June 1, 2018
by Mary Pat
169 Comments

13 Questions To Ask When You’re Adopting A Child Internationally

Welcome to the second post in the three part series about speech and language development in children who were adopted internationally.

So in our last post, we looked at what the research has to say about their language development. If you haven’t read that post already, you can read it here.

In this post, we’re going to give you 13 questions that you need to ask while you’re in the process of bringing your child home. Children who are brought home at older ages will have spent a longer amount of time in institutional care which means they’re at higher risk for speech, language, and communication challenges. They also have more catching up to do when they arrive home. But it’s important to remember that the research shows that most children are very resilient and make rapid gains in their language development after coming home. For example, in one study, Sharon Glennen reports that 65% of children aged between 12 and 24 months did not require early intervention services.

Before you bring your child home, it’s a good idea to get an idea of what their current speech, language, and communication skills are like. This helps you to get to know them better which will improve how you interact together. And it will also be really useful to have this information when and if you are working with a speech and language therapist. Of course it might be difficult to get answers to all of the questions we list below but it is important to see what you can find out. You might need to work with an interpreter to get more information. And some of the questions you can answer from your own observations like about eye contact and interest in interacting with others.

We’re basing this post on the suggestions of Sharon Glennen who has conducted a lot of research in this area.

  1. Does your child make frequent eye contact with adults when they are interacting together? (It’s important to remember that eye contact is cultural. In some cultures, children are not expected to make direct eye contact with adults because that would be disrespectful.)
  2. Does your child respond to his or her name being called?
  3. How does she let people know that she’s hungry or thirsty or that something’s wrong? Is it by using sounds or words or phrases or sentences? Or by moving her body?
  4. How does she show she’s had enough of something? Is it by shaking her head or saying no or crying? By explaining?
  5. Does your child start interactions by calling someone’s name or smiling or pointing?
  6. Does your child enjoy interacting with others? Think about this in terms of interacting with familiar people, unfamiliar people, and other children.
  7. What kinds of things has she available to play with and what kinds of play does she engage in? Does she play with other children or mainly alone?
  8. What can you find out about her medical history including things like information about hearing loss?
  9. Can she follow simple instructions?
  10. Does she need things to be repeated or made simpler so she can follow them?
  11. Do her caregivers think her language skills are generally what they’d expect for a child of her age?
  12. Is she using single words or two words together or sentences? Depending on her age, can she tell a simple story about something that happened?
  13. What do the caregivers think of her pronunciation? Can they understand her easily? If not, are there certain sounds or words that they can give examples of?

 

The answers to these questions will give you a solid foundation for getting to know your child and how to engage them in interactions with you. In our next post, we’re going to share with you what has worked for other parents in the early stages after coming home and give you some simple but powerful tips for encouraging your child’s language development. If you like this post, please pass it onto your friends!

Let’s get talking!

MP & Bríd

 

 

 

 

 

 

 

 

April 27, 2018
by Mary Pat
1 Comment

10 Things You Need To Know About Language Development In Children Who Are Adopted Internationally

If you’re in the process of adopting a child internationally or you’re the parent of a child who was adopted internationally, then this three part series is for you. Joining me is Bríd Mc Andrew: a speech and language therapist who has carried out research with parents of toddlers who were adopted internationally. In this first post, we’re going to look at language development in children who are internationally adopted so you can have a sense of what to expect.

 

Patterns of international adoption have changed with the overall numbers of inter-country adoptions declining over the years. And now the age at which children are being adopted tends to be older. This means that they will have spent more time in orphanages or foster homes before coming home. (Approximately 88% of children who were adopted internationally have spent time in institutional care). Adoption can help to overcome the early adverse effects of orphanage care as children get used to their new, enriched environment. And children who are internationally adopted show a remarkable resilience when it comes to language development. The research talks about ‘a spectacularly rapid acquisition’ of their new home language, for most children.

 

When your child comes home they experience a period of rapid change.  They’re now exposed to new people, new climate, new home, new routine, new food etc. As well as this, they’re exposed to a new language: the language of the home which is usually not their mother tongue. So they have been exposed to their mother tongue up until they come home and then their exposure to the home language stops abruptly. It’s replaced with exposure to the new language. (This is called a second first language. Your child is learning a first language for the second time). This is a unique language learning situation. Before they have fully learned their mother tongue, exposure to it is stopped and then it’s replaced with a new language. And they tend to lose their mother tongue quite quickly due to lack of exposure in their new home. Children are wired to communicate and acquire language so it makes sense that this would happen. The purpose of language in early childhood is to form connections with loved ones and to communicate your needs. And at the same time as your child is getting used to their new environment and learning the new language, they’re also engaged in forming an attachment with you.

 

Language and communication play an important role in the development of this attachment. The way in which you respond to your child’s bids for interaction (either verbal or nonverbal) can influence your child’s feelings of security in his/her environment. Being a tuned in communicator, using both words and nonverbal communication like facial expression and gestures, help form your attachment with your child. (We’ll show you how to do this in the last post in the series.) People’s experiences vary. Some parents have found it easy to form an attachment while others have found it more difficult when they don’t share a common language with their child in the early period after their child comes home.

 

So, you might be wondering what happens to language development in children who are internationally adopted? It’s quite confusing as there’s a lot of variation between the studies. One recent synthesis of the research so far came to these 10 conclusions:

  1. Overall, children who are internationally adopted present with great variability in their language outcomes.
  2. As a group, they seem to have a higher likelihood for language problems when compared with their non-adopted peers.
  3. There is a lot of variability in language outcomes during the toddler and pre-school years but language skills are still within the normal range compared to children who were not adopted internationally. They tend to do well language-wise up until about age 4.
  4. There tends to be slightly less variation in language skills during the school age years and into adulthood.
  5. School-aged children had slightly to moderately poorer language skills compared with children who were not adopted internationally.
  6. School-aged children tend to perform more poorly on standardised tests that compare their performance to a set of norms than they do on other measures such as checklists and parent reports.
  7. Language outcomes were slightly better for children who were adopted at under 12 months.
  8. Within a few years post-adoption children’s language skills are in line with their non-adopted peers. For example, Glennen (2015) found that children adopted at ages 1 and 2 reached expected language abilities for their age within 15 months of adoption. Children adopted at age 3 reached age-level expectations after 2 years of exposure to their new language, and children adopted at age 4 met expectations after 3 years of exposure.
  9. But later in life as the language demands in school increase, the language skills of children who are adopted internationally can fall behind their peers.
  10. This means that it is important to keep an eye on your child’s language development especially as they progress through school. This may be particularly important if your child tested in the low average range for language development when they were a toddler as they may be at a particular risk for language problems when they start school.

Here’s what else the research evidence says so far:

Essentially it shows that children who are internationally adopted make significant gains in acquiring their new home language in spite of their early experiences in orphanages or baby homes. (Many of the studies look at English). Although orphanages are not ideal places for child rearing, and children may not receive enough tuned-in interaction to acquire well- developed language, these effects can be over come when they come home. Generally, the research shows that by 4 years after coming home, most children who were adopted internationally score within the normal range on standardised tests of languages or checklists that parents complete. (This is compared with children who are learning language from their biological parents). Children who are adopted internationally tend to go through vocabulary growth spurts just like children who are not adopted internationally. Language comprehension or understanding of language tends to reach age-expected levels of development more quickly than expressive language (words, sentences, and grammar).

 

The research is confusing because each study asks different questions, uses different methods to measure different things, and involves small number of children who have widely varying pre-adoption experiences and has varying findings. And countries differ in terms of the quality of institutional care and their economies. Both of which can affect outcomes. For example, there is research showing that children adopted from South Korea and China tend to have better outcomes than children adopted from countries in Eastern Europe and Latin America. And children raised in foster homes tend to have better outcomes than children raised in orphanages.  So one source says that it’s important to remember that there is a subgroup of children who are adopted internationally who have significant language delays or difficulties. This subgroup is larger than what you find in the general population of non-internationally adopted children. And another study found that three years after adoption, that the percentage of children with language or speech delays matched estimates for what you’d expect in the general population of children being raised by biological parents. And there is still a lot more research to be done to really understand language development for these children.

 

When most children are brought home, they may have language delays, but they quickly make gains due to increased exposure to the new language and more opportunities to put their language to good use in conversations and through play. Of course, children’s language abilities will vary and more research needs to be done to understand their language development better. But the good news is that the majority of children who are internationally adopted, when given enough exposure and meaningful communication opportunities in the new home language, make remarkable language progress especially in their first year home. For children who are adopted before age 2, the language transition is smooth with most children eventually developing speech and language skills that are average for their age. And rapid gains are made in the first two years after they come home. Older children may take longer to catch up as they have more catching up to do. But there are lots of gaps in the research.

