Tuesday, May 24, 2011

Talkin' Tuesdays: A Link Up for Language (Really this time!)

My apologies if you saw this on blogger earlier today and clicked over only to find an 
empty page. I had a few, um, technical issues. Hopefully all is good now! :)

Welcome to my first ever Talkin' Tuesday- a link up designed to create a page full of ideas for language learning!  There are some amazing blogs out there and I'm excited to see our collective wisdom and resources unfold in front of us. If you are here to learn, I hope that you find what you are looking for. And if you are here to share, thank you for helping give others the gift of language.

Although the theme of this link up is language, the scope of it is large- your post doesn't have to be directly related to language to link up. Child development is a huge piece of language development, so I welcome any posts related to this topic as well.  Crafts, books, and games all provide a rich environment for any type of speech and language activities and we speech-language therapists are always on the look-out for creative ideas and awesome books; sharing yours is a gift to parents and speech-language therapists alike.

Please feel free to link-up below if you are a blogger with a post on:
  • Speech, Language, or Hearing
  • Child Development
  • Craft Activities 
  • Children's Books
  • Children's Games
Happy Talkin' Tuesday!

    Monday, May 23, 2011

    International Adoption and Language Part 2: What To Expect

    In International Adoption and Language Part 1, I filled you in on emerging research being done by Dr. Sharon Glennen about the language development of children who were adopted internationally. I told you when to worry and--more importantly--when not to. I also listed specific indicators that can help you determine when it might be a good idea to seek out a speech and language evaluation during your little one's first year home with you. That's not all the information we have, though.  Dr. Glennen also has data on what to expect after one year home, a turning point at which most children who were adopted under the age of two have successfully made the language transition. Here's what she has to say:

    If your little one arrived home before the age of 24 months, and has been home for one year:
    • Her receptive language (what she understands) should now be within normal limits for her current age,
    • Her articulation (how she produces speech sounds) should be within normal limits for her current age,
    • Her expressive language (the words she uses and how she puts them together into sentences), should be at least low average,
    • Her MLU (her average sentence length)  may be slightly behind average. This means that her sentences may be shorter than her peers' sentences, but not substantially so. This slight lag in her sentence length may last until the age of four. 
    This information is important on two counts. First, it is truly astounding to realize that most infants and toddlers who lose their birth language and change over to a new language will have almost completely caught up within one year of being home; this certainly speaks to the amazing resiliency of children.  Second, it suggests that if a child was adopted internationally under the age of two and has been home for at least one year, significant delays in expressive communication, receptive language, and articulation should be considered true speech-language delays that require intervention.* Parents should not hesitate to advocate for their children if they have delays in speech or language after one year home, as long as their child was adopted before the age of 24 months. 

    What, though, if a child arrives home after the age of 24 months? Unfortunately, these adoptions are less frequent and so our information is less complete, making our guidelines a bit fuzzier. What we do know, however, is this:

    If your little one who was adopted internationally arrives home after the age of 24 months:
    • She will probably lose her birth language quickly, within about three months home.
    • You can expect a period of no language proficiency, where she is no longer fluent in her birth language but has not yet mastered her new language.  Both of you may experience frustration during this time. Prepare for this, expect this, and work through it. It will pass. 
    • She should start to develop a significant vocabulary in her new language within 3-6 months.
    • She will likely acquire what is called Basic Interpersonal Communication Skills (BICS) within one year home. This means that she'll be able to use language to interact with others fairly well within one year home. 
    • Her Cognitive Academic Language Proficiency (CALP), however, will take longer to emerge.  CALP is the language she will need to succeed academically; it includes the more sophisticated vocabulary and language skills that allow her to work with written and spoken language to do things like compare, contrast, analyze, and infer. Depending on the age your child arrives home, it may take her up to 5-9 years to develop CALP.  This is an important point to remember because it suggests she may need extra support during her school years, even if it seems like she has mastered her new language during informal interactions with her family and her peers.
    It can be hard to know just what to expect when it comes to language development in your child who was adopted internationally.  Even with all the data that is now emerging, it can still be confusing at times. Dr. Glennen's data, though, at least gives us a basic map for guidance as we help our children transition from one language to another.

    *At one year home, children adopted prior to 24 months of age should receive a standard score of at least 80 on the Expressive Communication and Receptive Language sub-tests of the Preschool Language Scale and on the Goldman-Fristoe Test of Articulation.


