Dynamic Temporal Tactile Cueing (DTTC) for Apraxia: Caregiver Guide

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DTTC Flowchart created by Once Upon a TIme

Dr. Edythe Strand Explains CAS for Caregivers

Childhood apraxia of speech (CAS) is a label for a speech sound disorder that impacts one’s ability to plan sequential movements for speech productions. There are several evidenced based programs available for treating this neurological condition, one of which is Dynamic Temporal and Tactile Cueing (DTTC.)

DTTC Defined

DTTC is a therapy approach that helps kids learn how to move their mouth muscles for talking. It focuses on practicing different mouth movements. Unlike other speech therapies, DTTC is effective for kids with severe speech problems. Your speech pathologist picks specific speech motor movements to practice extensively, slowly helping kids do it on their own.

The amazing thing about this therapy is that when your child learns to make one speech motor movement, he can use that skill for other movements too. For example, learning to say the “p” sound in “up” can help with saying “p” in “pup.” And once your child gets good at saying single words, it helps him talk in longer sentences and have conversations.

Resources Caregivers Can Share With Their SLP

As a speech pathologist, my mission is to educate both caregivers and peers about resources that support children with CAS. DTTC offers an incredibly accessible program for any speech pathologist interested in improving their skill set. Child Apraxia Treatment is a program of the Once Upon a Time Foundation, a Nonprofit 501(c)3 Organization. This website directs speech pathologists to the following FREE coursework:

  • Introduction to CAS: Virtual course taken at your leisure for increasing knowledge of childhood apraxia of speech characteristics and basic treatment (.15 ASHA CEUs)
  • Diagnosis and Treatment of CAS Using DTTC: Everything you need to know about DTTC (.45 ASHA CEUs)
  • YouTube Channel: Link that directs you to view the online courses while bypassing ASHA CEUs
  • Advanced Workshops: FREE in-person 2 day workshop via application process for speech pathologists seeking advanced knowledge about DTTC (1.3 ASHA CEUs)

Hierarchy

Once Upon a Time created the above flowchart that concisely and brightly summarizes the supportive levels of DTTC towards spontaneous practice. The keys at the bottom further explain the types of cues utilized in DTTC and examples of prosody models. Ultimately, the goals are to fade cueing supports, increase speaking rates, build consistency, and expand prosody (tones) to at least two types. You can find a copy of the above image by navigating to this link and then clicking ‘Downloadable DTTC Hierarchy Infographic.’

Target Selection

Your speech pathologist begins with a dynamic evaluation, which allows your therapist to provide cues while assessing to make note of the most supportive options for therapy. Ultimately, your therapist selects anywhere from 4-6 speech motor movements for a practice round, depending on severity. Working on one movement, should generalize to other targets.

Motor Movements Defined

In your child’s session notes, you should see summaries using abbreviations for a variety of motor movements. Below, the therapist typically utilizes early movements in DTTC intervention, with a few examples listed for each.

  • CV: Consonant-Vowel (me, do, show, bye)
  • VC: Vowel-Consonant (eat, up, on, at)
  • Reduplicated syllables (papa, Dee-Dee, cuckoo, boo-boo)
  • CVC1: Consonant-Vowel-Consonant with the same first and last phoneme (mom, pop, dad, sis)
  • CVC2: Consonant-Vowel-Consonant with different first and last phonemes (home, mine, mad, book)
  • Bisyllabics: One consonant with two vowels (uh-oh, baby, daddy, mommy) progressing to more varied syllable shapes (happy, open, today, movie)
  • Multisyllabic Words: Multiple syllables (banana, video, peekaboo, lemonade)

Supportive Movement Focus

a mother talking to his daughter while sitting on the couch

Let’s take a closer look at each supportive stage in the DTTC hierarchy, so you can have a clearer picture of what this program looks like. Your therapist will use her clinical training and expertise to determine when your child is ready to advance to the next step.

Simultaneous

The first step is to practice saying the movement together at the same time. Following an explanation, your therapist may count down to help sync the productions. Sometimes, it’s beneficial for the therapist to fade her voice and just model the movement at this level. While varying prosody is encouraged, it is not necessary for advancement to the next step. At first, this level may take some time with up to 15 repetitions. Moving forward, trials will reduce and practice may begin at the highest level reached from the previous session.

Direct Imitation

Here, your therapist says the target and then your child imitates it immediately. Models may begin at a slower rate and then gradually increase in speed. Now, it is essential to model varied prosody with the intent of having your child imitate at least two variations. Don’t be surprised if your child masters one motor movement but struggles with a different prosody. Your therapist will adjust cues and supports accordingly. Ultimately, the aim is to practice without errors to establish a precise motor plan.

Delayed Imitation

Just as the title implies, imitations occur with a slight delay at this level. I have found that building on the delay is helpful. First, I explain this new step and then I use the word “wait” after my model paired with a hand gesture before I say “go”. I then build on repeating the word “wait” 2-3 times to lengthen the delay. As with direct imitation, we want your child to copy at least two prosody variations before moving to the final step.

Spontaneous

We have now worked our way to the final level. Once your child can produce a movement here, then he should be able to carry this over into phrases, sentences, and conversations. To prompt this practice, your therapist will ask a question, setting up your child to answer with the targeted word. Sometimes, I find it works to use a starter phrase like, “Ready, set, —” with a pause for the client to say “go” without hearing me model the word.

Incentives

During practice, your child should be free of distractions with your therapist positioned for optimal viewing of her face. If needed, then clients can earn incentives for blocks of practice in the way of: magna tiles, stickers, game pieces, bubbles, or puzzle pieces to name a few.

Feedback

Therapists begin by providing as much feedback as your child needs to be successful. Verbal feedback may include: “Open your mouth wider”, “Lips together!”, “That was it!” or “Try that again.” This feedback must fade so your child can self-monitor productions, gain independence, create accurate motor plans, and generalize skills unsupported.

Making Progress

As your child progresses in DTTC, we track their improvement in two ways. One way is by observing how well they do during sessions. Another is by doing a special test after a few sessions. During this test, your child tries to copy the movements without help. We give points based on how well they do. To “graduate” a movement, they need to get a high score. If not, we keep practicing it until they do better.

Frequently Asked Questions:

Does DTTC improve speech production in severely apraxia children?

Yes! DTTC was designed to benefit children with moderate to severe apraxia. Research and clinical experience suggest that children making little to no progress in traditional speech therapy may benefit from DTTC programming.

How is childhood apraxia treated?

Apraxia is best addressed when therapists factor the principles of motor learning (PML) as a guide during diagnosis and treatment planning. Motor learning is defined as a process of obtaining the ability to produce a skilled action. Therapists initially provide maximum supports to help the child produce motor movements and thereby develop an accurate plan to talk. Once a specific motor plan is established or created, then the child should be able to produce that motor movement in various contexts (word, phrase, sentence levels) and in multiple settings.

Does DTTC improve articulatory accuracy and verbal communication?

DTTC is one of several evidenced-based (research supported) approaches for improving verbal communication. However, it is imperative that a trained speech pathologist complete comprehensive and dynamic assessment before considering DTTC programming.

Why Isn’t My 18-Month-Old Talking? Key Milestones to Monitor

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Infant surrounded by toys

As speech pathologists, we often encounter one of the most common queries: Why hasn’t my 18-month-old started talking? Caregivers seeking guidance in understanding developmental milestones and potential causes for delayed speech require reliable support and information. This article aims to offer insights into typical developmental patterns, provide checklists, and explore the foundational skills necessary for speech development.

By the age of 18 months, many toddlers become quite energetic, exploring their environment with boundless curiosity. This age marks a pinnacle milestone, with significant progress in physical, social, and communication development unfolding simultaneously. While some toddlers begin to form words and simple sentences, others may not talk as expected, instead communicating through babbling or a variety of sounds and gestures. It’s important to recognize that each child develops at their own pace, and a very active 18-month-old not talking may still be acquiring language skills by understanding words and commands without actively speaking them.