 

However, there are some children who will experience speech and language difficulties and may require intervention and support. In general, children who were adopted internationally at an older age are at a greater risk for a range of difficulties. (Older meaning after 12 months of age) Although older children may have more advanced cognitive development, they also have more ‘catching up’ to do in terms of language acquisition in order to reach the same level as their peers. Children adopted at older ages may be at an increased risk of speech and language delays, due to spending longer in institutional care. But again, the research is not conclusive that this the case in general. And some studies have found that three years after adoption, age of adoption did not influence children’s performance on speech and language measures. Most of the research tends to focus on children adopted before age 2.

 

The bottom line is that children who are adopted internationally, need time to develop their new language. And most of the children do well when it comes to language development. It’s important to pay close attention when they start school as they may start to experience language problems as the language demands of school increase.

 

In the next post, we will focus on the questions you can ask before you go to bring your child home so that you can get a sense of their early experience and their current language ability in their in their first language.

Are you the parent of a child who was adopted internationally? We’d love to hear your story so be sure and leave a comment below.

 If you like this post, please pass it on to your friends! And if you haven’t already, be sure and sign up to get the next two posts in the series. 

Let’s get talking,

MP & Bríd.

Inspired by :

Glennen, S. L. 2007. Predicting language outcomes for internationally adopted children. Journal of Speech, Language, and Hearing Research, 50, 529-548.

 

Glennen S., (2007). International adoption: speech and language mythbusters. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations, October 2007, Vol. 14, 3-8.

 

Glennen, S. (2014). A longitudinal study of language and speech in children who were internationally adopted at different ages: Outcomes and assessment guidelines. Language, Speech, and Hearing Services in Schools 45: 185–203

 

Glennen S., (2015). Internationally Adopted Children in the Early School Years: Relative Strengths and Weaknesses in Language Abilities. Language, Speech and Hearing Services in Schools 46: 1-13.

 

Julian, M. M. (2013). Age at adoption from institutional care as a window into the lasting effects of early experiences. Clinical Child and Family Psychology Review, 16, 101-145.

 

Rakhlin, N., Hein, S., Doyle, N., Hart, L., Macomber, D., Ruchkin, V., Tan, & Grigorenko, E. L. (2015). Language development of internationally adopted children: Adverse early experiences outweigh the age of acquisition effect. Journal of Communication Disorders, 57, 66-80.

 

Scott, K. A., Roberts, J. A. & Glennen, S. (2011). How well do children who are internationally adopted acquire language? A meta-analysis. Journal of Speech, Language, and Hearing Research, 54, 1153-1169.

 

April 12, 2018
by Mary Pat
1 Comment

8 Simple Ways To Build Your Toddler’s Vocabulary In Any Language

So in my last post, you read all about your child’s vocabulary and why it’s important. (If you haven’t read it yet, you can read it right here.) It’s not just the number of words that your child knows that’s important. Knowing lots of different types of words like nouns (bottle, dog), verbs (splashing, walking, eating), adjectives (hot, cold, red), prepositions (in, on, under), and adverbs (quickly, slowly) is important too. So how can you help make their vocabulary bigger and wider then? Here are 8 things you can do that are free, easy, and natural. Consistency is key so you’ll need to do these things regularly. These tips assume that your child is already using some single words and is beofre or around 24 months old. These tips apply no matter how many languages your child is learning. Don’t try to do these all at once! Pick one strategy and one situation where you’ll try it out. Once you have the hang of that, then you can try another one.

 

#1 Use a wide range of words yourself when talking with your child

Diverse types of words are important so that your child has words to combine into sentences. So when you’re talking about what they’re doing, use nouns and verbs, possession words like mine, and yours, prepositions like in and on. Words for feelings like tired, sad, happy, annoyed. And use specific words too. So want and do are called general all-purpose verbs because they’re quite vague and can be used to mean a wide range of things. That’s fine to start out with, but it’s better to have a wider range of more specific verbs in your vocabulary so that you can communicate more precisely. Also remember to keep your own sentences grammatical too. They don’t have to be very long when your child is at the one word or two word stage. Let’s swing is short but grammatical and children learn language from your intonation too. Statements tend to have a downward intonation at the end. But questions have an upward intonation. So the intonation is a clue for your child to learn grammar and the intention behind your words. Are you looking for information or making a comment?

 

#2 Use everyday opportunities to build vocabulary

This links in with # 1. Vocabulary building opportunities are everywhere once you know how to spot them. Routines are a great place to start. Think about the opportunities available at bath time:

Nouns: bath, water, fun, arm, leg, ankle, knee, thigh, bellybutton and all the bath toys!

Verbs: fill, empty, pour, splash, drink, swim, float, sink, sit, stand, lie, sing, blow, laugh, cry

Adjectives: hot, cold, wet, dry, soapy, bubbly, empty, full

Prepositions: up, down, in, out, high, low, under, on

Feelings: happy, funny, sad, annoyed, tired

Pronouns: my, mine, you, yours, his, hers

Then remember to incorporate a diverse range of word types into these routines.

 

#3 Talk about what they’re interested in

This is the most effective way to build your child’s vocabulary. It means being face to face with your child, tuning in to what they’re looking at and playing with. And then adding the language in with your comments. You don’t try to direct their attention to something else. Being face to face may mean you have to lie on the ground while they’re sitting so that you are at eye level.

 

 # 4 Wait for them to take a turn

Building vocabulary is not just about you filling them up with words. It needs to be interactive. So if you make a comment, be sure to wait for them to take a turn. You can look at them expectantly to communicate that you’re waiting for their turn. If you feel the urge to jump in, count to five (or maybe ten!) and hold on! Their turn doesn’t always have to be a word. It depends on what you’ve said and their stage of development. It might be they wriggle around a bit to show they want more tickles or it could be that they point or nod their head or it could be a word or two words together.

 

#5 Use comments not questions

I wrote another post about this tip and you can read it here. Questions tend to kill conversation and aren’t communicative when you know the answer. So keep your focus on describing what’s happening.

 

#6 Repeat the words on different occasions and in different situtations

Word learning is complex and takes time. Your child needs to hear the same word many times so that they can store it in their mental dictionary. Once it’s stored, they can begin to use it. As adults we tend to seek out variety and novelty. Children seek out structure and repetition in order to learn. It may drive you mad at times but it’s what they need for language learning.

 

 #7 Use gestures with your words

Gestures are a kind of forgotten aspect of communicating with infants and toddlers. They’re really powerful though for word learning. You’re most likely using them  already in actions like waving hello and goodbye, pointing, doing the action for sleepy or rubbing your tummy to signal hunger. Facial expressions are good too for adding an extra sense of the word’s meaning and for engaging your child’s interest. So be animated but natural!

 

#8 Explain what words mean

When your child is age 2 onwards you can do this (or maybe before depending on your child- you’ll know best). So let’s say there’s a pedestrian crossing on your walk to your local park and you always cross the road there. You can tell your child: This is a pedestrian crossing. We’re pedestrians because we’re walking. Pedestrians walk. We can cross here. And so on. You can connect new words to their own experiences for example by saying something like:  Remember we crossed at the traffic lights at the shop yesterday? There’s no pedestrian crossing there.

So there you have it. 8 natural and simple ways to build your toddler’s vocabulary. If you like this post, please pass it on to your friends. If you haven’t already, please be sure to sign up to get the posts delivered directly to your in-box.

Let’s get talking!

MP

 

March 15, 2018
by Mary Pat
5 Comments

Why is your child’s vocabulary development important?

Your child’s vocabulary- what’s the big deal? Why is it important? It’s kind of amazing really as the research shows that when it comes to vocabulary, size does matter! Vocabulary means knowing and using words. It’s your child’s store of words. It provides the building blocks to language development. And vocabulary knowledge drives the development of grammar. There’s strong evidence to connect vocabulary with your child’s later language and cognitive development. Having a large vocabulary at 24 months, has been linked to stronger performance on measures of maths, reading, and behaviour at age 5. Your child’s vocabulary growth is considered to be directly related to their overall success at school. The size of your child’s vocabulary predicts her ability to learn to read.

