Apr 132014
Share Button

photo 3Today I am reviewing another app from Aptus Therapy called Turtle Talk. The app’s premise is very simple – essentially it acts as an interactive pacing board to decrease the rate of speech in children with fast rate of speech and imprecise speech inteligibility. In contrast to traditional static pacing boards Turtle Talk provides a fun visual cue to help the child pace their speech.

photo 1

Begin by choosing a conversation topic to answer the conversation questions using the app or choose your own. The clinician  then presets the speed with which the turtles fill with color in advance using the slider bar. The child then needs to press and hold down on a turtle and say a particular word. When the turtle has completely filled with color and turned around, they can then move on to the next turtle and say the next word. If they move on before the turtle turns around, they get a visual cue in the for of a ‘Too Quick’ reminder which flashes on the screen. 

photo 2

I’ve tried this app with several children on my caseload and I have to admit that having fun and concrete visuals have helped my clients significantly as compared to the usage of traditional static pacing boards. This app will also benefit therapists working with children with select developmental disabilities such as Fragile X, known for having increased conversational speech intelligibility.  You can find this app on iTunes for $4.99, or you can enter my Rafflecopter Giveaway to win one of 5 promo codes provided to me by the developer.

Disclaimer: Please note that after the contest’s completion the winners will be announced on the Smart Speech Therapy LLC Facebook Page as well as named by the Rafflecopter app embedded in the blog post. Due to the amount of giveaways and contests run by Smart Speech Therapy LLC, winners will NOT be individually notified by email. Failure to claim your prize within a 3 day period following the contest’s completion will result in the forfeit of your prize. 

  a Rafflecopter giveaway

Apr 092014
Share Button

Today’s guest post on how to elicit language from children with “shut-down” tendencies secondary to significant expressive language delay comes from Rachel Arntson, M.S., CCC-SLP of the  Talk It Rock It  Blog.

Have you ever worked with a child who would shut down the minute she thought you wanted her to say something? I find this phenomenon a lot with children who display significant motor planning issues and expressive language delay. One morning, I worked with a little two year old who showed exactly that pattern. She appeared to know that imitation of sounds and words is hard. And the more that her parents showed her that they wanted her to imitate, the more she shut down. What a dilemma. Continue reading »

Apr 082014
Share Button

When many of us think about the label “language disorder”, very infrequently do adolescents come to mind. Even in this day and age, much of the research in the field of pediatric speech pathology involves preschool and non-adolescent (under 12 years of age) school-aged children.

The prevalence and incidence of language disorders in adolescents is very difficult to estimate due to which some authors even referred to them as a Neglected Group with Significant Problems having an ”invisible disability“.       Continue reading »

Apr 082014
Share Button

Today I am reviewing an awesome social-pragmatic language app by Hamaguchi Apps called: Between the Lines Advanced, which focuses on targeting the following skills:

  • Interpretation of vocal tone
  • Recognition of facial expressions
  • Interpretation of body language
  • Recognition of idiomatic expressions and slang Continue reading »
Apr 062014
Share Button

Today I am a reviewing a new vocabulary app created by the Virtual Speech Center called Real Vocabulary Pro.  Developed to target the core curriculum vocabulary of K-5th grade students, it has tons tons of pictures and pre-recorded audio to target various vocabulary concepts as well as allows users to add their own words, pictures and audio recordings for a more individualized and targeted therapy sessions. Continue reading »

Mar 192014
Share Button

In March 2014, ASHA SIG 16 Perspectives on School Based Issues, I’ve written an article on how SLPs can collaborate with other school based professionals to successfully work with children exhibiting challenging behaviors secondary to psychiatric diagnoses and emotional and behavioral disturbances. In this post I would like to summarize the key points of my article as well as offer helpful professional resources on this topic. Continue reading »

Mar 182014
Share Button

Today I am reviewing Keyword Understanding, a new app from Aptus Therapy.  The app was created to improve attention skills of children with auditory processing as well as receptive language deficits.