Understanding speech and language milestones at the 18-month mark can help parents and caregivers gauge a child’s progress. Typically, an 18-month-old should have a vocabulary of approximately 5 to 20 words. They often comprehend far more than they can express and can follow simple directions or point to familiar objects when named.

However, if a child is not talking but seems to understand, it may be a sign of a speech delay, which can be common and usually addressable with proper interventions. A speech and language checklist can be a valuable tool for identifying if a child is meeting developmental milestones or if they may benefit from additional support or evaluation by a professional. There are some important prerequisites to talking that we will explore in the post.

Key Takeaways

  • Active 18-month-olds may vary in speech development, with some not talking yet but understanding language.
  • Typical language milestones include a vocabulary of 5 to 20 words and the ability to follow simple instructions.
  • Early identification of speech delays and targeted support can positively influence language development.

Understanding Toddler Speech and Language Development

Toddler speech and language development is a crucial stage where children typically begin to expand their vocabulary and start forming words. This progression allows them to express their needs and engage with their environment.

18-Month-Old Speech Milestones

By 18 months, a toddler often has a vocabulary of approximately 5 to 20 words. These words may be animal sounds and approximations for words. For example, “buh” for “ball” counts as a word as long as it is consistent. Other 18 month old speech milestones include:

  • Babbling with intent as if conversing
  • Gesturing to communicate needs or desires
  • Saying their first word by 12 months, with significant variability among individuals
  • Starting to imitate word combinations, such as “mama juice,” indicating a desire for juice from their mother, although this might not be consistent

18-Month-Old Language Milestones

Language milestones at this age reflect a child’s understanding, which often precedes verbal expression. An 18-month-old child usually can:

  • Understand and follow simple commands without gestural cues from adults
  • Point to objects or pictures when they are named, showing comprehension without producing words
  • Demonstrate recognition of body parts and/or clothing
  • Show interest in simple stories, rhymes, and songs
  • Turn to look at familiar sounds and understanding words for daily routines like “bath” or “sleep”

Identifying and Addressing Speech Delays

In monitoring a child’s development, understanding when to identify and address potential speech delays is crucial, especially at the 18-month milestone.

Prerequisites to Speech Development in an 18-Month-Old

  1. Hearing: Has your child had a number of ear infections or been diagnosed as having excessive wax in his/her ears? Even if your child has only been treated for a couple infections, that combined with a speech delay is enough to warrant further assessment.
  2. Comprehension: This one can be more difficult to rate than you think. Many young children are great at following everyday directions within a routine, so to really get some good information try calling your child by a different name. In this way, you are looking to see if your child fully comprehends the words you are saying or just responding to the sound of your voice.
  3. Gestures: Before children start talking, they use simple gestures like pointing or looking at desired objects. They may also reach towards or move away from objects to make their needs known. Keep an eye on them because while they are picking up small Cheerios on the table, they are also developing a refined movement with their fingers that will assist them in other activities like pointing.
  4. Babbling and jargoning: These noise making activities speak volumes about language ability. Infants begin by babbling one syllable at a time like ba, ba, ba or da, da. After some time, they learn to string these syllables together, which begin to sound conversational. Soon, they vary their tones from low to high and add some of those gestures mentioned above. Once in a while, you may hear a real word in the mix, usually around 10-12 months old.

What to Do If Your 18-Month-Old is Not Talking

If an 18-month-old is not talking, observing their comprehension and communicative gestures is important. Understanding without speaking can still indicate healthy development. If speech delays are suspected, the following steps are recommended:

  1. Hearing Test: Schedule a hearing test to rule out any hearing impairments that could affect speech.
  2. Consult: Speak with your pediatrician to discuss concerns and locate early intervention services.
  3. Speech Therapy: If indicated, enlist a speech-language pathologist for an evaluation and therapy.

Activities and Resources to Encourage Speech

While you wait for an evaluation, you can take these measures to stimulate communication:

  • Engaging the child in daily reading activities to stimulate language development
  • Simplifying language to match the child’s comprehension level
  • Ensuring consistent responses to the child’s communication attempts
  • Imitating the sounds your child makes
  • Transitioning from bottle drinking to open cup and straws
  • Teaching your child simple gestures and signs

For more ideas, check out this resource from ASHA.

Frequently Asked Questions

This section addresses common inquiries regarding the speech and language development of 18-month-old children who are not yet talking.

What are the common reasons for an 18-month-old child to not be talking yet?

Several factors may contribute to an 18-month-old’s lack of speech, including variations in development rates, being a late talker, or potential underlying issues such as hearing problems or speech and language delays. It is essential to observe the child’s overall development for a comprehensive understanding.

How can you tell if an 18-month-old child understands language even if they are not yet speaking?

An 18-month-old can demonstrate understanding through non-verbal communication, such as following simple instructions, recognizing familiar words and their meanings, and responding to questions with gestures. These indicators suggest they are processing language even if not verbally articulating words.

When should a parent be concerned about their 18-month-old’s lack of speech?

Parents should consult a healthcare professional if their child shows no speech progression, doesn’t understand simple instructions, or has no use of gestures by 18 months. These could be signs of developmental delays, and early intervention might be necessary.

What is the typical vocabulary range for an 18-month-old, and when is babbling considered normal?

The typical 18-month-old may have a vocabulary of approximately 5 to 20 words. Babbling remains a normal part of speech development at this age, especially as a precursor to forming actual words. Persistent babbling without clear words emerging may require attention from a speech-language professional.

Receptive & Expressive Language Growth in Early Childhood

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kids exercising in school

Receptive language refers to the ability of individuals to comprehend or understand language as it is spoken or written by others. It encompasses the processing of words, sentences, and meaning conveyed through language, which is crucial for effective communication. People use receptive language skills to follow instructions, understand stories, answer questions, and engage in conversations.

two toddlers sitting on grass field

Contrastingly, expressive language involves the production of language, allowing individuals to convey their thoughts, feelings, and ideas to others. This includes speaking, writing, and utilizing non-verbal communication gestures. Expressive language skills enable a person to ask questions, describe events, express opinions, and construct coherent narratives.

Expressive and receptive communication skills are foundational competencies that develop during early childhood. They are fundamental for social interaction, academic success, and overall personal development. Understanding the distinction between receptive and expressive language capabilities is important for identifying communication disorders and implementing effective interventions.

Key Takeaways

  • Receptive language encompasses the understanding of spoken or written messages.
  • Expressive language involves the articulation of thoughts and ideas.
  • The distinction between receptive and expressive language is key for tracking developmental progress and addressing communication disorders.

Understanding Receptive and Expressive Language in Toddlers

kid giving flower to dog on beige floor in studio

The development of receptive and expressive language is crucial during the toddler years, as it lays the foundation for communication skills. Mastery over these language skills allows toddlers to understand others and express their own thoughts effectively.

Definition of Receptive Language

Receptive language refers to the ability to understand words and language. It is the comprehension of spoken language, gestures, and symbols one receives and interprets. In toddlers, receptive language skills include understanding words, sentences, and the intent of questions. For instance:

  • Words and Phrases: Recognizing names of familiar objects, people, and actions.
  • Following Directions: Ability to follow simple commands, such as “Pick up the toy.”
  • Questions: Answering yes/no and WH questions: who, what, when, where.

Definition of Expressive Language

Expressive language is the use of words, sentences, gestures, and writing to convey meaning and messages to others. This includes articulating wants, needs, thoughts, and information. For toddlers, expressive language skills involve:

  • Vocabulary: The number of words a toddler can use consistently and appropriately.
  • Combining Words: Starting to put words together to form simple phrases like “More juice.”
  • Constructing Sentences: Formulating questions, comments, requests to express wants and needs.

By understanding these aspects of language development, adults can provide better educational and developmental support to toddlers.

