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Speech Therapist Tips for Children With Speech Delay

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Kawai is a working mom with twins who is surviving on coffee, naps and practical parenting advice.

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My daughter was referred to a Speech Therapist (ST) when she was about 2.5 years old, after the doctor had noted that she was falling behind in the number of words that she could speak compared to other children. According to Mayo Clinic, a child who is 24 months of age should understand about 50 or more words and understand simple instructions. However, my daughter could speak only about 20 words and seemed to be non-responsive when we talked to her.

Our sessions with the Speech Therapist were scheduled to occur about once a month, to kick start some support for her speech delay, while we continue to monitor her milestones to see if more intensive interventions may be required. At her age group, it was difficult to pinpoint exactly what was the issue.

Since the start of her treatment, we have seen some improvement in her speech and communication, though she is still falling behind her peers. However, I thought it would be useful to share some tips from our Speech Therapist which have contributed to some success in getting our little girl to use more words to communicate some of her needs and thoughts.

A Starting Point to Improving Speech

Using my little girl as a reference, I consider these tips to be a starting point to improve speech for a child who largely still relies on non-verbal gestures to convey her needs, but who I think possesses some receptive language (the ability to understand language), as I noted that she can:

  1. Use simple words to reply (e.g. saying ‘don’t want’) when we ask her easy questions.
  2. Recite A to Z, 1 to 10 and finish the sentences of songs and books that are read to her. I believe that she truly understands the words and her ability is not based on memory, because she can e.g. point to body parts without physical prompt, can perform actions such as ‘jump’ or ‘turn around’ when asked, without the actions being done in accordance to the sequence of a song she knows by memory.

Please note that the tips below are based on my own experience. Each individual child is different and you should be referring to a specialist for professional advice.

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1. Set Up the Right Environment

When setting up an environment to engage your child, you should consider the following:

  1. Create a calm and quiet environment which will allow your child to communicate effectively without too much distractions. For example, keep phones, tablets and TVs off when trying to engage the child. Also, keep the place simple with toys neatly stored in clear plastic containers.
  2. Encourage interactions and opportunities for the child to want to approach you. For example -
    • Put your child’s favorite toys and food out of reach to encourage the child to request for the items.
    • Put away toys in the bedroom, but include books to cultivate the habit of story time.
  3. Practice face to face interaction, as faces convey important social information that your child may not have picked up through words. As much as possible, sit opposite to the child and talk to them at their eye level.

2. Follow Your Child's Lead

Focusing on following your child’s lead instead of dishing out instructions or asking questions is important as your child will pay more attention to you as well as what is happening around them. They will be encouraged and motivated to engage with you as the activities involve their interest. So what exactly should you do?

  1. Observe: Simply start with watching what your child is looking at, what is their current interest and how do they respond to it.
  2. Wait: Wait before talking to them in simple language, give your child time to process what you have said, and have the opportunity to respond.
  3. Listen: Hear what your child is capable of saying and what he/she is trying to say. Provide your respond according to his/her level of understanding.
  4. Join in: Act like your child, to let him/her know that you are interested in his/her likes. Be silly, loud with exaggerated expressions and actions to get their attention.
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3. Provide a Running Commentary

The running commentary technique simply means describing what your child is doing as he/she is doing it. This should be done as you try to follow their lead (as described above). The combination of these 2 methods is important as it allows the child to lead without stress and the words you provide can help him/her to associate words to what he/she is currently doing or seeing.

The key is to be consistent and repetitive (repeat yourself 2-3 times at least) and do not force him/her to repeat after you as he/she might get frustrated. As long as you keep at it, he/she will naturally start to use the new words in the future to articulate the same thing.

For kids who have speech delay, it would be good to first focus on giving labels to words and actions, instead of trying to teach them things like manners (e.g. saying ‘please’ and ‘thank you’). If you keep inserting ‘please’ or ‘thank you’ in all the words or short phrases that you are trying to teach, they may include it incorrectly when they eventually response to you.

Personally, I think this strategy has worked the best for us, as I realised that my daughter had picked up more phrases and action words. Where possible, I became the background commentator when she is playing so I would say short simple phrases like "Kick the ball", "Splash the water", Roll the dough" and she has gradually started to pick on the words and use it correctly.

