20 Things to Do to Support Your Child with Speech Delay at Home
Since Adeline was born a preemie (4 months early), we knew she would have some language delays. After her NICU stay, even though she was technically (chronologically) 4 months old she was developmentally (adjusted), a newborn as she just reached her due date. Preemies have two years to “catch up” to their peers and automatically qualify for Early Intervention services (depending on their gestational age) through a federal program which is available in every state. On top of being premature, Adeline had many extended hospital stays which greatly impacts development and was sick quite a bit, throw in some surgeries (11 & counting) and she was sort of destined to have a delay. After her first birthday, she really was not doing much of anything in terms of her language. She would babble a bit, but I knew she needed intervention. We had her evaluated and she had more than a 50% delay, so we started speech therapy. That news was hard to hear, and I needed time to digest, even knowing what I know and understanding this would probably happen. I just could not believe my 13 month old was in the 4-6 month old range. I felt mad, sad, guilty, and even thought this cannot be right. But I accepted it, since she was herself during the assessment, moved on, and got to work! I am incredibly proud to say, at nearly 3 years old, she no longer has a delay and only sees her speech language pathologist for feeding. But it did not just happen naturally because she was in therapy. It happened because of what I am just about to tell you!
Speech therapy is essential, but you are more important, and so is how the time is spent with your child. Even if you get therapy, it’s only 1 time per week, for 1 hour, there are many other hours in the day. It’s key that you create a language-based environment in your home, so that your child has many opportunities to increase their language. Um, what is a language-based environment? Well, it’s an environment in which you contrive situations in which your child must communicate. If I can’t open a jar (story of my life), but need it to cook, what do I do? “Babe, can you open this for me?” I communicate. When children learn to communicate in their natural environment in real-life situations with their caregivers, they are more motivated to communicate and are better able to apply their newly-learned skills to other situations.
I was lucky in that my master’s degree is in special education, with two certificates in early intervention and teaching kids with autism. I worked with kids with language delays my entire life, so this stuff came naturally to me. Not all parents have a degree in this stuff when they have a kiddo who is not talking yet. But don’t worry, I got you! I want to share all the secrets with you, so that your child can increase their progress, start communicating more, and everyone can be less frustrated.
1. Play daily, set aside 30 minutes a day to play without the distractions of cell, etc. (Want to know how to play? Check this out)
2. Create many, many opportunities to practice it throughout the day. Language is something that you have to practice and use in order for it to maintain. Practicing it in many situations and in many different ways increases the likelihood that it will generalize and maintain
3. Use verbal routines, use language that is predictable and can be repeated. On the swing I will say, “ready, set, Go!”
4. Follow their lead – use the OWL method O- observe to see what they like W- wait for them to initiate or answer L- listen to what they are saying
5. Developmentally Appropriate: Use simple language: at or slightly above your child’s currently level of speech. When Addie was not talking yet I would say, “More milk?” instead of “Adeline, would you like more milk for breakfast?”
6. Keep items out of reach Keep items that are preferred or used often out of reach. This is incredibly powerful. Put their water cup, snack, out of reach, keep their favorite toys in a basket too high, or in a container they cannot open. This way if they want these items, they need to communicate.
7. Have some fun: be animated, act silly, use over exaggerated facial expressions or voices.
8. Get on the floor: Communicate clearly- slow down, get down on your child’s level, play on the floor and make eye contact
9. Model the language you want him or her to use. For example, if they come over to you and lift up their arms you say, “Can you pick me up please?” or even just “Up” based on your child’s current level of communication
10. Narrate your Play: Talk about what you’re doing, what he’s doing, and describe things.
Example of modeling language with toy: Why should we push the ball? We want it to go down. Put the green ball ON top. Let’s push the ball. Look! It’s going DOWN! Down.”
