Early Intervention - Lessons in Speech with Nanette

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

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

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.
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.
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.
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:

Hearing Test: Schedule a hearing test to rule out any hearing impairments that could affect speech.
Consult: Speak with your pediatrician to discuss concerns and locate early intervention services.
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.

Speech Development in Babies: From Babbling to First Words

by Nanette Cote

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?

Babies may start to imitate sounds around 6 months, but this can occur as early as 4 months in some individuals.
Between 9-12 months, babies may imitate simple animal sounds and names of favorite objects
Some great books to encourage sound play are: Brown Bear Slide and Find by Bill Martin Jr. and Eric Carle, Barnyard Dance by Sandra Boynton, and My Very First Book of Animal Sounds by Eric Carle.

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.

Why Straw & Cup Drinking are Better Options than Sippy Cups

by Nanette Cote

Honey Bear with Supportive Accessories for Teaching Straw Drinking

Just Say No to the Sippy

Sippy cups, prolonged bottle drinking, and excessive pacifier use can hinder oral development. As a speech pathologist, I advise families to switch to straw and cup drinking. This post aims to discuss why opting for straw and cup drinking over sippy cups can significantly benefit your child’s oral development and overall health.

A sippy cup mimics bottle feeding, promoting an immature sucking pattern. By age one, children should transition to straw or open cup. A suckle pattern means that your child needs to stick his or her tongue out of the mouth to drink. There is little to no tongue retraction involved in this movement. Most of the time, the liquid will drip out of a sippy if you turn it upside down.

Extended use of a bottle or sippy cup may promote poor tongue posture. As a result, you will notice your child’s tongue rest outside of the mouth and you may observe articulation difficulty, especially with production of sounds made inside the mouth along the palate (t, d, k, g, n). As toddlers grow, we want to support transitioning them from a suckle pattern to a more mature movement. Toddlers, particularly those with speech delays, often protrude their tongues slightly while speaking or eating. This tongue position mirrors the placement for suckle drinking.

Nuby Cup

Now that you know the pitfalls of using a sippy cup, let me offer two other options that not only secure liquids in a cup but also promote good oral motor development: a Nuby cup and straws. First, the Nuby cup looks like a sippy, but has a flexible top that encourages sucking rather than suckling to drink. The flow of liquid cannot drip out as easy as the sippy cup; rather it requires some effort, or sucking on the child’s part. Similar to straw drinking, this sucking pattern pulls the tongue back into the mouth thereby supporting good oral motor development.

Straw Drinking Supports

A built-in straw cup is another great option but can be a little challenging for beginners, so it may be easier to start with a regular straw. If your child is not sure how to use a straw, then trap some liquid in one end and slowly release that liquid into your child’s mouth once he puts his lips around the straw. In the event that your one-year old or child with special needs needs more supports in learning how to drink from a straw, then I would highly recommend the Bear Bottle Collection from Ark Therapeutics.

Bear Bottle, lip blocker, and one-way valve:

This adorable, bear-shaped bottle is a great way to transition your child from bottle to straw drinking with several supports for quick success. We attach a lip blocker to the straw to prevent excessive insertion into the mouth and encourage tongue retraction. This durable tool stays put after washing. There are three types of blockers sold by Ark Therapeutic which allow for graduation as your child improves his ability to position musculature for drinking without tactile feedback. The one-way valve traps fluid in the straw, preventing it from dropping back when suction is released. This makes learning to drink from the straw less effortful and sets the child on a quick path for success.

The Benefits of Straw Drinking

Straw drinking promotes tongue retraction into the mouth while drinking. To draw liquid from the cup, the tongue must retract into the mouth, a crucial movement for speech sounds like (t, d, k, g, n). You can also mix things up a little by varying the intensity of the straw. Shorter straws with thin liquids suit beginners, while longer or twisty straws with thicker liquids demand more effort. The latter version challenges older children to improve oral motor awareness. Drinking thick beverages with a straw improves lip and tongue awareness, aiding sound placements. Speech therapy alongside this change shows success.

I’ve long advocated for the straw’s benefits, even using seasonal ones as speech practice prizes. A small change can impact development significantly. While eliminating sippy cup usage is a great start, it will not be the only change that you need to make. Please continue working with your speech pathologist and practicing sound targets at home to develop muscle memory for improved articulation development.