How many words should your child know and at what ages? This is a bit like asking how long is a piece of string? Although people have been researching this area for decades, it’s still hard to find clear answers because no study is perfect and they tend to approach the topic in different ways using different methods. Let’s have a look at some ballpark figures though:

  • At 18 months, some sources say your child should say 50 words
  • Other sources say by 18 months they should say at least 24 words
  • I’ve read also read: between 43-50 verbs at 24 months with children acquiring 8 new verbs a month
  • They should be combining words by 24 months

Children of professional parents, girls, and children whose parents tend to use an encouraging style of interaction (as opposed to giving lots of commands for example) tend to have bigger expressive vocabularies. Children who had a very low birth weight or where their mothers had health problems have been found to have smaller vocabularies. One study from the 1980s found that children of professional parents would have experienced 42 million words by the time they were 4 years old! Imagine!! Their children were hearing on average 2153 words an hour. That study also found that between 86-98% of children’s vocabularies at age 3 came from their parents’ vocabularies. (Swear words any one?!!)


What if your child is learning two languages or more?

In this situation, your child is acquiring two or more vocabularies. It’s likely that they’re not going to have the same level of vocabulary in any one of their languages as a monolingual speaker of each language would have. Why? Because they’re not 2 or 3 monolinguals combined. And there are lots of factors that influence language development involved. Like how much exposure and opportunities to use the languages they get. The quality of the exposure is also important. It’s not enough to talk to them. It’s about how you talk with them. Other influences are: how alike or different the languages are (for example Spanish and Italian are closer than Spanish and Mandarin Chinese) and the statuses of the languages where you live. But still monolingual vocabulary levels tend to be the measurement benchmark which isn’t the appropriate reference point. The research that compares monolingual and multilingual children’s vocabulary size has found that multilingual children have smaller, bigger, and similar vocabularies when compared with monolingual children’s! If you test an English-only speaking child’s vocabulary, you’re testing their whole vocabulary. But if you test a multi-lingual child’s vocabulary in only one language, you’re only testing one component of their vocabulary. Not fair and not accurate. Studies which measure the total vocabulary of multilingual children have found that they’re the same size or bigger than the monolingual child’s total vocabulary. And when researchers measure what’s called conceptual vocabulary (basically number of concepts or ideas that children have a verbal label for), both groups are similar. So the bottom line is that speaking two languages or more does not disadvantage children when you measure total and/or conceptual vocabulary. Using monolingual norms to make judgements about multilingual children’s language development is a no-no. They’re not an appropriate reference point. If your child’s vocabulary is being tested maybe at school or by a speech and language therapist, make sure you keep your focus on total vocabulary. And also think about the amount of exposure to the languages.

 

There’s a lot of variation in the research and there are lots of studies that report smaller vocabularies for multilingual children. One study which looked at vocabulary in 1738 children between age 3 and 10 in the US found that that although the bilingual children had smaller vocabularies in both languages, the difference had to do with vocabulary associated with home environments. This isn’t an indication of a problem. Of course there was an imbalance because we use language differently according to the situation we’re using it in.  When it came to vocabulary for school, the monolingual and bilingual children were more comparable. This means that bilingual children are not at disadvantage when it came to academic performance, learning to read and write, and using spoken language for school related topics.  There’s a lovely line at the end of that paper by Ellen Bialystock and her colleagues: Bilingual children are constructing the world through two telescopes, and their two vocabularies provide the lenses.

 

There are several influencing factors on language development like I mentioned above. One recent study in Canada set out to control for many of these factors such as socioeconomic status, the statuses of the languages, the amount of exposure and so on. That study found a strong and systematic relationship between vocabulary development and the amount of exposure to the languages in the 5 year old children who participated. There was a clear relationship between expressive vocabulary (looking at pictures and naming them) and the amount of exposure: more exposure led to higher scores. When it came to comprehension, it wasn’t so clear. They found that once exposure hit 40-60% in either French or English, increasing exposure didn’t lead to higher scores.

 

It’s a complex picture but the bottom line is that multilingual children, by and large, pass through the same developmental stages in each of their languages as monolingual children do in their one language.  There are also things that are particular to multi-lingual language development too. And generally multilingual children go through the stages at roughly the same ages. It is important to remember that there’s a lot of variation in early child language development, no matter how many languages your child speaks.

 

So what can you do to build your child’s vocabulary?

The good news is there are lots of natural, simple ways to do this and I’ll show you how in my next post.

If you like this post, please share it with your friends. And if you haven’t already, be sure to sign up for more posts delivered directly to your inbox.

Let’s get talking!

MP

Inspired by:

Bialystock, E, Luk, G., Peets, K., and Yang, S. (2010). Receptive vocabulary differences in monolingual and bilingual children. Bilingualism 13(4):525-531.

De Houwer, A., Bornstein, M., and Putnick, D. (2014). A bilingual–monolingual comparison of young children’s vocabulary size: Evidence from comprehension and production. Applied Psycholinguistics 35 (6): 1189-1211.

Hadley, PA., Rispoli, M, and Tsu, N. (2016) Toddlers’ verb lexicon diversity and grammatical outcomes. Language, Speech, and Hearing Services in Schools 47 (1): 44-58.

Morgan, P., Farcas, G., Hillemeir, M., Hammer, C., and Maczgua, S. (2015) 24-month-old children with larger oral vocabularies display greater academic and behavioral functioning at kindergarten entry. Child Development 86(5): 1351-1370.

Rudolph, J. and Leonard, L. (2016) Early language milestones and specific language impairment. Journal of Early Intervention 38(1): 41-58.

Thordardottir, E. (2011). The relationship between bilingual exposure and vocabulary development. International Journal of Bilingualism 15(4): 426-445.

 

 

March 1, 2018
by Mary Pat
120 Comments

What happens after your child says their first words?

We all eagerly await the day our child says their first word. It’s so exciting! Looking back, the first word my little girl understood was kiss. And her first word was /k/. But ‘That’s not a word!’ you say. Oh but it is in this context as she always used to it to request Katy Perry’s Firework song to be played on the computer. A word is the same sequence of sounds used to refer to the same thing each time. After that came kiss and tickle.  Tells you a lot about what was happening in her world! So first words are expected to come any time from 8- 15 months depending on what you read. (Or even 18 months according to one source I looked at) There’s a lot of individual variation among children in their language development which makes it hard to work out what’s in the range of typical development and what’s not. (If you’re worried that your child is late to talk, read here and here.).

 

Individual variation in language development is also a key feature if your child is learning 2 languages or more because each family situation is unique in terms of the languages spoken, the amount of exposure to each language that your child receives, the opportunities to use the languages that they have, and the relationship between the languages like Spanish and Italian vs Spanish and Mandarin for instance.

 

But first words are only a stepping stone in language development. Now, don’t get me wrong, they’re a very important step on the way to developing longer and more complex utterances and sentences. What comes next is important too.

 

So what happens next? Word combinations is what. Now, things like all gone and thank you are not considered true word combinations because they’re most likely learned as one chunk by your child. The fancy name for them is holophrases. They communicate one single intention like requesting, rejecting, labelling, greeting. Language is used to communicate something and these communicative intentions are important because they show that your child is learning to use language to do something like asking for more tickles or rejecting food that they don’t like. These early combinations are really cool and tend to allow our children to communicate in three useful ways: # 1 making statements about things that interest them, # 2 giving orders (!!) , and # 3 asking questions. Here are some examples:

You do it (order)

Here you are (statement)

All gone (statement)

Go away (order)

I wanna do it (statement or maybe request- would depend on the situation)

Lemme see (order)

Where the bottle (question)

About 11% of our toddler’s language is thought to be made up of holophrases. Thank you is not a true 2 word combination if your child can’t use thank and you in other utterances such as you go or thank me and so on.

 

If you’re worried about your child’s language development and want to keep an eye on them, you can write down the words they say and then look at what are they doing with those words- they need to develop a range of these communication intentions so it’s good to have a look at what they’re doing with the words they’ve got.

 

At about 18 months then, children begin to combine separate words into meaningful utterances. There are three types of these.

#1 Word combinations which are made up of 2 words of equal status. What would this look like? Let’s say your child sees a ball on the table and she says Ball table. What she means is The ball is on the table or I can see the ball on the table or Look at the ball on the table. So two little words can mean quite a lot! Our job is to work out what she means and say it as she would if she could. That will help her language to develop in a natural, tuned-in way.