11. Narrate your Day: talk all day long to your child, tell her what you are doing at every moment of the day. “Addie, Jpeg needs to go for a walk. He has to go potty. Lets get the leash and put our shoes on. We have to open the door and hold Mommy’s hand when we cross the street."
12. Expectant Pause: Provide opportunities for your child to use language, without asking them directly to repeat what you say, or to label objects. (E.g. in a book, you might be reading a story to your child where the last word in each sentence rhymes. Once your child is familiar with a book, read the first part of the sentence leaving off the last word, pause and look at your child. Wait for several seconds. If the child responds, praise and keep going. If not, provide the child with an acceptable response (model) and then continue with the story.)
13. Model: Rather than testing your child’s knowledge, see your job as giving your child lots of models. For example when looking at a book, you can describe the pictures to your child. The length and complexity of your models will depend on the child’s age. For example, if a child is 2 years of age, you might model using 2 – 3 word sentences. Try not to give a model and then expect your child to repeat and take the pressure off your child to ‘perform’.
14. Word Approximation: the best consonant-vowel combinations a child is able to produce and most closely resemble the word they are attempting to verbalize. For example, instead of "milk", Addie says "muck". These word approximations serve as functional communication
15. Verbal Routines: a tool that Speech Language Pathologists use to encourage speech in the late talker. Verbal routines are made up of words that are repeated at a predictable time during an activity One common verbal routine is saying “ready, set, go.” during activities
16. Contrive situations: Create situations in which they have to communicate. You can contrive situations by; don’t give all the materials, give the wrong items, give too little, give choices, and set them up to need your help
17. Read:When reading, ask questions and leave out words that are easy to anticipate. Children need to hear words often, which is why many of the books I recommended include books with predictable, repetitive text. They learn words better when they are interested, so its important to keep that in mind. They also learn best when adults are responsive to them, which is ideal during reading time. Check out my recommended Best Board Books for Babies (& Toddlers) ,24 Best Falls Books, and Christmas Books Every Toddler Needs..
18. Repeat: When the child does talk, repeat them. But don’t repeat them word for word. Add in other words to help expand on their ideas and teach them how to use complete sentences. For example, if your toddler points to a butterfly and says “pretty”, you could add “The butterfly is very pretty. It has blue and white wings. Look how it flaps it’s wings to fly.”
19. Consider other types of communication:If your toddler or older child isn’t talking yet- or is only talking a little - you might consider introducing some form of multi modal communication. Don’t panic- that just means allowing your child- or student- to use lots of ways to talk- like signs, gestures, or communication boards. Start with a few basic signs containing core vocabulary, such as ‘more’, ‘want’, ‘stop’, ‘go’, ‘eat’, ‘drink’. Think basic verbs, adjectives, or prepositions. Of course, signs like mama, dada, hi, or other meaningful words can be great starters, too! You can absolutely still talk in sentences, but don’t be afraid to sign those target words, and then say the target word one more time for good measure. We love and used Baby Signing Time.
20. You. The best gift or thing you can give to your child to help with their language development is YOU. Your TIME, DEDICATION, ATTENTION, FOLLOW THROUGH, CONSISTENCY, is going to be the thing that makes the most difference.
If you are concerned about your child’s language, if you have that sort of nagging feeling in your gut, my best advice is to schedule a speech evaluation to see if they need early intervention. Do not wait, or just tell yourself that “he’s just a boy”, or “he understands what I am saying,” or “he just doesn’t feel like talking” or any of that sort of stuff. Because if your toddler does have a speech delay, now is the most critical time for them to get intervention due to their rapid brain growth. They will make the most progress, learn the most, and basically you are getting more bang for your buck. Also, many reputable pediatric speech language therapists have a waiting list. If you wait to get evaluated, you may have to wait 6 months to a year before you can start therapy. There are two possible scenarios if you get your child evaluated which is either they will not need speech therapy so can relax a little or they’ll need therapy and you will be getting them the help they need in order to communicate. Win win!
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