Signs of Receptive/ Expressive Language Disorders

kids exercising in school

Common signs of a receptive language disorder include difficulty following directions, understanding questions, or grasping the meaning of words and sentences. Specifically, these are some of the milestones observed across the following age ranges:

  • 12-15 months: Completes a one-step command without gestures
  • 15-18 months: Points to several body parts on a doll
  • 18-21 months: Understands action words like sit, walk, sleep
  • 21-24 months: Follows two-step related commands like “Pick up the ball and roll it to me”
  • 24-27 months: Comprehends concepts “one”, “big”, and “small”
  • 27-30 months: Responds to simple questions
  • 30-33 months: Answers yes and no questions correctly
  • 33-36 months: Follows three-step unrelated commands

An expressive language disorder may manifest as limited vocabulary, trouble forming sentences, or difficulty using language in socially appropriate ways. Unless your child is demonstrating signs of a gestalt language processor, then these are some typical milestones seen in the toddler years:

  • 12-15 months: Says up to 10 words independently without imitation models
  • 15-18 months: Uses 15 meaningful words and asks for “more”
  • 18-21 months: Imitates phrases and starts using a 2-word phrase independently
  • 21-24 months: Expresses up to 50 words which may include animal sounds and consistent approximations (i.e., “muh” for “more”)
  • 24-27 months: Starts using a 3-word phrase regularly
  • 27-30 months: Consistently responds to greetings
  • 30-33 months: Uses plurals and prepositions
  • 33-36 months: Talks in sentences

If you observe your child struggling in receptive and/ or expressive language skills, then talk with your pediatrician about your concerns and seek an early intervention evaluation. Trust your gut and finds ways to support your toddler sooner rather than later.

Frequently Asked Questions

The following commonly asked questions address the distinctions, development, and challenges associated with receptive and expressive language skills.

How can expressive language skills be developed in early childhood?

Expressive language skills in early childhood can be developed through consistent engagement and conversation with the child. Reading books, singing songs, and playing interactive games that encourage children to verbalize their thoughts and feelings are effective methods to foster these skills.

In what ways do receptive language skills impact overall communication?

Receptive language skills are fundamental to effective communication. They allow individuals to process information, follow conversations, and respond appropriately. Without strong receptive skills, engaging in dialogue or learning from verbal instructions becomes challenging.

What should I do if my toddler understands everything I say, but isn’t talking?

If a toddler shows good receptive language skills but limited expressive language, it may be beneficial to seek advice from a speech-language pathologist. They can assess if the child is within a typical developmental range and provide strategies to encourage speech development.

Speech Therapy Near Me: Your Guide To Finding Pediatric Care & Affordable Services

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Brightly colored clinical waiting room

Seeking the right speech therapy services can be a crucial step for many individuals and their families. If you are searching for pediatric speech therapy for your child, or looking for the best speech therapist in your vicinity to address specific communication challenges, understanding your options is essential. You are your child’s best advocate in their early years of development and talking with your pediatrician is a great starting point. Early intervention is particularly important for children with speech or language delays, as it can greatly enhance outcomes by addressing issues as soon as they are identified.

Speech therapists are trained professionals who assess and treat communication, speech, language, fluency, social pragmatics, voice, feeding, and swallowing disorders in children and adults. Their expertise can be invaluable in fostering effective communication, which is a vital part of personal development and daily living.

A colorful office with toys, books, and a cozy seating area. A speech therapist works with a child, using visual aids and interactive games

Accessibility to such services plays a significant role, as proximity can influence the consistency and convenience of attending sessions. Additionally, it’s important to consider the cost, as therapy is sometimes a long-term process, and budgets can vary widely. Many insurance plans cover speech therapy services, so call your carrier and ask about in-network benefits. Some policies also allow out-of-network coverage.

Key Takeaways

  • Identifying the right speech therapy service is important for communication development.
  • Convenience and proximity are factors that can influence therapy outcomes.
  • Costs vary; seeking affordable options, especially for early intervention, is beneficial.

Understanding Speech Therapy

A cozy office with colorful toys and books, a friendly speech therapist working with a child, engaging in speech exercises and activities

Speech therapy is a clinical approach aimed at improving speech and language skills and oral motor abilities. This field is especially significant for children facing challenges with communication.

The Role of Speech Therapists

Speech therapists are qualified professionals with specialized training in the evaluation and treatment of communication disorders including difficulties in speech, language, fluency, pragmatic, voice, and feeding/ swallowing. These professionals work to develop individualized plans tailored to each person’s needs, which may include:

When assessing if your child needs speech therapy, speech therapists will consider factors including but not limited to:

  • Reduced articulation and speech intelligibility
  • Difficulty following instructions
  • Problems forming sentences that are coherent and fluent
  • Limited vocabulary for their age group
  • Challenges with social communication skills
  • Vocal quality in terms of pitch and resonance
  • Oral motor structure, function, and use for speech, feeding, and swallowing

Benefits of Early Intervention

Early intervention is the process of providing services and support from birth through three years to children who are at risk of or already have developmental delays or disabilities. The benefits are immense and include:

  • Maximizing Potential: Early therapy can leverage children’s plasticity of their developing brains, facilitating improvements in speech and communication skills.
  • Preventing Worsening: It can prevent challenges from becoming more severe as the child grows.
  • Supporting Development: Enhances a child’s personal, social, and academic growth, laying a strong foundation for further development.

If you suspect your child may benefit from speech therapy, it’s advisable to consult with a speech therapist for an evaluation. Early detection and intervention can be pivotal in ensuring successful communication skills for your child.

Finding Speech Therapy Services

When searching for speech therapy resources, pinpointing the right services geared towards specific needs, budget, and location is crucial. Understanding your options helps in making an informed decision.

Searching for Pediatric Speech Therapy

Locating pediatric speech therapy services near you can be done through multiple avenues. Hospitals and pediatricians often provide referrals to certified speech therapists who specialize in childhood communication disorders.

  • Social Media: Post in local parent groups for word of mouth recommendations.
  • Online Directories: Utilize online directories specifically designed to find pediatric speech therapists.
  • Local Health Departments: Check with your local health department for a list of pediatric speech therapy services.

Remember, when selecting a pediatric therapist, ensure they hold the appropriate credentials and have experience in dealing with children’s speech issues.

Options for Affordable Speech Therapy

Affordable speech therapy might seem challenging to find, but there are several options to consider:

  • Insurance and Medicaid: Confirm if the therapist accepts your insurance or Medicaid, which can significantly reduce out-of-pocket costs.
  • University Clinics: Local university speech and hearing clinics often offer lower-cost services provided by supervised students.
  • Non-Profit Organizations: Some non-profits provide speech therapy at reduced rates or even free for those who qualify.

Ensure you inquire about all potential costs upfront to avoid unexpected expenses.

Financial Considerations

A colorful office with toys, books, and speech therapy tools. A welcoming waiting area with comfortable seating and a friendly reception desk

When considering speech therapy options, understanding the financial implications is crucial. Assessing insurance coverage and comparing the costs between private and school-based services will guide your decisions.

Navigating Insurance Coverage

Does insurance cover speech therapy? Most health insurance plans provide coverage for speech therapy, but the extent varies. You should review your policy for speech therapy specifics, including the number of sessions and types of therapy covered. Prior authorization may be required for therapy to be covered, so it is important you communicate with your insurer to understand your benefits.

The No Surprises Act, launched in January 2022, safeguards consumers from unexpected expenses. It is well within your rights to ask for a detailed outline of what is covered before starting therapy sessions. Moreover, early intervention programs may be covered under different rules, usually provided at no cost through state programs, so it’s worth checking with your local early intervention office.

Private vs. School Speech Therapy

Why should you seek private speech therapy if your child receives speech in school? School-based speech therapy is a valuable resource, but it may not meet all your child’s needs. School programs often focus on educational performance, whereas private therapy may address a broader range of communication issues. Moreover, private therapy sessions are typically more frequent and can offer more individualized attention.

Frequently Asked Questions

Navigating the landscape of speech therapy options can be overwhelming. This section provides clear, expert responses to common inquiries regarding pediatric speech therapy and related services.

How do I get my child evaluated by early intervention?

For children under the age of 3, you can contact your state’s early intervention program directly for an evaluation. If your child is eligible, then they may receive services without cost or at a reduced cost, depending on your state. Remember, early intervention can be pivotal for the best outcomes in speech and language development.