# 2 Pivot schemas where it’s like there are two slots- the pivot word which stays the same and the other slot that can be filled with a range of words depending on what they want to communicate. Isn’t that amazing?! The order of the pivot word + the other slot tends to be fixed. The order of the words tends to mirror the order that your child is hearing in their everyday environment. Common ones are like this:

more + X: more cookie, more fish, more high, more hot, more juice, more read

no + Y: no bed, no fix, no home, no mama, no more,, no down

other + : other bib, other bread, other milk, other pocket, other shirt, other shoe

 # 3 True two word combinations which express two separate ideas. These are really cool too as they’re predictable in the sense of the kinds of meanings they can express. Here are some examples of the range of meanings that our clever infants can communicate about as they discover their world:

Kinds of meanings Your child says What your child might mean
Action + Agent Doggie walk  The dog is walking.
Action + Object Push train I’m pushing the train

You’re pushing the train.

Push the train with me.
Agent + Object Man hat The man has a hat.

The man is wearing a hat.
Action + Place

 

 In bath I’m in the bath.
Object + Place Teddy bed The teddy is in the bed.
Possessor + Possession Jamie car This is Jamie’s car.
Thing + Attribute Water hot The water is hot.
Demonstrative +Object This train THIS train (not THAT train).

This is a train.

Our children are expected be combining two words together by 24 months of age with about 50% of their utterances expected to be made up of two word combinations at this age.  Before being able to combine words, your child needs to have a diverse vocabulary. That means nouns, verbs, prepositions, and adjectives. A recent study found that children who were described as being late word combiners (not combining words at 24 months) were found to be more at risk for future language problems than children who were slow to produce their 1st words (late word producers- not producing single words by 15 months).

How will you know when your child is ready to start combining words?

# 1 When you notice that their vocabulary includes  different kinds of words like I mentioned above. Nouns (car, house doggie), verbs (eat, sit, walk, crawl, smile, laugh), adjectives (hot, cold, bad, sore), and prepositions ().in on under). Once they have a wider range of vocabulary than just nouns, they have the foundations they need to start combining them.

# 2 When they use Gestures and Words

This is another cool thing about our infants! Before they can put two words together, they usually use one word plus a gesture which adds extra information so that they can get their message across. (If you want to read more about baby sign which is different from natural gestures, you can read all about it here.). So if your child points to the packet of biscuits on the kitchen counter and says Mama, she’s expressed two ideas. # 1 Agent Mummy and # 2 Action- give me a biscuit! Your child pointing to the biscuit while saying biscuit only expresses one idea. So does lifting their arms up to you saying Up– one idea. But lifting arms up and saying Mama is two ideas: Agent Mama+ Action Lift me up.

So what can you do to help things along? Here are four of the most supportive things you can do when playing with your child to encourage them to start combining words:

# 1 Observe what your child is interested in and comment on what they are looking at. This means you’ll have to resist the urge to point something out to them that you think is interesting. So let’s say they’re looking at a cat out the window. They might point and say Cat. You then say Oh, I see a cat or The cat’s in the garden. It’s important to keep your sentences grammatical too. Keep them short and simple but full sentences. Do your best to avoid trying to teach them overtly by drawing their attention to something else- this isn’t an effective way to teach them. Following their lead is more helpful.

# 2 Abandon all attempts to get your child to repeat what you want them to say! It’s not communicative and is a form of pressure to perform. Interactions with your child need to be meaningful to them and having them repeat things isn’t a genuine communication exchange. Bite your lip! I know it’s hard especially when they’re so cute but it’s worth it in the long run!

# 3 Make sure you use a range of different words other than just the names of things when you’re playing with your child. So talk about how the dog is spotty or brown or big or small or under the bed and so on.

# 4 Say it the way they would if they could. This comes back to #1 above. It’s best to use short grammatical sentences and not things like doggie bark for instance. So if  your child says doggie bark, then you can say The doggie is barking or Doggies bark which are short, expanding on your child’s effort, and still grammatical.

What two word combinations did your child use? What one’s are they beginning to use? Be sure to leave a comment below.

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Let’s get talking!

MP

Inspired by

De Houwer, A. (2009) An Introduction to Bilingual Development. Bristol: Multilingual Matters.

Hanen’s It Takes Two to Talk.

Hart and Risely (2003) The Early catastrophe: the 30 million word gap by age 3. American Educator Spring 2003: 1-8.

Paul, R. (2018) Language Disorders from Infancy through Adolescence: Assessment and Intervention. (3rd ed) London: Wiley.

Rudolph, JM. and Leonard, LB. (2016) Early language milestones and specific language impairment. Journal of Early Intervention 38(1):41-58.

Saxton, M (2010) Child Language: Acquisition and Development. London: Sage.

 

 

February 14, 2018
by Mary Pat
192 Comments

When should you start reading with your child?

So I’ve started writing a book about how to develop all of your child’s languages when you speak two languages or more. I’m doing a lot of reading around the topic at the moment and there’s one thing about children and language development that regularly blows my mind. What’s that? It has to do with when babies start to learn language. There is a robust field of research on what’s called infant speech perception which shows that once their ears begin to function in the womb, in about the 7 month of pregnancy, babies start to learn about languages. While still on the inside, they can distinguish between sounds like a power drill, a door closing, their mother’s voice, a bell, and music. Not impressed? How about this- unborn babies can learn to recognise the telling of a particular story.

One study from the 80s had mothers read a particular story to their babies at 7 and ½ months into the pregnancy. One of the stories was the first part of Dr Seuss The Cat in the Hat. Another one was adapted from the 2nd half of The Cat in the Hat and was called The Dog in the Fog. And the third one was called The King, The Mice, and The Cheese. Mothers were asked to read one story twice a day from 7 and ½ months which meant that by the time the babies were born, they had heard the story about 67 times. Three days after they were born, the babies were found to show a preference for the story they had heard while in the womb over the other two stories. (How did the researchers work this out? They measured the sucking rates of the babies and the babies tended to suck more enthusiastically when hearing the familiar story).

Other  studies have shown that where babies were read prose passages for 6 weeks before they were born, they preferred those passages when they were born over ones they hadn’t heard before. They preferred the familiar passages even when they were read by an unfamiliar female voice. So it wasn’t just their mother’s voice they were responding to but the acoustic properties of the speech signal- the sounds, the intonation. And by monitoring  babies’ heart rates while they were still in the womb, researchers noticed that at 37 weeks of the pregnancy, the babies distinguished between familiar and new poems.

What do the findings mean? They mean that babies tune into intonation patterns of the languages they hear from their outside world environment. Intonation is like the music of language- the ups and the downs. Hearing through layers of muscle, skin, fat, and amniotic fluid is going to sound a bit like the noise from next door-the sound waves are passing through a lot before they reach the baby.

There are other amazing things babies can do after they are born and even before they’re six months old but that’s for another day! So to answer the question, when should you start reading to your baby? You can start as early as 7 and ½ months or so into your pregnancy. When they’re older, the actual way you read with them becomes important. If you’d like to know how to share books with them naturally in fun ways that build their language skills, I have an e-book that shows you just how to do that. You can get that here.

If you liked this post, please share it with your friends. And if you haven’t already, be sure to sign up to get more posts directly to your in-box every two weeks.

Let’s get talking (and reading!)

MP

Inspired By:

Before First Words website.

Paradis, J., Genessee, F., and  Crago, M. (2011) Dual Language Development and Disorders: A Handbook on Bilingualism and Second Language Learning. (2nd ed.) USA: Paul Brookes Publishing.

Saxton, M (2010). Child Language: Acquisition and Development. London: Sage.

 

January 18, 2018
by Mary Pat
407 Comments

3 Important Reasons Why LOL Surprise Dolls Are Good For Your Child And You…

So my little girl has become enamoured with LOL Surprise Dolls recently. I was reluctant to let them into our world but relented in the end. Setting aside all totally reasonable arguments about toy companies manipulating us and our children, not to mention the environmental impact from all that plastic , there are 3 major reasons why LOL Surprise Dolls really are great. Read on to find out what they are. (If LOL Dolls are not the latest craze in your house, you can substitute many other toys that our children come to love for the same benefits)

#1 The most obvious reason is to do with your child’s imaginative play, vocabulary, memory, and story-telling skills. Of course, these are not the only toys that develop these skills but if you have succumbed to them, you may as well console yourself that there are genuine benefits! They are great for all of these things though. The range of story lines and characters are endless and your child’s ability to re-purpose other toys to add into the story lines is also very good for symbolic play development. Language is all about symbols and if your child can use the LOL balls to make a train or a carousel or a boat, this is very good for play and ultimately, language development. Play is also great for working out things that might be bothering them at school or limits that have been set at home. It’s very useful emotionally to have a baddie in your story that you can vent some steam through without actually hurting anyone! Story telling is also very good for language development and learning to read.

