Curious about simple ways to promote communication in your infant or toddler?
In this episode, we speak with Carrie Clark, a pediatric speech-language pathologist and the creator of the website, “Speech and Language Kids.”
Carrie offers 5 simple strategies families can implement into their everyday lives to promote communication in young children. These include use of: Sign Language, shorter utterances, parallel and self-talk, expansions, and visual supports.
Carrie and Ayelet go into detail about how to use each strategy, discussing specific examples and useful ways to implement each one with a child at different communication levels.
Great resources we mentioned in this podcast episode (in order they were mentioned):
Carrie’s Sign Language Flashcards
Sign Language Dictionary (Lifeprint)
Carrie’s e-book “Jump Start Your Late Talker”
Carrie’s “late talker” resource page
“Let’s Talk: Infant & Toddler Development” facebook group
Carrie’s “Speech Therapy Solution” membership site with ASHA-approved CEU’s
Connect With Us:
Ayelet: Facebook / Instagram / Pinterest
Carrie: Website / Facebook / Instagram / Pinterest
Text Transcript of this episode
Ayelet: Hi! Today on Learn With Less, I’d like to welcome Carrie Clark, a speech and language pathologist and creator of speechandlanguagekids.com which provides free resources about speech and language skill development for families and speech-language pathologists. Carrie is also a mom of young kids. Carrie, how old are your kids – and welcome, by the way!
Carrie: Thank you! I am a mom. I have two kids, my oldest is 3 years old and my youngest just turned one… so, things are always a little bit chaotic at my house, especially because my oldest has sensory processing disorder, and some days are pretty challenging! It’s always a journey!
Ayelet: Exactly! I think pretty much anyone could agree to that! Good, so in your career, you’ve worked with clients of all ages. Let’s talk a little bit about those early communicators. So, infants and toddlers who are not yet using verbal language. Can you describe to our listeners a little bit about what that means and what that might look like?
Carrie: Sure! Generally, we expect to see our children get their first words between about 12-15 months. So, we’re going to see that first word or two appear during that timeframe. But, a lot of our children just tend to net get those words right away. And it may be a little while before we see that language emerge. Now, this doesn’t mean that they’re not communicating.
We have a lot of our infants and toddlers who are really good at letting us know what they need. I’m thinking of my own one-year old right now, and he is quite insistent on his life, and rarely uses an actual word for those things. But he’s able to let you know with his body language or pointing, or grunting, or screaming like a crazy man. So, we often see a lot of this communication happening, but not the language piece – and by that I mean the specific words to accompany those thoughts.
So, with our younger kids, sometimes we would call those late talkers, sometimes we’ll call that a language delay, but any time we’re not getting those first words between that 12 and 15 months, or maybe they’re more like 18 months to 2 years and they only have a couple words as opposed to the larger vocabulary that we would expect to see at that age, we tend to call those our “late talkers” or just a general “language delay.” And that happens for a variety of reasons, there’s not really one cause or one fix, but that’s kind of where we end up seeing some of these children fall.
Ayelet: Right, because as speech-language pathologists, I think a lot of people assume that many of us work – and many of us do work with older children, or children who are not pronouncing certain sounds, or adults who have had any kind of neurological deficits, perhaps. But, a lot of us (including myself) are working with infants and toddlers because they are delayed in speech or language.
Carrie: I’ve had people sometimes that’ll say, you know, people that don’t know what I’ll do, and I’ll say “yeah, I’m working with this 2-year old…” or whatever – and they’ll say, “how do you speech therapy on a kid that can’t talk?” And, well that’s the point! I’m teaching them to talk!
Ayelet: Yes! Exactly. So, that leads me to my next question which is that I want to hear about some strategies today that you might use as a speech & language pathologist who works with that population.
Carrie: Absolutely. So, generally I start off with 5 basic strategies, and my approach has always been to teach these to the families. The family is going to be the ones that are with the child most of the time. I might see them once a week, maybe twice a week if I’m lucky, but that’s not enough time to create this global change that we’re wanting to see in these children.
So it’s really important that families are able to do these things at home, and these are things that you can start at any point – you don’t need to wait until a speech pathologist “prescribes them” to you – they’re great for all children who are learning language, so you can try these strategies. My general approach has been, try these simple strategies, and if doesn’t work, then we start moving into some of the more advanced strategies that you do need a speech pathology degree to be at least able to explain and to figure out which type of strategy will work best for the child.