At what age should a child begin pediatric speech therapy?

If you notice delays in your child’s speech and language development, it’s beneficial to start pediatric speech therapy as early as possible. Intervention can begin from as young as 6-12 months, as therapists can work with children at any age when concerns arise. Infants born with a known syndrome should immediately qualify for early intervention services.

What types of speech disorders can be treated at a speech clinic?

Private therapists in clinics may seek specialized training in apraxia, stuttering, and myofunctional therapy. There are several sites that these therapists can apply for recognition following continuing education training such as PROMPT and Apraxia Kids.

What are the early intervention strategies for speech therapy?

Early intervention strategies for speech therapy might include play-based therapy, parent training and coaching, the use of pictures and gestures for communication, and specific exercises targeting the development of sounds and language comprehension.

Telegraphic Speech: An Important Milestone

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Keyboard

Telegraphic speech refers to a form of communication commonly used by young children as they are developing their language skills. It involves speaking in short, simple phrases, usually comprised of only the most important words needed to convey a message. These 2-3 word phrases exclude non-essential parts of speech, such as articles, prepositions, and auxiliary verbs. Telegraphic speech sounds like telegrams, where brevity was valued and filler words were left out to save time and cost.

A person typing on a computer keyboard with a speech bubble containing short, fragmented phrases

Telegraphic speech is an important phase in speech development. It emerges once children have progressed past the babbling and single-word stages, typically between 18-24 months. As children’s vocabularies grow and their cognitive abilities become more sophisticated, their sentences gradually become longer and more complex, including a wider range of grammatical structures. Telegraphic speech is a natural and expected stage of language development that signifies a child is learning to communicate their thoughts and needs effectively.

Over the last decade, research has concluded that modeling telegraphic speech with children beyond this phase of language development may hinder them from making grammatical progress. This warrants reflection for therapeutic intervention, especially among autistic populations.

Key Takeaways

  • Telegraphic speech is a typical stage in children’s language development involving short and simple phrases.
  • It is characterized by the omission of non-essential words, mirroring the concise nature of a telegram.
  • The evolution from telegraphic speech to more complex sentences indicates growth in a child’s communication skills.
  • Using telegraphic speech models beyond this phase of development may hinder grammatical progress.

Understanding Telegraphic Speech

A child pointing at simple objects: ball, cat, book

In this section, you’ll learn about the concise form of communication known as telegraphic speech, which is critical in early language development.

Definition and Characteristics

Telegraphic speech refers to the two-word phrases that children begin to use when they start speaking. This form of speech is typically observed in toddlers around the age of 18 to 24 months. It is characterized by the omission of non-essential words, leaving only the most important words to convey a message. The name “telegraphic” draws from the way telegrams were written, omitting unnecessary words to save costs.

Examples of telegraphic speech:

  • “Want cookie” instead of “I want a cookie.”
  • “See dog” rather than “I can see the dog.”
  • “Mommy up” to shorten “Mommy, pick me up.”

Characteristics include:

  • Omission of articles: “a,” “the.”
  • Skipping auxiliary verbs: “is,” “can.”
  • Leaving out prepositions: “to,” “for.”

It is a critical stage that signifies growing comprehension and the ability to express core ideas.

Role in Language Development

Telegraphic speech plays an important role in your child’s language development. This stage demonstrates that they are beginning to understand sentence structure and the concept of grammar. While their sentences are simple and lack the complexity of adult speech, this phase is fundamental for practicing communication and building vocabulary.

Your child’s ability to convey basic needs and thoughts through telegraphic speech serves as the foundation for more complex sentences. Over time, as their cognitive and linguistic abilities advance, they will start incorporating more words into their speech for clarity, eventually developing grammar and fluency that mirrors adult speech.

Progression to Full Sentences

The shift from telegraphic speech to full sentences can be expected to occur between ages two and three. Progression is evidenced by:

  • Sentence Expansion: Telegraphic speech will gradually include more words and vital sentence components.
  • Grammar Introduction: Use of prepositions, conjunctions, and articles starts to become apparent in the child’s speech.
  • Complexity: The sentences grow in complexity, reflecting a better understanding of language structure.

By the age of three, most children are capable of constructing simple, multi-word sentences that adhere to the rules of grammar more closely. In summary, telegraphic speech is essential for enabling children to communicate effectively and serves as a building block for their ongoing language learning journey.

Encouraging Language Growth

A young child pointing at objects, saying single words. Books and toys scattered around. Time passing, child using more words

Supporting language development in children is crucial, especially when they begin to use telegraphic speech, which typically consists of two-word phrases. As you foster this developmental stage, be proactive and patient, providing plenty of opportunities for language use.

Strategies for Parents and Caregivers

Talk to Your Child: Engage in regular conversation with your child using simple sentences. This exposes them to the structure and rhythm of language.

  • Read Together: Shared book reading can introduce new vocabulary and sentence structures. Eliminate non-essential words while reading to reinforce telegraphic speech patterns.
  • Simplify Your Speech: Use clear, concise language when communicating with your 18-24 month old. This makes it easier for them to imitate and learn.

Listen and Respond: When your child uses telegraphic speech, reinforce their efforts by listening and expanding on their phrases. For example, if your child says “more juice,” you might respond with “You want more juice? Here is your juice.”

  • Play Language Games:
    • Matching Games: Connect words to pictures or objects to build vocabulary.
    • Role-Playing: Act out scenes with figures or dolls to practice different scenarios.
    • Seek and Find: Hide mini objects in plastic eggs/ boxes and model an action to go with the object like “car go.”

When to Seek Professional Help

Monitor Development: Keep an eye on your child’s speech milestones. If you notice a significant delay or lack of progress in language development, consider consulting a professional. A speech pathologist can provide a thorough evaluation of your child’s language abilities and create a tailored speech therapy plan if needed.

Recognize Signs: Difficulty in following simple instructions, limited vocabulary, or lack of two-word phrases by a particular age might warrant professional advice.

Early Intervention: The earlier you seek help, the better the outcomes for your child’s language development. Speech therapy often plays a key role in supporting and accelerating language growth.

Research

While telegraphic speech is a typical phase in language development, research suggests that we should not continue modeling this speech when working with children who have language delays.

One study in 2014 by Shelly Bredin-Oja and Mark Fey of the Kansas Medical Center concluded that “providing a telegraphic prompt to imitate does not offer any advantage as an intervention technique.” Another study by Courtney Venker suggested that parents using higher rates of telegraphic speech with their autistic children negatively impacted these children from developing language skills two years later. These findings reveal that using telegraphic speech with children beyond this phase may hinder grammatical language development.

Frequently Asked Questions

Telegraphic speech is a normal phase in linguistic development where children communicate using short and simple constructions. This phase typically excludes unnecessary words, making the speech sound abrupt, much like an old-fashioned telegram.

Do all toddlers use telegraphic speech?

Yes, toddlers often begin to use telegraphic speech when they are between 18 to 24 months old. It marks an important phase in language development.

How does telegraphic speech manifest in children with autism?

In children with autism, telegraphic speech may manifest similarly to their peers but can extend beyond the typical age range. These children may particularly omit function words and might rely on this mode of speech for longer as they develop language skills at different rates.

How is telegraphic speech addressed in a psychological context?

Psychologists consider telegraphic speech a natural and expected stage in language acquisition. It serves as an indicator of typical cognitive and language development and is not usually a cause for concern unless it persists beyond the expected age range alongside other delays.

Speech Development in Babies: From Babbling to First Words

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Three infants seated at a table with balls

Speech development in babies is a fascinating and vital aspect of their growth, revealing the intricate process in which infants learn to communicate with the world around them from babbling to first words. From the very first coos and babbles to the formation of syllables and first words, this developmental milestone is crucial for social interaction and cognitive development. Comprehension goes hand in hand with speech as babies begin to understand and respond to language, setting the foundation for effective communication. As caregivers, there is much you can do to begin laying the foundation for communication with your little loves.