Seated Drinking

Children don’t need a cup in hand all the time. Overconsumption of liquids from sippy cups can hinder eating. Many children fill up on these liquids, making it difficult for them to eat because their bellies have an excess. Plus, it is far more challenging for children to drink while walking around, than it is when they are seated. Toddlers focus on moving around, making drinking from a cup challenging. They might spill or choke as they navigate and drink. Seated postures for drinking are just more optional all around. Let’s make sure children are seated safely before offering drinks, though they can still have water throughout the day.

In conclusion, by eliminating sippy cups and opting for better drinking choices, you’re not just improving oral motor development but overall health.

How Many Words Should my Toddler Say?

by Nanette Cote

Mother sitting outside holding a child in her lap with a basket of fruit on the table in front of them

Prerequisites

Communication is an amazing and complicated ability that literally explodes in the early years leading many to ask how many words a toddler should say. For some toddlers, this explosion happens early while others are “late talkers.” This range makes it tricky to predict the right time to seek out an evaluation.

Monitoring a child’s language development is a critical aspect of understanding their overall growth. As children grow, they reach various developmental milestones that signal their progress. Speech development is one important area where caregivers and professionals look for specific advancements. Two-word phrases, for example, are a significant hallmark that typically emerge when a child is between 18 to 24 months old. Recognizing the number of words a child should know or use at different stages can be a useful gauge of their language acquisition.

A child pointing at objects while saying simple two-word phrases. By 15 months, they can say around 10-50 words

By 15 months old, it is expected for a child to say eight to ten words. This early vocabulary will usually include names for parents, common objects, and possibly a few action words. By 16 months, the expected range can increase to around 15 words as the child starts to experiment with sounds and the meaning associated with them. A 17-month-old might be expected to say a similar number of words, but individual progress can vary. Moving forward, an 18-month-old child may have a vocabulary of 20 to 50 words. By the age of two, a child’s vocabulary typically explodes to around 200 words, a significant increase that underscores the rapid development in this stage.

Key Takeaways

Speech milestones act as indicators of a child’s language development.
Vocabulary size typically expands rapidly between 15 months to 2 years of age.
The emergence of two-word phrases marks an important progression in speech acquisition.

Developmental Milestones Overview

A young child is pointing to objects and using two-word phrases to communicate. They are actively engaging in speech development, reaching the milestone of using around 15 words by 15 months

Understanding developmental milestones helps you monitor your child’s growth and developmental progress, particularly in speech and communication.

Speech Development Fundamentals

Speech development is a critical aspect of your child’s overall development. By 15 months, a typical toddler might have a vocabulary of 8 to 10 words, although it’s not unusual for the number to vary among individual children. By 16 months, your child should use at least 15 words, increasing to nearly 20 words consistently by 17 months.

At 18 months, a child’s vocabulary undergoes significant expansion, and they can often learn new words rapidly, with some children reaching over 50 word. Simple phrases like “more milk” and “mommy go” may emerge alongside this single word vocabulary development.

By 24 months, a child should comprehend at least 300 words, with some capable of understanding and using more. Variability is normal, and these figures serve as a general guideline. Speech development relies on both genetics and environmental factors, like interaction with parents and caregivers.

Early Communication Milestones

Age	Expected Vocabulary
15 Months	8-10 words: mama, dada, familiar objects
16 Months	At least 15 words
17 Months	Minimum of 20 words
18 Months	Rapid word learning, >100 words likely
24 Months	50 recognizable words, phrases emerging

Your child’s early communication includes gestures, babbling, and responsiveness to auditory stimuli even before the first word is spoken. You should observe increased intentionality in communication at around 18 months, with notable improvements in the complexity and clarity of expressed ideas. Early interactions greatly influence these milestones; engaging with your child through reading, talking, and playing supports their learning process.

