Speech and language development

[JonGilmartin]

Hi there! My name is Jon and I’m a Speech and Language Therapist from I CAN, the children’s communication charity.

I’m happy to answer questions about any aspect of speech, language and communication development that you might have.

Maybe you want some information about what to expect next from your child’s communication skills or would like some advice about finding the right support for your child’s speech and language?

Please do ask away!

There are loads of things we can do to help our child’s communication skills. These top tips from I CAN are a great way to start:

• Visual clues are great for helping children who struggle with communication. They help them to understand, and can give them ways they can get their message across to you.

• Messy play is great to help children develop language skills. Talk about different actions, objects, colours and textures while you play!

• If your child is struggling with a particular sound or word remember to repeat it back to them the right way. For example, ‘That was a good kick, a really good kick.' That's better than asking them to repeat it the right way!

• Try not to ask too many questions, especially ones that sound like you’re constantly testing your child.

There are many more things you can try; reply to this post or ask your own question if you’d like some information and I’ll be sure to get back to you soon. Thanks, Jon.

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UPDATE - May 2017

My time as resident expert has come to an end, but I am delighted to hand over to my colleague Mandy Grist who is taking over the role and will be available to help you with any queries you have regarding children and young people’s speech, language & communication. Please carry on posting your questions below. Wishing everyone the very best.

[sarah.mellor]

Hi Jon, can you help with my son?

He gets really frustrated because no-one apart from me can understand what he says. Even I struggle sometimes though. He says loads but his speech sounds like gobbledegook. He’s four. His behaviour is getting worse and I think it’s because he can’t talk properly.

His nursery is trying to help but his behaviour is a problem now. Should we take him to see someone?

[JonGilmartin]

Hi Sarah,
Thanks so much for getting in touch with us and for submitting a question. It can be very frustrating for children when they struggle to be understood and we often see this having an impact on their behaviour. By age four, I’d expect a child to be understood by everybody so I would advise that you consider making a self referral to your local speech and language therapy service. This can be done by visiting the TalkingPoint website: www.talkingpoint.org.uk and following the ‘find local services’ link. Parents/carers can usually make the referral themselves.

In the meantime, here is a link to some useful background information on communication needs and behavior in children that you can have a look at http://www.talkingpoint.org.uk/search/node/behaviour

Some general top tips when supporting your child’s developing sound system would be:
• Saying the word the right way for him e.g. if he says 'do' instead of ‘go’ you can say 'yes lets go, lets go in the car, ready, steady go!. That way he can hear the right way the word should be said many times.
• Make up some 'silly sound books' including pictures that begin with the sound(s) he is having difficulty with. This draws on the same idea that we are raising his awareness of the differences between the sounds without asking him to make the sounds, as he is finding this tricky.
• If he can't say the sound or say a word back to you using the sound try to avoid putting pressure on him to say it. He is probably using his substitution for the sound which is easier to say. He may also not be ready to work on this sound yet.
I CAN have a factsheet on speech sounds that is downloadable here: http://www.ican.org.uk/~/media/Ican2/What%20We%20Do/Enquiry%20Service/Speech%20Sounds%20factsheet.ashx
Also, perhaps you might consider booking a free callback from one of our speech and language therapists? If so, then please do not hesitate to call us on 020 7843 2544 to arrange a convenient time for one of our therapists to phone you. I hope this has given you something to go on for now and thanks again for getting in touch. With best wishes, Jon.

[milliemooh]

Hi John, my daughter is 2 and has a brain condition called cerebellar hypoplasia. She is non verbal, and has regular speech and language therapy. She has no understanding of language at present . I have purchased a big Mack machine and I would appreciate if you could give me some tips on how to use it with my daughter .

Many thanks, Orla

[JonGilmartin]

Hello Orla,
Thanks for posting a question. Before I launch into listing apps and approaches to engaging young children with technology, may I please clarify what you mean by a big Mack Machine? If you would let me know then I can properly direct my advice and suggestions for you! Thanks Orla, look forward to hearing from you.
Jon.

[JuliaT]

The Christmas holidays have just started for my 5-year-old, and I'm feeling nervous. He struggles with his communication and easily gets frustrated, leading to tears and tantrums. Do you have any tips to help me over the holidays?