Babies babble, point, and smile while engaging with caregivers. They respond to sounds, gestures, and facial expressions, building social and communication skills

Social development in infants is characterized by their increasing ability to interact with others and the environment. This includes the capacity for shared attention, turn-taking, and recognizing social cues, which are essential for building relationships and understanding social norms. Interaction and attachment are also key components of a baby’s development. Between 0-3 months, infants are already socializing through brief eye contact while feeding, recognizing varying caregiver tones, and smiling for the first time upon seeing and/ or hearing a caregiver. The attachment formed between a baby and their caregivers, often through consistent and sensitive interactions, fosters a sense of security and trust, which influences their ongoing emotional and social growth.

Key Takeaways

  • Babies’ speech and comprehension advancements are critical for communication and cognitive growth.
  • Social development is characterized by the ability to interact with others and recognize social cues.
  • Secure caregiver attachment is essential for a baby’s emotional and social well-being.

Babbling to First Words

A baby babbles and gestures, while a caregiver listens and responds, creating a nurturing and interactive environment for early speech, comprehension, and social development

In the first year of life, your baby will progress from simple cooing to uttering their first words, beginning with the foundational babbling stage which paves the way to meaningful speech and comprehension.

Cooing: When do Babies Start to Coo?

Babies may start making cooing sounds as early as 6 weeks, leading to the growth of their verbal skills. By 2 months old, you should hear your baby making noises similar to vowels that mimic laughter.

Babbling: When do Babies Start Talking Gibberish?

  • Around 3-6 months, your baby may begin babbling, producing repetitive consonant-vowel combinations, which is a critical precursor to language development.
  • By around 6 months, you may notice your baby laughing and cooing to show happiness, an initial form of social interaction.
  • Sounds progress in variation near 6-9 months making this an opportune time to play early games like peek-a-boo to model, “mama”, “dada”, “baba”.
  • Music is another wonderful way to stimulate early sounds.

First Words: When Should Baby Say “Mama” and “Dada”?

Expect your baby to say their first word between the age of 9 to 12 months. Common first words are “mama” or “dada,” though at this stage, they may not fully grasp the specific parental association. Many babies say “mama” and “dada” by their first birthday with intention.

Sound Play: When do Babies Imitate Sounds?

Comprehension: What do Babies Understand?

  • Early signs of comprehension may be seen in infants between 0-3 months when they cease fussing upon hearing a familiar voice or move limbs when a parent uses a pleasant voice.
  • Understanding gradually develops, with name recognition typically emerging between 3-6 months, followed by consistent responses to commands like “no” and “want up.”
  • From around 9 months old, babies start understanding simple commands like, “give”. They look at objects and familiar people when named and begin to recognize some body parts.
  • Notably, waving usually occurs by 9-12 months, indicating an understanding of gestures associated with language.

Attachment and Social Interaction Milestones

Babies reaching for toys, babbling, and making eye contact with caregivers. Smiling and responding to sounds and gestures

Your baby’s journey through early speech and social development is marked by key milestones. Understanding these benchmarks helps you support and nurture your baby’s communication and bonding skills.

Emotional Engagement

During the first few months, cooing serves as the foundation for your baby’s future social communication. Around 2 months old, when babies start making cooing sounds, marks the beginning of speech development and their interaction with the world. Your baby’s emotional engagement grows alongside their cooing. In addition to cooing, babies cry when hungry and to get attention in their early months, with varied cries indicating different needs.

Social Play and Interaction Development

As babies grow, their interactive abilities gain complexity. They become more responsive in social situations and their sounds start to include babbling, or what is sometimes referred to as “talking gibberish.” This stage is crucial for social play and the progression towards meaningful speech.

Interactive play involving back-and-forth exchanges with caregivers fosters social and language skills. Peek-a-boo, for instance, is not just a game; it teaches your baby about communication, turn-taking, and emotional connections. Beyond playing this game with your infant, you can read books like, Peek-a-Baby by Karen Katz and Peek-a-Who? by Nina Laden.

Recognizing Social Cues and Imitation

Babies can recognize social cues and imitate sounds quite early in their development. Interactions where they engage in mimicking facial expressions or sounds are crucial for their social and communication skills. Play with your infant while looking in a mirror by clicking your tongue or blowing raspberries. Model animal sounds, especially those with make with our lips like, “ba, moo, woof”.

Playing with toys also becomes a form of social interaction where you can see your baby’s comprehension and imitation abilities:

  • As early as 4-6 months, babies may begin to grasp and play with toys, setting the stage for future social play and interaction.
  • Look for toys and objects with various textures that are great for exploring and grasping!
  • Find toys that support engagement between you and your child. Demonstrate, model, and support baby in playing with toys.

Gestures and Physical Expressions

Babies engage in social interaction, using physical expressions and speech to develop comprehension and social skills. They interact with others, showing curiosity and responsiveness

In the journey of your baby’s development, physical expressions serve as the building blocks of social interaction. This section focuses on how these gestures, such as clapping, waving, and pointing, are pivotal for engaging with others and understanding social cues.

When Should Babies Clap?

Your baby will likely start to clap hands around 9 to 12 months of age, which is a joyful way for them to show excitement and communicate. They can sit on their own and have more control over their limbs and hands to communicate with gestures like clapping. 

When do Babies Wave?

As they approach their first birthday, you may observe your child beginning to wave goodbye, which symbolizes their growing awareness of social norms and relationships. Two wonderful books for encouraging gesture and sign development are My First Baby Signs by Linda Acredolo & Susan Goodwyn and If You’re Happy and You Know it by Annie Kubler.

When Should Your Baby Point?

Pointing with one finger often emerges by the end of the first year through 15 months, serving as a non-verbal tool for your baby to express interest or desire towards an object or direction. Books that foster pointing through touch:

Gestures and physical expressions lay the groundwork for a baby’s use and understanding of the social cues that are critical for communication.

Frequently Asked Questions

A group of babies engaging in various activities, such as babbling, listening, and playing together, while caregivers observe and interact with them

Understanding the progress and stages of your baby’s development can provide reassurance and guidance as you assist their growth. The questions below are designed to directly address common concerns related to speech, comprehension, social development, and attachment.

What are the key milestones in speech development for babies?

In the first year, babies typically begin to babble and may say simple words like “mama” or “dada.” By the end of their second year, most children can use about 50 words and start combining them into 2-word phrases. As your baby’s vocabulary expands with both nouns and verbs, you’ll notice these phrases beginning to emerge.

How can parents support their child’s comprehension development in the early years?

You can aid your child’s comprehension by consistently talking to them, reading books, and explaining and naming the environment around them. Encourage their attempts to communicate and participate in these mini conversations. Below are some classic books to foster comprehension:

How does early interaction and attachment influence a baby’s development?

Secure attachment, formed through consistent and responsive caregiving, leads to better emotional regulation and social relationships. Positive early interactions directly support cognitive and language skills, fostering a foundation for healthy development.

At what age should a child typically start forming clear, understandable words?

Most children start to form clear, understandable words between 12 and 18 months. They gradually improve clarity and expand their vocabulary as they approach the age of two.

Bedtime Stories: Great Time For Boosting Speech & Language

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ethnic mother and little kids reading book in bed

Bedtime Tales: Boosting Speech & Language Skills with Stories

a family reading a book on the bed

In today’s digital age, where screens dominate our children’s lives, the power of storytelling remains a timeless tradition. Bedtime stories not only engage and captivate young minds but also offer a unique opportunity to boost speech and language skills. By immersing children in the magical world of stories, parents can help them develop crucial communication skills that will serve them throughout their lives.

Through the art of storytelling, children are exposed to a rich vocabulary, varied sentence structures, and complex characters and plots. Listening to stories stimulates their imagination and enhances their ability to express themselves verbally. While listening to bedtime stories, children naturally enhance their pronunciation and fluency by picking up on the rhythm of language.

Furthermore, bedtime stories provide a safe space for children to explore emotions, solve problems, and develop empathy. By empathizing with storybook characters, children learn to identify and articulate their own feelings, enhancing their emotional literacy.