As for vocabulary, we have had endless discussions about the following words: opposites, club, sugar, spice, angel, demon. So you have concrete vocabulary like club and then more abstract terms like angel and spice when talking about a character as opposed to food. This is building your child’s vocabulary network in terms of multiple meanings for words. Strong vocabulary is linked to learning to read so it’s a neat way of building a diverse vocabulary. We’ve also had great chats about concepts such as worth and value. As in, is the big glitter ball worth the €65.34 and the 22 weeks it will take you to save for it? Other concepts we’ve explored are terms like ultra-rare, popular, and common. And manipulation, supply, and demand, duplicates. My little girl got Kitty Queen who is, according to some people like gold dust because she’s ultra-rare. However, she’s not interested in Kitty Queen; she prefers Kicks who’s popular. So we talked about the value you attach to something. (On a side note, I discovered I could have sold the infamous Kitty Queen for £85 or more because of the value attached to her by a lot of people.) We’ve also talked about word play when we see the names of some of the dolls like M.C. Hammy, Hoops D.O.G.G. and Curious Q.T..

#2 The second reason LOL dolls are actually a good thing has to do with your child’s emotional development, emotional literacy, and resilience. How so?
When you buy an LOL doll, you don’t know which one is inside. We were very lucky initially and never got a duplicate. But that day came and we had only opened the first layer of plastic (I know, I know- 7 bloody layers!) and got the little clue so she knew it might be one she had already. And so it was. Cue hysteria! Oh she railed against those dolls and declared she never wanted to see another one (‘Oh please, yes’ I thought! And then ‘Although she’d better play with the ones she has after all the money I’ve spent’.!! ). So because I was on holidays and not exhausted, I found it in me to acknowledge her feelings and say things like ‘It’s really disappointing. You didn’t want Beats again. You wanted Kicks. She’s your favourite. It’s so upsetting when you get a duplicate’. I also had to fend off my well-intentioned mother from chipping in with things like: ‘There are lots of little girls who have no dolls you know’!! It was really interesting though. After a few minutes of intense emotion, she calmed down and about 20 minutes after that she was able to come up with solutions to her dilemma. For example, she could use Beats’ clothes for another doll. She could pretend that Beats had an identical twin or a clone or that Beats was a changeling. This is the whole point of allowing our children to feel what they’re feeling. It allows them to be better problem solvers. And it gives them a safe place to feel what they’re feeling without any pressure to stop it or change it into something we deem more acceptable. They need to feel accepted as they are. If they can’t do that with us, then how can they ever come to feel that they’re okay just the way they are? And that what they feel isn’t something undesirable but something that makes us uniquely human and connected to each other as we all feel these feelings at one time or another?

#3 Believe it or not, LOL Surprise Dolls are good for you too! What? Yes! Two reasons- A: they allow you to enter your child’s world, find out what’s important to them, and get to know them better. When you join in and play, you can see what they value, what they’re interested in, what might be bothering them, and be amazed by their imaginations. These are precious gifts indeed.

And B they give you an opportunity to teach your child about goal setting, planning, and money. And to be their guide to handling challenging emotions on the journey towards their goal. LOL dolls are an expensive toy at €11.99 each so they’re never going to be a frequent treat. So my little girl decided to save for this one big ball that has 4 dolls in it and a range of accessories. She has identified what she wants- the big glittery ball- the goal. It’s good to know what you want and have a specific outcome so you’ll know when you’re there. Together we have worked out the numbers- it will take 22 weeks to save for it and you can’t buy anything else in the meantime. We’ve had chats about how you could get to your goal quicker (problem solving and generating solutions) – like do more work to earn more money- and she’s working out what exactly she’s prepared to do to get to her goal faster. As it turns out, cleaning the bathroom sink for €1 extra is not one of them! So she’s clarifying her values.

It’s going to take her a long time to save the money so she’s having to learn to deal with feelings of longing and struggle and frustration. And disappointment when some of her strategies like asking for her pocket money in advance and I say ‘No’. Or trying to get more pocket money without adding value in the world. (Hard lessons indeed! We’d all like money for nothing!!) This gives me plenty of opportunities to guide her through the feelings, acknowledge them, let her feel them, and move on. This is not easy! Especially when it can start first thing in the morning as the first thing that comes out of her mouth as she tries to get me to give her money to get to her goal faster! It’s so hard not to preach about patience as my mother used to do!! Or get annoyed by the seemingly relentless focus on what she wants. But is gives me great opportunities to put what I’ve been reading and learning into practice and build the muscle of being tuned in and guiding her through the rough seas.

So what are your child’s favorite LOL Surprise Dolls? Be sure and leave a comment below!

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Let’s get talking!
MP

December 2, 2017
by Mary Pat
Comments Off on What exactly is a speech problem?

What exactly is a speech problem?

So your child has a speech problem. But what exactly is a speech problem? For this post I’m talking about problems with speech sounds and pronunciation. Having a lisp. Or saying tar when you mean car. Or speech that sounds slurred or strained. Other speech problems would be stuttering or stammering. I’ve written other posts about that. If your pre-schoolchild starts to stutter, you can read this. If your family speaks 2 languages or more, and you’re worried about your child stuttering, you can read this. Voice problems like being hoarse are another kind of speech problem which I’ll be covering in a future post.

 

There’s a lot of theoretical discussion in speech and language therapy about how to classify the different types of speech sound problems. There’s no universally agreed upon one yet. I’m sharing with you the one I use to teach speech and language therapists in training. The idea is that any child’s speech sound problem should be able to fit into the system. Essentially there are 7 possibilities and 1 exception when it comes to children’s speech sound problems. So let’s get started!

 # 1 Articulation Impairment- in the mouth

This is where your child has trouble producing particular sounds, usually /s/ or /r/. For English speakers this can be a lisp (technically called an inter-dental /s/). Usually /s/ is made with the tip of your tongue up behind your front teeth. With a lisp, your tongue comes between your teeth. I had a lisp until I was 17 and had no idea I had one until I visited a local speech & language therapist to find out about training to be one!! I couldn’t make a /s/ with my tongue tip behind my front teeth. So I make my /s/ with my tongue tip behind my lower teeth. My little girl has a lisp too. I think it’s really cute for now! She has no front teeth though so I’m waiting to see what happens when her permanent teeth come in. For /s/, the air is directed out of the center of your mouth. Make one and see if you can put your focus on what’s happening in your mouth when you do. Then try and do a lisp. Another articulation impairment affecting the /s/ sound is when the air comes out the sides of the tongue- often called a lateral lisp. Both of these sounds are not speech sounds in English which can be another way of working out that your child has an articulation impairment (and they only speak English).

 

An articulation impairment can also affect /r/ so your child might say wed when they mean red. If you ask them to say /r/, they can’t do it. Same applies for the /s/. A general rule of thumb is that articulation impairments are in the mouth- a problem with the physical articulation of sounds. The meaning of words is generally not affected so it won’t necessarily be harder to understand your child because their meaning will still be clear.

 

Problems with /r/ are a little more complex in that meaning is affected. Wed and red do not mean the same thing.  So I tend to think of problems with /r/ as an articulation impairment with phonological consequences. Bear with me- I’ll explain more about phonology in # 2 below!

 

Speech therapy for articulation impairments is basically showing your child how to produce the sound by itself. This involves explaining how to make the sound. Then the sound is combined with a vowel. Either a vowel first followed by the /s/ for example, ee-s. Or the /s/ first followed by the vowel, s-ee. Then the sound in words- either at the beginning (son) or the end (house). Then in phrases and sentences and ultimately in spontaneous speech when it has become automatic. I got rid of my lisp by saying the prayers at Mass out loud until I could do it without thinking about it!! Some researchers say that your child would need to be at least age 7 and really committed to changing their speech for therapy to work. It’s a lot of drill work and practice so motivation is important. Here’s a handy table with ages at which you can expect most children to say particular sounds- interpret flexibly though as there is a lot of individual variation. These are from Australia and not written in stone- use as a rough guide.

Next up is

 #2 Phonological Delay: in the mind

Big word phonology! ‘What the hell is that?’ you may be wondering. It has to do with the organisation of sounds and meaning. It’s about rules. So for example knowing that in English you can have str at the beginning of words like strawberry but not nd at the start of words. If you do crosswords a lot, you’ll recognise patterns like this and use the knowledge to work out what the answer might be.