    Glennen, Sharon, (2009). Assessment and Intervention for Internationally Adopted Children: ASHA Self Study. Rockville, MD

    Tuesday, May 17, 2011

    A Shout Out To Some Language Learning Peeps

    A few posts that I think are great....
    • Jenae at I Can Teach My Child discusses the value of wordless picture books, and I couldn't agree with her more! In Books, Toddlers, and Language, I told you how sometimes it's best to ignore the words in a book and just describe the pictures instead; wordless picture books make it super duper easy to do just that. When looking at these books with beginning language learners, you can use use simple language modeling as your little one flips through the pictures at his own rate. Then, as he grows into his preschool years, you can help your child's imagination grow along with his language as you teach him to weave the pictures together into stories.
    • Allison at No Time For Flashcards hosts her weekly Link-n-Learn, where over 80 blogs link up their best posts of the week (I may or may not be one of the blogs that likes to link-n-learn). The links are chock full of fun activities into which all kinds of language can easily be worked. Her website is also an amazing resource of books and crafts, sorted by category. 
    • Lisa over at The Huffington Post touches on why parents of babies and toddlers shouldn't feel pressure to fall into the "teach your baby to read" craze. Teaching your baby to read might sound pretty awesome, but many researchers believe that drilling a child with flashcards only teaches him to respond rotely to symbols that he can't really yet understand.  They worry that doing so takes away from the rich language-based conversations about the world that is flowing around him.  Instead of drilling with flashcards, engaging your child in simple conversations about the things that interest him will help him develop the full meaning of the vocabulary words he will need to understand his reading later on--when he's really ready to read. Language and love in the early years will give way to smarts and reading the the elementary ones. 


    Wednesday, May 11, 2011

    International Adoption and Language 1: When To Refer

    Over five years ago now, my family became one of thousands of other families who have adopted internationally.  It was a decision that has forever changed me--so much so that I simply can't remember who I was before my beautiful baby boy entered my life. It was also a decision that made me wonder: how does being adopted internationally affect language development?

    Until recently, our field didn't have a great answer to that question. We've studied the language development of children who grow up in bilingual homes for quite some time now.  Children who are adopted internationally, however, are generally not bilingual.  Unless their adoptive parents are fluent in their birth language, children who are adopted internationally do not usually speak two languages at one time. Instead, they start their language development in one language and then move into an environment where they lose access to their birth language and are suddenly surrounded by a brand new language.  Because international adoption was relatively rare until recently, we haven't had great information about what to expect out of children who go through a language transition like this.  Luckily, this is changing. Dr. Sharon Glennen, speech-language therapist, professor at Towson University, and fellow adoptive mom, has been studying the language development of young children who were adopted internationally and has put out some guidelines to help. Here's what she has found.

    When To Seek Out a Speech-Language Therapy Evaluation

    When a young child is adopted internationally, her language will undergo a transition. For a period of time, she will struggle to communicate effectively in her new language. This is expected. However, during this period of time, there are clues in other areas of development that can provide insight into her potential for language development.  Even when a child is making a transition in language, we can still take a peek at her use of eye contact, play, and gestures.  Children who are adopted internationally may struggle to use verbal words at first, but their use of eye contact, play, and gestures should not be affected by the switch in languages. And because these areas of development are closely related to language development, they can help us decide if a child is at risk for a language delay.  If you, as a parent, have recently adopted a child internationally, you can check out these posts to find out what your child should be doing with play and gesture use. Find your child's age, click on the post, and read the sections about gesture use and play.

    If your little one isn't yet using gestures and play as expected for her age, you may want to consider talking to your pediatrician about a referral to an early intervention specialist.  Use your judgment, of course, in deciding how quickly to act. Your little one needs time to connect with you and feel comfortable in your home; unless something is really concerning you, there is nothing wrong (and probably a lot right) with giving her a bit of time to make the transition into your home.  Once she's comfortable with you, she may reveal whole new sides that you didn't know she had upon first meeting her. But do keep an eye on her eye contact, her use of gestures, and her play skills. Once she is comfortable with you, these areas of development should be at age appropriate levels pretty quickly. If they're not, a good early interventionist can teach you strategies to nudge those areas of development along a bit.