Discover bedtime story benefits and practical tips for a cherished tradition in this article. So snuggle up, grab a favorite book, and embark on a journey that not only entertains but also nurtures your child’s speech and language skills

How Bedtime Stories Can Enhance Speech and Language Skills

Stimulating speech and language skills through story reading is crucial during early childhood development as it fosters vocabulary expansion and comprehension. Reading stories aloud helps your child better understand and interpret sounds, words, and sentences, boosting their listening skills. Engaging in storytelling activities also strengthens parent-child bonds and encourages a love for reading from an early age.

Bedtime stories offer a fun and engaging way to enhance speech and language skills in children. When children listen to stories, they are exposed to a wide range of vocabulary, sentence structures, and language patterns. This exposure helps them expand their vocabulary and develop a better understanding of how words and sentences are used to convey meaning.

The use of descriptive language in stories also aids in the development of expressive language skills. Children learn to describe characters, settings, and events, using adjectives and adverbs to paint a vivid picture in their minds and express their thoughts and emotions.

Additionally, stories provide opportunities for children to practice listening skills. As they follow the plot and understand the sequence of events, they develop their ability to pay attention, concentrate, and follow instructions. This is especially important for children who may struggle with attention deficits or auditory processing difficulties.

Benefits of Bedtime Stories for Children’s Cognitive Development

ethnic mother and little kids reading book in bed

Bedtime stories not only enhance speech and language skills but also offer numerous cognitive benefits for children. When children engage with stories, their cognitive abilities are put to work as they make connections, analyze information, and develop critical thinking skills.

Story comprehension requires children to make predictions, infer meaning, and draw conclusions. This process stimulates their cognitive development and helps them develop problem-solving skills. As children encounter various characters and situations in stories, they learn to analyze and evaluate different perspectives, fostering their ability to think critically and empathize with others.

Furthermore, the imaginative aspect of storytelling activates children’s creativity and encourages them to think outside the box. By envisioning story settings and characters, children exercise their creative muscles and develop their capacity for imaginative thinking.

Choosing the Right Stories for Speech and Language Development

Selecting appropriate stories for speech and language development is essential to maximize the benefits of bedtime stories. When choosing books, consider the following factors:

1. Age-appropriate content: Select stories that are suitable for your child’s age and developmental stage. Younger children may benefit from simple, repetitive stories with clear illustrations, while older children can handle more complex narratives.

2. Rich vocabulary and varied sentence structures: Look for books that introduce new vocabulary and expose children to different sentence structures. This will help expand their language skills and challenge their cognitive abilities.

3. Engaging and relatable themes: Choose stories that are engaging, relatable, and capture your child’s interest. Children are more likely to stay engaged and actively participate in storytelling sessions when the themes resonate with their experiences and emotions.

4. Interactive elements: Seek out books that encourage participation, such as stories with repeated refrains or interactive elements like lift-the-flap pages. These interactive elements can enhance engagement and make storytelling sessions more enjoyable for children.

By considering these factors, you can ensure that the stories you choose align with your child’s speech and language development goals, making bedtime storytelling an effective tool for nurturing their communication skills.

Incorporating Storytelling Techniques to Engage Children

To make bedtime storytelling sessions even more effective, you can incorporate various storytelling techniques to engage children and enhance their speech and language skills. Here are some techniques to try:

  • Use expressive and animated storytelling: Bring characters to life by using different voices, facial expressions, and gestures. This will captivate your child’s attention and make the story more engaging and memorable.
  • Pause and encourage responses: Pause at key moments in the story and ask questions to encourage your child to participate. This can be as simple as asking them what they think will happen next or how a character might be feeling.
  • Encourage retelling and sequencing: After reading a story, ask your child to retell the main events or sequence them in the correct order. This helps develop their comprehension skills and strengthens their ability to organize information.
  • Explore different perspectives: Prompt your child to consider different perspectives by asking questions about the characters’ motivations or how they would have solved a problem differently. This encourages critical thinking and empathy.

Incorporating these techniques into your storytelling sessions will not only make them more enjoyable but also provide valuable opportunities for your child to practice and develop their speech and language skills.

Tips for Parents and Caregivers to Make Bedtime Storytelling Effective

mother and daughter lying on bed while reading a book

To make bedtime storytelling sessions as effective as possible, here are some tips for parents and caregivers:

  • Establish a consistent routine: Set a regular time for bedtime storytelling to create a sense of anticipation and make it an integral part of your child’s bedtime routine. Consistency helps children feel secure and reinforces the importance of storytelling.
  • Create a cozy and comfortable environment: Make the storytelling environment comfortable and inviting. Dim the lights, use soft cushions or blankets, and eliminate distractions to create a calm and focused atmosphere.
  • Be enthusiastic and engaged: Show genuine enthusiasm and interest during storytelling sessions. Your enthusiasm will be contagious and help captivate your child’s attention.
  • Allow for interaction and discussion: Encourage your child to ask questions, make predictions, and share their thoughts and feelings about the story. This interaction promotes active engagement and enhances their speech and language development.
  • Personalize the stories: Relate the stories to your child’s experiences, emotions, or challenges. This personal connection makes the stories more meaningful and encourages your child to actively participate in the storytelling process.

By following these tips, you can create a nurturing and effective bedtime storytelling routine that not only enhances speech and language skills but also strengthens your bond with your child.

Recommended Bedtime Stories & Resources for Boosting Speech and Language Skills

Choosing the right books and resources can greatly enhance the impact of bedtime storytelling on speech and language development. Here are some recommended books and resources:

1. “The Very Hungry Caterpillar” by Eric Carle: This classic picture book introduces children to basic vocabulary and sequencing through a charming story.

2. “Giraffes Can’t Dance” by Giles Andreae: This rhyming story celebrates individuality, self-expression, and the importance of believing in oneself. It promotes expressive language and emotional literacy.

3. “The Gruffalo” by Julia Donaldson: This imaginative story introduces children to descriptive language, rhyming patterns, and creative problem-solving.

4. Speech and language therapy resources: Online platforms and apps such as Speech Blubs, Articulation Station, and Tactus Therapy offer a wide range of interactive games and activities designed to support speech and language development.

These are just a few examples, and there are countless other books and resources available to support speech and language development. Explore different genres, themes, and authors to find the ones that resonate with your child’s interests and developmental needs. Subscribe to our email list below to receive a free ebook! You’ll get 65 stories for bedtime, grouped by theme, every month of the year.

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Speech and Language Therapy Techniques That Can Be Integrated into Storytelling

For children with specific speech and language difficulties, integrating speech and language therapy techniques into storytelling can provide additional support. Here are some techniques that can be incorporated:

1. Articulation practice: Choose stories that include words or sounds your child needs to practice. Encourage them to repeat and pronounce these words correctly during the storytelling session.

2. Vocabulary building: Pause during the story to introduce and explain new vocabulary words. Encourage your child to use these words in sentences or retell the story using the newly learned vocabulary.

3. Sentence expansion: Model and encourage your child to expand on simple sentences used in the story. For example, if the story says, “The cat sat,” prompt your child to say, “The fluffy cat sat on the warm mat.”

4. Narrative skills: Help your child develop narrative skills by discussing story elements such as characters, setting, problem, and solution. Encourage them to retell the story using proper sequencing and descriptive details.

By integrating these techniques into storytelling sessions, you can turn bedtime stories into effective speech and language therapy sessions tailored to your child’s specific needs.

Conclusion: The Power of Bedtime Stories in Nurturing Speech and Language Skills

Bedtime stories offer a wealth of benefits for children’s speech and language development. By exposing children to rich vocabulary, varied sentence structures, and engaging narratives, stories help expand their communication skills and enhance their expressive language abilities. Additionally, storytelling provides a safe space for children to explore emotions, develop empathy, and strengthen their cognitive abilities.

By choosing the right stories, incorporating storytelling techniques, and engaging in interactive activities, parents and caregivers can make bedtime storytelling an effective tool for nurturing speech and language skills. The consistent practice of bedtime stories not only fosters speech and language development but also strengthens the bond between parent and child.

