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Receptive Language Skills 2012
- 1. Addressing the Receptive Language Skills of Young Children Corey Herd Cassidy, Ph.D. CCC-SLP Communication Sciences and Disorders Waldron College of Health and Human Services Radford University Audio Details Call: 1-866-842-5779 Enter Code: 463-661-9330
- 2. Corey Herd Cassidy, Ph.D. CCC-SLP Communication Sciences and Disorders Waldron College of Health and Human Services Radford University
- 3. Addressing the Receptive Language Skills of Young Children Corey Herd Cassidy, Ph.D. CCC-SLP Communication Sciences and Disorders Waldron College of Health and Human Services Radford University
- 4. To ensure that you will enjoy and learn from today, you will need: Something to write with (anything will do!)… Something to write ON (preferably on material that you can read)… Your own ideas to share with others
- 5. What is receptive language? • Also known as… Language Comprehension Auditory Comprehension Let’s chat! How well we understand the language we hear
- 6. The relationship between comprehension and cognition Share your best idea in CHAT
- 7. The Milestones! At what age would you expect a child to: Discriminate between angry and friendly voices? 2 months 8 months Birth 6 months
- 8. Receptive Language Skills of the Newborn • Shows awareness of a speaker: • Quiets to a familiar voice • Moves in response to a voice • Attends to other voices • Attends to the speaker’s mouth • Discriminates between angry and friendly voices
- 9. At what age would you expect a child to: Recognize family members’ names? 3 months 9 months 6 months 12 months
- 10. Receptive Language Skills of the Infant • Shows awareness of a speaker: • Recognizes , stops, and looks at person when own name is called • Looks at familiar people when named • Maintains attention to the speaker • Responds to “no” (not always consistently!) • Attends to pictures and objects mentioned in conversation • Gestures in response to verbal requests • Follows simple commands occasionally • Responds to “come up” or “want up” • Verbalizes or vocalizes in response to verbal requests
- 11. At what age would you expect a child to: Understand 50 words? 6 months 12 months 18 months 24 months
- 12. How about these milestones: Follow a 3-step unrelated command and respond to What and Who questions? 15-18 21-24 27-30 33-36 months months months months
- 13. Receptive Language Skills of the Young Toddler • Understands approximately 50-150 words • Identifies body parts and clothing on self or a doll • Finds familiar objects not in sight • Identifies objects by category • Understands the meaning of action words • Identifies pictures when named • Follow two-step related commands • Picks up on new words rapidly Share some words!
- 14. Receptive Language Skills of the Older Toddler • Answers Yes/No questions • Answers What/Who/Where questions correctly • Follows three-step commands • Understands the concepts of one and all • Understands the concepts of size and location • Identifies parts of an object and action words
- 15. What is a receptive language disorder? • Difficulty understanding language that results in differences in how and what a child understands when compared to other children his/her age • Early signs and symptoms of a receptive language problem: • Ignoring spoken language • Difficulty following verbal directions • Repeating a question rather than answering it • Answering a question incorrectly
- 16. True or False? Most young children who have a receptive language disorder have typically developing expressive language. Use the poll tool! Yes = True No = False
- 17. My top TWELVE tips for addressing receptive language in the natural environment
- 18. 1. Keep it simple.
- 19. 2. Follow the child’s lead.
- 20. Let’s chat! 3. Use words that the child uses.
- 21. 4. Provide lots of visual cues!
- 22. 5. Repeat again…and again… and again.
- 23. 6. “Chunk” your directions.
- 24. 7. Use different words when the child does not seem to understand.
- 25. 8. Provide lots of opportunities for the child to show that he/she understands.
- 26. 9. Follow the child’s lead... …and tell him/her to do things that he/she’s already doing! what you would Share what you would say!
- 27. 10. Provide hand-over-hand guidance...
- 28. 11. Pause frequently…give the child time to think. Remember the 5 second rule!
- 29. 12. Be consistent with realistic expectations.
- 30. A few notes about echolalia… • What is it? • Why is it important in language development? • Two types: • Immediate • Delayed
- 31. Echolalia…when should we be concerned? http://www.youtube.com/watch?v=NxJvoeqpjQw • Autism Spectrum Disorder • Motor Planning Disorder
- 32. Current research regarding echolalia
- 33. What is the impact of receptive language on… all other areas of Share your thoughts! development?
