Wednesday, January 1, 2014

Getting the "Talking Train" Moving: Tips for Working with Nonverbal Toddlers

Hey, everyone!
Lately I have been working with several toddlers who demonstrate moderate to severe expressive delays and have played around with numerous techniques to get that "talking train" moving. I've finally compiled a list of what I find to be the most useful techniques that I have self-employed and expressed to parents.
1) Encourage vocal play.
This includes squeals, animal noses, syllables/syllable repetitions, and onomatopoeia, in general. A good way to do this is by demonstrating play in front of the child using objects you have at least 2 of, so you can act out an action w/ a corresponding sound and then pause for the child to do the same. My favorite game is to take farm animals and have them take turns “eating” hay (“mm-mm-mm” or “mumumumum”). Integrate the sounds the animals make, and then when they are “done’ eating, push them away and wave, “bye bye!”
2) Use predictable play sequences with consistent sound usages.
For example, in the play routine I described above, I have about 5 animals at my disposal. I do the same play routine with each animal so the child learnsthe routine and therefore anticipates what will happen next, and eventually, hopefully, will chime in imitatively or spontaneously, perhaps with some pausing. 
The routine looks like this:
1) Pick up animal - expressively give animal sound: “MOO!”
2) Make animal eat hay - “mumumumum”
3) Push animal away - wave + “bye bye”
Once the child begins to master/participate vocally within this simple sequence, you can expand on it. For instances, I bring in a bed and we put each animal to sleep and say, “night night!” after they’re doing “eating”.
3) Keep in mind early developing sounds when choosing target syllables/words to approximate.
Use 1-2 word models that contain EARLY sounds.
For instance, I will generally encourage a child to say, “moo” before encouraging “cow”, because /m/ is a target sound at this point and /k/ is not. Once the child will imitate syllables and/or is attempting word approximations, you can start expressively labeling with greater precision. I will usually start introducing the animal, for instance, as “COW! Mooooo.”
4) Integrate play routines that prompt the child to say the same syllable or approximation multiple times at the BEGINNING of the session.
This means using a syllable or word approximation that the child uses semi-consistently to get the TALKING TRAIN GOING.
For instance, I often use a shape sorter for this kind of thing. We sort the shapes and after each one, say “done” (usually “duh”). There are enough shapes to get at least 15 approximations in a relatively short amount of time. This gets the kid talking EARLY in the session. In other words, I like to start with activities I know the child will participate verbally in before integrating new vocal play or verbal play routines.
This is certainly not by far an exhaustive list but just some things that I have found significantly productive.

What I want to know is: what are some of your favorite tricks for getting those nonverbal kiddos to begin vocalizing?
Leave a comment down below and let's get talking. 

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