Just the other day I had a few questions from parents regarding their little one’s understanding of language and following directions…more specifically…what is a good starting point when working on following directions. If you suspect that your child is having difficulty in understanding what you are saying to him…how can you work on this skill so that he will better understand language? To start off….let’s begin with an activity that may seem really simple..but is a good starting point..and this is how I would run a therapy session if targeting a child’s ability to follow simple directions and to eventually understand language and what is said to him.
Gather two of his favorite toys…I find starting with familiar objects works best…why because he is familiar with them…he knows what they are and what they are called…so for example in the picture above..you see my Gregory with his toy car and some blocks. So the set up for this activity would be to have the toy car and one of the blocks in front of him…as the two of us sit on the floor facing each other…with the two objects between us.
Now the goal is for your little one to understand the phrase: Where is the_______ orShow me the____________ or Point to the__________.
So while sitting with your little one say:
“Where is the car?”
“Where is the block?”
Does he understand what you are saying…now initially he may not understand the language Where is….however….he hears the word car…..and he is familiar with that word/object…because he plays with it so frequently….he has heard you say the word car. So when he hears you say: Where is the car….he may initially be locating the car…because he hears the word car….but eventually he will just understand the words Where is the…and will generalize to other objects familiar and unfamiliar. So once you see him following the directions with the words Where is the_______change your phrase and say: Show me the________…….and then change your phrase again to Point to the__________.
You can make the task more challenging by saying: Give me the_________. Initially you may have to extend your hand when asking him to give you the object…but then you can phase out the visual cue (your hand extended)….and just say to him: Give me the______.
You can again challenge him by adding more objects to the group.
Challenge him again by using unfamiliar objects.
More challenges….ask him to follow directions such as:Put the block in the cup (set up would be: block, cup, car, toy keys)
Challenge: Set up:
block, car, toy key
also need a table and a chair
Ask him to follow directives such as:
Put the block under the table
Put the car on the table
Put the keys under the next to the car.
When I am working with a little one on understanding skills….it is important that they learn that they have to “listen to understand.” Some children will listen….they hear you…..but they are NOT being sure to “listen to understand.”……I often tell my husband of almost 18 years (we got married in 1993)…..that I know he heard me….I know he was listening…..but he was not listening so that he understood me….so that he will remember. With the little ones….my goal is to teach them to listen so they understand and also remember.
When I work with a little one….in order to help her to listen to understand…the session may sound something like this:
Set up: ball, car, block and box are used during this listening task
Therapist: “Wait”(as I hold her hands on her lap)…..”Listen” (as I tap on her ears)……”Put the ball in the box”.
Saying these words…wait and listen while keeping her hands still and tapping on her ears…will help her to learn to listen to the direction…..so that she starts to understand that she has to listen to understand.
Now with the little ones that are having difficulty in the understanding of language…I help them by using the strategy: Ready, set….Action!
What does this mean…it means that I am tieing action and words together…..I will help her to understand the direction…..by…..hand over hand….picking up the ball together….putting the ball in the box…..and as I am doing this with her….I am saying…..”Ball in box”
Tieing your action with words helps your little one to understand language.
Following directions…listening…waiting…taking turns…compliance and flexibility.
One of my biggest challenges at times can be a little one’s compliance and flexibility…her ability to actually attend to the task…and be flexible and tolerate certain expectations. Now of course the receptive component in a little one’s overall development has an impact on how well she is able to be flexible and compliant. By this I mean…if she is notunderstanding and processing language…then she for sure may not understand the expectations…and when a language demand is placed upon her…she may have a melt down….she may appear to be a “misbehaved” child…when really she is just not understanding what is being said to her. When she has developed a stronger foundation with regard to receptive language…and I know that she is understanding more…than I may be ready to place more demands on her.
So picture your little one…she is very rigid…likes things a certain way…you can not messwith her routine…very self directed…she has a hard time following directions…not because she does not understand…but because “she wants things the way she wants them“…she is NOT flexible…she is NOT compliant…she has a strong temperament….and she is very routinized. She has trouble handling transitions. For example, there are some little ones who have a difficult time when there is a piece missing in a puzzle…when Mr. Potato Head’s nose does not fit in just right…when its time to clean up.