So, snuggle up, grab a favorite book, and embark on a journey that will not only entertain but also nurture your child’s speech and language skills. Storytelling unleashes your child’s communication potential, paving the way for lifelong success.

Why is Mean Length of Utterance (MLU) Important?

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mother and baby girl reading a book

Unlocking the Power of Language: Understanding Mean Length of Utterance (MLU)

kids sitting on green grass field

Language is a powerful tool that allows us to communicate our thoughts, express our emotions, and connect with others on a deeper level. But have you ever wondered how language develops in young children? How do they progress from babbling to forming coherent sentences? One way to measure a child’s language development is by measuring their Mean Length of Utterance (MLU). In this article, we will explore the concept of MLU and its importance in understanding language development.

MLU, or Mean Length of Utterance, measures how many words or parts of words your child typically uses when speaking. It helps track their language development, including vocabulary and grammar growth. By analyzing a child’s MLU, speech pathologists can assess language milestones, identify potential language delays or disorders, and design appropriate interventions.

Understanding MLU is not only crucial for professionals working with children but also for parents who want to support their child’s language development. By unlocking the power of language through MLU, we can foster better communication, enhance social relationships, and open doors to a brighter future for young learners.

Join us as we dive into the fascinating world of MLU and discover how it can unlock the potential of language development in children.

anonymous ethnic tutor helping little multiracial students with task in classroom

How to calculate MLU

Calculating MLU involves analyzing a child’s spoken or written language samples and determining the average number of words or parts of words per utterance. To calculate MLU, follow these steps:

1. Speech pathologists collect a representative language sample from the child. This is typically done during play with the therapist limiting questions and opting for probes to unleash more language. For example, we may say, “Tell me about your favorite toys/ games/ vacation” rather than ask a question that would yield a single word answer.

2. We typically record the language sample to write out sentences later.

3. Next, we count the total number of words or morphemes in the sample. A morpheme is the smallest meaningful unit of language, such as a word or a prefix/suffix. When we calculate MLU, we count morphemes, which are the smallest units of meaning in a word. In “running,” “run” is one morpheme and “-ing” is another, making it two morphemes.

4. Finally, we divide the total number of words or morphemes by the number of utterances (words/phrases/sentences) to obtain the mean length of utterance.

For example, if a child’s language sample consists of 20 utterances with a total of 100 words, the MLU would be 5 (100 words divided by 20 utterances).

Milestones in child language development

MLU milestones indicate the progression of language development in children. As children acquire new language skills and vocabulary, their MLU increases. Here are some general MLU milestones based on age:

  • 12-26 months: At this stage, children typically have an MLU of 1-2 words. They focus on single-word utterances, such as “ball” or “dog.”
  • 27-30 months: MLU expands to 2-3 words as children begin to combine words to form simple phrases or sentences. For example, “want juice” or “big car.”
  • 31-34 months: MLU increases to 3-4 words, and children start using more complex sentence structures. They may use questions like “Where is my toy?” or make statements like “I like ice cream.”
  • 35-40 months: MLU reaches 4-5 words, and children develop more advanced sentence structures. They use conjunctions like “and” or “but” to connect ideas, and their sentences become more grammatically complex.
  • 41-46+ months: MLU continues to grow, and children become more proficient in using complex grammatical structures and expanding their vocabulary.

It is important to note that these milestones are general guidelines, and individual children may progress at different rates. MLU milestones provide a framework for assessing language development but should not be used as the sole indicator of a child’s language skills.

Influential Factors

Several factors can influence a child’s MLU and language development. These factors include:

1. Language exposure and input: The amount and quality of language a child is exposed to can impact their MLU. Children who have rich language environments and frequent interactions with caregivers tend to have higher MLU.

2. Cognitive abilities: Cognitive abilities, such as memory and attention, play a role in language development. Children with stronger cognitive skills may have higher MLU as they can process and produce more complex language.

3. Socioeconomic status (SES): Socioeconomic factors can influence a child’s language development. Children from lower SES backgrounds may experience fewer language-rich environments and have lower MLU compared to their peers.

4. Language disorders or delays: Children with language disorders or delays may have lower MLU compared to typically developing children. MLU can be used as a diagnostic tool to identify potential language difficulties and guide intervention strategies.

5. Bilingualism: Bilingual children may have different MLU patterns depending on their language exposure and proficiency in each language. MLU calculations need to consider both languages when assessing language development in bilingual children.

Understanding these factors can help professionals and caregivers identify potential challenges or areas that require additional support in a child’s language development.

Using MLU as a diagnostic tool for language disorders

MLU is a valuable diagnostic tool for identifying language disorders or delays in children. A lower MLU than expected for a child’s age may indicate potential language difficulties that warrant further assessment and intervention. MLU analysis can help professionals determine if a child is experiencing difficulties with vocabulary acquisition, grammar, or syntactic structures.

MLU, when combined with other language assessments and observations, provides a comprehensive picture of a child’s language skills. It assists in identifying specific areas of language that may require intervention, such as phonological disorders, expressive or receptive language disorders, or pragmatic language difficulties.

Early detection of language disorders is crucial for effective intervention and support. MLU serves as an objective measure that helps professionals make informed decisions and develop targeted intervention strategies to address a child’s specific language needs.

Strategies to promote MLU growth in children

mother and baby girl reading a book
Photo by William Fortunato on Pexels.com

Promoting MLU growth in children involves creating language-rich environments and providing opportunities for meaningful interactions. Here are some strategies to support MLU development:

  • Engage in interactive conversations: Have frequent conversations with children, encouraging them to respond and express their thoughts. Ask open-ended questions, provide descriptive feedback, and expand on their utterances to model more advanced language structures.
  • Read aloud and encourage storytelling: Reading books aloud and encouraging children to tell stories helps develop vocabulary, sentence structure, and narrative skills. Engage in discussions about the stories, ask questions, and encourage children to express their opinions and ideas.
  • Play language-rich games: Engage children in language-rich games, such as “I Spy” or “Simon Says,” that encourage vocabulary development, turn-taking, and following instructions. Incorporate new words and concepts into the games to expand their language skills.
  • Use visual aids: Visual aids, such as picture cards or drawings, can support language development by providing visual cues and prompting discussions. Use visuals to help children make connections between words, objects, and concepts.
  • Provide opportunities for peer interactions: Encourage children to interact with peers, as peer interactions promote language development and MLU growth. Arrange playdates or group activities where children can engage in conversations, share ideas, and practice using language in social contexts.

By implementing these strategies, caregivers and educators can create language-rich environments that foster MLU growth and support overall language development in children.

Conclusion: Emphasizing the value of MLU in language assessment and intervention

Mean Length of Utterance (MLU) is a powerful measure that unlocks the potential of language development in children. By analyzing MLU, speech pathologists and caregivers can gain valuable insights into a child’s language skills, identify potential language delays or disorders, and design targeted interventions. MLU serves as a diagnostic tool, guiding language therapy and promoting MLU growth through language-rich environments, interactive conversations, and engaging activities.

Understanding MLU empowers us to support children in their language development journey, fostering effective communication, enhancing social relationships, and opening doors to a brighter future. By unlocking the power of language through MLU, we enable young learners to express themselves, connect with others, and thrive in all aspects of life.

Four Qualities to Look for in Toys to Promote Speech

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Baby holding a play phone next to its ear

Embark on a journey to uncover the essential features that make toys the ideal tools for promoting speech development.

One of my primary missions in my speech and language practice is to educate families on the importance of opening the doors to communication.  Speech is so much more than talking.  It is listening, comprehending, taking turns, gesturing, commenting, asking and answering questions, and requesting to name just a few.  The right toy can set the stage for many of these opportunities.

Throughout the year, parents often ask me for advice on toy/ gift ideas, especially near their child’s birthday and holiday season.  Some toys are better than others, as they contain certain features important for supporting speech and language development. The toys that catch my eye typically have four things in common:

They make HARDLY ANY noise

portrait photo of woman with brown curly hair doing the shhh sign

I am probably not the first SLP to make this comment and I surely will not be the last!  Bottom line is that we want the kids to do the talking.  Sometimes that talking is a sound or part of a word and sometimes it is a word/phrase/sentence.  It’s nice to be able to hear these moments without interruptions. Some of my favorite, quiet, interactive toys are: Critter Clinic Toy Vet Set, Fisher Price Farm House, Stacking Blocks, Ring Stacking Toy that Spins, Barnyard Bingo, Melissa and Doug’s Wooden School Bus, Matchbox Cars, and dolls.