Speech Milestones By Age

Understanding speech milestones helps you monitor your child’s language development effectively. Here are some highlights from the American Speech-Hearing Association (ASHA), when it comes to speech expectations:

By one year old, a toddler should say 2-3 words (such as hi, dog, dada, mama, uh-oh) and make attempts to imitate sounds.
Between 13 to 18 months, a toddler should say names of common objects, some actions, and important people. You will likely also hear long strings of sounds, syllables, and real words that appear conversational.
By two years, most toddlers should say over 50 words, which in turn gives them a large enough selection to combine single words into phrases like: “more apple”, “no bed”, “mommy book.”
Somewhere between 2-3 years, a toddler should be able to say sounds: p, b, m, h, w, d, n and most vowels in words. At 3 years old, toddlers are typically combining three words into a phrase to talk about things.

More Resources

As a speech pathologist, I often send families this Google Document with alphabet labeling and ask caregivers to fill in a word count. This information aids in documentation of the Rossetti Infant-Toddler Language Scale when it is time for an initial assessment. The Rossetti measures communication from birth through three years. While there are a number of factors in measuring communication development, for purposes of this post, these are the number of words a toddler should say by range:

15-18 months: says 15 meaningful words
18-21 months: uses single words regularly and imitates phrases
21-24 months: uses 50 different words
24-27 months: *MLU 1.50-2.00
27-30 months: *MLU 2.00-2.50
33-36 months: *MLU 2.50-3.00

*MLU: Mean Length of Utterance

Constructing Two-Word Phrases

A child pointing and naming objects, using two-word phrases, reaching developmental milestones in speech by 15 months

When you observe speech development in toddlers, constructing two-word phrases is a significant milestone. Around the age of 24 months, you will likely notice your child beginning to pair words together. This step is crucial as it represents the start of combinatorial speech, allowing your child to express more complex thoughts and needs.

Key Aspects:

Expression: Two-word phrases enable your child to convey relationships between concepts, like possession (e.g., “my toy”) or actions (e.g., “go home”).
Understanding: This stage reflects an increasing understanding of grammar and syntax, even in its most basic form.

Expected Progression:

Age	Milestone
18 months	Imitates two- and three-word phrases
20 months	Uses two-word phrases occasionally
24 months	Routinely constructs two-word phrases

Vocabulary Growth: Your child’s word bank typically includes 50-100 words by the time they are 2 years old. This richness in vocabulary supports the construction of meaningful two-word combinations.

Examples of Two-Word Phrases:

Requests: “More milk,” “Hold you,” “Help please”
Comments: “Doggie big,” “Truck loud,” “Shoe off”
Identification: “Mommy coat,” “Daddy car,” “Baby sleep”

You can encourage your child to form two-word phrases by reading to them, speaking in simple sentences, and naming objects during your daily routines. It is important to acknowledge and reinforce their attempts at speech. Each child develops at their own pace, but if you have concerns about your child’s speech development, consulting with a pediatrician or a speech-language pathologist might be beneficial.

Frequently Asked Questions

A child pointing at objects, babbling, and using two-word phrases while reaching for a bookshelf

This section addresses common inquiries regarding the progression of early language development in children.

By what age do babies typically start using two-word phrases?

You can expect babies to typically begin forming two-word phrases between 18 and 24 months. This is a natural progression as their vocabulary expands.

How many words should an 18-month-old typically be able to say?

At 18 months, a child may typically say between 20 and 50 words. The range is wide as individual growth varies.

What are the expected language milestones for an 18-month-old child?

An 18-month-old child usually recognizes names of familiar people, objects, body parts, and actions. They also begin to follow simple instructions, imitate two- and three-word phrases, and spontaneously say a two-word phrase on occasion.

At 2 years old, about how many words should a child know?

By the age of 2, children often comprehend about 300 words, express 50 recognizable, and combine words into short phrases.

The Best Speech Therapy Early Intervention Activities

by Nanette Cote

Speech Therapy & Early Intervention

Early Intervention speech therapy services are appropriate for children from birth until their third birthday. This service delivery model is rooted in parent training and coaching to work on developmental goals from speech to physical motor skills during everyday play routines. My experience has taught me that the more practice a child has of any target, the quicker you will witness developmental gains and progress. What better way to work on developmental skills than to incorporate engaging activities for preschoolers?

Mother and daughter making dumplings in traditional clothing, close up — Mother and daughter Engaging in Crafts

This post contains examples of the best speech therapy early intervention activities with complete details of materials, speech and language targets, and play sequence suggestions for each of the following themes:

Water Play
Arts and Crafts
Play dough
Sensory Bins

For a unique activity that is especially fun at Easter, read my post about using plastic eggs to discover mini treasures.