Ok. So the first one is Sign Language. I love Sign Language for young children because a lot of times, that motor piece of getting their mouth to say what their brain is thinking… that is just too complex. Their brain isn’t ready, their motor pathways aren’t ready, for whatever reason, it’s too hard. But these kids are already using their hands to gesture, they may be pushing you away, they may be pointing at something, they may be grabbing for things. So using hands to communicate is just a nice, natural way to do this.
Now, I will say, I have a lot of parents that will say, “woah, wait! If we do Sign Language, then they’re not gonna talk! They’ll just use their signs, and they won’t have a reason to use their mouths!” So, here’s my answer to that: First of all, there has been research done that has shown that using Sign Language or some kind of augmentative communication does NOT prevent children from speaking. This is actual research that has shown that’s not the case, and in many cases, it sort of helps them speak more quickly, because it serves as a bridge to language.
The research is not supporting that your kid’s gonna stop talking. And the way I like to think about it is – think of a baby who’s crawling. So, that baby doesn’t yet have the motor skills to stand up and walk. They’re gonna crawl to get that need of movement met. If they couldn’t crawl, they would just get super frustrated and scream all the time, because they want to get over there! So, that baby’s gonna crawl. But once that baby’s body is ready to get up and walk, that child is going to stand up and walk, because that is always going to be easier than crawling. So, just saying what you want is going to be easier once the mouth catches up.
Ayelet: So, we can think of signing as, much like crawling, a bridge to the eventuality of the most efficient way to communicate, which is talking, or the most efficient way to move, which is walking. That’s a great analogy.
Carrie: And you don’t have to try to learn an entire language, also. You can just pick up a couple of signs that you think would be helpful for your child, and sign those when you’re saying those words. I like the Baby Signing Time videos, those are great, you can watch those with your child, and then you’re learning along with them, and then use those signs throughout your day. Or I have some Sign Language flashcards on my website, or there’s other Sign Language dictionary websites where you can just go look up a word. So, there’s lots of resources – you don’t have to feel like you need to master the whole language to do this.
Ayelet: That’s it. So we’ll like to those flashcards on your website, Carrie, and then I also have a download that we’ll link to on the podcast page for this episode, as well, which are 10 early developing words – the signs for those. We’ll give our listeners access to those things today.
Carrie: Ok, so the next suggestion I usually give to parents is to speak in shorter utterances. Now, this goes against some advice that parents will get, which is, “speak in full sentences to your child so that they’ll understand!” – which is fantastic, and I highly recommend that, I do that with my own son. But when you are looking at a child who is having trouble getting these words out, they need some simpler models to imitate. You can still be using full sentences around your child, to your child – that’s fine.
But some of your communication with your child needs to be a single word or two words. So, what we’ll say is that when you’re having this really great language interaction time, when you’re sitting down and playing with your child, you need to be speaking at or right above your child’s level. So, at would be: if they’re speaking one word at a time (or none), you go one word at a time.
Right above that would be two words together. So, you sit down with a ball. You hold up the ball and you say, “ball.” Just that – that’s it! – “ball.” And then you can say, “roll ball!” and then roll it. Or, “my ball!” and then take it back. So you can just model the word, and then you build on that just a little bit. And what that does is it gives the child a model that they have a better chance of repeating back to you than, “ooh! Mommy has a pretty new ball! Would you like to play with the ball with Mommy?”
Ayelet: Right! Which, of course, you can introduce the activity like that, but then once – I like how you said that, when you’re sitting down, you’re starting to interact, and you’re watching what your child is doing, you’re looking at what he or she is looking at – he’s looking at the ball and you say, “ball! Yup, it’s a ball! Ball.” I love that. I love that. I think a lot of parents get overwhelmed with, “ok, how does this actually look,” but that example that you gave, I think is great.
Carrie: So, we talked about Sign Language, we talked about shorter utterances – which, “shorter utterances” is going to help you with that Sign Language, because you’re not going to feel like you have to sign a whole sentence, you can just sign, “ball.” You just have a single word to sign.