    If your child is using eye contact and gestures and play as expected for her age, then there are some additional guidelines to consider to help you decide if she is learning her new language as we'd expect. The guidelines are different depending on the age that your little one arrived in your waiting arms.
    • If your child arrived home before the age of 12 months, you should seek out a speech and language evaluation using the same guidelines as a child who had spoken English all her life. You can review what to expect out of children at different ages here,
    • If your child arrived home between 13 and 18 months of age, you should seek out a speech and language evaluation if she's not using 50 words and/or two-word phrases by 24 months,
    • If your child arrived home between 19 and 24 months of age, you should seek out a speech and language evaluation if she's not using some English words by 24 months, 50 words by 28 months, and 2-word phrases by 30 months,
    • If your child arrived home between 25 and 30 months of age, you should see out a speech and language evaluation if she's not using 50 words and 2-word phrases by 31 months, and
    • If your child arrived home after 30 months, you should seek out a speech and language evaluation if she doesn't start to understand you pretty well within a few weeks of coming home. You can also expect her to develop a significant English vocabulary within 3-6 months.
    Whew! Is your head spinning yet? Mine is! You'll need to use a bit of flexibility with these guidelines, of course. If your child arrives home at 30 months and 17 days, for example, it is probably a stretch to expect her to be using 50 words and two-word phrases in her new language by 31 months. And, since exact birth dates are often unknown in international adoption, you'll definitely need to take these guidelines with a grain of salt if you are unsure of your child's age.

    For those very interested parents and speech-language therapists out there, Dr. Glennen has quite a bit more data to explore, too. You can find it here.  And, for more information on what to expect out of language development in children who were adopted, click here.

    Also see:

    Glennen, Sharon, (2009). Assessment and Intervention for Internationally Adopted Children: ASHA Self Study. Rockville, MD

    Monday, May 9, 2011

    Choices, Choices: Improving Behavior and Language Through The Power of Choice

    It was one of the very first lessons I learned as a novice speech-language therapist: Don't ask a young child if he wants to do something if he really doesn't have a choice in the matter. It took me a while to learn this, mainly because by the time we are adults, we have all learned to couch our requests carefully inside of questions. We use these indirect requests to be polite and avoid seeming demanding. For example, I might carefully ask my husband, "Did you see that the trash is full?" when what I really want to say is "The trash is FULL again and I KNOW you saw it. Take it out!"

    As adults, we use indirect requests all the time, and there's certainly nothing wrong with that. They help us navigate relationships smoothly and effectively. Many of us, though, carry these indirect requests down to the toddler and preschool level. We say things like, "can you go inside?" or "do you want to clean up?" when what we really mean is "It's time to go inside," and "I need you to clean up." This is confusing to young children because their little minds are too immature to understand that we are telling them what to do when when we ask them a question. Children don't really begin to consistently understand indirect requests until they are 4-6 years old. And even then, when we ask a young child if they want to do something, there is a good likelihood that they will say, "no." Having given them an option, we are then stuck with their answer. 

    So, the first thing I learned as a young graduate student was to tell children what I wanted them to do, clearly and without suggestion of an option (unless there really was an option to say no!). This was an important lesson. The second thing I learned, though, was even more powerful: When faced with a stubborn toddler or an independent preschooler, the best way to get them where you want to go is to give them a choice in getting there. I started embedding choices into my therapy sessions as a graduate student and never stopped:
    • "It's time to play! Do you want a puzzle or a book?" "
    • Now  it's time to go outside. Do you want to walk or hop?"
    And as a parent, I use this little strategy all the time with my (very independent-minded) daughter.
    • "Do you want your diaper changed on the table or on the floor?"  
    • "Time for snack. Do you want milk or water?" 
    •  Let's go outside. Do you want to hold mama's hand or dada's? To walk or be carried?"

    The power of choices is that you can almost always work a choice into anything you want a child to do. You end up getting your way, but you give your child a sense of power and control over her environment at the same time. And since young toddlers and preschoolers are developmentally programmed to strive for independence, giving them a way to assert their authority means fewer power struggles for everyone.