This app is great for children with processing difficulties which need to improve their ability to follow directions with a variety of embedded concepts. When you open the app you get the below screen which contains the following options. Continue reading »

Mar 172014
Share Button

Today’s guest post on treating bilingual middle-schoolers who stutter comes from repeat guest poster,  Zoya Tsirulnikov, MS CCC-SLP, TSSLD , an SLP from the NYC’s Department of Education. 

Disclaimer: The views, opinions and positions expressed by the guest blog authors and those providing comments on these blogs are theirs alone, and do not necessarily reflect the views, opinions or positions of Smart Speech Therapy LLC’s blog’s author, Tatyana Elleseff, MA CCC-SLP. Continue reading »

Mar 122014
Share Button

As an SLP who works with children with social pragmatic language disorders, I can’t but think of what happens after these clients leave school? How will they continue to improve their social cognitive abilities in order to effectively meet social challenges in their workplace? Michelle Garcia Winner and Pamela Crooke effectively address this issue in their recent book “Social Thinking® At Work: Why Should I Care”.   In it, they offer practical advice to adults with social thinking® challenges regarding how to navigate the intricacies of social interaction in the workplace. Continue reading »

Mar 092014
Share Button

Assessing speech-language abilities of children with genetic disorders and developmental disabilities is no easy feat. Although developmental and genetic disorders affecting cognition, communication and functioning are increasingly widespread, speech-language assessment procedures for select populations (e.g., Down Syndrome) remain poorly understood by many speech-language professionals, resulting in ineffective or inappropriate service provision. Continue reading »

Mar 062014
Share Button

Today I am reviewing Let’s Be Social is a new app from Everyday Speech, which targets basic social pragmatic language skills through 25 interactive lessons on the topics of recognizing emotions, solving problems, friendships, as well as making predictions. Continue reading »

Mar 052014
Share Button

Today I am doing a product swap and giveaway with Whitney Smith, the author of the Let’s Talk blog, who’s created a book companion packet to the popular children’s book: Bear Wants More by Karma Wilson.  Those of you who are familiar with my prior posts know that I am a big fan of Karma Wilson’s Bear Books, which is why I was so excited to review Whitney’s  comprehensive product, which in addition t0 having  story related concepts and vocabulary also contains information on the different food groups, types of food, healthy eating, as well as seasons. Continue reading »

Feb 252014
Share Button

Today I am doing a product swap and giveaway with Sharon Schackmann, the author of the Speech with Sharon blog, who’s created a product entitled: Winter Non-Fiction Leveled Reading Passages and Questions with a focus on teaching non-fiction text to older students: elementary through -high school ages.

This mega sized 44 page packet includes 7 passages on a variety of winter related topics including: Continue reading »

Feb 162014
Share Button

winter wellness collageToday I am doing a product swap and giveaway with Rose Kesting of Speech Snacks. Rose runs a fun and unique blog. In her posts she combines her interest in nutrition and healthy cooking with her professional knowledge as a speech-language pathologist.  I’ve collaborated with Rose in the past on a variety of projects and have always been impressed with the quality of her speech and language products, which are typically aimed at language remediation of older children (upper-elementary, middle school and high school ages). Continue reading »

Feb 152014
Share Button

I have been using Social Language Development Tests (SLDT) from Linguisystems since they were first published a number of years ago and I like them a great deal. For those of you unfamiliar with them – there are two versions of SLDT, elementary (for children 6-12 years of age) and adolescent (for children 12-18 years of age).  These are tests of social language competence, which assess such skills as taking on first person perspective, making correct inferences, negotiating conflicts with peers, being flexible in interpreting situations and supporting friends diplomatically (SLDT-E). Continue reading »