WATER PLAY: SPEECH THERAPY EARLY INTERVENTION ACTIVITIES

Water play activities for preschoolers are always a splash in my coaching sessions. You will need a bucket or bin filled with a little water or you could set up your online therapy room near a kitchen or bathroom sink. No need to purchase fancy bath toys, but if you have some at home then you can use them. These everyday items will lend to some language enrichment just as well:

Small disposable or plastic cup
Funnel
Dish soap
Sponge
Empty bottles (hand soap, dish soap, shampoo)
Baby doll or dishware for pretend play
Child’s watering can
Wash cloth
Grow towels from the Dollar Store

Following Directions with Water

I ask parents to bag up a few things and keep it handy for the session. There is no need to fill the bucket, bin, or sink before the therapy session. Why take the fun of it at the start, right? Instead, your child can use bottles, cups, faucets to fill the container and squirt in a few pumps of soap. This is a great way to work on following directions such as:

Get bin.
Fill bottle with water.
Turn the water on/off.
Pour in cold/warm water.
Squirt 3 pumps of soap

You can even practice 2-step directions by combining the above or creating your own. When the water bin is filled, it is time to break out the objects for play. Your speech pathologist should give you a reminder about the goal you are targeting in this activity just before you open the bag/ container of objects. However, once the action gets going, you should not hear much instruction to allow for the natural flow of communication. Below are some examples of goals that you can target in this water play activity:

Imitating actions/ sounds/ words
Using objects/ pictures/ signs/ gestures/ words/ phrases to make requests
Following simple directions
Using two objects together in play
Expanding play sequences (i.e., put toy cars in the water, scrub them with a brush, dry them)

Bubble Bin

You could always transform this water play bin into a homemade bubble one! I stumbled upon this little gem years ago one overcast, summer day and my neighbor and I decided to try it out with our kids aged four through seven years old. They all LOVED it; big kids included! You can follow this bubble link to a site that tells you how to make the solution and use your finger wands. Plus, there are some activities included in the post that enhance speech and language.

After 15-20 minutes you can give your child a movement break or have him help clean up objects while you listen to specific feedback from your speech pathologist, review homework for enhancing communication during functional routines, and discuss the next week’s coaching session.

ARTS AND CRAFTS: SPEECH THERAPY EARLY INTERVENTION ACTIVITIES

Arts and crafts activities for preschoolers require just a few materials: paper, crayons/markers, and/or a Magna Doddle. You can tell that I like to keep things simple! Here are some goals you can address in at home speech therapy arts and crafts activities:

Imitation:

Draw 2 horizontal lines while saying “ZOOM” leaving a few inches between them.
Now make vertical lines while saying “ZAP”.
Enjoy your train track for pretend play!

Early Speech Sound targets:

Trace hands while singing any tune that the child enjoys.
Model/ demonstrate me, mine, my, you, big, tiny, hi, and bye while coloring the hands together.

Following directions (varies according to ability):

1 Step: Identify objects in fields of 2-3 choices (Get paper, Give crayon)
2 Step: First get the paper, then give me the crayon/marker.
Novel: Put the paper on your head.
Descriptive: Give me the blue crayon/marker.

Pragmatic skills (Using gestures, pictures, sounds, words, or phrases):

Greeting and Departures: Practicing “hi” and “bye” during the activity.
Requesting objects: Giving choices or placing objects within reach for selection.
Responding to questions
Protesting
Turn taking with the same colored crayon/marker.
Commenting: Labeling hand sizes (big/tiny).

Language Skills:

What color is this crayon/marker?
What do we do with crayons/markers?
Where should we hang this picture?
Which hand is big/tiny?
Did you like this?

If you want to add a sensory experience to this early intervention activity for preschoolers, then you could use scented crayons/markers and talk about the things you smell. Another option would be to color the hand drawings with some glue and then sprinkle Jell-O powder or a fragrant spice. Most importantly, encourage FUN because that is what will bring out the most communicative interaction!