On a good day, she will repeat after me immediately. Otherwise, she seems to be passively listening or maybe even ignoring me, but a word or a phrase may suddenly pop out from nowhere. So I concluded that even when she appears to be oblivious to me talking, she is actually listening and learning.

As your child improves, you can add more and more words. For my daughter, she had always used single words to convey what she wanted e.g. saying “water” or “biscuit”. However, I added “I want” in front of the request, and it took about 2 weeks for her to start saying “I want water/biscuit”.

Typically, we will start to teach kids the words of objects like “apple”. So once they have mastered that, we could include action words like “eat apple” to increase his/her vocabulary.

You could also use runny commentary to describe your everyday actions. Talk about what you are doing in the house e.g. cutting, washing, showering. As much as possible, try to show the different locations and times you might do these actions (e. g. washing hands, feet, floor, dishes).

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4. Teach Action Words

As mentioned above, action words can be introduced to increase your child’s vocabulary. Action words are crucial as they are needed for sentence building. However, action words are more difficult to teach as they need to be taught when the action is happening.

To help you along, below are some additional suggestions on how to teach action words:

1. Sing more songs and nursery rhymes involving action words.

E.g. If you are happy and you know it clap your hands

  • If you run out of ideas on new songs, you can always go to Children YouTube Channels for inspiration (Cocomelon, Simple Songs and Tidi). My personal favourite is Simple Songs, because they have a lot of easy-to-follow songs which you can easily adapt to add more words. Some great songs are “What do you hear”, “Walking in the forest” and “Hello”.
  • Cocomelon’s songs are not too bad too, and I highly recommend the “Funny Face Song” to teach your child facial expressions. I use it to teach my little girl and modify it with tons of dramatic expressions to get her attention so now she can make out the different emotions. However, my daughter’s Occupational Therapist (OT) informed us that though she may appear to recognise emotions, she may not be able to understand how to appropriately react to it (e.g. giving comfort to someone who is sad). So this is something which we have to work with the OT.

2. Play action toys or action games/activities.

You can use action toys such as spinning tops or drums to play with you child, or engage in action games/ activities such as kicking a ball, catching or art and crafts. This will also give you more opportunities to introduce action words.

You could demonstrate the action and tell your child what you are doing. Then take turns with your child to do the action and give him/her a chance to tell you what to do. If you feel like your child is having some difficulty expressing what he/she wants, you could also offer choices e.g. “Shall I jump or run”.

Regardless of the method, you should start with 1-2 simple action words and use it repetitively, so it is easy for your child to pick up.

I personally love letting my daughter play Playdoh because I can teach her a variety of action words such as cut, roll, fold, stick, put etc.

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5. Use Playful Obstruction

Playful obstruction is another great technique introduced by our ST and it simply means playfully getting in the way of what your child wants to do.

This technique is important because as parents, we are pretty good at guessing what our child wants, which leads to us helping them too quickly and doing all the work.

Playful obstruction helps your child to:

  • Have more chances to communicate
  • Be more motivated to communicate
  • Work together with you in the same activity
  • Communicate with you longer
  • Try to interact in various ways e. g. looking, pointing, reaching

Some techniques include:

  1. Playing dumb – which is doing silly or unexpected things to get his/her attention. E.g. helping to wear one sock and pretending to forget the other and acting confused when he ask or gesture for the other sock. If your child did not clearly use his/her words (but you know what he/she wants), pretend to be confused and encourage the child to try again.
  2. Get in the way – which is playfully withholding what your child wants. This will encourage your child to use words and ask for things that he/she wants.

For playful obstruction, it is important thing is to keep it fun. It should be subtle and playful disruptions to the flow of activities. Do not cause extreme frustration by making your obstructions overly aggressive or annoying. If we push it too far, it may cause the child to dislike the interactions with you.

All activities should end with a positive note, by letting your child do something calming without any disruptions or expectations for a few minutes.

Quick Summary

To sum up, the 4 ways in which you can encourage speech in you child are:

  1. Having an appropriate environmental setup
  2. Following your child's lead
  3. Running commentary technique
  4. Teaching action words
  5. Using the playful obstruction technique

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2021 Kawai

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