Feb 152014
Share Button

In recent years there has been an increase in infants, toddlers and preschoolers diagnosed with significant social-emotional and/or behavioral problems.  An estimated 10% to 15% of birth-5 year-old population experience serious social-emotional problems which significantly impact their functioning and development in the areas of language, behavior, cognition and school-readiness (Brauner & Stephens, 2006). Continue reading »

Feb 142014
Share Button

preschool pragmatic checklist When it comes to assessment of social pragmatic abilities, the majority of SLP’s often worry about their school age students. Yet social-emotional disturbances and behavioral abnormalities in preschool children (<5 years of age) are more common than you think. —

Egger & Angold (2006) found that “despite the relative lack of research on preschool psychopathology compared with studies of the epidemiology of psychiatric disorders in older children, the current evidence now shows quite convincingly that the rates of the common child psychiatric disorders and the patterns of comorbidity among them in preschoolers are similar to those seen in later childhood. (p. 313)” Continue reading »

Feb 032014
Share Button

You’ve received a referral to assess the language abilities of a school aged child with suspected language difficulties. The child has not been assessed before so you know you’ll need a comprehensive language test to look at the child’s ability to recall sentences, follow directions, name words, as well as perform a number of other tasks showcasing the child’s abilities in the areas of content and form (Bloom & Lahey, 1978).

But how about the area of language use? Will you be assessing the child’s pragmatic and social cognitive abilities as well during your language assessment? After all most comprehensive standardized assessments, “typically focus on semantics, syntax, morphology, and phonology, as these are the performance areas in which specific skill development can be most objectively measured” (Hill & Coufal, 2005, p 35). Continue reading »

Jan 242014
Share Button

SLP Frenzy TabThere is a fun activity SLPs can participate this weekend: SLP Frenzy Hop. From 8 AM EST Friday, January 24 through 10 PM EST Monday, January 27 some of your favorite SLP bloggers will be having a Facebook Frenzy.  During the Frenzy, you’ll get the opportunity to download 20 freebies!  Each will be different and they will target a variety of different topics!  So hurry and start your Frenzy Hop today by clicking on the interactive image map below.

frenzy map

How to participate: Click on any of the 20 images on the interactive map. The link will take you to Facebook where you will see the following image SLP Frenzy Tab click on that image and follow the directions of how to download that blogger’s freebie and move on to the next one. Have Fun Hopping!




Jan 232014
Share Button

Today’s guest post on temporal processing comes from an audiologist colleague, Olga Lis MS, CCC-A.

Disclaimer: The views, opinions and positions expressed by the guest blog authors and those providing comments on these blogs are theirs alone, and do not necessarily reflect the views, opinions or positions of Smart Speech Therapy LLC’s blog’s author, Tatyana Elleseff, MA CCC-SLP. Continue reading »

Jan 222014
Share Button

Today I am reviewing a brand new app by the Virtual Speech Center -Articulation Carnival (requires iOS 7 or later; compatible with iPad).  Virtual Speech Center did a great job creating a fun app, where the kids get to go to a “carnival’ and practice their articulation at the word, phrase, and sentence levels.

Much like all their other apps, this one is super easy to use and very intuitive to navigate. With a variety of options to boot. Applicable to children of all ages beginning with 2+ years, it’s phoneme targets include 20 pictures per phoneme and per word position as well as phrases and sentences.  All phonemes are editable which is a very convenient options for therapists who need to customize their client’s phoneme lists based on the child’s present level of ability and needs. Continue reading »

Jan 202014
Share Button

Today’s guest post on Fragile X Syndrome comes from Happily SLPCarly Fowler. 

Fragile X is an inherited disorder that is associated with mental retardation and developmental disorder. This is a sex-linked disorder.  Fragile X is linked to the 23rd chromosomal pair; specifically the X chromosome. Physical characteristics of fragile X syndrome (FXS) in males are a long face, large ears, and macroorchidism (enlarged testicles).  Often individuals also have loose connective tissue, double jointed-ness and flat feet.  Many young children do not show these characteristics until they reach puberty (Abbeduto & Jenssen Hagerman, 1997). Continue reading »

Jan 192014
Share Button

Today’s guest post from undergraduate SLP in training, Jane Jusova, provides an introduction to pediatric cochlear implants. 