So for these little ones….I start to think about when they go to preschool ( I should have stated this is specific for little one’s around 2 1/2 years of age)…..back to the preschool thought…how will they sit at circle time…how will they wait..will they listen to the story or the activity..will they be compliant…and how flexible and tolerant can they be maybe when the weather bear is missing his umbrella…and today is a rainy day! Oh no…what can we do?
Co-treating for me…is a great way to learn and grow as a therapist…so the other day when working with little J…the session went like this:
J was sitting on the floor…she had to sit and WAIT
and then listen to the direction.
Therapist: J…look at my eyes…
J waits..sits patiently…criss-cross-applesauce…she sits waiting..looking at the therapist’s eyes….now she needs to listen.
Using the puzzle above…or any other three-piece puzzle…I love Melissa and Doug…
Therapist: J…look at my eyes….listen…I am going to put the cow under the couch.
***Now this is a pretty big deal for J…because this is NOT how you do a puzzle…she knows how to put the pieces in…so will she be able to “deal” with the fact that we are putting the puzzle pieces in places they should really NOT be.
Ah…she handled it well…
Therapist: J…look at my eyes…listen…I am going to put the horse on mommy’s leg.
J is still sitting…she has not moved..her legs still crossed..she listening to what the therapist is saying…she’s waiting…yea…I like what I see.
Therapist: J…look at my eyes…listen…I am going to put the sheep next to your brother.
**Great to include the sibling…because this is not part of the typical therapy routine…can she handle it…will she be compliant…flexible….she struggles with it a little..but we can re-focus her.
Okay….so now let’s do the puzzle.
Therapist: J…look at my eyes…listen….get the cow and put it in the puzzle.
Therapist: J…sit down…look at my eyes..listen…get the sheep and put it in the puzzle.
Therapist: J….sit down…look at my eyes…listen…get the horse…and give it to your brother.
Oh boy…this was very hard for her…she struggled…got upset…threw her head back. Hard to be compliant and flexible..when your routine is thrown off…and this is a skill that you actually struggle with. These are all pre-frontal lobe skills…your executive functions…the ability to be flexible…to transition…to be able to tolerate and deal with your own frustration..to problem solve…to be compliant in a given situation….to handle transitions. So we will continue to work on these skills for little J.
What I liked…what I saw…she sat for about 5-8 minutes…she waited…she listened…she followed directions…and she is learning how to be more compliant and flexible…how to transition.
Great work J!!!
WH QUESTIONS: (WHO, WHAT, WHEN, WHERE, HOW, WHY)
Parents will often tell me that their little one has difficulty in answering questions such as:
1. What do you want to eat?
2. What do you want to drink?
3. What toy do you want to play with?
4. What TV show do you want to watch?
Children that have difficulty in understanding language often have difficulty in answering WH questions (who, what, when, where, why, how). I plan on addressing all six of the WH questions….but will start off with WHAT questions.
Now if your little one is having difficulty in answering what questions….we have to make it easier…and one of the best ways is to provide her with a visual cue. So I tell parents that the question answer session may look something like this:
Therapist: Do you want bubbles? (showing her actual bubbles in my right hand) or do you want blocks? (showing her blocks in my left hand). Holding both toys up at the same time…eye level to the little one.
Now she may not have language yet to answer the question….so she may non-verbally point to her desired choice…GREAT!!!! Because that is non-verbal communication. So when she points to the blocks….you say…..”Blocks…..you want blocks!” Tie your words with the visual. Keep asking what questions…giving her 2 visual choices. The visual will help her to understand the question.
Let’s go back to the above question asked by the therapist…if your child does have verbal language….she may be able to answer the question as indicated below:
Great if she was able to verbally answer your what question…..keep giving her visual choices when working on WHAT questions. Try this for about a week with her….and then ask her a what question without a visual……so you would keep the same scenario as above….except there is no visual….just you saying : “Do you want blocks or bubbles?”
TIP: I tell parents when working on WHAT questions (with and without the visual) be sure to say the desired choice first. So if you know for sure that your little one wants blocks…..start off the WH question with blocks and ending with bubbles as the second choice. WHY….because children that have trouble in understanding of language often repeat the last word they hear….so to be sure she is answering the question and not just repeating the last word she heard…present the desired choice first…..Remember this only works when you KNOW what her desired choice is.