PLAY DOUGH: SPEECH THERAPY EARLY INTERVENTION ACTIVITIES

I have yet to meet a child who will not sit for a good period to create with playdough. While there are some fun playdough products on the market, you can use just about anything with dough such as:

Seasonal cookie cutters like spring flowers, shamrocks, or an umbrella
Sturdy plastic cups for making circles and/ or rolling dough
Plastic knife for cutting
Mixing bowl to store tools and supplies

In the event that you do not have some play dough on hand, then you can make your own ahead of your session with this recipe. I might suggest adding some green food coloring to transform the play dough into grass and decorate it with flowers using plastic gems, pipe cleaners, seashells, feathers, or outside objects like mini rocks or pine cones.

Now, what can we address with play dough? A better question might be: what CAN’T you target with play dough? Here are some of my personal favorites:

Create “fossil” imprints with outdoor items retrieved on a scavenger hunt. Use a cell phone to take pictures of the treasures in your yard and then go on a hunt for those objects. Target concepts such as same and different while matching objects to impressions.
Work on imitating actions to roll, press, smash play dough using familiar tunes to sing a song.
Address following directions at the simple or complex levels.
Use the play dough to cover puzzle pieces in a bin. Your child then searches for a piece to complete a puzzle. Pieces shaped like an object can be used to make impressions in the play dough for a conversation piece.
Make a pretty flower with your child. I suggest sorting whatever objects you have on hand into bins or an appetizer tray, so the decorative items are within sight but out of reach to prompt requesting.
Foster pretend play by making small “hats” for Lego figures/ mini objects/ baby dolls. This also lends for a nice opportunity to work on a simple lexicon: hat, on, off, hat on/off. Another option would be to make “food” like thin spaghetti, pizza, or hot dogs and then model feeding a baby doll these delicious creations.

SENSORY BINS: SPEECH THERAPY EARLY INTERVENTION ACTIVITIES

Last, but certainly not least, my favorite early intervention activity for preschoolers is a sensory bin. For this activity, you will need a bin, preferably one with a cover to foster having your child make requests/ ask as opposed to reaching into an open bin and taking desired items. Also, you need something to use as a fill. Here is where you can get creative and use some nearly expired dry goods that you were about to toss. Some of my favorite, sensory bin fills are:

Assorted, dry pasta
Decorative straw typically used in gift bags
Dried beans
Cotton balls
Sand
Play dough

Note that I did not include rice as a preferred fill. It makes too much of a hot mess for my liking and is a pain to clean up later. If the intent is to pull together a fun activity with easy clean-up, then I would advise reserving rice for meals only.

Enhance Play with Toy Integration

Sensory bins are a F A N T A S T I C way to liven just about any play task, such as puzzles, mini objects, Mr. Potato Heads, blocks, pretend play, and flashcards. Below is a breakdown on the speech and language targets you can address using sensory bins:

Matching object to picture with puzzles: There’s just something exciting about searching for puzzle pieces hidden in a sensory bin rather than just dumping the parts onto a table.
Answering basic questions with mini objects: Mini objects are everywhere at home! You could use doll house figures; Fisher Price play set items; wind-up toys; or a variety of matchbox/ pull back vehicles. In this sensory bin, I would suggest partially hiding items to allow for visible answer choices and coaching parents to ask: “Where is the car?” or “What can we drive?”
Mr. Potato Head: Target identifying or expressing body parts with this classic toy. Again, partially hide objects for visible, answer choices.
Blocks: Duplo, Legos, or wooden blocks will work fine in a sensory bin. Address color recognition/ naming; early prepositions like “up”, “on”, “off”, or following directions.
Pretend play: I have used beans and mini work trucks to create a construction truck bin or garden for planting fake flowers into mini pots. You and your speech pathologist could brainstorm something based on your child’s likes and interests.
Flashcards: I prefer using flashcards from sensory bins over traditional drill practices for expressive vocabulary and speech sound targets. Flashcards can be homemade or bought online.

At the end of the day, fostering an emotionally charged, fun play experience will support retention of communicative skills. All this planning ahead of sessions takes time, but the rewards are certainly worth the efforts!