Pediatric hearing loss may occur due to many reasons, which include being born with parts of the ear that didn’t form correctly and as a result don’t work well. Other problems can occur due to illness, including serious infections, such as meningitis, as well as accidents resulting in head injuries. Many children may have recurrent ear infections, causing a build-up of fluid in the middle ear, which can also cause hearing loss.

There are two major kinds of hearing loss that children can experience: conductive hearing loss and sensorineural hearing loss. Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones called ossicles of the middle ear. This type of hearing loss can often be corrected medically or surgically. Sensorineural hearing loss on the other hand happens when the cochlea is not working correctly because the tiny hair cells are damaged or destroyed. Depending on the loss, a person might hear most sounds (although they would be muffled), hear in quiet spaces but not in noise, hear only some sounds, or hear no sounds at all.

Sensorineural hearing loss is almost always permanent and a child’s ability to develop typically may be affected by it. Hearing loss in children can have a harmful effect on their speech and language development. There are several effective treatments for sensorineural hearing loss, one of which is cochlear implants. Children who are deaf or severely hard-of-hearing can be fitted for cochlear implants.

A cochlear implant is a surgically implanted device that replaces hair cells in the cochlea and under the skin behind the ear for the purpose of providing useful sound perception via electrical stimulation of the auditory nerve to restore hearing to a severely or profoundly deaf individual.

Since the first cochlear implant approved by the US Food and Drug Administration in the early 1980s, great advances have occurred in cochlear implant technology. In the United States, roughly 38,000 children have received them.

Cochlear implants can be implanted in prelingually or postlingually deaf children. A good candidate for a pediatric cochlear implant is a child at least 12 months of age with severe to profound sensorineural hearing loss in both ears who demonstrates limited or no functional benefit from conventional hearing aid amplification.

Cochlear implant evaluation can begin prior to 12 months of age. There is a comprehensive testing performed by audiologists and speech language pathologists to evaluate candidacy for a cochlear implant.

Children who end up receiving cochlear implants require ongoing audiological management and otolaryngological follow up. Ongoing management by an audiologist includes programming the implant parameters and monitoring device performance from electrical threshold and dynamic range data. Electrically evoked auditory brainstem responses (EABR), middle latency responses (MLR), or acoustic reflexes (EART) may be used intraoperatively with stimuli delivered to the cochlear implant prior to leaving the operating room or postoperatively on outpatient basis to facilitate the fitting process. These objective measures can be particularly useful in children who are either difficult to condition or otherwise unable to respond consistently to the electrical stimuli used to program the speech processor.

Follow up audiological evaluations are required to assess improvement in sound and speech detection and auditory reception of speech following implantation. Medical evaluation by an otolaryngologist should be performed as needed to monitor the postoperative course and medical status of the child.

Approximately one month after surgery, the audiologist activates the implant. Weekly, then monthly, extending to visits three to four times per year, the implant settings are adjusted. Biweekly auditory therapy is recommended for each child. Therapy may take place either by team therapists or by other professionals in the school or community. Annual evaluations with the audiologist, speech language pathologist and social worker document the child’s progress and allow any concerns to be addressed.

In addition to facilitating the child’s development of sound awareness and sound discrimination, the role of SLP also includes providing parental education about cochlear implants to ensure that the parents understand the importance of device compliance. This includes asking parents to keep track of how many hours a day the child wears the device, explaining to the parents the input that the cochlear implants provide and the importance of assuring the child wears the device consistently, teaching parents how they can ensure that the child continues to wear the device (e.g., distracting the child if he or she reaches to pull out the device as a means of interrupting the behavior, using praise once the child stops trying to pull out the device, etc.,)

Children who have lost all or most of their hearing later in life will benefit tremendously from cochlear implants. They learn to associate the signal provided by an implant with sounds they remember. This often provides recipients with the ability to understand speech solely by listening through the implant, without requiring any visual cues such as those provided by lip reading or sign language.