- 34. My challenge to you: How many ideas (strategies) can you come up with during your next visit with a family that address the receptive language skills of the child?
- 35. things you learned in today’s webinar. strategies you will put to use in your own practice. idea that you want to learn more about in the near future.
- 36. Questions and Answers What questions do you have for me?!
- 37. Corey Herd Cassidy, Ph.D. CCC-SLP Waldron 341 (Box 6970) Waldron College of Health and Human Services Radford University Radford, Virginia 24142 540-831-7637 cherd@radford.edu
Notas do Editor
- Wait slideafter orientation.
- Dana to Introduce Corey.
- Hello! I am thrilled to be here today with all of you. .. Today we will discuss more about how children learn to listen…what we can and should expect from infants and toddlers regarding their receptive language and listening skills…how we, as ADULTS , can engage young children so that they can most effectively listen and learn!
- Receptive language can also be referred to as language comprehension or auditory comprehension skills. This refers to how well your infant or toddler understands the language he or she hears. *I want you to all jot down 2 or 3 examples of a child demonstrating a skill that requires the use of receptive language on your own paper, for yourself. Take about 20 seconds to think about this…Okay, now choose your best example. Feel free to share your “best” example on chat.[wait 15-20 seconds and then note some of the responses on chat:“I see some great ideas being posted…”]Examples of receptive language include how a toddler follows directions such as “Give me your cup,” or how he might walk toward the bathroom when you announce, “It’s time for bath.” These skills begin from birth when the baby begins to purposefully look at you and respond to your attention and when he starts to notice environmental sounds such as the neighbor’s dog barking or a loud fire engine. Receptive language developmentprogresses when he begins to pay attention to what you’re talking about so that he looks around when you announce “Daddy’s home,” or watches as you point to a bird outside the window. He begins to understand early games such as “Peek-a-boo” well enough to cover his head himself and lights up when he pulls the blanket off and you yell, “Boo.” Language comprehension alsoincludes the ability to point to body parts when you ask, “Where’s your nose” and to find pictures in books when you say, “Show me the dog.”
- Receptive language is closely tied to an infant’s cognitive, or thinking, skills. Until a child is 3 years or older, it is difficult to separate receptive language and cognition. In fact, as most of you may have noticed, the majority of the skills listed on early developmental charts are actually similar for both domains. While it is true that some children demonstrate cognitive strengths such as a good memory or exceptional visual skills, often, poor language comprehension skills are linked to underlying cognitive deficits. When assessing how well an infant or toddler understands language, it is important to be sure that the child is responding to the words that you’re saying and not the nonverbal cues you might be providing instead. For example, when you’re asking a child to, “Give me the block,” he may be responding to your outstretched hand as he gives it to you, or he may see the juice box you’re getting out of the refrigerator rather than understand the question, “Are you thirsty?” Children also rely on routines to follow directions or participate in everyday activities. For example, if a parent shares a snack at the table in the kitchen every morning, the child may follow the directions to “Sit at the table” because he or she is associating the action with the snack that the parent is preparing, rather than with the words “sit” and “table”.*Let’s think about this for a few moments. We provide young children with these “hints” about language without even realizing that we are doing it—and that’s great because we WANT the children to learn from the experiences and to understand the language within the context in which we’ve provided it! I want you to consider all of the automaticcues—including both gestures and routines—that you use when you are expecting an infant or toddler to follow your directions. Take about 40 seconds and then feel free to share your most commonly used cues or HINTS with us on the chat feature.[wait 30-40 seconds and then note some of the responses on chat:“You are all really aware of the cues that you are using!…”]
- Okay. I am going to share some information about typical receptive language milestones…but let’s go ahead and test your knowledge first!*Okay, I want you to choose the age that you believe corresponds most closely with the emergence of this skill. To show us your choice, you're going to put a sunburst on the age that corresponds to when you think this milestone is typically met. Find the toolbar to the left of the slide on your screen. Click in the box that looks like a little sun. Then click on the age of your choice to leave a sunburst there. We'll see which age has the most sunbursts to see what you all think.The answer is…BIRTH…or at least almost.The answer is: Within the first 4 days of life, a newborn is discriminating between angry and friendly voices.