So, my third strategy: if you’re having trouble figuring out what to say when you’re using these shorter utterances, is do some parallel and some self-talk. So, self-talk is going to be talking about what you’re doing; parallel talk is talking about what your child is doing, or thinking, or looking at, or paying attention to. You’re playing with the ball, and you say, “ooh, ball. Big ball! Throw ball.” So you’re doing all these things. And then your child does something with the ball, and you label that. So, “ball” (remember, we want to use those one-words, too!), and then you say what the child’s doing. Maybe you say, “throw! Johnny throw! Throw ball! Johnny throws the ball.” So you can use all these different types of shorter utterances while you’re talking about what you’re doing and what your child is doing. It’s kind of like narrating, is kind of the idea of parallel and self-talk.
Ayelet: Right, I’ve heard it described in the past as sort of, you’re the radio announcer. You’re the podcast host, basically. And I talk a bit about those two strategies on my free “Building Language” course for building language into caregiving routines that you can access. I’ll put the link in there, as well. That’s great. I love how these three have already built upon each other, and it shows, really, how you can use them all in conjunction. So, what else do you have for us, Carrie?
Carrie: Ok, our fourth tip today is “expansions.” An expansion is when you take what the child has done and you build upon it. So, this is also called scaffolding if you’ve heard that term. I like the word “expansions” because it makes me think of expanding what they’re already doing. So, if a child says, “ball,” you repeat “ball” back, but then you add one thing, and that can be any piece of language you want. It can be the action that’s happening with the ball – “throw ball,” it could be a descriptor – “big ball,” it could be a possession, whose ball is it? – so, “my ball / your ball / Johnny’s ball.”
It doesn’t matter what it is – it could be “the ball!” – you could add an article. It doesn’t matter what it is, you’re just adding one piece to make it slightly more complex. And, the cool thing about this strategy is that you can continue to use this all the way through their language development. So, if the child says, “I want ball,” you say, “I want the ball.” Then you added an article, you’re helping him build grammar. So, you can continue doing this, regardless of how long his utterance is, you just add one thing to either make it more complex or more complete. That’s the way you do it if the child’s already talking.
Ayelet: I want to just pause and mention that, because I think that’s a great example, but I also want to make sure that parents realize that we’re not encouraging you to go in and say, “no, no, no, it’s the ball!”
Carrie: Right – you’re just repeating it back to them so that they have that model. You’re not demanding that they say it back to you, you’re not demanding that they fix it – you’re just adding some information, so that the next time, maybe they have it in their brain.
Ayelet: Right, yeah, you’re providing a grammatically correct model.
Carrie: If you have a child who’s not speaking yet, you can still use this, it just looks slightly different. So, if your child comes up and points at something, your expansion is to add the language to that. So, you say one word of what it is. So, they point at the ball, and you say, “ball,” or they sit down and throw a fit, you say, “angry. You are angry.”
So, you’re giving them words for the body language or the gestures, or even maybe just what you think they may be thinking. So if they’re sitting there staring at the refrigerator, you say, “Hungry? Are you hungry? Do you want something to eat?” So you can give them these words, even if you’re not entirely sure what words they may be thinking of, but it gives them some options and some ideas of words that they can eventually try to say as well.
Ayelet: Right. I think that’s really useful for parents, as well, because it gives us as grownups an insight into putting ourselves into the minds of our own children, and assuming intentionality, which, I think, is a really important part – especially with those pre-verbal kiddos. Because that’s how they’re learning language! They’re learning it through us, through our model, by imitating us, and by watching what they do. So when we give an intention to what we think we see, even if it’s not totally clear, then we model the language that we infer.
Carrie: Yeah. And this one can be especially powerful if you add the expectant pause afterwards. So if you are expanding on what a child says, and you, let’s say, were labelling. So they point at a ball and you say, “ball” and then look at them expectantly and wait. And you should always wait longer than you feel comfortable doing, because we have a tendency to just keep talking, and talk over the child’s turn because they’re not talking as much or not taking that turn.
But if you just say, “ball…….” And then wait? What that does is that it gives them an opportunity for them to say it back to you – if they want – we’re not requiring it, we’re just providing the opportunity. Or at the very least, you’re just signaling to that child that you are saving a place for their conversational turn. So when they’re ready to talk, you’re ready to listen, because you’re providing that space. And I like this a lot better than – some speech-language pathologists will give you the advice of, “oh, well, if your child’s just gesturing, ignore them until they say the right word.” You want to acknowledge any communication, but you want to also provide them the opportunity to say the word when they’re ready.
Ayelet: Exactly. And like you were saying before, it is that bridge, as a gesture is a bridge to verbal language. That’s great, Carrie, thank you. Perfect. Alright, we’ve got one more.