    That's the good news. The even better news is that there's another huge benefit to choices.  Each and every time you give your child a choice, you are giving her an opportunity to communicate with you. Toddlers and preschoolers are notorious for wanting what they want, when they want it.  When you give your child a choice, it slooooows the activity down, and creates a pocket of time where you can help her learn to communicate.  The beautiful thing about using choices to enhance language is that it is a strategy that can be used across all levels of language development.  Take snack time as an example.  Pretend your daughter loves crackers and bananas.  You have two bowls: one full of bananas and one full of crackers.  You get her up in her high chair, give her one of each to ease her hunger, let her eat them, and then hold up both bowls for her to see and wait.  Always wait to see what she does on her own first. It gives her a chance to initiate communication and you a chance to build on what she does. (And she may surprise you with what she does!). So, wait. See what she does first.

    • If she reaches or points toward a bowl to indicate what she wants, say the name for what she wants, wait for just a moment, and give her some. Remember that a gesture is communication! Show her that you are hearing what she is "saying" by giving her what she wants while you add language for her. Over time, she'll start using the word along with the gesture, especially if you remember to wait just a bit before handing something to her.
    • If she's not yet imitating words, you might also think about using baby sign language.
    • If she uses a single word to request, use expansion by putting the word that she used into a two-word phrase for her. So if she says "nana" you say, "more banana!" And if she says "cracker" you say "eat cracker" as you it to her and watch her eat. 
    • If she's consistently using single words to request on her own, you might want to use a two-word phrase when you give her a choice.  You could, for example, say "mama's cracker...or Molly's cracker?" and "all done banana...or more banana?" If she only imitates one of the words, just model the two-word phrase again as you hand her what she wants. She'll get it eventually.
    • As she gets closer to three, you can work concepts such as color and size into your choices.  You might ask her if she wants the "blue bowl or the red bowl," the "big plate or the little plate" or "one cracker or two crackers." 
    Although parents sometimes feel that they need to teach language inside of structured activities, you'll find that your daily activities are full of language and concepts that can be worked into choices with no preparation at all. Choices provide a rich language experience in which speech and language can be easily taught throughout the day. Combine this with the fact that choices can also be a powerful behavioral management strategy and you'll find that using choices with your child is a win-win situation for everyone involved. No choice required there.

    Looking for more tips?

    Thursday, May 5, 2011

    All Kinds of Talk: Using Your Language to Change Your Child's

    It seems almost too simple to be true: To help your child learn to talk, you'll need to....talk to your child. And yet as simple of a concept as it is, it's also a very powerful one. So powerful, in fact, that it appears to have long-lasting effects on your child and his development.

    One oft-cited research study, for example, found that the amount of "family talk" that surrounded a child was strongly related to that child's vocabulary and their IQ at age three...and, importantly, still at age nine (Risley and Hart, 2006). This remained true even after variables such as socio-economic status were accounted for.  What's more, the type of language families used with their child was also important. Families in the study seemed to use two types of language; the "business" talk of telling children what needed to get done (do this, come here, put that down) and the more positive, engaging, conversational talk of describing the world to their children.  It was the families who used conversational talk with their children who talked more to their children....and the children in these families who had bigger vocabularies and higher IQ scores.

    When I am working as a pediatric-speech language pathologist, then, I almost always start by teaching families how to talk to their kids.  One of the first things I share with parents is how to use four specific types of "conversational" talking with their children: parallel talk, description, self-talk, and expansion.
    • Parallel talk occurs when a parent talks about what the child is doing (Eating soup. You're eating soup!)
    • Description occurs when a parent describes an object to which the child is attending (Hot soup!)
    • Self-Talk occurs when a parent describes what the parent is doing as she does it. (Soup. Mama's eating soup. Eat Soup), and
    • Expansion occurs when a parent takes what the child says and expands it by one or two words. (Child: Soup. Mom: Yummy soup!). 
    Simple? Yes.  But research has shown that a child's language can change for the better just by changing the language input they get from their parents. When parents are taught to use focused, simple language to describe what their child is doing and seeing, children make gains in their language skills (McLean and Cripe, 2000).  This isn't to say parents should talk in short sentences all the time, of course. Children need to hear their parents talking in longer, conversational sentences as well.  It's the balance between the short, focused language and the longer conversational sentences that seems to be the most effective.