- The newborn is amazing! Within just the first month of a child’s life, he or she begins to show awareness of a speaker by:Quieting to a familiar voiceAttending ANDMoving in response to a voiceAnd of most interest to me…Attending to the speaker’s mouth! We learn early on where the SOURCE of information seems to come from and attend it that specific direction.Newborns are also able to discriminate between angry and friendly voices—and react accordingly—by the end of their first month on this earth. Just amazing.
- Let’s move on to the first year…between the ages of birth and one year…when do we expect an infant to recognize and respond to family members’ names?*Again, go ahead and choose the age that you believe corresponds most closely with the emergence of this skill. To show us your choice, you're going to put a sunburst on the age that corresponds to when you think this milestone is typically met. Find the toolbar to the left of the slide on your screen. Click in the box that looks like a little sun. Then click on the age of your choice to leave a sunburst there. We'll see which age has the most sunbursts to see what you all think.By 6 months of age, an infant is able to recognize family members’ names.
- Between birth and the first birthday, an infant is truly learning to comprehend the world. These little humans continue to show awareness of a speaker…as they get a little older, however, their skills improve. By one year of age, a child is able to :Recognize , stop, and look at person when own name is calledLook at familiar people when namedMaintain attention to the speaker Infants are also able to follow simple directions that are embedded within routines or everyday activities. They also learn to respond with gestures or vocalizations to adult verbalizations—even though they may not have the words, they are beginning to understand that when an adult or older child talks to them, they should “talk back!” Ultimately, before a child is one year old, he or she is already learning to understand the rules of conversation.
- *Again, go ahead and choose the age that you believe corresponds most closely with the emergence of this skill. Go ahead and put a sunburst on the age that corresponds to when you think this milestone is typically met. Find the toolbar to the left of the slide on your screen. Click in the box that looks like a little sun. Then click on the age of your choice to leave a sunburst there. We'll see which age has the most sunbursts to see what you all think.At what age would you expect a child to understand at least 50 words?Typically, a child recognizes and understands 50 words by 18 months of age.
- Last one….at what age should we expect a child to follow a 3-step unrelated command…such as “Put the plate in the sink. Throw out your napkin. Put on your shoes.” ??? And at around the same age, we would also expect a child to answer ‘what’ and ‘who’ questions with relative ease…by what age do you believe these skills are mastered?*Using the sunburst feature again, go ahead and choose the age that you believe corresponds most closely with the emergence of this skill. Click in the box that looks like a little sun. Then click on the age of your choice to leave a sunburst there. We'll see, one more time, which age has the most sunbursts to see what you all think.36 months is the correct answer. By 3 years old, a child should be capable of following fairly complex directions and answering basic questions.
- By the time a toddler is 18 months old, he or she understands an entire arsenal of vocabulary…and is learning approximately 6 new words a DAY! These words will typically relate, again, to the child’s everyday activities and routines. They learn through repetition of the words AND the objects, actions, or pictures that go along with the words. At this stage, a child will only learn words and concepts that have a concrete symbol that goes along with them…*I want everyone to brainstorm for about 30 seconds. On your paper, make a list of 5 words that you think a typical toddler of around 18 months might learn and/or USE. [wait 30 seconds]…Before sharing with the group, examine your list…Consider how the child might use these words?Look at which types of words predominate? Do you have a lot of nouns? Or verbs? Or names of familiar people? Are the words “concrete” ; for example, can the child SEE and TOUCH and TASTE these words??If you answered YES to my last three questions, then you are ready to share these with the group on the chatline!
- By the time a child is between two and three years of age, his or her comprehension, or receptive language, skills are becoming more refined—and more complex. Children are now beginning to understand more abstract concepts….vocabulary does not have to be QUITE so concrete in order for an older toddler to process the meaning. With this in mind, these older toddlers are able to answer more questions, follow more complex directions, and think beyond the “whole” to understand and identify the features and the parts.