Cochlear implants, coupled with intensive post implantation speech therapy, can help young children to acquire speech, language, and social skills. Early implantation provides exposure to sounds that can be helpful during the critical period when children learn speech and language skills.


  • American Speech-Language Hearing Association. Degree of Hearing Loss.
  • American Speech-Language Hearing Association. Working Group on Cochlear Implants
  • American Speech-Language Hearing Association. Cochlear Implants and the SLP 
  • Koch, D.B. (2000). Hearing Loss & Cochlear Implants. The Children’s Hearing Institute.
  • Niparko, J., Lingua, C., & Carpenter, R. (2009). Assessment of candidacy for cochlear implantation. In J. K. Niparko (Ed.), Cochlear implants: Principles & practice (2nd edition, pp. 313-345). Baltimore: Lippincott Williams & Wilkins.
  • Papsin BC & Gordon KA. (2007). Cochlear implants for children with severe-to-profound hearing loss. New England Journal of Medicine, 357, 2380-2387.
  • Peters, B.R. (2006). Rationale for bilateral cochlear implantation in children and adults. White paper available from Cochlear Americas.

183857_490704327630675_423773830_nBio: Jane Jusova is currently an undergraduate in a Speech Language Pathology program at Adelphi University. Her interests include Early Intervention, Autism Spectrum Disorders as well as fluency.

Jan 182014
Share Button

Today’s guest post on working with middle school students comes from  Zoya Tsirulnikov, MS CCC-SLP, TSSLD , an SLP from the NYC’s Department of Education. 

The middle school population is fun and exciting to work with, however  it may prove to be quite challenging for some SLPs. This is my fifth year working for the New York City Department of Education at the Middle School level. I started out working with high school and elementary school students and quickly realized that this particular age group is different from its younger and older counterparts. Whereas at the elementary grades, students are learning new skills and concepts and building the foundation for expository text, the middle school students are expected to have bridged over to more rigorous text. Therefore, the achievement gap is very noticeable since students are tackling more de-contextualized discourse. Continue reading »

Jan 172014
Share Button

Rachel_Drew_6x6_300dpiToday’s guest post on how to use music to improve children’s speech language abilities comes from Rachel Arntson, M.S., CCC-SLP of the  Talk It Rock It  Blog.

Have you ever watched a group of pre-school children dance and sing to their favorite rendition of “The Wheels on the Bus” or “Twinkle, Twinkle Little Star”?  With a song in their heart, children show freedom in their movement, smiles on their faces, and uninhibited singing that most adults would only do in the shower.  There is something about music that seems to capture the very essence of who children are.  What draws children to sing and enjoy music so much? What do they learn from listening to and participating in music?  Can such a wonderful tool like music be used to help other areas of development? Continue reading »

Jan 162014
Share Button


Smart Speech Therapy (SST) LLC Receives ASHA Approved Continuing Education (CE) Provider Recognition

ASHA Approved CE Provider Status Demonstrates Commitment to High-Quality CE Programming for Audiologists and Speech-Language Pathologists Continue reading »

Jan 142014
Share Button

A few weeks ago I guest posted on Scanlon Speech Blog regarding which areas parents should focus on when selecting the right speech language pathologist for their child. In case you missed it here’s my take of what criteria does matter when it comes to clinician selection.