[JonGilmartin]

Hi there Julia, thanks for your question. Christmas is a time for playing games so why not try having a communication focus when you do? How about playing a game of ‘Guess What?’ This should help your son listen to information in sentences and use clues to help him understand. Cut out some pictures of Christmas objects from old magazines (or you could use real objects) and arrange them on the table (things like baubles, holly, bells, snowman, crackers, cards). Tell him that you are thinking about one of the things and then give him some clues to help him work out which one you are talking about. Clues can be about what type of thing it is (for example a toy, something you eat etc), what it is made of. Can he guess which one you were thinking of? How many clues did it take? You can encourage him to take a turn too so that he can practice giving the clues to you.
Most important of all, enjoy playing together and keep it fun! If you would like to talk through this and some more interesting approaches to keeping your son engaged in fun activities, you could get in touch with our free Enquiry Service.
If you contact I CAN Charity on 020 7843 2544 we can book in a free call back for you from one of our speech and language therapists. That will give you a chance to talk things through in detail and we can provide you with some free resources too. In the meantime, have a look at our I CAN Help page where you will find some really interesting Factsheets that you can download. These explore different approaches to try out with children to help support their speech and language development. www.ican.org.uk/help
I hope this is of help to you Julia and I wish you a very Merry Christmas! Jon

[Liz]

Hello. My brother is an adult with learning disabilities. Over the last few years he has started to use just the first letter of words in place of the whole word. He usually does know the word, he just skips it. I usually interrupt him and prompt him to tell me the whole word which sometimes works. Do you know of any other techniques as I feel bad interrupting him when he's having good day and obviously has lots he's trying to say. Thanks

[JonGilmartin]

Hello Liz,
Thanks so much for contacting us through FamilyHub. This is a very good question! I CAN are a children's communication charity and that is where our real expertise lies, but I can certainly provide you with some general advice on helping your brother.

You have very insightfully picked up on the importance of trying not to interrupt him – a common approach that I suspect we all use, maybe a tad too often?!

It can be easily modified to make it quite effective for you both. If you can allow him the extra bit of time it takes for him to complete what he is saying, then once he has finished, if you model back to him the way you would say it yourself this can have a very positive impact. firstly, it says to him that you have understood him. This in itself should have a positive impact. But secondly, it is a nice way of saying that you like him talking to you. This is a really nice way to encourage him to keep trying to communicate using his speech and also allows him to receive the correct model for pronunciation without you having to interrupt or correct him. A win-win situation, so to speak?

I hope that helps Liz. I’m sure if you would like to book in a call with one of our speech and language therapists on the I CAN Enquiry Service, we could talk this through with you in more detail and that would give us the chance to learn a bit more about your brother and what might help you to help him further. You can arrange for a free call back from one of our friendly speech and language therapists by calling us on 020 7843 2544 to book in a call back at a time that is suitable for you. All the best for now Liz.
Jon.

[jayneee]

Hi Jon,
My adopted daughter has ASD, DD, ADHD, pssible FASD, poor memory and speech and language disability. She is 13. I have battled with SALT in special school for more therapy, but they keep signing her off saying there is nothing more they can do for her, except in class from TA support.
I have since found out that poor muscle tone in her jaw, possibly due to FASD, maybe a problem she could be helped with, can you give any advice please ?

[JonGilmartin]

Hello Jayneee
Many thanks for getting in touch. My first thought is to encourage you to book in a call with us on our Enquiry Service. We have a team of very friendly speech and language therapists and we will arrange a convenient time for us to call you back after you have made initial contact with us. That way we can talk through the various elements that could well be having an impact on your adopted daughter’s speech, language and communication strengths and needs and we would pay for the call. The contact number is 02078432544.

In the meantime, I noticed you said it is possible FASD. How far towards a diagnosis is your adopted daughter? I would suggest that poor muscle tone in her jaw may have an impact on her articulation rather than on her language development. FASD would need to be confirmed by medical diagnosis in order for any related impact to be considered though, I would think. I also understand that one of the risks from FASD is developmental delayed speech and language so this may well have contributed to her experiencing delays when she was very young as well as now.

