Useful Links

There are many building blocks needed for a child to develop their language, speech and social skills in the way we expect. If one of the building blocks is missing or is not a strong as we expect, this can have an effect on the rest of the skills.

For example, the development of speech sounds is at the very top of the pyramid, but in order to develop this, there needs to be good attention and listening, and practice during conversations in place, and they must understand the words they are trying to produce. Speech Therapists work with children who might be struggling with any of these areas: 

• Speech and sound development
• Verbal conversations
• Simple conversations
• Understanding and using phrases and sentences
• Using single words
• Verbal understanding
• Pointing
• Gesture
• Situational understanding
• Turn-taking
• Babble
• Vocalisation
• Hearing
• Attention
• Listening
• Looking

Your child has difficulties with their talking. This means:

• They are not using as many words as they should. For example they may just be making noises and not using any meaningful words
• Your child may be using some words but we want to encourage them to use more e.g. they may say “car” and we would encourage them to say something like “big car”

How can I help at home?

1. Be on the same level as your child when you are communicating with him/her. This refers to: 

• The same physical level e.g. if he/she is lying on the floor– you lie on the floor; if the child is sitting on a chair– sit on a small chair as well
• The same language level– therefore you need to use short, simple, repetitive words or sentences, emphasising the key words when communicating with your child.

2. Follow your child’s lead. Communicate with him/her about what he/she is focussing on and focus on his/her interests within an activity. Try the following techniques:

• Watch what your child is interested in
• Wait to see if he/she attempts to communicate (wait for up to 10 seconds– this is a long time and will feel strange to begin with) to see if he/she makes any attempts at communication; (try to let the child take the first turn)
• Respond to  any communication attempt, you may need to interpret their message. Be face-to face

3. Imitate: Copy your child’s actions, facial expressions, sounds, gestures, words etc. this is an excellent way to encourage your child to allow you to enter his/her play/ activity.

4. Interpret: Treat any sound, facial expression or gesture as if it was an attempt at communication. Copy it back to your child and give it meaning e.g. when your child looks at something, points and makes a sound to indicate that he/she wants it.

5. Comment: Comment on what your child is doing e.g. if he/she is splashing in water you say “splash” at appropriate times. If he/she is making up and down movements with a paintbrush you say “up”/ “down” as appropriate– this will be more meaningful for your child as you are commenting on what he/she is doing.  

6. Avoid asking your child to say words. 

Some children find it hard to structure and order their stories. These children may:

• Struggle to re-tell an event or story
• Muddle up their written stories at school
• Muddle up the order of events within their stories
• Not include all the information needed when telling a story (e.g. miss out who they are talking about) 

How can I help at home?

1. Read stories regularly to provide exposure to stories and formal language

2. Teach your child ‘beginning, middle and end’ concepts Talk about these ideas in stories as well as in everyday activties.

3. Use scaffolding questions to help plan narratives:

• Who was there?
• What happened?
• When did it happen?
• How did she/he feel?
• What did she/he do?
• How did it end?

4. Practice retelling of events and life experiences

5. After a TV programme or DVD, talk about the story in this way too

6. Make your own story books. 

Some children have difficulty in recalling/ remembering names of items and pictures. This can restrict their vocabularies and sentences. Children may present with word finding difficulty in one or more of the following ways:

• Hesitating to give him/her self more time to think of a word, e.g. “ we went to erm….”
• Substituting specific vocabulary for general filler words, e.g. “we went to that place….”
• Talking about the word rather than using a specific label, e.g. “we went to a place with swings and slides”
• Changing the sentence to avoid using the word, e.g. “ I played on the swings”
• Confuse words with similar meanings, e.g. “I went to the fair” (instead of park)
• Confuse the way words are said, e.g. “ I played on the round-around” 

How can I help at home?

1. Time– where possible give your child plenty of time and reassurance to think of the word, e.g. “there’s no rush….I’m listening”.

2. Descriptions– encourage the child to describe the word, e.g:

• Does it belong to a group of things e.g. vegetables?
• What does it do?
• Where might you find it?
• Can you describe it?
• What does it look like?
• What else can you do like this?
• What else does it make you think of?  

3. Sound cues– encourage your child to think about the following:

• Is it a long or short word?
• What sound does it begin with?
• Can you think of any other sounds in the word?
• Can you think of a word it rhymes with?
• Can you clap the number of syllables in the word? 