Mastering Teletherapy for Early Intervention

by Nanette Cote

Mother with child in Teletherapy Session

By: Janet L. Courtney, MS, CCC/SLP

Founder and CEO of Lighthouse Therapy LLC

Lighthouse-therapy.com

I am excited to introduce Janet Courtney, CEO of Lighthouse Therapy LLC, a teletherapy company. With over 25 years’ experience, she’s passionate about mentoring and supporting others. You can find Janet’s blog at https://www.lighthouse-therapy.com/blog, contact her at Lighthouse at contact@lighthouse-therapy.com or call 888-642-0994.

Teletherapy for Early Intervention

“My son is two and he isn’t talking yet, is that normal?” “Our one-year-old doesn’t feed herself and has trouble holding a spoon, is that normal?” A teenage mom with a 2-year-old and a 3-year-old is feeling overwhelmed and doesn’t know how to handle her children’s bad behavior. All these scenarios are great examples of children who will benefit from teletherapy for early intervention. The federal Individuals with Disabilities Education Act, Part C, (IDEA) covers services for children and families from Birth through age 3. The Preschool Program of Part B covers children for ages 3 to 5 (Section 619). These programs mandate special education services to be provided to families and their children with developmental delays or disabilities.

Referrals

Who plays a role in spotting these issues in students? Referrals can come from different sources. Parents are usually the first to notice issues, but teachers or doctors may also notice delays. Seeking help is crucial as these services greatly impact a child’s development and future education. The first 5 years are critical for physical, social, communication, and academic development.

Referrals for Early Intervention or Preschool involve a team of professionals who create an Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). The team composition depends on the child’s needs. Together with parents, team members outline concerns and services for the child and family. An IFSP, in particular, involves the entire family, emphasizing education and consultation. The program also sets goals related to the child’s development.

Groundwork for Success

Some parents and professionals may question how telepractice can meet children’s needs online and if it’s effective. Will it really work? How can therapists gather data for eligibility without being physically present? These are valid concerns that need addressing, especially regarding Early Intervention (EI) and Preschool services provided through telepractice. When a child is referred for these services, developmental assessments and parent/teacher questionnaires play a crucial role in understanding the child’s functioning. These assessments and interviews can be conducted via telephone or through the telepractice platform, often sent electronically. Lighthouse Therapy’s platform ensures safe and confidential sharing of information, reducing the risk of exposing Personal Health Information.

Online Video Conferencing

Portrait of cute girl listening to music on headphones while using laptop at home

Therapy sessions are conducted via online video conferencing, allowing flexibility for sessions in the child’s home or preschool classroom. Clinicians coach parents on targeted strategies, observe progress, and adjust techniques accordingly. In preschool, a support specialist or assistant aids the child in joining sessions. Through engaging activities and documentation cameras, therapists monitor and guide students effectively. Lighthouse Therapy’s platform is adaptable, ensuring a dynamic experience for all involved.

Parent Coaching in Teletherapy for Early Intervention

As therapists, it’s crucial to communicate clearly with parents and caregivers, offering practical strategies to enhance communication and learning at home. We teach parents how to emphasize key messages and directions, provide repetition and modeling for the child, and encourage recording interactions to track progress over time.

Wondering how to make teletherapy sessions successful for young children? SLPs plan multiple activities for a 30-minute session to maintain engagement. Themes, interactive videos, picture activities, and memory games keep sessions lively. Using stamps, drawings, and show-and-tell encourages communication skills.

For a FREE ebook that details parent coaching, please subscribe below:

Developmental Links

It is important for the professionals to have access to developmental norms, so I have included a couple links:

Many areas of the country desperately need these services. Engaging telepractitioners will provide key services crucial to children’s future academic success.

Five Popular Thanksgiving Activities to Delight Preschoolers

by Nanette Cote

After months of Fall and Halloween themed lessons, it seems I only have a week to cram in Thanksgiving. This post is a review of five popular Thanksgiving activities to delight preschoolers. Warning: smiles are contagious!

Play Dough

First up is my Play dough appetizer tray. I have seen so many fabulous pins on Pinterest of Play dough trays, like this one from Pre-K Pages, so I grabbed a tray at the Dollar Tree and put my own spin on the contents. I utilized my craft supplies and bought decorative leaves and alphabet letters to enhance the activity.

We have worked on requesting, commenting, and following directions while making unique turkeys. Some used Popsicle sticks for legs, others used pipe cleaners and decorative leaves to create feathers for their crafts. The Popsicle sticks have also come in handy for cutting the dough. Hands down, this activity has been highly preferred among many (including caregivers.)