- Okay…so now that we’ve established which skills we EXPECT a child to use receptively over the first three years, what about those children for whom these skills do NOT emerge?A receptive language disorder is characterized by difficulty understanding language that results in differences in how and what a child understands when compared to other children his same age. Receptive language disorders can also be called auditory comprehension disorders. Another diagnosis which is closely related for young children is Central Auditory Processing Disorder or CAPD. CAPD is defined asdifficulty in the ability to attend to, process, comprehend, retain, or integrate spoken language. I want to note, however, that audiologists are not able to clearly diagnose CAPD until children are at least 5 or 6 years old…so we need to be cautious about using this particular terminology in the early intervention arena.Children who have receptive language disorders often don’t follow directions. This is not because they are being “disobedient” or “noncompliant.” Instead, they don’t follow directions because they don’t understand what’s being said to them. They also may seem to “tune out” because words don’t mean anything to them yet. Early signs and symptoms of a receptive language problem may include:Ignoring spoken languageDifficulty following verbal directions, especially if the command is new or you’re not using visual cues such as pointing or showing them what you want them to doRepeating a question rather than answering itAnswering a question incorrectly (Such as shaking their heads “yes” when you ask them a question with 2 choices. Giving an off-target response such as saying “2? when you ask, “What’s your name?”)
- *Do we tend to see a receptive language disorder WITHOUT an expressive disorder?Go ahead and discuss this statement amongst yourselves, if you are with a group, or decide for yourself. When you are ready, go ahead and complete the poll—yes indicates true and no indicates false. We're going to use one of the polling features for this one. Look to the left of your screen and find the participant box. Under your name, you'll see a series of small boxes. Click on the box with the check mark to get a drop down menu where you can make your choice.FALSE: Children may have expressive language disorders but typical RECEPTIVE language skills…however,if a child has receptive language difficulties, these issues will typically carryover and have an impact on their expressive language skills as well.If a toddler is not yet talking…or an infant is not expressing himself vocally at an age-expected level, you want to be sure to assess, or refer the child to a speech-language pathologist to assess, the child’s receptive language skills as well! Never assume that cognition and receptive language are okay when expressive language is delayed…
- While engaged in daily routines within a child’s natural environment, we need to pay attention to HOW we’re talking to the child. Toddlers with receptive language difficulties often need very specific and focused “teaching” (for lack of a better word) to begin to link words with objects, people, and events. They need help making the connection between the symbol—which is the vocabulary word—and the referent—which is the object, action, or concept that is being labeled or described. If these children were just going to “pick up” the terminologyin daily conversations, they would have already done it, and there wouldn’t be a problem. Children with difficulty understanding and processing language need adults who are there to “interpret” the world for them. They benefit from nurturing parents, teachers, and providers who can provide support to help them understand words and associate them with their environments. The questions therefore, are: how can you do this for the children with whom you work? What information can you share with the families so that they can provide this support to their children?
- Researchers have determinedthat labeling--simply stating an object or an event name--is more effective than any other kind of talking to help a child maintain attention to what he is doing.Ultimately, we need to break it down for a child who is struggling to understand by using single words and simple, short phrases when you’re talking to him. Sometimes this isn’t stated to families clearly enough. The advice is:simply talk to your child. Even then, however, this doesn’t always work with children with receptive language disorders. Since there’s a problem with your child learning to understand, we must simplify what we’re trying to teach since he’s not getting it the “regular” way. Let me give you an example you can probably relate to. This is like sitting in a college calculus class and knowing how to add and subtract, but you have forgotten how to solve an algebraic equation. Or imagine being dropped off in Mexico when the only Spanish you know is how to count to 5 and a few food words like “taco,” and being expected to understand directions to the airport to book the next flight home. You’re in over your head. That’s how it is for a child with a language delay. He understands some of it, but not enough to get him through the day. Many times adults “mindlessly narrate” when a child is playing…we offer all kinds of words, or descriptions, or directions that make no sense to the child based on what he’s attending to that which is at his language level. Can you imagine it now? A non-verbal two-year-old eyes a rubber ball. His mother begins her monologue,“I think you’ve found something you want to play with. What do you think you’ll do with that right now? Are you going to bounce it high up in the air or will you roll it on the floor? Maybe you want to kick it over here to me. Let’s play a game and take turns.”Do you all recognize the problem? Although the parent in this situation is certainly talking about what’s captured the child’s attention, she didn’t simplify by labeling “ball” or use a language-level that’s appropriate for him.A better way might be to say something like,“Ball! There’s a ball. Wow! Look at the Ball! Let’s play ball!”Use lots of single words. Use lots of short phrases. Avoid long explanations or questions. When you’re asking the child with a language disorder if he wants a cookie, avoid launchinginto, “Do you want one of these yummy chocolate chip cookies that I just bought at the grocery store?” Instead, hold up the cookie and ask, “Want a cookie?” See the difference? By using simple language and repeating your target word, there’s a much greater chance that the child will actually make the connection between the object and the word.Many times we overwhelm late talking toddlers with too many words. They walk away looking disinterested or bored when they’re really trying to tell us, “I don’t understand a word you’re saying.”