With regard to the support that is to be offered (or is being offered already) in class from a TA, It is increasingly common now for TAs and other school based staff to provide one to one and sometimes group support for children with speech, language and communication needs. From I CAN’s point of view (the Charity I work for!), we are keen that the right level of support is provided for school staff to ensure that each child gets the most out of this approach. The relevant school staff can be trained in how best to support communication needs in children and young people to increase their chances of accessing the curriculum, reaching their individual targets and having more opportunities to interact with their peers. I CAN have devised a list of recommendations for good practice in classrooms that you might want to have a look at. You can see them here: http://www.talkingpoint.org.uk/parents/finding-right-school/secondary-school-checklist

Another option you might want to consider of course Jayneee is to investigate the possibility of having an independent speech, language and communication assessment for your adopted daughter. There is an online database for independent, that is, private speech and language therapists. You simply type in your postcode and select an age range and all therapists practising in your local area will be listed with what they specialise in. This would be at a cost to you of course and it may be worth you speaking with the school prior to doing this to ensure that they would be happy to accept an independent therapist’s assessment report. The website is www.helpwithtalking.com

I hope this has given you some useful pointers. You can get back to me here for further information but please do consider booking in a call with one of our therapists so that we can talk through these options and see what else might be available for you to try to support your adopted daughter.
My very best wishes to you,
Jon.

[TheRobinsons]

Hi Jon

Just after a bit of professional advise please. Our son (8) has verbal dyspraxia and moderate learning disabilities, he's had S&L therapy for 4 years or so and not really progressed much. We are wondering if there's a rule of thumb for progression with S&L as he struggles with therapy etc. Any advice is appreciated thanks

[JonGilmartin]

Hello and thanks so much for getting in touch. I must apologise for the long delay in replying to your query.
This is a very interesting question and unfortunately not one with a straightforward answer. Lots of factors can influence how effective speech and language therapy may be and so it is difficult to know for sure between one individual and another whether they have reached their full potential. There are different types of therapeutic interventions and it may be that a different approach or approaches may give him a fresh approach? From your query, I’m not clear how the input your son has received has been provided (i.e. via your local NHS provision, at school, at home etc.) and how his progress has been reviewed across this time period.
It may be that he may respond very differently to a different type of therapy or it may depend on the environment in which it is happening and also how much opportunity there exists at present for him to practice working on his sounds.
I wonder if, on reflection, you would consider booking a call back from one of our speech and language therapists so that we can talk through the various factors with you in more detail? We have a small but dedicated team of highly specialist therapists and you can easily book for a free call back at a time and date that suits you for half an hours discussion and some signposting too if that would be helpful? The number to contact us on to book a call back is 02078432544.
In the meantime, you may want to visit the following websites if you haven’t already:

Part of the University College London Hospitals NHS...

http://dyspraxiafoundation.org.uk/

http://www.apraxia-kids.org/

Each contains a lot of very valuable information on dyspraxia and may provide you with further avenues in which to explore.
Please do consider booking in a call with us and I wish you well in the meantime.
Jon.

[mumof2]

Hi Jon,

My son is rising 8 and is still non-verbal. He has a diagnosis of autism with profound special needs. He communicates with us via text message but half of the time it's echolalic, and otherwise has the typical toddler communication where they will come and get you and take you to something, he'll point to what he wants and generally he's quite well understood - he gets his needs met and emotionally you can understand him quite well just through observation. I was wondering if you have any tips on encouraging his speech? He very occasionally will babble but he doesn't seem to make any concerted effort to try and verbalise anything he wants, unless he's upset and then he'll scream. They use PECS with him at school and he's using a word processor to answer questions about stories they've read or to make short requests.

Thanks

[JonGilmartin]

Hi @mumof2

Thanks for your message, I’ll try and give you some helpful ideas. It sounds as if Augmentative and Alternative Communication (AAC) is a useful tool for him that school are using. Often children who struggle need a whole range of tools in their ‘communication toolkit’ – perhaps talk to the school (does he have a speech and language therapist there?) about getting the best from his communication skills.

Using a whole range of ways to support speech can be useful; I know you said your son uses PECS. Maybe talk to his speech and language therapist if he has one about using other pictures, photographs, visual aids, or apps to help ‘illustrate’ words for your child. Visual supports can be very helpful and encourage your child to communicate in a variety of ways.

Another useful way to encourage speech is the use of choice making. So, if you know there is something he wants (a favourite snack, or something that he is pulling you towards) hold the item, or a picture of it, in front of him alongside something that he doesn’t want. Ask him “do you want yoghurt [put it forward] or raisins [put this one forward]”. Repeat this if you think it will help. He may not say the word, but if he gestures towards one, or tries to take it, say the label “ah, raisins” as you give it to him. He is therefore always hearing the words alongside the item, and you are showing him one purpose of talking...to ask for something.