Some children have gaps in their knowledge of words. They may present with some of the following behaviours:

• Slow to respond
• Quick to respond, but give an incorrect answer
• Say “I don’t know”
• Use “thingy” a lot

How can I help at home?

1. Use real objects and model action words
2. Use words that are appropriate to his level, e.g. car not vehicle
3. Repeat key words and phrases several times within one situation. E.g. apples are juicy, the apple is red, I like to eat apples
4. Use consistent labels– do not switch between words that mean the same e.g. ‘small/little’, or  ‘cup/mug’
5. Talk about the link between words. E.g. apples and pears are fruit, we eat them

General Activities

Look through a picture book talking about each picture, naming them and occasionally ask your child to find one of the pictures or try and name a picture themselves.  

Play lotto by using two copies of a picture or bought picture matching games. Keep one set of pictures whole (to make boards) and cut the other set into individual pictures. Give your child a board, turn over a picture and encourage your child to try to match it to the board once you have named it. You take turns to turn the pictures and name them.  

Extend this by keeping the picture hidden on your turn and encourage your child to find the picture on the board without seeing your card.

Turn an old box into a post box and encourage your child to post pictures you name in to the box. Or they can choose a picture, name it and post it.  

Your child has been referred for Speech and Language Therapy because they are having trouble getting their words out. This can be called non-fluency or dysfluency. Many young children experience this non-fluency, which can resemble a stammer/stutter.  

There is no evidence that parents cause their children to be non-fluent. However, there are a number of things which parents, and others who come into contact with the child (e.g. other family members, playgroup staff etc), can do to help the child who is showing dysfluent speech.  

The following tips will help your child manage their dysfluency.  

Do not draw your child’s attention to their speech by suggesting that they try things such as slow down, start again, think before you speak etc.   

• It is difficult for your child to slow down. Adults find it hard enough to change their rate of talking and we should not ask a child to do something we cannot do ourselves! Your child may be able to go more slowly for a moment or two, but it is unlikely that it will last – then you will both become frustrated!
• Your child may be more fluent if you ask them to say the difficult word again; however, this is unlikely to help hem the next time they try to say the same word.
• Telling your child to think first before they speak again draws their attention to their speech and is also likely to have only a short-term effect. In addition it can also add to their frustration – they may already be putting a lot of thought into speaking!

If your child does not appear affected by their dysfluency then simply accept it and do not draw attention to it.  

However, if your child shows awareness of their dysfluency by becoming upset, cross, anxious or making comments such as “I can’t say that word” then 

• acknowledge the speech difficulty in a matter-of-fact way; the same way as you would with any other problem
• try not to label it as stammering
• be encouraging and supportive - provide reassuring comments such as “Isn’t it a nuisance when those words won’t come out” etc
• help your child to continue the conversation by making comments such as “You were asking me if you could have a drink, let’s go and get one” etc
• Do not ask your child to stop, slow down, think carefully and / or try again!  

Slow down your own speech when you talk to your child. This will:

• make it easier for them to follow what you are saying
• help them feel less rushed 
• create a calm, relaxed atmosphere for talking

This can be more helpful than telling your child to slow down, start again or take a deep breath.  

You could also try to introduce some extra pauses between sentences and phrases. 

It may help to pause for one second before you answer your child or ask them a question. This slow, less hurried way of speaking gives your child time before answering and again slows down the rate of the interaction. Pausing for a second before you ask or respond to questions is known to help encourage fluency.

Allow time for your child to finish what he or she has to say, rather than finishing it for them.  

Maintain eye contact and ensure you show interest in what they are saying throughout an episode of dysfluency. Try not to look away whilst your child is speaking and demonstrate interest in what your child is saying rather than how he is saying it.  

Reduce the number of questions you ask your child. Make comments instead e.g. instead of asking “What did you do at nursery today?” you could say “I bet you had a good time at nursery today”.  

Pay attention to the number of times the child who is stammering is being interrupted, or interrupts others. Explain to all the family the importance of taking turns when talking and encourage everyone in the family to do so. This will:

• reduce the number of interruptions within conversations
• reduce the pressure on the dysfluent child  

Try to arrange some time during the day (it can be as little as five minutes) when your child can have your undivided attention in a calm and relaxed atmosphere.

Praise your child for the things they do well (not related to talking) as this can help build confidence.  

Treat your child who may be stammering in exactly the same way as you would any other child regarding their behaviour - discipline needs to be appropriate and consistent.  

Children who are dysfluent respond well to a structured environment at home and at school with predictable routines.  