While we are on the topic of noise, do not fall into the trap in thinking that an electronic book option is any better than a noise-making toy.  In my opinion, you should always opt for a quiet interactive book like a lift-the-flap or sensory-enriched option with touch and feel textures if you want your child to progress in his speech and language skills.

Now, having said that, a good, old fashioned single, noise making toy never hurt anyone.  For example, the Elefun makes a whirling sound when activated and I’m okay with that because it motivates kids to request “more”, “go”, and “stop.”  I also love a good ball popper for bringing out some laughter and excitement, which in turns fosters speech and language usage.

The bottom line is: I steer clear of those toys that kids get trigger happy with and all you hear are a million sounds and words all at once.  Not fun.  Personally, I avoided noisy, talkative toys when my son was little and I have lived quite happily in my SLP world for a couple decades without all the noise.

They fit right in with my theme

Christmas decorations

Herein lies my year-round shopping problem.  I’m always looking to add materials to my theme units.  I cannot help myself.  I have to admit that I love bringing out the Fisher Price Thanksgiving sets and Holiday train, Learning Resources camp fire sets, and Super Duper magnetic fish.

One toy that can be used for birthday, Valentine’s Day, and Christmas themes is Mini presents by Learning Resources. First, the client opens a mini box; takes out the object; and then I label it several times while placing it down on a picture of number one.  This continues until we get to three total choices.  Finally, I ask clients to “get/give me” a targeted object.  This super cute set has been fun for my 4-6 year old clients.  You can even target pronouns by using a baby doll and practicing, “She wants a purple gift.”

When seasonal toys are only available for a short amount of time, I think you get more bang for your buck from them.  It’s the same concept of rotating toys in your home so the old ones feel like new when you cycle through them.  For more details on some of my favorite, summer toys, visit my post on seven of my favorites!

They stand the test of time

Baby holding a play phone next to its ear

This rationale is two part: durability and traditional.  I like a toy that can take a beating and clean easily, so I reach for the plastic Velcro foods and walk right by felt food.  If I cannot clean them fast with a Clorox wipe, then I cannot have them in my therapy closet.  While there are always cute, new toys being released, I stick with traditional themes like Mr. Potato heads to work on learning about body parts.  Another great option is any toy that is alphabet-related.  Two of my favorite hits for kids aged 2-8 years old are ABC puzzles and alphabet toys.  What better way to work on letter-sound recognition than with toys?!

You can perform a few different functions with them

baby in a chef hat playing with a toy kitchen in a chef hat

Your child’s speech and language development builds alongside play.  The more opportunities you can create to further communication with your child, the better.  For example, I prefer a small collection Velcro foods over a 100 piece set of foods that are static. 

Having something to do with the object helps you model and teach a functional sequence.  In this case, you can gather all the Velcro foods and sort them to make a salad.  Then, you “cut” each item and put them in a strainer for rinsing.  Finally, you “dry” the slices and transfer them to a bowl.  Modeling these real-life events supports teaching your child to make connections with a sequence he has seen before, which in turns strengthens memory skills.

In conclusion, when it comes to selecting toys for speech development, prioritizing those that make hardly any noise, fit the session’s theme, endure over time, and offer versatility is key. These criteria ensure engagement, continuity, and diverse learning opportunities, laying the foundation for effective speech therapy sessions. By choosing toys thoughtfully, you empower your child to thrive in their language journey while making learning enjoyable and effective.

Why Did My Child Qualify For Articulation Therapy?

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Woman holding the letter S with child imitating a touch cue in speech therapy
Bowl of pastel colored alphabet letters

ARTICULATION

Why is understanding the journey of speech sound development crucial, and what is the basis for evaluation and treatment in articulation therapy? Making progress in speech development starts with understanding the evaluation and treatment process for articulation delays, as discussed in this post.

In this comprehensive guide, we will navigate the journey of speech sound development and discuss the basis for evaluation and treatment in articulation therapy. Understanding the milestones and stages of speech sound acquisition is crucial for identifying potential delays and designing effective intervention plans. Articulation therapy, distinct from phonological and childhood apraxia of speech therapies, targets specific speech sound errors to enhance clarity and pronunciation. We’ll explore the various assessment methods used to evaluate speech sound production and discuss evidence-based treatment approaches.

Additionally, we’ll highlight the pivotal role of home programming in reinforcing therapeutic gains and supporting speech progress beyond the therapy room. Join us as we navigate through the fundamentals of speech therapy and empower caregivers with practical strategies for facilitating speech development in children.

Milestones and the Evaluation Process:

Speech pathologists assess speech sound development using a test battery containing all consonant sound targets. Most of the time, a child with an articulation delay can produce vowels accurately, but not consonant sounds.  If your child hasn’t mastered age-expected sounds, their score may indicate therapy is necessary. The chart pictured below is my all-time favorite speech development reference tool from 1972 for parents.  I particularly like how it displays the wide range for development of each sound target.

Speech Sound Development Chart

Some children need more time to master sounds with any number of factors influencing that timeline. Ear infections, fluid buildup, wax, growth, attention issues can delay sound mastery for months or years in some children.

In 2018, McLeod and Crowe published a study updating developmental expectations for speech sound development. Note that these researchers suggest that all speech sounds are acquired by six years. Under these guidelines, more children may qualify for speech services.

McLeod-Crowe-2018-English-consonants-Treehouse-A4

After the Evaluation:

You just learned that your child is eligible for speech services due to an articulation delay.  If you are in early intervention, then you likely will not see specific sound targets in your treatment plan, but that all changes in an IEP- Individualized Education Plan.

Let’s walk through the meetings that lead to an IEP in the school system. First, attend a brief referral meeting at the school to determine testing needs with the team. A couple months later, you will reconvene and review all test results.  If your child qualifies for speech, then you will create an IEP at that eligibility meeting.  Listen carefully to the goals for speech articulation, which are written to be met in one year.  Given that these goals must be achieved in a year, they should be concise, measurable, and appropriate for your child’s age.

Here is an example of an achievable objective, focusing on an early sound production: Increase accuracy of /b/ in all positions (i.e., ball, cowboy, web) of words with 85% accuracy.

Here is an example of a lofty goal which should be divided into smaller components as there are 18 objectives in this one example: Increase accuracy of /p, m, h, n, w, b/ in all positions at the word level with 85% accuracy.

In summary, you have the right to ask questions during any meeting, be it for eligibility or treatment planning. If goals seem unattainable, express concerns during IEP meetings. Parents are one of the most important team members because you know your child best!

Therapy:

Woman holding the letter S with child imitating a touch cue in speech therapy

Your child needs articulation therapy when he substitutes or distorts one or more sounds.  For example, he may substitute the /w/ for /r/ in the word rabbit or distort the /l/ in the word ladybug such that the /l/ does not sound clear and crisp. In articulation therapy, we teach lip and/or tongue placement for target sounds. Here, we progress from isolated sounds to sentences and practice sounds in all word positions: initial, medial, and final. So, someone working on the /s/ sound may practice “sun”, “glasses”, and “cats.”  Typically, we look at mastery in one position before moving onto another.  We target developmentally appropriate sounds and increase the level as the child progresses.

Homework:

Your speech pathologist will want your child to practice sound targets at home once progress is noted in treatment sessions. Waiting for accuracy is crucial; clients who practice at home generalize skills, reducing therapy time and ensuring error-free practice.

Conclusion

In summary, understanding speech sound development lays the foundation for effective evaluation and treatment of articulation disorders. By incorporating home programming into therapy plans, caregivers can play a crucial role in reinforcing progress outside of sessions. Consistent practice in natural environments enhances therapy outcomes and promotes long-term speech proficiency.

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