Sunday, March 17, 2013

Using Gestures to Predict and Promote Language in Children

Most people don't automatically think of gestures as an important part of speech and language development. Quite the opposite, in fact. When most people think of the milestones that make up a child's early communication development, the focus tends to be on spoken language: first sounds, first words, first sentences. It turns out, however, that gestures play a big part in both predicting language and promoting it.
Gestures Predict Language Development

An important turning point in young children's early language development occurs when infants become intentional communicators.  This occurs when children begin to communicate messages to others in their life and, in doing so, begin to control the environment around them. My husband and I jokingly called this the "Dance Puppet Dance," stage of babyhood- the time when adults are so enamored by the fact that their little one is communicating that they are willing to drop whatever they are doing to meet the whims of their child!
Although it may seem like children's intentional communication starts with their first word, communication actually starts long before this.  Think of a nine-month-old child reaching toward something he wants, while looking back at his mom.  This child is clearly communicating without saying a word.  In fact, when we look at how children first communicate, we find that they use some very consistent forms of gestures along the way. According to Capone and McGregor (2004): 
  • One of the earliest form of gestures is showing off. This occurs when infants repeat their behavior in order to get an adult to laugh or comment on what they are doing. 
  •  "Ritualized requests" occur between 9 and 13 months of age.  These gestures occur when, instead of whining or fussing, children use more mature gestures as a form of requesting. Ritualized request gestures include reaching toward a desired object with hands that open and close rapidly ("I want, I want, I want!") and placing an object in an adult's hand to get help with that object.
  • Children begin to use deictic gestures around 10-11 months.  Deictic gestures are "showing" gestures that are used to get someone to attend to something in the child's environment.  Early deictic gestures include: showing an object to an adult to get that adult to look at it, giving  an object to an adult to show it to them, and pointing at objects to draw another's attention to that object. 
  • Representational gestures emerge prior to, and along with, first words.  Representational gestures occur when a child uses a gesture in place of a word.  For example, the child might flap his arms to indicate "bird".  The ability to use representational gestures tells us that a child is starting to think symbolically; in other words, the child who flaps his arms is using a symbol to represent "bird." This early-developing demonstration of symbol use is something we all look for as early interventionists, because words are symbols! When a child shows us he is beginning to understand and use symbols, we know he is ready for first words.
Looking at gestures in little ones becomes a very important step in assessing communication skills for a number of reasons.  First, gesture use indicates that a child is an intentional commmunicator.  Intentional communication is a huge stepping-stone toward verbal language, so we get really excited when we see a child is communicating with gestures, even if he isn't yet communicating with words. We worry less about a child who is using the right gestures at the right time than one who isn't.

A lack of gesture use, then, helps us to identify those children who might be at risk for a more significant diagnosis.  Research indicates that children who don't use the deictic gesture of pointing by 18-24 months are at risk for a diagnosis of autism spectrum disorder.  You can find out more about this by reading my post on the Red Flags for Autism in Toddlers. Although it can be really scary to see these signs in a little one, early diagnosis and treatment can be extremely helpful for children with autism spectrum disorders. The earlier we figure out what is going on, the earlier we can help.

Looking at gesture use can also help us tell the difference between late bloomers (toddlers who speak late but catch up by the age of 3) and late talkers (toddlers who speak late and continue to struggle even at the age of 3). It turns out that late bloomers use significantly more gestures to communicate than do late talkers (Thal et al., 1991).  Although late talkers use gestures, those gestures are more limited and are produced less frequently. If we see that a late talker isn't using a wide range of gestures to help communicate, we might be more likely to provide speech and language therapy.

Gestures Promote Language Development

So, gestures can be really helpful when we are trying to decide if a child needs some additional help with speech and language. And, they can help us identify those children who do need help at a pretty early age.  That's the good news.  Here's the even better news: gestures can also be helpful in assisting children to develop speech and language. 

According to Capone and McGregor (2004), gestures and verbal language are related neurologically. In other words, the brain mechanisms that support the use of gestures seem to be related to those that support speech and language.  Encouraging use of one may facilitate use of the other.  I use this all the time in my work a pediatric speech-language therapist.  I've long known that pairing an action with a word is more likely to get a child to imitate the verbal word.  Further, I frequently use Baby Signs as a bridge to verbal language. Although parents sometimes worry that this will keep their child from talking, I've found the opposite to be true: using the Baby Signs as representational gestures is an excellent bridge to verbal language. Gestures are also fantastic because:
  • Children often imitate gestures and verbal words at the same time
  • We can help children use gestures and signs by actually moving their hands to show them how to do the gestures or sign, something we can't do with spoken language
  • Gestures help children learn to understand language and seem to promote the conceptual, symbolic thought needed for language
  • Gestures and signs are more concrete and last longer in time than verbal words; this is a huge advantage for children who process information just a bit more slowly than others
  • Gestures and signs are great for children who are visual learners, such as children with Autism
  • Some children, such as children with Down Syndrome, have a very specific strength in use of gestures - tapping into this strength can be a beautiful way to increase language skills overall,
  • Gestures and signs increase a child's ability to communicate with those around him, which descreases frustration.  And decreased frustration is good for everyone!

Capone and McGregor (2004). Gesture Use: A Review for Clinical and Research Practices. Journal of Speech Language and Hearing Research, Vol 47: 173-186. 

Thal, D., Tobias, S., & Morrison, D. (1991). Language and gesture in late talkers: A one-year follow-up. Journal of Speech and Hearing Research, 34, 604–612.

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