 

Sounds are organised in classes to do with shared properties so we have long sounds like /s/ /z/ /f/ /v/ and short sounds like /t/ /d/ /p//b/. If you say them yourself, you’ll feel the difference. There are front sounds /t/ /d/ /n/ and back sounds /k/ /g/ and the sound at the end of words like sing. There are quiet sounds like /p/ and /t/ and loud sounds like /b/ and /d/.  To feel this difference, put your fingers on your throat and say a long /s/. Then say a long /z/. You should be able to feel a difference with some slight vibration on the /z/.

 

Children who have a phonological impairment might say deben instead of seven.  Or tar when they mean car. Or boon when they mean spoon. If your child has a phonological impairment, this means that they have trouble with learning the rules of their language. (This learning the rules is happening unconsciously). In a way, it’s a language problem that affects the organising of speech sounds into a system of sound contrasts. The contrast is important because that’s connected to the meaning of words. If you want tea, you need to be able to say tea and not have key come out instead.

 

There are 2 kinds of phonological impairment. The first one is phonological delay. So for children who speak English as their only language, the ages and stages of speech development are fairly clearly mapped out. When they’re learning to speak intelligibly (takes up until about age 5 and possibly up to age 8), they make predictable and acceptable errors. For example aminal instead of animal, hopsital instead of hospital. We expect them to make errors like leaving out the last consonant in a word when they are between 18 and 24 months. In fact in this time period they may be making all of these errors at the same time:

  • leaving out one of the consonants where two come together: boon for spoon
  • saying tat when they mean cat
  • saying tar when they mean car.
  • saying dit when they mean sit
  • saying wed when they mean red
  • saying door when they mean tore and
  • saying gog when they mean dog

 

And that’s typical development! No need to correct them. The best thing to do is to repeat the words correctly after them in a natural sounding way. Here’s a very quick video I’ve made to show you how to do this.

 

A phonological delay then is when these kinds of errors don’t go away at the ages you’d expect them to. (There’s a lot of individual variation in early child speech and language development so it’s important to think of the ages and stages in a flexible way). So if your child’s 3 and a half and is still leaving out the consonants at the ends of words. Or they’re 6 and saying sawn when they mean Seán. And here’s another handy table with general ages at which these error patterns (also known as phonological processes) should be gone by. But remember, speech development for multilingual children won’t be exactly the same as this because of the language systems interacting.

The next one is:

 

# 3 Consistent Phonological Disorder

Some errors that children make are not found in typical development. (I’m talking about monolingual English speakers here. It’s slightly different when you speak two or more languages.) Things like leaving out the first sound in a word or the middle sounds in words or using a back sound instead of a front sound. That would be saying kar when they mean tar. This is called a phonological disorder. There are 2 kinds of phonological disorder. The first one is a consistent phonological disorder where your child says the word wrong the same way each time. So it’s always kar for tar. There’s still a consistent pattern in the errors.

 

Speech therapy for phonological delay and consistent phonological disorder focuses on helping children organise their speech sound system and learn the rules. So it would mean talking about long sounds and short sounds for example. Having your child listen and identify long and short sounds and then producing long and short sounds. They would play games where they pick a picture from a pile of pictures with word pairs such like sick (long sound at the start) and tick (short sound at the start). The therapist can’t see which picture. Your child says the name of the picture and the therapist points to the one she hears. The idea is that if your child says tick and the therapist points to tick,  but your child meant sick, they realise that they need to use a short sound instead.

 

# 4 Inconsistent speech disorder

 The other type is an inconsistent speech disorder. The problem here is with selecting and sequencing speech sounds correctly. It means that your child will say the same target word (the word they’re trying to say) differently each time they say it. So seven might be teben, deben, seben. You can see how this makes it hard to understand your child because there’s no predictable pattern in their speech. Things change constantly.

 

The therapy for an inconsistent speech disorder is called. It the core vocabulary approach and works like this. The therapist together with you, your child, and your child’s teacher make a list of 50-70 words that are meaningful to your child and that they’ll have an opportunity to use in day to day interactions. Words like people’s names, pets’ names, foods, favourite things, words like sorry and please and thank you. Generally, your child attends for 2 thirty minute sessions in a week over the course of 6-8 weeks. The first goal is to get their best production. It doesn’t have to be the same as yours. It just has to be consistent so that they’re always saying a word the same way. That will make it easier to understand them and for them to experience successful communication. That’s the first step and it goes on from there.

 

#5 Childhood Apraxia of Speech (previously known as Developmental Verbal Dyspraxia or developmental dyspraxia.

This is a difficult one to explain. The technical description says it’s a difficulty planning and programming movement sequences resulting in errors in speech sound production and prosody. I know! What would that sound like though? Well if your child is very hard to understand, has trouble producing many consonant and vowels, has trouble saying long words, and has unusual sounding speech, then they may have childhood apraxia of speech.

 

It affects 1-2 children per 1000. There are a range of interventions for children with CAS. Two that I have used are the Nuffield Centre Dyspraxia Programme and the Kaufman Speech to Language Protocol which is a little like Core Vocabulary. One early aim is to get consistent production of your child’s best attempt at the words they’re aiming to say. There’s unpublished case study data on the website to show it works. As for the Nuffield programme, there’s published and unpublished evidence about it.

 

#6 Childhood Dysarthria

This means weakness or slowness or poor coordination of speech movements. It can affect your child’s breathing, vocal quality, muscle tone, nasal-sounding speech or, slurred-sounding speech. It’s not as common as the other types. It’s caused by neurological impairment which could occur during or after birth like cerebral palsy. Intervention for children with childhood dysarthria depends on the type of dysarthria, how severe it is, and on what aspects of speech are involved.

 

#7 A combination of issues

Children’s speech may fit neatly into one category. For example, your child has a lisp or articulation impairment and that’s it. However, because children’s speech sound systems and their language is developing, they may have trouble in other areas too. So for example,  your child may have dysarthria related to cerebral palsy and trouble with the physical production of speech sounds, they may also have a phonological impairment.  Or they have a cleft palate affecting their speech (nasal sounding) and a phonological delay, not related to the cleft palate. So while I’ve presented the types separately, it’s not as simple as that in reality. The idea is that SLTs need a system to explain your child’s speech symptoms so they can plan intervention according to their understanding of the type of speech problem it is. So if your child has a lisp, they need articulation intervention. And so on. The intervention needs to fit with the diagnosis.

 

The exception

There’s another category called speech difference. And this is an important one for families who speak two languages or more. If you’ve read my post on what you need to know about speech development for multilingual families (here ), then you’ll know all about languages interacting and how ultimately with high quality input and opportunities to use all of their languages, the speech of most multilingual children develops without problems. What can make it a little more challenging to identify one of the speech problems above is that the languages interact in ways that can produce errors that would be considered a disorder in monolingual English speakers. For example, leaving out the first sounds in words is unusual in monolingual English speaking children but not unusual for French speaking children. That’s why multilingual children need to be assessed in all of their languages and why SLTs need to find out about the different sounds in the different languages they try to work out if there is a problem or not. They call this difference vs disorder in the literature.

Lastly, accents are not speech problems. Everyone has an accent whether they think they do or not! The fancy word for it is idiolect and it includes language as well as speech. So for example I say I do be talking to her. Or I’m after burning the dinner. These are common for some Irish English speakers and artefacts from the Irish language. It’s also common for Irish English speakers to sound like they’re saying dis, dat, dese, and dose  for this, that, these, and those . If you live in South London, you might say souf for south and it’s dialect not a diagnosis! In the US, for Tuesday you say toosday. In Ireland we say chewsday! Tomayto, tomato! Accent is not a speech sound problem.  And no accent is better or worse than any other. Now, if you’re an adult who learned a second language later in life and you feel that your accent is interfering with getting your message across, then a speech and language therapist can help you although it’s important to know that this an area that is only beginning to emerge in speech and language therapy practice and not without controversy. If you want to read more about accents and speaking two languages or more, here are two interesting articles by the renowned Francois Grosjean. (You can read them here and here.

 

If you’re concerned that your child has a speech problem, be sure to contact your local services.

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Let’s get talking!

MP

 

Inspired by:

Barbara Dodd (2005) Differential diagnosis and treatment of children with speech disorders. London: Whurr.

McLeod & Baker (2017) Children’s speech: An evidence-based approach to assessment and intervention. London: Pearson.

November 17, 2017
by Mary Pat
1 Comment

What happens to children who are late to talk?