    And, as it turns out, some parents may do this intuitively.  In 2005, Deb Roy, a cognitive scientist and director of MIT Media Lab’s Cognitive Machines Group, set his home up with cameras and microphones to record everything his son and his son's caregivers said during the first two years of his son's life.  Although he expected to find that the caregivers' language got steadily more complex as his son aged, he actually found something very different.  When the caregivers talked to the baby, they didn't necessarily use simple language and short sentences-- at least not at first. But then--just as a new word was about to emerge in the toddler's language--something changed.   The caregiver's language became more and more simple....until the word emerged in the child's language, and then the caregivers slowly made their language more complex again.  This pattern repeated itself across words and caregivers, even though the caregivers didn't even know they were doing it. If this research stands up to time, it may show that parents who are really in tune with their babies and toddlers do a kind of dance with their child, where the child's language influences the parents' as much as the parents' language influence the child's.

    It's important to note that many children will also need additional strategies woven into their days as well: many parents talk a blue streak at their children only to find their children don't talk back.  This is by no means the fault of the parents-- some children just need more help then others getting started talking. This blog touches on many of the other strategies we use to help children learn to talk, and a good early intervention professional will help parents sort through these strategies and figure out how and when to apply them. The first step along the way, though, is almost always to teach parents to use those four types of conversation speech consistently and carefully and lovingly around their child.

    All of this to get at one small, yet somehow very big, idea:  Talk to your baby, your toddler, your child. Talk about the things he sees, and the things he does, and the things that make him laugh.  And as you do, know that you are giving him one of the most powerful gifts of all: the gift of language.

    Looking for more ideas?...


     McLean, L. and Cripe, J. (2000). The Effectiveness of Early Intervention for Children With Communication Disorders. In Guralnick, M. The Effectiveness of Early Intervention.  pp 349-428.

    Risley, T. R & Hart, B. (2006). Promoting early language development. In N. F. Watt, C. Ayoub, R. H. Bradley, J. E. Puma & W. A. LeBoeuf (Eds.), The crisis in youth mental health: Critical issues and effective programs, Volume 4, Early intervention programs and policies (pp. 83-88). Westport, CT: Praeger.

    Monday, May 2, 2011

    Do Twins Have a Secret Language?

    (A.k.a. The One Where I'm Debbie Downer)

    You may have already seen this very cute video of two twin boys having a grand time "talking" to each other:

    These two are clearly enjoying each other and it is very sweet to watch them do so.  And, in this case, the boys look to be very early communicators who are just having fun playing around with sounds. The video does spark an intriguing question though: Do twins really communicate to each other in their own secret twin language?

    The idea of a "twin language" (or "cryptophasia" if you want to get really fancy) has been around for some time now.  It's been reported that up to 50% of young twins will have their own twin language--one which they use to communicate only with each other and one that can not be understood by others outside their little duo.  The theory behind this "twin language" goes a little something like this: twins are so close to each other and rely on each other so much that they don't have as much of a need to communicate with the outside world, so they make up their own idiosyncratic language that develops only between the two of them. It's a fun and almost magical idea, for sure. But does it stand up to reality?

    It turns out that many researchers think it does not. Some research studies seem to indicate that what appears to be "twin language" might actually be two children with the same delay in phonology. Phonology refers to rules that children use to put speech sounds together into words.  As I've explained in other posts, children tend to develop speech sounds in the same general order and they often make the same types of errors in their speech.  Children with phonological delays have speech sound systems that don't develop as we'd expect, and this makes it hard to understand their speech.  Some researchers now believe that what is often described as "twin language" is actually two children whose speech sounds are not developing as we would expect.

    Researchers further theorize that these speech sound errors (the "phonological delays") are prolonged in twins because each twin has a partner who seems to understands him and uses the same type of speech as he does.  While this does make it kind of a "twin language" (because the two twins seem to understand each other when others can not), it's also a delay in speech sound development that might need to be addressed by speech therapy. And in fact, studies have also linked the presence of a twin language to language delays later in in the school age years.

    This is not to say that parents of twins who have their own language should panic. There does seem to be a small percentage of twins who have both their own language and are able to communicate effectively with their parents in the "real" English language. These twins will switch back and forth between their own language and the English language, depending on who they are talking to.  This type of "twin language" is not linked to later language delays.  It's also, however, less likely to occur.

    It's also important to note that researchers have not found that all twins who have their own language will go on to have language delays. Twin language seems to be a risk factor, not an absolute indicator the twins will struggle with speech and language. It's enough of a risk factor, though, that an evaluation by a speech-language therapist might be beneficial in helping decide what's really going on.

    Bishop, D.V., & Bishop, S.J. (1998). "Twin language": A risk factor for language impairment? Journal of Speech, Language, and Hearing Research, 41(1), 150-160.