I have to admit that this post was actually indirectly inspired by a casual question from my mother.  I was shopping around for a new family doctor and when I found one, the first thing my mom asked me was: “How many years of experience does he have?” That got me thinking about how often I hear this question from parents of the children that I serve.  And the answer is quite often. But let us deconstruct this question for a minute. Is it truly reflective of what the parents want to know? The parents are of course inquiring about how experienced is the practitioner in treating their child. But will the answer they receive correlate with the appropriateness of care? Continue reading »

Jan 142014
Share Button

Research TuesdayOnce again I am joining the ranks of SLPs who are blogging about research related to the field of speech pathology.   Today I am reviewing a 2013 article in the Journal of Speech, Language, and Hearing Research, by Kent and Vorperian, which summarizes research on disorders of speech production in Down syndrome (DS)

Title: Speech Impairment in Down Syndrome: A Review

Purpose: To inform clinical services and guide future research on assessment and treatment of DS. Continue reading »

Jan 122014
Share Button

Today’s guest post on genetic syndromes comes from Rebecca Freeh Thornburg, who is contributing information on the Apert Syndrome. Rebecca is a repeated guest blog contributor. Her informative guest post on the CHARGE Syndrome can be found HERE.


Apert Syndrome is a genetic condition resulting from a mutation in gene FGRF2 – fibroblast growth factor receptor 2 – on chromosome 10. Incidence estimates vary from 1 in 65,000 to 1 in 120,000 births.  Most cases of Apert syndrome result from a new mutation, rather than being genetically inherited from a parent.  Children born with Apert Syndrome are affected by characteristic craniofacial differences caused by premature fusion of the bones of the skull, as well and limb anomalies, especially fusion of skin of the fingers and/or toes.  Multiple craniofacial and limb procedures, as well as other surgical interventions are often necessary to minimize the medical complications and cosmetic impact of the disorder. Continue reading »

Jan 112014
Share Button

Today two of my guest bloggers Drs. Stella Fulman and Zhanneta Shapiro explain the importance of pediatric hearing tests beyond the newborn screenings.

The importance of hearing testing isn’t widely understood by many parents. Parents may schedule appointments with an opthamologist or a dentist for their children at regular intervals – but never think to similarly schedule a hearing test with an audiologist. We think perhaps that if a child responds to our voice in a room of our homes that their hearing must be fine. Jokingly we think that if they don’t respond to the calls for dinner that they should have their hearing checked – but rarely follow up on this. Continue reading »

Jan 102014
Share Button

Today’s guest post on Monosomy 13q Syndrome is brought to you by the ever talented Maria Del Duca, M.S. CCC-SLP of Communication Station: Speech Therapy, PLLC, located in southern Arizona. 

Overview: Also known as “13q Deletion Syndrome”, this is a chromosomal disorder that results in intellectual disabilities as well as congenital malformations of the skeleton, heart, brain and eyes. The causes of this syndrome can be hereditary or non-hereditary.  When the long arm of chromosome 13 (labeled “q”) is missing/deleted or when both parts of chromosome 13 have been lost/deleted and have reconnected to form a ring (called “ring chromosome 13”), and the genetic mutation occurs before conception, during formation of the egg and sperm (gametes), this results in “monosomy 13q” (non-hereditary genetic mutation).  However, there are times the cause is due to a parent carrier who passed down an inverted or translocated chromosome to the child subsequently resulting in a hereditary etiology.  Risk of 13q Deletion Syndrome to occur in subsequent pregnancies is very low.  If mother is the carrier, the risk is 10-15% and if the father is the carrier the risk is 2-4%. Continue reading »

Jan 082014
Share Button

In today’s guest post,  Natalie Romanchukevich advises readers on how to create opportunities to expand children’s spontaneous communication skills.

Helping young children build speech- language skills is an exciting job that both caregivers and educators try to do every second of the day.  We spend so much time giving our children directions to follow, asking them a ton of questions, and modeling words and phrases to shape them into eloquent communicators.

What I find we do NOT do enough, sometimes, is hold back on our never ending “models” of what or how to say things, questions, and directions, instead of allowing our children initiate and engage with us.  Greenspan refers to these initiations as opening circles of communication (Weirder & Greenspan “Engaging Autism”, 2006).