Recently I wrote a blog post for Bilingual Kidspot about children who are considered to be late talkers. If you want to find out what exactly does it mean to be a Late Talker, you can find out here. In this post, I’m talking about language. That means when your child says her first words, starts putting words together to make sentences, tell stories, and so on. That’s different from speech sounds and children’s pronunciation. (If you’re worried that your child may have delayed speech, read these 2 posts here and here.

 

This post is all about what happens to children who have been identified as being Late Talkers or having an expressive language delay. Do they catch up? How long does it take? I had a look to see what does the research say. Most of the research is on monolingual children and it’s hard to find recent studies. It’s also very hard to find anything about multilingual children. And different studies define and measure things differently so it’s complex! You can see the list of what I read at the end of the post. I’ve extracted what I think is the most useful information for you but I’m aware that it’s not the whole picture. This is a very nuanced topic!

 

A delay in expressive language is one of the most common reasons that young children are referred for language assessment. Between 10-20% of 2 year olds are affected by late language emergence. There’s a range of small scale and longitudinal studies which indicate that most late talkers do achieve average range language scores on language tests by age 5, 6, or 7 years. So overall the prognosis for late talkers is good. That means, most children who are late talkers do go on to have language skills in the average range. (There is a but here- keep reading to find out what it is. Actually there are several buts as it turns out!)

 

For preschool children, a summary of research on small scale, longitudinal studies of outcomes for late talkers shows that most children scored in the normal range on language tests by age 4 or 5. Delays in grammar tend to linger for longer than delays in vocabulary. Significant predictors of outcome, (which did vary across studies) included receptive language (that’s understanding of language), gestures/play skills, the degree of delay at 2 years, the range of consonants used by the child, a family history of reading problems, and word learning.

 

What about school aged children? Again, small scale longitudinal studies of school-age outcomes for late talkers indicate that most late talkers scored in the normal range by age 6 or 7 but continued to have significantly weaker language skills than typically developing peers through to adolescence. So as a group, late talkers are at heightened risk for language or learning issues. Significant predictors of outcome, (which again, varied across studies), included vocabulary at age 2, nonverbal IQ, and preschool expressive and receptive language.

 

I’m extracting the main points here as studies vary a lot in terms of the numbers of children involved, the age of diagnosis, what they measure and how they measure it. Leslie Rescorla, who is a much-published researcher in the areas says that a robust finding across many studies is that most late talkers attained language scores in the average range by age 5 or 6 or 7. In addition, most late talkers in primary school score in the average range even on tasks that appear to be the most challenging for them like grammar and verbal memory measures.

 

Another very robust finding reported by Rescorla is that late talker groups consistently attained significantly lower scores on most language measures than groups with histories of typical language development. BUT their scores for oral language, reading and writing are still in the average range. So while the scores are lower, they’re not always statistically or clinically significant. She suggests a spectrum of language skills deriving from variation in many discrete skills. So it’s like language ability exists along a continuum. What are these skills though? Things like auditory perception or processing, word retrieval, verbal working memory, motor planning, discriminating between speech sounds, and grammatical rule learning. (Complex!)

 

Where a child had a delay in both understanding and use of language (called a receptive/expressive language delay), outcomes tend to be poorer than if they have an expressive language delay alone. These are the late talkers most in need of intervention. Children whose only developmental issue at 18-35 months is an expressive language delay are less at risk as most late talkers catch up to  normative expectations- some not until age 5 or older and their language skills continue to be weaker than those of their peers, on average. The existing evidence suggests that most children with language delays at age 5 were not late talkers. The estimated proportion of late talkers who go on to display persistent language difficulties varies widely from 6%- 44% depending on the study you read.

 

But what happens to late talking children as they get older than 7? There’s evidence to show that groups of late talkers typically obtain scores that are significantly lower than groups of children with typical language development as they get older. Leslie Rescorla has published studies of children at age 9, 13 and 17. (It’s important to remember that studies generally compare groups of children. What’s true for the group, may not be true for your child.)

 

So at age 6-9 she found that late talkers did not have lower reading scores than comparison peers at ages 6 &7 when they were all in the early stages of learning to read. On the other hand, she found that late talkers did have significantly poorer reading/spelling skills at ages 8 & 9 than their comparison peers, as reading skills became more established in both groups. But their scores were still in the average range. She also found that expressive vocabulary as reported by parents of toddlers (aged 24-31 months) on a checklist that took 10 minutes to administer was significantly associated with school-age language skills at age 6-9 years. Meaning that children identified by the questionnaire as late talkers versus typically developing children, all of whom had normal receptive language and nonverbal ability, differed significantly on language and reading measures at ages 6 to 9. And that expressive vocabulary at age 2 is an excellent measure of general language ability at that age. For late talkers with normal receptive language, this weak language ability shows up later, not in clinical impairment but in slightly poorer language performance than would be expected given their socio-economic status and nonverbal abilities. It also means that vocabulary skills at 2 to 3 years  of age may be a better index of underlying language ability for late talkers than grammatical skills measured in the preschool period, when most late talkers are catching up to comparison peers.

 

What else does this mean? Rescorla says that it means that you can be confident that most late talkers with normal receptive language skills will perform in the average range by national standards in most language skills by the time they go to school. (Her work is based in America) In addition, you can anticipate that relatively few late talkers will develop problems with reading. On the other hand, she says it’s  important to know that early expressive language delay may indicate some subclinical weakness in the skills that serve language development and learning to read. She suggests then that it might be a good idea to give late talkers, even those with normal receptive language skills, with extra exposure to games and activities that may help to strengthen vocabulary development, verbal memory, awareness of sounds and letters and so on.

 

What happens at age 13? Once again, all the participants in her study who had been late talkers performed in the average range on all standardized language and reading tasks at age 13. But they scored significantly lower than socio-economically matched peers on combined measures of vocabulary, grammar, verbal memory, and reading comprehension. They were similar to their comparison peers in terms of reading and writing mechanics.  Again the age 2 vocabulary score from the parent checklist was a significant predictor of age 13 vocabulary, grammar, verbal memory, and reading comprehension. She says that her findings suggest that slow language development at age 2–2 ½ is associated with a weakness in language-related skills into adolescence relative to typically developing peers. And she recommends boosting your late talking child’s language abilities with games and activities as that might well help to prevent future language weaknesses relative to typically developing children from the same backgrounds.

 

And finally what happens at age 17? Rescorla again found that although the late talkers continued to be comparable with comparison children on nonverbal tasks, their scores on most of the language measures at age 17 were lower than those of the comparison children, despite being in the average range. So children identified with delayed expressive language as toddlers generally scored in the average range at age 17 years and didn’t have significant language impairments. According to the teenagers themselves and their parent, they were all making good progress in high school and were on track to graduate. But, they continued to have weaker language skills at age 17 years than peers with typical language histories—a finding that is consistent across a range of studies.

 

It’s important to remember that late talking is a characteristic not a disorder in itself. And the most likely outcome for individual late talkers is that they will catch up to their peers with typical development. How much a toddler understands may be a better predictor of expressive language outcome than how much he or she says. Children with better comprehension have a better prognosis for language development. Late talkers are at relatively low risk for language or learning disorders. Being a late talker does not mean a language disorder is in your child’s future.

 

If you like this post, please pass it on to your friends. If you’d like even more resources to build all of your child’s languages while still having fun, visit the Talk Nua shop here.

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Let’t get talking!

MP

 

Inspired by:

American Speech-Language-Hearing Association (2017) : https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935380&section=Incidence_and_Prevalence

 

Fisher, E. (2017). A systematic review and meta-analysis of predictors of expressive language outcomes among late talkers. Journal of Speech, Language, and Hearing Research 60: 2935-2948.

 

Petrucelli, N., Bavin, E,. and Bretherton, L. (2012). Children with specific language impairment and resolved late talkers: working memory profiles at 5 years. Journal of Speech, Language, and Hearing Research 55:1690-1703.

 

Preston, J., Frost, S., Menci, W., Fulbright, R., Landi, N., Grigorenko, E., Jacobsen, L. & Pugh, K. (2010). Early and late talkers: school age language, literacy and neurolinguistic differences. Brain: A Journal of Neurology 133: 2185-2195.

 

Rescorla, L. (2011). Late talkers: do good predictors of outcome exist? Developmental Disabilities 17: 141-150.  

 

Rescorla, L. (2009). Age 17 language and reading outcomes in late-talking toddlers: support for a dimensional perspective on language delay. Journal of Speech, Language, and Hearing Research 52:16-30.