TIP: Is she still struggling…is she still not understanding….be sure that the second choice presented is a completely undesired choice. An undesired choice is something she definitely does not prefer. So ask her: “Do you want bubbles?” (showing her bubbles in your right hand)….”Do you want car?” (showing her a car in your left hand)…..this item has to be an undesired choice…a choice you know she would never pick……this way you are encouraging her to non-verbally or verbally make the desired choice.
When I am working with children on improving memory and understanding skills….it is most important that they understand that they have to “listen so that they understand and remember.” Children will often hear what you are saying….however….do not remember the details to what you said.
When I working on memory and understanding I like to start off the session with activities I call: “Jump Start” questions. These are simple memory exercises….that should be easy for your little one to answer. When I work with Lauren….a young girl I have been seeing for services since 2008 (working on cognitive rehabilitation)….we start off the session with the “Jump Start” questions. You will see below what they look like. Initially, Lauren could not answer the simple questions…and she also had the most difficulty in answering the questions in a full sentence. Okay…so read below what my “Jump Start” questions are like:
What is your name?
My name is Lauren.
What is your dad’s name:
My dad’s name is Mike.
What is your brother’s name?
My brother’s name is Eric.
Initially….just formulating the sentences was difficult for Lauren….also due to word retrieval issues. However, after repeatedly answering these questions….Lauren was able to answer them fluently.
Next I made the “Jump Start” questions more challenging….by telling Lauren that she needed to answer the question and then add detail to the answer. Giving me one fact about herself…her mom or dad or brother….so she may have answered the question like this:
“My name is Lauren and I love macaroni and cheese.”
Next….to address her memory skills….I would give her information about myself and see if she could recall the details…..so my statements would sound like this:
I would be sure to state the following first:
“Listen so that you understand and remember.”
“My birthday is in March and my favorite color is green.”
Next, Lauren would be asked:
When is my birthday?
Your birthday is in March.
What is my favorite color?
Your favorite color is green.
Now, most important!!
I would write the “Jump Start” questions down….and every session I would ask her the same “Jump Start” questions….and add a new one. Eventually…the answers were transferred from her short-term memory to her long-term memory. Most importantly, though, she learned how to listen so she understands and remembers.
I use the next activity (THREE PARTS TO SMARTS) to continue to work on memory and understanding skills…..and teaching the child to “listen so they understand and remember.”
“THREE PARTS TO SMARTS”
Be sure to start off the activity with….”I want you to try to listen so that you understand and remember.”
“I am going to tell you a story. There will be three details in the story. Listen so you understand and remember. Then you will answer questions about the story in a full sentence.”
“Anne went to Stop and Shop to get bananas.”
Who went to Stop and Shop?
Anne went to Stop and Shop.
Where did Anne go?
Anne went to Stop and Shop.
What did Anne get at Stop and Shop?
Anne got bananas.
As simple as this three-part story may seem….children that have difficulty with memory and understanding may struggle to answer the questions, to recall the details, and to formulate a full sentence when answering. Repetition of activities like this will help your little one’s memory and understanding skills.
As she improves her ability to complete these activities…make the stories longer…add more details…..and make the stories more challenging:
“On Saturday it was raining so Anne and I could not go to the park. Instead we went bowling and then went out to the Diner for lunch. I had macaroni and cheese and Anne a cheeseburger. We had fun. Hopefully, on Tuesday we can go to the park.”
Again see if your little one can answer questions about the story above….there is more detail…it will be more challenging…..and you may have to use the strategies filed under the word finding help page to help you help your little one.
And be sure to go to the word finding help page for more information on how to help your little one or big one with word retrieval concerns.
ANSWERING WHAT QUESTIONS IN REFERENCE TO ACTIONS: (FOR EXAMPLE: WHAT AM I DOING?)
Asking questions to your little one will help to elicit language….and also will help in their understanding of language……however…you have to be sure of what your expectations are and what your little one is capable of understanding and communicating.
Let’s start off with the first picture above….you can clearly see that the girl is jumping. A great strategy to help your little one both understand and use language is this:
As you are jumping…ask your little one: What am I doing?……wait and see if she is able to answer. Hopefully the visual of you jumping will cue her to say jumping….even if she is not understanding the phrase: What am I doing?….she may answer correctly by saying JUMPING….because the visual gives it away…..now this is not cheating….it is helping your little one to understand language better….because you are tieing your action and words together.