Speech- language development can be thought of as having three interacting and equally important domains- Form ,Content, and Use (Lahey, 1988).

Form refers to the grammatical correctness of our words and sentences (eat vs. eat+ ing).

Content is what the we are essentially communicating- the meaning of our words and sentences.

Use (also known as pragmatics) refers to the function of our words or for what purpose we are using them.

The communicative functions that slowly emerge and characterize communication over the course of language acquisition in vary in typically developing young children.  Children communicate to greet others, comment on objects/actions, request desired objects, request assistance, protest, deny (a statement), ask questions, regulate others (e.g. “blow!”, “open!”), entertain, and narrate events.

In order for children to be able to express these functions, aside from the intent to communicate, there must also be opportunities to express ideas, wants, needs.  For example, why would Timmy request for an object (nonverbally or verbally) if the caregiver hands everything to the child at the slightest sign of a tantrum.  Why ask a “where?” question if every toy or beloved object is comfortably in sight?  Why ask for help if the caregiver readily assists the child with all activities.  The educators describe it as assuming the child’s needs.

Of course we do it out of love and care for the child, and, let’s be honest, sometimes, to save time.  However, it is important with both typical and delayed children to be mindful of what (form, content, use) we model, when (timing is crucial in teaching) we model it, how (facial expression, tone of voice, etc) we model it, and why (is it developmentally important to teach it now?) we model it at this very moment.

Just as it is important for kids to comprehend concepts, follow directions, and understand the different wh- questions, it is also paramount that your child is able to initiate communication.  After all, communication is the ability to express ideas, thoughts, and wants, not just understand those expressed by others.  Answering questions and following commands is not initiating.  Language that is elicited by us- is not spontaneous.

To use language spontaneously, effortlessly and creatively, children need opportunities to practice the skill, to experience taking the lead.  In order for our children to get there, we must first offer models of how to initiate communication and do so appropriately.  We can then create opportunities for the child to speak up.

The most basic strategies you can use to encourage spontaneous initiations (whether nonverbal or verbal) may seem seem initially as counterintuitive.  I mean what is the point to introducing attractive new toys or displaying a yummy snack and then putting it away? Yet it is exactly that action which may very much encourage your child to run after you with gestures or words.  Even then, you may still choose to play “dumb” and be “unsure” as to what it is your child wants.  Does s/he want that bag with new toy or snack “opened?” and “out?”

If the child is nonverbal, his use of gestures to regulate your actions to get the desired item out and open may be the child’s initial step toward sound imitation.  If you are working on getting the child to request help (not just objects), here is your opportunity to model “help” if the child can’t open the item independently.  On a side note, I often hear educators model “help me please!” when the child is clearly at a single word level.  This is not a developmental way of teaching.   Yes, it is nice to hear a full sentence but your child may not be ready for it.

While playing with your child and actively commenting on your joint play, you may find it productive to suddenly become quiet and cease all attempts to ask questions.   This often works beautifully in my therapy sessions; usually, after I have engaged the child into some sort of cooperative and enjoyable play! But it takes a conscious effort and self-control on the part of the adult, since we are so used to engaging in this adult- directed (telling the child what to do as opposed to letting him/her lead and you follow) approach to teaching.

However, once you are able to contain your speech and actions (I promise you it is possible), you may be surprised to hear some immediate or delayed imitations of words/ phrases as well as spontaneous meaningful language.  The language produced, to me, is an indication that the child wants more of the experience- more language enriched play.  Use this opportunity to expand on what s/he is already saying.

Here, timing is really important as you want to imitate back everything your child is doing.  This is another way to communicate with your child.  Build on your child’s language to further describe the objects or people in play without using long sentences.  So, allowing nothing to happen for a few minutes at a time may just be the push to help your child come out with some form of communication.