Keeping your language simple is also really important - it helps your son follow what you’re saying and makes it easier for him to imitate your speech. So, try speaking mostly in single words or very short phrases. Giving a commentary on what he is doing/playing is also helpful, rather than asking questions. Join in play and tell him what you’re doing, by saying for example “ball” or “kicking”.

Modeling language can also be helpful. Your son may not know the specific word for something, but if you know what he wants, you can tell him the word. For example, if he helps himself to a drink tell him, “you got water”. Giving the model will help improve his receptive and expressive language.

Encourage him using things that you know are motivating. This could be an object, activity or person. Take the opportunity to use routines to help him learn to use speech. For example if you know he loves the slide, try using repetitive phrases and leave a gap for him to complete it. Say “ready, steady, go” to demonstrate the routine a few times. After a while try holding him at the top and say “ready, steady.....” and wait for him to indicate or attempt to say “go” before he slides down.

Try some of these, and remember – persevere. It might take a while before there is any impact. Of course, as I’ve not met your son these are quite general ideas, they might not all work for him, but have a try.

I hope that’s been helpful. Don’t forget, you can always book a phone call with one of our speech and language therapists to chat through these ideas and any other questions that you have. Call 0207 843 2544 to book a call.

All the best,
Jon

[Rachel]

Hello there,
My daughter is 18months, has downs syndrome.
What are the reasons for delayed talking, and does that mean she never will?
She had an assessment and they said she was at 3-6 months, in terms of sounds etc. Is it usually learning disability, or muscle tone, hearing, or everything.
What can i do, as a parent, to help?
Many Thanks
Rachel

[JonGilmartin]

Hi @Rachel,

Thanks for getting in touch; it’s good to hear from you.

As you may know, children with Down’s Syndrome struggle with different parts of learning to talk. Some struggle more than others and children can have different strengths and challenges. The reasons for these difficulties can be a combination of the things that you mention. Some children have better muscle control and therefore their speech is easier to understand, other find it hard to be clear in their speech because of weaker muscle control. Many children find learning new words tricky, and grammar is often hard too.

But, having said that, most children with Down’s Syndrome do learn to talk, and respond well to support for this. Tackling these difficulties from an early age offers them the best possible start to develop good communication skills.

Have you seen a speech and language therapist for your assessment? Hopefully they can give you some helpful ideas about how to support your daughter’s speech and language development. If you haven’t had ideas, do go to speech and language therapy and ask for a programme of ideas you can follow.

These things might be helpful for you to try, but remember they are quite general ideas as it’s hard for us to be specific as we don’t know your daughter:

• Help her to learn new words by supporting with pictures or gestures. So, when you give her a drink, say ‘drink’ and do a drinking gesture. Or when you’re saying goodbye, accompany it with a wave. If you use gestures and actions with words, she will relate what she sees and does with the language that she hears. We know that supporting speech with sign helps to encourage talking to come.

• If your daughter is babbling, copy her. This is a very good way to show how we take turns to talk and it encourages children to make even more sounds.

• Talk to your daughter about what you are doing (e.g. 'Mummy is putting shoes on'). Use opportunities to speak to her about something that they can see. This helps children to connect words to the world around them.

• If she is attempting words, give her lots of praise. Repeat the word back the right way so that she hears a good model. If she starts to say lots of words, repeat them back and add something to what she says, so if she says ‘car’ you say ‘a red car’.

• Name the objects your daughter sees around her. This could be her toys or things like clothes, parts of her body or household objects. The more a child hears a word, the quicker they will remember it.

I hope that’s been a little bit helpful. You can book a phone call to talk to one of our speech and language therapists if you’d like to speak to someone about your daughter’s communication skills. Call 0207 843 2544 if you’d like to book a chat.

[Niemand]

My son is 28 years old.

His support requirements are for
Severe Learning Difficulty
Autistic Spectrum Disorder
Emotional / Behavioral Disorder

He is in residential care but comes home several times each year, usually between terms and at half term breaks. He does not go to
college full time anymore but those times are mutually suitable for the residential home and us.

His speech is very rapid and is difficult to understand. We try to understand him by picking out keywords that we hear. Staff at the care home ask him to slow down and they say this helps. When he talks it's like a stream of consciousness, and can contain a lot of information.

He has very good comprehension and understands and follows clear instructions. In certain areas I believe he has above average intelligence.