- When you’re eating snack with a child and he’s looking at his milk and goldfish crackers, use those actual words and talk about the snack itself. Don’t break into a dialogue about what happened at daycare yesterday or grandma’s visit next weekend. Keep it simple and in the here and now so it “makes sense.” In order to know what he’s paying attention to, you’re going to need to be “with” him and engage him throughout the session…or when coaching parents, throughout their day. Encourage families to provide lots of opportunities for their child to participate and stay engaged—by following his or her lead in order to limit the time that he “zones out” or “shuts down.”
- Children with language difficulties need adults who go out of their way to “teach” them the words they need to communicate. We want to avoidspending too much—if any!—time using baby talk…we also want to avoid using adult conversational styles. Instead, we need to grab opportunities to talk using single words and simple sentence structures that the child can process and learn. One of the easiest ways to do this, as stated in #2, is to follow the child’s lead. Observe the activities in which the child is interested…watch what he or she is involved in…and then use simple, one or two word utterances to provide the child with opportunities to hear the words, experience the words, and process the words!*Take a look at the picture on this slide. You may have noticed that these boots do not QUITE fit this 2 and a half year old! But her grandmother is doing the best that she can to follow this little girl’s lead. I want everyone to take 20 seconds to brainstorm by yourself—or with the group, if you are participating with others—what are some of the words that we might encourage Grandma to use with Alison to “teach” her in this moment?
- Usually children with language comprehension delays and disorders rely heavily on visual cues since they don’t consistently understand or process the words that are presented to them verbally. Point to the object or the activity to direct the child’sattention. When practical, show him the actualobject. If you’re using books, point directly to the picture, say its name, and then make a brief comment. Provide other visual cues including gestures such as leading him and moving objects within his line of vision to be sure that he knows what you are talking about. Because they need visual cues, children with language disorders may depend on your facial expressions to add meaning to your comments. Make your expressions match your words. If you’re upset and he’s about to be in trouble, don’t send mixed messages by continuing to smile as you warn him. He may misread your cues. (This goes for husbands too!) Some children need picture schedules to help them know what to expect next. Many preschools use these kinds of systems to provide additional support—if you are not already using these—and I realize that many of you are!!!—be sure to consider adding pictures that can be used as cues throughout the day. Take digital pictures and put them in a small album or post them on the refrigerator to “show” the child things he may not yet understand in his daily routines.
- Toddlers with receptive language delays need lots of extra repetitions to be able to process the words and the information that has been presented. Resist the urge to say, “I’ve already told you once (or twice).” Repetition helps a child create connections in his brain in order to solidify and store information…the more repetition…the more likely it is that the child will be able to process and recall information that has been presented to him earlier. I always tell my students—and the families with whom I work: If you feel like you have said a word WAY too many times and are tired of hearing yourself say something over and over and over again…you probably have not said it QUITE enough times just yet.
- Until a child is following directions consistently, limit yourself to simple commands with one piece of information at a time such as, “Get your cup,” rather than “Take your cup to the sink.” Once he’s gotten the hang of familiar directions, then work on adding more parts. “Get your shoes and bring them to Mommy.”*Let’s brainstorm a bit here. How might we simplify the following commands?:Be sure to put your shoes back in the closet after you come inside.Don’t forget to wash and dry your hands after you go to the bathroom.3. I would appreciate it if you would throw your tissue out after you blow your nose into it.