In addition, stopping a novel activity or toy exploration at the very height of your child’s excitement also works well with many children.  You don’t have to be  confrontational about it, “if you don’t imitate my word/ phrase I just won’t give it back to  you”.  make sure to create these “obstructions”, as Greenspan refers to them, in a friendly, playful and positive manner.  Obstructions or fabricated “problems” are also a big part of social-cognitive and constructivist theories of language learning.

The idea behind these “obstructions” is that the children are forced to problem solve and use resources (language being one of them!) so they can get what they want.  Allowing your child to problem solve is critical to overall cognitive development that affects and shapes speech and language. Presenting your child with developmentally appropriate activities that involve thinking and figuring out of how to get X is an invaluable strategy that I always use with all of my children.

In sum, stop access to items that are already loved, tape up containers, close boxes and jars with favorite snack and toys, give your child all but ONE important item that is needed to complete an activity (glue, scissors), give your child the “wrong” item, or offer the “wrong” solution to the problem.  All of these “problems” will push the kid to think and figure out what to do next.  This, in turn, facilitates spontaneous language use.

Letting go of control and just allowing for things to spill, break, or simply not follow the predictable comfortable routine, too, elicits a ton of speech- language and fun communication.  These are the most teachable moments as our children experience all the new words and concepts first hand.  Perhaps, this is why many children learn “dirty” or “wet” attributes before they learn their colors.  These concepts are more easily learned because they are experiential and bring about relevant words to describe these personally relevant and emotional experiences.  Cleaning up and taking turns arranging things back in place is super educational too as our children need to learn responsibility and helping others.

Moreover, exposing children to objects that are completely novel and foreign (but safe!) may help elicit an attempt to ask a question “what this?” because the child wants to know.  The motivation is there.  Now s/he needs language to get the answer from you.  Some children may use a word with a rising intonation, which too is a question form, just not grammatically mature one.  For example, “Hat?” is as much of a question as “Is that a hat?!”.  If all your child is capable of verbalizing is “wow”, then you can go ahead and model “what IS that?” question a few times.  Of course, you want to pair it up with an exaggerated expression of surprise and excitement in your voice.

To sum up, do not be afraid to experiment, get “messy”, stay silent, entice, intrigue and just wait for a few minutes to see what your child will do.  Yes, we want to teach our children to attend, sit down for a structured activity, and identify objects, shapes, colors, and actions; but these adult- directed activities do not allow for self- expression or spontaneous language use.  You also want to follow your child’s natural interests and inclinations as this is frequently a way into their world.  If you show interest in your friend’s ideas and you let him/her speak, will they not want to bond with you even more? Will they not want to communicate with you?

Creative and talented teachers are those who can use unconventional materials presented in unexpected ways while targeting all the skills that must be learned!  Learning to manipulate the environment to get the most out of your child’s skills can be difficult but indescribably rewarding.


  1. Lahey, M. (1988). Language disorders and Language Development.
  2. Greenspan, S. & Weider, S. (2006). Engaging Autism: Using the Floortime approach to help children related, communicate, and think.
  3. Wetherby, A. & Prizant, B. (1990). Communication and Symbolic Behavior Scales. ChicagoIL: Applied Symblix. 


Natalie Romanchukevich has a MS in Communication Sciences and Disorders from Long Island University (LIU) as well as Bilingual (Russian/English) Certification, which allows her to practice speech- language pathology in both Russian and English. Following graduation, Natalie has been working with both monolingual and bilingual 0- 5 population in New York City, and has been an active advocate for preschoolers with disabilities in her present setting.  Natalie’s clinical interests and experience have been focused on  early childhood speech- language delays and disorders including speech disorders (e.g., Articulation, Childhood Apraxia of Speech (CAS), Pervasive Developmental Disorders, Autistic Spectrum Disorders,  Auditory Processing Disorders, Specific Language Impairment (SLI), as well as Feeding Disorders. Presently she is working on developing her private practice in Brooklyn, NY.