 

Rescorla, L. (2005). Age 13 language and reading outcomes in late-talking toddlers. Journal of Speech, Language, and Hearing Research 48:459-472.

 

Rescorla, L. (2002). Language and reading outcomes to age 9 in late-talking toddlers. Journal of Speech, Language, and Hearing Research 45:360-371.

October 21, 2017
by Mary Pat
521 Comments

What to say when your child is frustrated or disappointed.

It’s very hard being a child. You have a lot of ambition but your body can’t keep up. You want to do many things that seem to be beyond your ability like dressing yourself, walking, running, getting that toy that’s in the washing machine, climbing the stairs, and so on. Other bothersome things are asking for what you want using your words and getting your grown up to do what you want. Sometimes they’re very strange. As far as you’re concerned, you’ve clearly said I want my teddy or Where’s my spoon? Or I don’t want to go in the buggy. Or I don’t want to go home yet. But they’re looking at you with a somewhat puzzled look on their face. You don’t get what you want. They try to stop you having fun by leaving the playground before you want to go. You get frustrated often. You cry. You scrunch up your face. You might even throw yourself on the floor and kick and hit. You want what you want and you want it right now. Yet you can’t have it. You demand, you insist, you whine, you try to wear your parents down. It’s very frustrating! For everyone! From our point of view, it’s a good thing that they’re not well co-ordinated so we can avoid the hits or kicks a lot of the time!

 

Frustration may be one of the most misunderstood emotions of our children. I know it’s so intense and can seem extreme from our point of view. Good news though, it does begin to abate between 5 – 7 years of age as their impulse control improves and they learn to use their words instead of their whole bodies. And they can say things like I kind of want to go to the party and I kind of don’t want to both at the same time.

 

Frustration is necessary for our children’s brain to develop and we do our children no favours when we try to bypass it or prevent it from happening. This was news to me too when I did a course on understanding pre-schoolers with The Neufeld Institute but I’m converted to the need for frustration now. Hear me out! I’m not saying it’s easy to handle or cope with but when you see it as a part of child development, it does take on a different meaning.

 

How about this for a different way of looking at frustration? Our children’s brain development depends on it. Frustration is a biological response that happens to us when something isn’t working for us. (This isn’t how I want it). Frustration is the feeling that arises when we encounter something that we cannot change (this is called futility). For example:  Mama says we have to leave the playground. And I can’t change her mind. Or The new baby is here and she’s not going away. I have to share my mama with her.

 

I’ve just finished reading Deborah MacNamara’s book on pre-schoolers called Rest, Play, Grow. She’s from the Neufeld faculty. And her book is like a mini version of the course I did. Our job is to help our children learn to accept limits and restrictions.  It’s not good for them when we bend to their will too much and give in. Sometimes it has to be a clear No with no room for negotiation. Life will give them plenty of Nos and if they’re not accustomed to hitting a limit, then they’re in for a shock. Helping them navigate futility prepares them better for life. It builds resilience and keeps them in right relationship with us. We’re the captains of the ship, not them. Remember Veruca Salt in Willy Wonka & The Chocolate Factory? I want it now!

 

What we need to work out, in the face of their tears, is when to change something for them and when to help them accept what they can’t change. (Logic won’t work. I learned this the day my 2 &1/2 year old was crying because she wanted the doll that was in the washing machine. In a very reasonable tone of voice I told her: You can’t have the doll. She’s in the washing machine. You can have her when the wash is over. What happened then? She kept crying! What eventually worked? When I remembered to acknowledge the feeling and said: You really want that dolly and you can’t have her. It’s hard when you can’t have what you want. The storm passed- amazing!

 

Deborah MacNamara says that frustration is the emotion of change. It makes us work hard at getting what we want or to change things that don’t work for us. We want to help our children learn to harness the power of this emotion so that they can make changes in more civilised and responsible ways. We need to help them realise that they can’t always get what they want and that they can survive things not going their way. To be able to do this, we need to respect their wants and wishes. It doesn’t mean we have to give into them all the time. It does mean that we respect their right to want what they want. Even if it is chocolate for breakfast or staying up late. This is an emotional process meaning logic or reason will not work. Why not? Because it’s an emotions issue and pre-schoolers in particular are all about feelings. Trying to talk them out of what they want in a reasonable manner generally fails because they’re unreasonable. They can only be unreasonable at this stage of development! We need to appeal to their soft little hearts and not their heads. They need to feel that they’re up against a wall. That Mama has said no and is not changing her mind. This needs to register in their hearts.

 

We then need to help them to hear our No and eventually accept it emotionally. Generally this involves tears. Tears are really important. As Gordon Neufeld says, healthy children are emotionally messy. They need to be moved to tears because this shows that they have felt the futility. They need to experience the dead end so that they can then find another way through. Mad needs to move to sad. So they feel mad when they hear the No and realise it’s a definite No and not We’ll see. Then, when they realise that it’s a definite, unchanging No, they’ll be moved to feel the sadness and disappointment that comes with futility. Being supported to feel feelings of sadness and disappointment about what they can’t change helps them become more resilient and resourceful. They don’t have to cry tears necessarily but you’d expect to see their eyes water at least. You want to help them adapt to the limits while preserving their spirit.

 

Here’s another interesting idea from Aletha Soleter of Aware Parenting: When children cry, the hurt has already happened. Crying is not the hurt but the process of being unhurt. Tears cried in sadness release toxins from the body. Oxytocin is also released and that inhibits the stress hormone cortisol. When our children cry and we comfort them, it also increases oxytocin and decreases stress hormones. It’s also important that we allow our sons to cry just as we allow our daughters to cry. When tears are not welcome, they can lead to aggression as the suppressed emotion has to come out somewhere.

 

Disappointment may be the most important emotion says Gordon Neufeld. Our children need a safe place to cry; one where they will not be talked out of their tears but supported through them so that they can become resourceful and resilient. They won’t get invited to every party. They won’t win every game. Fun times come to an end. It’s in being with them through these experiences that we kindly and compassionately prepare them for the bigger disappointments that life will bring. It’s our job not to be afraid of their tears. Sadness drains away frustration.

 

9 Things not to say:

# 1 Cut it out

# 2 Stop crying

# 3 Why are you crying?

# 4 If you don’t stop crying, I’ll give you something to cry about (from many an Irish childhood!)

# 5 Calm down

# 6 Control yourself

# 7 Pull yourself together

# 8 Stop doing that.

# 9 Don’t be such a cry baby.

 

Frustration and tears are our child’s clearest signal to us that they need our help. They cannot control themselves. Sometimes it seems like something really trivial has set off a very intense reaction in them. It could be something as little as a stubbed toe, a misplaced toy. Tears lie waiting to be expressed and we need to come alongside them to help them flow.

What to say and do when your child is experiencing frustration and disappointment:

This is going to depend on your child’s age and language level and you’ll need to work out what feels natural to you and your relationship with your child. So for a toddler, you might say something like ‘Grrr. Mad baby’ or ‘You’re not happy about that’ or ‘You don’t want to go to the café. You want to go home’. For older children it might be something like:

  • Oh my goodness! Something’s not working for you.
  • This isn’t going the way you want.
  • Something’s not going your way.
  • I can see you’re frustrated and it needs to come out and this is not the way to do it. (This would be where the behaviour is not acceptable like kicking or pinching)
  • You have hits in you. Let’s help you get the hits out.
  • It’s hard isn’t it?

 

In order for our children to really feel the futility of the situation, we need to close the door to change, for example, by saying something like: Mama said no. This is what’s happening. It’s time to go to bed. The child realises there’s nothing left to do but cry. You say: This is what you wanted. Mummy said no. Daddy said no. But this is not what you wanted. It makes you very sad. We need to come alongside them physically and hold them and maybe rub their back and say nothing for a moment or two.

 

Some more ideas for what to say:

  • I see you’re frustrated. Something isn’t working for you. That frustration needs to come out. Here, let me help you find a way.
  • I’m sorry sweetheart, it’s just the way it is. I’m not prepared to do that right now. That’s what I’ve decided.
  • That’s part of being a person. This is nothing bad. This is normal. I’m not worried.
  • Those are very big feelings. I know.
  • Show me how mad you feel. You can get some paper and crayons and let them scribble or poke holes in the paper to let the mad feelings out.

Not always easy to remember this but it’s totally worth it!

If you like this post, please pass it on to your friends.

Let’s get talking!

MP