- When you’re getting that look (like “Huh?”) or if the child is tuning you out, try using other words. If you’re saying, “We aregoing to the park now. We have to get ready to leave,” and he’s not attending to you at all, you might try calling his name and saying, “It’s time to go bye-bye.” or “Come here.”I love the photo on this slide. This is actually my husband, Jim, and my 2 and a half year old niece, Aggie. They are clearly eating watermelon…and Aggie knows that word. But earlier in the day, they were “discussing” the pit in the center of the peach that she had been eating…Jim told her “don’t eat the pit!” She asked: “what’s a PIT?!” and he told her it was like a “rock” in the middle of the fruit. When they began to eat the watermelon, she told him: “Uncle Jim, be careful; there are rocks in your watamelon!” Even though it was not QUITE the word he was trying to teach her, Jim taught Aggie a word that related to the novel one…and one that she could use in her statement to him.
- Consistently ask the child to, “Show me the ____, ” and “Where’s the _______.” If he’s not pointing yet, encourage him to look around to find what you’ve asked him to locate. Other activities you can include in your daily routines may be to: Have him point to pictures in books. Focus on names of objects & actions. “Where’s the dog?” and “Show me who is sleeping.”Once he’s mastered basics names for objects and common actions, up the ante. Teach object use/function with words such as, “Which one is for riding? Which one goes on your feet? Which one do you use to drink? Which one says moo?” Help him identify parts of an object rather than the whole picture - “Find the door of the house, the wheel of the car, the dog’s foot, etc..”Retrieve objects upon request. Have him get items or put away specific toys on request, “Get your ball,” or “Bring me your puzzle.”Have her perform familiar tasks related to daily routines. Toddlers can get diapers or wipes before changing time, throw things in the trash, put their own cups in the sink, take off their own shoes and socks, close a door, wipe off a high chair tray, pet the dog, and help you clean up toys by placing them in a basket. Involving them regularly in these kinds of activities increases their opportunities to follow directions (and help you out!) During playtime give short directions and help him perform the action. For example, “Put ball in,” and then help him do it.When you’re playing with puzzles, hold up a piece and label it with a single word as he completes the puzzle. When he is finished, have him retrieve the puzzle pieces one at a time by asking, “Give me the ________.”When dressing, tell her to put her arm in the sleeve or leg in her pants. Hold up a sock and shoe and ask her to, “Get the sock.”When he’s seated near a toy, hold out your hand and say, “Give me the _____.”Place several items related to your play in front of her and ask, “Where’s the ______.”In the bathtub or during diaper changes, ask him to point to body parts, and help him follow through.During play time ask her to give her baby doll a drink or put her baby down to sleep.
- For example, if he’s headed for a ball, say, “Get the ball.” If he’s reaching for a book, say, “Read your book.” Get in the habit of narrating—with simple language—what the child is already doing…or even anticipate what it seems like he’s ABOUT to do…and label the object or action.*Take a look at this photo. What is the little girl doing? How might you talk to the child about the object? The action? The activity?Let’s take some time to practice this. Considering this photo again, take about 20 seconds to jot down what you might say to follow this little one’s lead and to talk about, SIMPLY!, the things that she’s already doing.
- Once you’ve given a child a verbal direction and repeated it one time (maybe twice if he wasn’t attending to you), get up and help (make) him follow through so that you are providing, by example and with hand-over-hand guidance if necessary, a connection between the words that you have said and the actions that go along with them. Keep things simple but repeat the directions as you engage him in themso he can link the activity with the words. If a child still does not respond, be sure to move closer to him, get down on his level, and touch him to redirect his attention. Try to make some directions fun too, such as “Come here so I can tickle/hold/kiss you.” Teach some fun standards like, “Gimme 5,” so that everything isn’t about “obeying.” When my niece was younger, we taught her to “fist bump” instead of “high fiving”…she LOVED that and she learned the vocabulary for “fist” and “bump” through the repetitive nature of the game!