I believe my son has the capability to speak clearly, and I also think doing so would help him to understand more of the world around him.

I know from a series of educational games that he played many years ago (PC Genius, 1997) that he is able to understand concepts such as "today", "yesterday," "tomorrow", "in front of", "behind" and so on. He also demonstrated an understanding of counting, adding up, etc.

I think giving my son the ability to communicate by speaking his thoughts in a perspicuous way is key to him communicating and interacting with the world around him in ways that simply are not possible at present. Communication would enable him to understand relative chronological concepts such as "now", "later" "tomorrow" etc. He understands days of the week. My son has a tendency, like me, to understand things better in pictorial format.

I have found that drawing for my son to explain things has helped. For example, a horizontal line with today on it and an event happening in the next few days further to the right, with days in-between marked off with short vertical lines. Sentences for my son have to be short with no complications. A simple "Do you want tea of coffee?" is about as complicated as you can get. His carers thought that was too complex, assuming he'd pick the last word he heard ("coffee") but I disproved that with a simple demonstration: my son prefers tea and chooses tea when he wants it (which is most of the time) - wherever it is placed in the question.

If the choices are more complex, "Which of these do you prefer?" then my son would not understand. But if I was to list the choices, one by one, on a sheet of paper (he can read), and ask him to choose, then he would do so and understand that he was being asked to make a choice.

I have asked the residential home to supply him with an iPad, because I have read several reviews that say iPads are especially good at enabling autistic children to communicate. But speech therapy and ideas to help my son communicate in an unambiguous way is my prime aim.

We live in Essex and the residential home is in the East Sussex area. My son's Care Manager has asked Essex services if there is anything they are prepared to provide in relation to Speech and Language Therapy for my son, but it seems they will work with people only in the Essex area. East Sussex services have informed us that they will not be able to provide any services to address the rapidity of my son’s speech. I am going to have further discussions with the residential home about this, but I would still like to know if there is a general strategy that I can employ to bring my son's speech to an understandable level. On rare occasions, when asked to really slow down, he has spoken very clearly and understandably, for which we praise him a lot.

[JonGilmartin]

Hello and thank you so much for contacting us through the Family Hub. I would like to start off by saying what a deep insight you have into your son’s communication strengths and needs. I can imagine that it has taken considerable time and perseverance for you to establish the most effective strategies and approaches to support your son’s communication.
Now, if I have this right your main quest is to identify a reliable strategy you can make use of to help your son moderate the rate of his speech? While I would love to be able to help you further with this, I fear it may not be the most suitable advice for your particular query. You see, I CAN – the Communication Charity I work with – have most expertise in working with children and young people. Therefore, I suspect I would not provide you with particularly suitable suggestions or approaches for your son in his adulthood.
I imagine you have already tried two of the most well known Autism charities in the United Kingdom but I thought I would mention anyway that both The National Autistic Society and Ambitious About Autism have online communities with many contributors. It may be worth exploring both of these further and possibly contacting each charity by telephone to ask for their advice? The helpline number for the National Autistic Society is 08088004104 and you can get in touch with Ambitious About Autism on 02088155444.
With regard to your query regarding speech and language therapy and gaining some ideas to help your son communicate with less ambiguity: I wonder if you might think about getting back in touch with East Sussex Services to request some input from their adult services (possibly even their learning disabilities team? ) You could ask if it is possible for someone to make a visit and recommend some additional strategies. I thought it might prove worthwhile to say that you are looking for all round support for your son’s communication skills, not just the speed of his speech.
An alternative approach to accessing adult speech and language therapy services is to consider seeing an independent (private) speech and language therapist. This would be at a cost to you of course. If this is an option that you decide to pursue, the best service for easily searching for independent speech and language therapists is via the website www.helpwithtalking.com
Thanks again for getting in touch with us and I hope I have been able to give you some ideas to think over in your search to find more and better ways to keep supporting your son. My very best wishes to you and your family.
Jon.

[Niemand]

Hello Jon,

Thank you for your detailed response. You have hit the nail on the head with the start of your second paragraph: I want to enable my son to moderate the rate of his speech.

I think a lot of positive things would happen if he did that, including being able to have a conversation with him and to understand his daily reports more clearly when he tells us what he's been doing that day, and what he's looking forward to doing!

I will contact the NAS and AAA as part of my strategy for going forward with this. I will suggest to the care home that they get in touch with East Sussex Services to request some input from their adult services.

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Martin