Dysfluency can increase when a child is tired. Try to establish regular sleep patterns and a regular, healthy diet. 

• Stamma
• Palin centre

18 months to 3 years:

I learn these sounds first (by 3 years)

• T
• D
• B
• M
• W
• N
• P
• and vowels

4-5 years:

I learn these sounds next (by 4 years)

• F
• K
• G
• H
• Y
• S (by 5 years)
• NG (by 5 years)

6-8 years:

These sounds develop by 6 years:

• blends
• CH
• L
• Z
• J
• TR
• SH
• V
• SP
• PL
• TH (by 8 years)
• R (by 8 years)

Some children find it difficult to say some sounds correctly. They may change sounds for another or miss sounds off at the start or end of words. Children with speech sound problems may not know that they are saying words incorrectly. They may make mistakes with the sounds in words because they haven’t fully learnt the rules for using the sounds for speech.

How can I help at home?

1. Let the child know that you WANT to understand them– show this by your body language and attention– be a good listener.  
2. Admit when you have not understood. Acknowledge the parts that you have understood and ask him/her to tell or show you the other bit again.  
3. Repeat the child’s sentence correctly to check you have understood and to provide a model for repeating the word back. Some children will copy, but do not put them under pressure to do so.
4. Exaggerate the speech sound they are having difficulty with when you repeat it. This may help your child work out where they are going wrong e.g. “S...oap”.
5. Be positive in your modelling and correction. Don’t say. “it’s not a tat, it’s a cat, say cat”, this may confuse your child and may stop them saying the word again for fear they will get it wrong. Instead repeat it back to them, with lots of praise.  
6. Try to end conversations successfully, even when there have been parts you have not understood.
7. Slow down- keep conversations at a slow pace.  
8. To help develop their awareness of sounds—go on listening walks around the house and outside. Listen out for all the sounds they can hear, (e.g. a car door shutting verses a bin lid closing; the distant sound of dog barking). See if they can tune in to these sounds, this will help them tune in to speech sounds which are harder to discriminate between.
9. Pick a sound and look for all the items in the house which start with it, e.g. pan, peas, pots, perfume; playing I-spy with older children helps in the same way.

Your child has attention and listening difficulties. This means they:

• Appear to ignore you
• Cannot sit still
• Talk when they should be listening
• Cannot tell you what you have been talking about
• Do not appear to know what to do
• Can only concentrate on one thing
• Are easily distracted
• Do not settle with one toy, but flits from activity to activity

How can I help at home?

1. Make sure you look at the child you are speaking to.
2. Ensure you have the child’s attention BEFORE giving the instruction e.g. say the child’s name first and wait for them to look.
3. Background noise, e.g. other people talking, television etc, is a distraction– try to reduce it where possible.
4. Use short simple sentences with a familiar vocabulary and avoid ambiguous language.
5. Introduce classroom rule such as Good Looking/Good Listening/Good Sitting/ Good Waiting.
6. Keep tasks and instructions short. When they remember and follow the rules—make sure you remember to praise them.  
7. Set time limits for children to complete tasks (make these more than achievable to start with). Use a timer of some sort to help the children be visually aware of the progress of time e.g. sand timer.
8. Write down your instructions for your child to remember (or get them to do it), or if reading/writing is tricky use pictures/ visual support.
9. Offer forced choice answers, so instead of saying ‘what do you want for dinner?’ say ‘would you like chips or sausages for dinner?’
10. Break long instructions into short steps.
11. Give instructions in time ordered sequences.
12. Slow down your delivery and use pauses. Allow time for slower responding pupils to process instructions/ questions.
13. Be prepared to repeat or rephrase messages.
14. Set the child manageable goals. Ensure previous task is completed before giving instructions for new one.
15. Gradually increase the length of time you expect the child to work for.  

Auditory memory is considered to be a higher level skill, it affects all learning and language skills. It includes recalling information, and the order in which it is heard.  

Characteristics of a child with auditory memory difficulties may include:

• Difficulties following instructions, particularly as length increases
• May only remember part of a long instruction
• Poor retention of words in songs
• Difficulty remembering sequences of information
• Confuses directions

How can I help at home?

1. Allow extra time for your child to respond.
2. Use short, simple instructions and breakdown longer instructions.
3.  Make sure your child is listening before giving any instructions.
4. Use pictures or gestures when giving instructions.
5. Give written or picture lists to support memory.
6. If your child has not understood repeat the instruction in shorter bits e.g. change “After you finish your dinner place it in the sink and wash your hands” to “finish your dinner (pause), place it in the sink (pause) go and wash your hands”.
7. Give instructions in the order they should be done.  