Carrie: Ok, so the very last strategy we have for you today would be what we call “AAC,” or visual supports, we’re kind of lumping these together. So, AAC stands for “augmentative and alternative communication,” and basically, that’s just any way of communicating and using language other than spoken language.
So, Sign Language counts as AAC. You may have seen devices or apps where you push a button and it speaks a message for the child. These are all really great tools. I feel like if you are just a parent looking at this, surface level, you probably want somebody to guide you through the process of finding a good AAC system for your child, so I wouldn’t just jump into that, willy-nilly. Don’t go download a $300 app and think it’s going to fix your child, because it won’t.
Ayelet: Please don’t do that.
Carrie: So, that would be something to explore with your speech-language pathologist, but it’s good to just kinda know that’s out there. But as you’re kind of waiting for that process, or if you just want to dabble a little, you can just basically use some visual supports. And what I mean by that would be having pictures that will help your child communicate. So if you have, let’s say for example you have a couple of snacks or drinks in the fridge that you know your child always wants, but they’re not able to say those words. So they just go to the fridge, they bang on the door, and they throw a massive fit. I’m speaking from experience, guys.
So what you could do is just go on your computer, get some clip art pictures of those different foods, photos are going to be better but if you can just find clip art, that’s fine, too, and then just print those out and tape them to your fridge door. So you have a picture of milk, you have a picture of juice, you have a picture of applesauce – whatever the things are that your child really wants. And your child goes over to the fridge, they start banging on the door, and you say, “oh, you look hungry. Let’s look and see what we want.” And you look at the pictures, you say, “do you want milk?” and you point to milk, you pause, “do you want juice?” and you help them look at those pictures, and, ideally, they would point to one to tell you what they want.
Now, that is communication: we want to reward that. Now, if that doesn’t work, you open up the fridge door, and figure out which one it was, they grab it or whatever. You close the fridge door and you go back to the pictures and you say, “look! Applesauce! You picked applesauce.” And then you could even model the sentence – “I want applesauce,” and point to the picture. So, you can use visuals in that way to give them another option. Ok, Sign Language isn’t working, maybe their mouth isn’t working – maybe they can just look at what they want. That’s great! Any way that we can get them communicating is what we want at this point.
Ayelet: Right. And I think that’s great because we’re really thinking then, about playing to, number one, the child’s interests and desires and needs, and then also, creating a language-rich environment, where you have representations of the objects if they’re not in plain view. So, I like that you started with food because I think that’s a really obvious one. Can you give us a good example of what that might look like in a play routine, for instance? If the child, say, really likes blanket blank.
Carrie: Yeah. So you can definitely have pictures of favorite toys, and maybe you have those higher up on a shelf or maybe you have them in a jar or some place where they can’t get to them, and you help them use that picture to communicate that with you. You can also use pictures for things like “my turn,” like “I want a turn with that,” so that they’re not just grabbing. So when they go to grab someone else’s toy, then you can show them the picture and help them, “ok if we touch this, that shows that I want a turn.” So you can help them through that.
You can have different fun play activities or actions, so you could have a picture for “hug” or “tickle” or “wrestle” (which would be my boy’s favorite!) and say, “you know, when you want to wrestle, you can show me with your picture and then we can do that activity.” So, there’s all kinds of ways to build pictures into your day. You know, you could have even a little notebook that you carry around with some pictures, or you could just have some stashed in places where you know you’ll need them.
Ayelet: Right. Because it’s great for choice-making, it’s great for very obvious decision-making where a child is creating very specifically through a picture or a puzzle piece, or whatever it is that they find to express exactly what it is that they want to do or what they want to say.
Carrie: Yeah. I really like looking at, what are the times when your child is having the most behavior problems? Because that generally indicates that the child has a very strong need that they’re not getting met because they can’t communicate that. So, if your child has a fit because he wants to get out of his high chair at dinner, he wants to be all done with dinner, then you can give him a picture that says “all done” and he touches that picture and you say, “ok! I’ll get you out of that high chair” or whatever that meltdown is, try to figure out, “ok, what would he be saying if he had words?” and give him the picture – that’s super easy to use!
Ayelet: Give him the picture, show him the sign, say the word, that’s it. Beautiful, thank you. And then, you mentioned before that these are good strategies for really anyone, and I think you gave us some good examples about the way that we can use them for really young children who are not yet communicating verbally, and then also older children who are emergently verbal or truly verbal at this point. But, you would say, just to reiterate, that these are generally appropriate for any infant and toddler? Or are these strategies specific to kids who are experiencing delays in communication?
