory processing disorder, food allergies, gastroesophageal reflux disease (GERD), or motor-planning disorders.

If you have concerns about your child’s feeding skills, consult with your pediatrician and an occupational therapist or a speech-language pathologist to help you determine if your child may need additional feeding support.

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

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