General Strategies

It is probably not possible to ‘teach’ a better memory, but we can all learn strategies which help us to organise our memories better. Better organisation leads to more efficient recall, and better working memory skills.  

• Rehearsal: Repeating the word or words over and over again under your breath or in your head.
• Visualisation: Many children have quite strong visual memories. Thinking in pictures is an excellent strategy. Another visualisation method is to remember a list of items by making a chain of links or story e.g. elephant, banana, chair, pig– the elephant is eating a banana, the banana is on a chair, the pig is hiding under the chair.   

Children who have difficulties with understanding language find it difficult to follow verbal instructions. They need help to listen and extra clues, such as, a gesture to help then understand. It is important to change your language to make it easier for your child to understand.  

How can I help at home?

1. Avoid lots of questions or trying to get your child to repeat words.
2. Instead, comment on what she/he is doing, or what she/he is looking at, then pause (count to 5 in your head, or even 10 if you can bear it– it feels like a really long time!), this gives him/her a chance to comment too.
3. Remember to repeat an instruction again if the child doesn’t follow it, make sure to wait 10 seconds before repeating; if they still do not follow the instruction then try rephrasing it to make it easier
4. Use gesture, sign and/ or symbols as well as the spoken word when giving your child an instruction.
5. Speak slowly.
6. Emphasise important words that carry meaning, e.g. if you had a choice of 2 balls: ‘show me the big green ball’.
7. Gain the child’s visual attention before speaking– call them by name, tell them to listen.
8. Give instructions one step at a time. For example, “get your coat” - wait for your child to get their coat “now get in the car”.  

Some children have difficulties with making friends and using language appropriately when talking to adults or other children. Children with social skill difficulties may have difficulty:

• Taking turns in a conversation
• Making eye contact when talking
• Understanding how other people feel
• Understanding that their actions have an effect on others
• Understanding non-literal languages such as ‘sayings’ like “it’s raining cats and dogs”

How can I help at home?

1. Model good social skills at home and in the classroom
2. Talk about a particular skill with your child (e.g. one of the rules of talking is that ‘I a have turn, and then you have a turn’)
3. Role play or ‘act out’ using the skill, starting with a game may be the easiest (e.g. card games, board games)
4. Talk over the role play and point out what made it work (e.g. “that was fun, we both had turns”)
5. Make rules about how a skill will be used (e.g. in the home/classroom e.g. “it’s important to let others talk too”)
6. Discuss specific situations when you have seen poor social skills (e.g. “when you look at me I know you are listening”) 

Dummies can help…

• To soothe and relax your baby
• Parents manage during difficult times  

But, regular and extended use of a dummy or a bottle can create problems with your child’s speech. 

Speech sounds and talking:

• Dummies can prevent babies from babbling – an important step in learning to talk.
• Many sounds are made at the front of the mouth e.g. p, t, d etc. Regular dummy use may result in your child not developing these sounds properly
• Learning to talk can be tricky, so toddlers need lots of practice. Children learn words by listening to and copying adults.  
• A dummy may discourage your toddler from chatting with you. 

Advice

• You may consider offering a dummy when settling the baby to sleep.  
• If you are breastfeeding, wait until your baby is over 4 weeks old, and breastfeeding is well established 
• If you are using a dummy at sleep times; use it consistently within the baby’s sleeping routine until your baby is over 6 months old.
• Aim to withdraw the dummy between the ages of 6 to 12 months to avoid any negative effects; at this age you can also start to wean your baby off a bottle and start using a cup to drink. 

Ideas to help

• Don’t use the dummy as an instant ‘plug’, try to identify the problem.
• Use the dummy as a last resort if a baby is unwell or going to sleep, try not to use it when your baby is content so that they can practise using their voices!
• Take the dummy out when your child is awake. If your toddler is still using a dummy, always ask them to take it out before you talk to each other.
• Never dip your child’s dummy in anything sweet. This could lead to tooth decay. 

Practical ideas

• Offer a comfort blanket or try reading a story instead
• Give the dummy to Father Christmas or the dummy fairy
• Swap the dummy for a reward  
• Once you remove the dummy, don’t be tempted to give it back. Most babies and toddlers will fret for no more than two or three days.