- This is hard for those of us who are super-talkative (including myself, of course)! We need to remember to provide the child with enough time to THINK…to process the information that we are presenting…during our conversations. You may have to purposefully (but silently) count to 5 before moving on to your next point, or before you repeat yourself to be sure he’s had time to respond. It may seem like a long time…but it’s time that the child NEEDS in order to create connections between the words and their meaning. I always share with students that those 5 seconds may feel like FOREVER….but it really does allow the child to process the language. *Okay…I want everyone to count to 5…slowly…get a feel for how long we need to wait while allowing a child to process information…and GO!
- Children who have difficulty understanding language need the same rules day-in and day-out that are easy to remember and to follow. They need to be able to count on their routines. If a child’s ability to understand language is much lower than his chronological age, you’re going to need to keep that in mind when determining behavioral standards and even disciplinary methods. For example, time out is recommended for children who are 2 years and older. If your child is 26 months old, but his comprehension is at the 16 month level, time out is not an appropriate choice for him. He will simply not understand the cause and effect—the MEANING or intent—behind the timeout process.Some parents disagree with this and think that this is how you “teach” them, but believe me, you’re fighting an uphill battle. This is like trying to teach a 3 year old to tie his shoes or to jump a full-size hurdle. He’s just not ready yet. Use the same discretion when determining what is and is not appropriate behavior based on his comprehension level, and the child will LEARN rather than struggle.
- I want to take just a few minutes to share some information about echolalia—what it really is and its relationship to language processing.Echolalia is repeating or ”echoing” what another person has said. Children who are echolalic imitate what they have heard someone say in everyday life, lines they’ve listened to from a book, lyrics to a song, or a script from a show or movie. Echolalia can also include not only the words spoken, but the exact imitation of a person’s inflection, tone of voice, and volume. Professionals most often characterize children as “echolalic” when many of the words or phrases a child uses seem to be repetitions from a previous activity rather than new utterances a child comes up with on his own. Echolalia is classified as immediate echolalia or delayed echolalia. Immediateecholalia is the repetition of words or phrases that occur immediately or very soon after the original words are spoken. An example of immediate echolalia is the child who repeats a question such as, “Do you want some juice?” rather than responding yes or no. Delayedecholalia is the repetition of words or phrases that are echoed after the fact, even hours, days, weeks, or months later. An example of delayed echolalia is a child who might sing, “Happy Birthday” when someone new enters her home. Children with echolalia use what many professionals describe as “more advanced language” than they can typically generate. For example, a toddler who is exhibiting echolalia can quote long segments from a favorite TV show or sing an entire song word for word, but yet he can’t ask for milk when he needs it or answer a question his dad asks him. Even though this child ”talks” since he can technically say lots of words, he doesn’t seem to completely understand what he’s saying. In essence, he’s just repeating words without really being able to “use” them.
- Echolalia is one of the characteristics sometimes noted in children with autism. In fact researchers have found that up to 85% of people with autism who are verbal exhibit echolalia in some form. The silver lining in this is that echolalia is actually a positive sign that children with autism may eventually be able to learn to use language to communicate. I have a short video here for you of a young child demonstrating echolalia. Your screens will change now while we launch a browser on your end.(MUTE MY PHONE LINE AND REMIND PEOPLE TO):TURN UP THE SOUND ON your COMPUTERS.[Play video now (47 seconds)] PLEASE TURN THE VOLUME BACK DOWN ON THEIR COMPUTERS—and close the browser so that you are back in Blackboard!Echolalia is also a part of normal language development. This phase begins around 18 months of age when a child has mastered imitating words and is just beginning to imitate phrases. Experts tell us that echolalia peaks around 30 months of age, and declines significantly by the time a toddler turns 3. This coincides with when a child becomes conversational and truly begin to talk on his own, generating his own original thoughts, asking new questions, and responding to questions appropriately. In children with autism, however, echolalia occurs with greater frequency and lasts for a longer period of time that it does in children with typically developing language. For example, a child with typically developing language may be able to quote a few phrases from a favorite TV show, sing a song, or learn to count to 10 by rote, but he doesn’t do this repetitively many, many times a day, and when he does do this, it seems to “fit” what’s happened rather than leaving adults or other children around him wondering, “Okay………..What’s that about?” Children with motor planning issues, or apraxia, also can “get stuck” in this phase for a couple of different reasons. First of all, children with apraxia begin speech therapy with very poor imitation skills. Once they learn how to repeat what they’ve heard, they seem to want to hang onto this phase for a very long time. Secondly, repeating may become the “motor plan” they learn best, and it may be easier for some of these children to map a previously rehearsed message than come up with a new one. I want to note that we typically don’t diagnose children with apraxia until they can or will at least ATTEMPT to imitate phrases…so even though we may be tempted, a good SLP will not diagnose a child until he or she is at least 3 or 4 years of age.