Carrie: That’s it – these are great for any child. I mean, all of our children are learning language. At whatever level they’re at, they are looking at the language around them and incorporating that into their own language systems. So, using Sign Language, using pictures, using shorter utterances – all of these things are going to help any child who is communicating and learning to communicate, regardless of whether they have a delay or not.
Ayelet: Right. And we do, we modify our speech naturally, often times. We use more gestures with early communicators often times, too. So, this is just sort of an extension of that. It’s not, you know, I mean I think as speech-language pathologists we like to think of ourselves as “magical communication makers,” which, of course we are, but these are the strategies that we use, because these are the things that are just extensions of what we do naturally to provide language to our children, and to help parents and caregivers really delve deep and make those things that we naturally do slightly more obvious or take it to the next level. Ok! So, Carrie, can you share some of your favorite resources for parents? Or for educators who work with this age group?
Carrie: Sure! So, the first thing I’ll say is that if you are a parent and you have a child who maybe isn’t speaking as much as maybe you think they should or maybe doesn’t understand, the best thing you can do is go sit down with a speech-language pathologist who can look at your child, lay eyes on your child and tell you, “no we’re good” or “yeah, we need some interventions here.” I know as a parent of a child with special needs, I spent way too much time thinking, “is this normal, is it not normal? Maybe it is normal, no I don’t think it is” – and going back and forth and just torturing myself! And thinking, “well, maybe if I just try some strategies on my own, I can figure… no, that’s not working!”
So, just go sit down, you know. You can do an hour-long evaluation and know exactly where your child is. Even if that speech-language pathologist tells you, “no, he doesn’t need therapy right now,” she’s gonna give you some strategies that are specific to your child that will definitely help. So, just go talk to someone! Don’t feel like you can solve it all on your own through the internet, although there are tons of great resources out there, but the best thing you can do is just go sit down with someone. That being said, there are lots of great resources if you just want more information. I have some over on my website, I have an e-book for late talkers that goes into these strategies, gives weekly assignments, and just kind of gives you a path to take, because often it just feels very overwhelming to try to do all of this at once.
That’s over at https://www.speechandlanguagekids.com/jump-start-your-late-talker/, so you can find that there. And I also have free resources over there for late talkers, as well. There’s just a dropdown, you browse by topic, and there’s a late talker section. You can find tons of great stuff there. I know you have tons of great stuff, Ayelet. There’s all kinds of resources and support, too. You know, going to other families who have been through this – that can be really helpful.
Ayelet: Yup. There’s a Facebook group that I run with another speech-language pathologist called, “Let’s Talk: Infant & Toddler Development” that is full of parents, caregivers, educators and other therapists who work with infants and toddlers of all developmental levels, so that’s a nice resource, as well, for parents. Great!
So finally, can you tell us a bit about your latest projects over at Speech & Language Kids [The SLP Solution]?
Carrie: Absolutely! Yeah, so over at Speech & Language Kids, I have a ton of free resources. Almost everything there is free, there’s blog posts, I like to break down skills into manageable steps, so if you’re like, “oh my god, we’re stuck on ‘where questions,’ head on over there and there’s a post on “where questions,” breaking it down into how you do this. So, we’ve got a ton of free stuff over there, we also have a couple e-books, like I mentioned, and then the coolest thing we’ve got going on right now is our membership for speech-language pathologists.
So I know a lot of people listening are parents, but for the SLPs in the group, we do have a membership area that is, basically, we’re providing training, we’re providing workshops and materials you can print off, we answer your questions if you’re stuck with a case and you need to ask some questions about it, and we just got approved to offer ASHA CEU’s, so we’re gonna start that in September of 2017. So we’re going to be able to provide those CEU’s that you need to keep your license, and if you get into the group before September 1st 2017 (if you’re listening in the future), you’re going to lock in a lower rate because we are raising the price in September. So. That’s over at speechandlanguagekids.com/join, and you can see all the fun benefits of the membership!
Ayelet: Super. Thanks so much, Carrie, this has been really helpful, and I can’t wait for all our listeners to be able to take advantage of all your great strategies and tips.
Carrie: Thank you for having me, this was fun
Ayelet: My pleasure, see you soon! Woohoo!