Sorting Pie

Next, is my sorting pie from Learning Resources. What better way to prepare for Thanksgiving than to sort some fruit into a pie? The game includes two sets of tongs for choice making and multiple choice boards for matching colors, objects, or numbers. My clients aged 2 through 7 enjoyed requesting more, naming colors, commenting, and matching objects to pictures using this super, cute pie.

Tablecloth

Another hit during Thanksgiving was my paper tablecloth. I scored this find while looking for Halloween clearance items at Target, so I grabbed a few to use across a couple years. My younger clients have colored while listening to auditory bombardment lists containing target speech sounds while my older clients have played tic tac toe or earned a chance to color as a reward for completing work.

Farm House

What’s a speech and language session without some pretend play time? I paired my farm house with Fisher Price Thanksgiving pieces to talk about sitting at the table, eating, and bringing food from the farm to the dinner table. You can pick up some shredded, yellow paper to use as hay for the barn and easily dispose of it between clients. This particular toy set used to be much more affordable than it is now. You may still find a sale on Amazon or score it in a Thrift shop sometime.

Interactive Books

Years ago, I purchased a collection of interactive Thanksgiving books from Jenna at Speech Room News. This collection contains books that target action words, commenting about likes and dislikes, and other thematic vocabulary. I have used these colorful books to engage busy toddlers, assist in sentence completion tasks, and promote answering questions about action words using speech generating devices.

Simple Speech Therapy Early Intervention Activity using Eggs

by Nanette Cote

Crack open the door to engaging speech and language development with our simple yet effective speech therapy early intervention activity using eggs! All you need are a dozen plastic eggs and objects small enough to fit in each! There is just something about finding mini treasures that delights youngsters between the ages of two and five years old. I have used this bag of tricks during the spring/ Easter season and beyond with great success! For more winning, speech therapy early intervention activities, head to this post.

Communicative Purpose

In the world of speech pathology, we often reference: communicative purpose. These are the various ways that we express our intentions to connect with others. The greatest thing about using this simple activity of filling plastic eggs with treasures, is that you can elicit several purposes for social communication. Below is a sample of a speech session from start to finish using eggs filled with objects to tempt communication with young children:

Requesting object: indicating a choice for an egg with pointing, eye gaze, reaching, or vocalizing
Requesting assistance: reaching, signing, vocalizing, or expressing “help” to open an egg
Greeting: waving and/ or saying “hi/ hello, bye/ see ya” as you take objects in and out of eggs
Requesting action: gesturing and/ or vocalizing to say “go” after a verbal prompt of “Ready, set…” with a wind up toy; matchbox car/ small vehicle; or spring-loaded pop-up toy
Requesting continuance: gestures, signs, and/ or vocalizes “more”
Labeling: using a sound/ syllable/ word for famous characters like Elmo, Sponge Bob, and Dora
Commenting: using facial expressions, sounds (ew), words (yuck, wow) to make comments about sticky, slimy, gooey, messy things
Responding to questions: Potato Head pieces for naming and/ or identifying body parts
Protesting: shaking head “no”; pushing object away; placing it in an egg; or vocalizing “no”
Requesting termination: gesturing, signing, and/ or vocalizing “all done”

Treasure Hunt

While you may find many objects around your home, below are some great places to look for more items to fill in eggs.

The Dollar Tree typically has a wind up toy or two somewhere in the store or you can find bundles on Amazon. I like having one of these in each sound box because they allow for a little more opportunity for target practice while you play with it. You may also find magnet numbers, miniature animal figures, individually packaged specialty characters, and small Koosh objects at your local Dollar Tree store.
Target Dollar spots sometimes have mini object erasers in a pack of 4 for $1. I found a fruit one on clearance for 30 cents that had a strawberry, banana, grapes, and a watermelon.
Party stores often have trinkets for favors or decor for themed parties
Walmart carries seasonal favors that are fairly priced. I found a collection of stretchy body parts during Halloween a few years ago that the kids love.
IKEA sometimes carries animal finger puppets in a collection of 5-6 that are fun for varying play during a seek-and-find game.
Dinky Doodads on Etsy.