- Professionals used to view echolalia as something that should be eliminated. However, current researchers tell us that many times echolalic speech can serve a purpose for children with autism. For example, a child who wants to go outside may say to his mother, “Let’s put your shoes on,” as his way of requesting this activity since he’s heard his mother say this many times just before he gets to leave the house. A child may say, “Want me to hold you?” when he’s crying or “It’s okay Ben,” when he’s upset since his parents have said this to him in this context over and over again. I’ll give you another example. A little boy who I was working with last Christmas called Santa Claus: “It’s Santa,” all season long because the first time his mother taught him this word, she declared enthusiastically, “It’s Santa!” He lifted the whole phrase and his mother’s elevated and joyful tone of voice as this character’s name. When his teacher at his childcare center asked him, “Who’s that?” it was appropriate for him to respond in this way: “It’s Santa!”; during a home visit, however, when I gave him a choice in play by asking, ”Do you want Santa… or this reindeer,” he replied, ”It’s Santa;” it didn’t make much sense in this case. In these cases, echolalia is representative of how these children process information. They learns in “chunks” without processing meanings of individual words. This learning style is called a “gestalt” style of language acquisition. Children who learn this way also process the sensory and emotional components of the event. In the previous example with Santa, the little boy processed “It’s” as a part of Santa’s name along with the enthusiasm in his mother’s voice. Every time he said this, he repeated it in just the way she had originally said it. Sometimes echolalia does not serve an identifiable purpose. For example, the child who repeats every line from the book “Go Dog Go” for no apparent reason while in the grocery store. There’s no dog in sight and no link to associating this book with riding in the cart while his mother selects food. I try to teach parents with children who seem to be stuck in echolalia to look at this as an opportunity for us to know exactly what he or she is having difficulty learning. Echolalia can serve a purpose for us. For example, the child who is walking around aimlessly quoting a movie or book may need help in finding an appropriate activity, or he may be feeling stressed or anxious and uses this routine to calm himself. A child who asks his mother, “Do you want a cookie?” needs help in learning to initiate requests in a more appropriate way. A child who repeats a question needs help learning the meaning of the words so he can accurately process the question, or he may need specific cues to learn exactly how to answer. A child who repeats, “Good job (his own name)” needs to learn a declarative phrase such as, ”I did it!” A child who repeats his brother’s words may just be trying to take a turn in conversation and doesn’t know what else to say. By taking a moment to determine if the echolalic utterance serves a purpose, discovering what the child’s intent is, and then finding ways to teach the child what he should say in this context—by SHAPING the utterance into one that is functional for the child-- you’ll be much more effective than if you are constantly attempting to eliminate echolalia.
- *Now it’s your turn to do the explaining! Based on all of the information that I’ve provided today…and the chats that we’ve shared, how does the development of receptive language impact other areas of development? How Take about 30-40 seconds to consider this…discuss the concept amongst your group or jot down a few ideas.Now be sure to share some of your thoughts on the chat line!
- Just as we share with the parents and caregivers with whom we work on a daily basis, “YOU ARE A CRUCIAL PART OF THIS PROCESS”. Don’t ever underestimate the role that you take on when you walk into a home and begin to build that relationship with a family.We know that we play a part in ensuring that each child with whom we interact is going to grow…and learn…and change. As we arm ourselves with knowledge, therefore, we expand the opportunities that we have to share information and coach the caregivers to work most effectively with their own children!I challenge YOU to continue to challenge YOURSELF to do just that!
- Okay! I think I’ve talked enough! We have a few minutes for me to answer any questions that you may have. I am also going to turn it back over to Dana to let me know if there are any questions that you have already submitted through chat that I may have missed.
- Okay. I am finished! I want to share my contact information with you. Please feel free to contact me if you think of any questions or concerns that you may have in the future …