Now if she does not have the language to answer the question….you answer the question for her…..with a simple one word response: JUMPING. Being sure to change your pitch and inflection…giving your verbal production some melody.
Continue asking simple action questions….remember to choose actions that are familiar to your little one…..here is a list below:
Now let’s refer to the second picture above…
ANSWERING WHAT QUESTIONS IN REFERENCE TO OBJECTS: (FOR EXAMPLE: WHAT IS THAT?)
In order to help your little one understand WHAT questions (in reference to objects) and also use her language to answer WHAT questions….you can use the strategy listed below:
Find familiar objects in your home….you should use objects that your child is familiar with….so that answering the question is not too much of a challenge. Point to an object and say: What is that? Now your child may answer the question and say: BUS….because you are pointing to the BUS. She may not be understanding the actual question: WHAT IS THAT? However, the more you repeat this type of question…and point to the object as you ask the question…..the easier it will be for her to answer the question without the visual of you pointing. So moving forward….she will eventually understand a question like: What is that?……without the visual (you pointing to the object).
Now if your little one can not answer the question…..answer it for her…changing your pitch and inflection…putting a little bit of melody to your answer…with a one word response: BUS. Questions like: What is that? as you are pointing to the object…are the easiest types of WH questions for your little one to answer.
Remember children learn through repetition. Continue to practice the WH questions in reference to actions and objects. And if your child can not speak yet….and can not imitate what she says….no worries….take the pressure off of her…….you do the talking….use the self talk strategy…(find this strategy under the teach me to talk page).
Last night….on our way to the supermarket….the kids asked if they could play “cash car“. This is similar to “cash cab” a show they enjoy watching on television. What a fun and language enriching game…..I never thought to play it with them before…..Gregory and Katie both initiated the idea. They were not only enjoying the car ride…we were all laughing hysterically…..okay so how do you play…and what prize are you playing for….in my kitchen I have a mason jar that I keep extra change in…….so I told them that if they won “cash car” they could have all of the money in the jar. To them….that was like winning lotto…..Gregory said: “really we can keep all of it….now way….really mama!” FYI: there was a total of $1.50 in change in the jar….so many pennies….that to them….it was a significant amount of money.
To play the game….they had to answer the questions correctly….being sure not to get three strikes before we arrived at . We love Uncle Giuseppe’s….even the little ones love going there….it’s and adventure all in itself.
We also asked them red light challenge questions….. for the red light challenge…this meant that the question was more challenging….as we waited at the red light..and they have to be sure to answer the entire question before the light turned green……and if they got the question right it was worth double the points….so for each question they got correct they earned ten points…and for the red light challenge they would earn twenty points. Still the prize…no matter how many points….as long as they did not get three strikes…was all of the money in the mason jar.
If you would like to play “cash car” with your kids…..below is a sampling of questions I asked…..be sure that when your child answers the question…they re-state the question….this will help them in school…when they have to answer a question….re-stating the question…and being sure to answer in a full sentence. I will give examples below:
CASH CAB QUESTIONS:
1. When is Dad’s birthday?
Answer in a full sentence: Dad’s birthday is January 1, 2011
2. How many months are there in a year?
Answer in a full sentence: There are twelve months in a year.
3. What is Andrew’s middle name:
Answer in full sentence: Andrew’s middle name is George.
****So I think you probably get the idea of re-stating the questions….question four and five below are red light challenge questions:
4. Name ten foods Andrew would NEVER eat.
FYI….My Andrew is a very picky eater…many sensory issues when it comes to eating. I have not yet had a chance to discuss feeding concerns in young children…and approaches that are beneficial to addressing sensory concerns when eating….but I will be sure to post about feeding concerns specific to sensory. A sensory feeding issue refers to a child’s inability to eat certain foods….not because of an INABILITY to bite, lateralize, munch, chew and swallow….rather a sensory concern…because the child does not like how the food: LOOKS, SMELLS, or TASTES….this means the food may not look appetizing….Andrew can just look at macaroni salad and almost gag…because it does not look like he could eat it…..sometimes it is the smell that a child can not tolerate….and most importantly when it comes to sensory issues and feeding…the texture is too much for the little one to handle…..for Andrew it is the texture of many foods….but especially the banana. Here is a great link if your little one has sensory feeding issues: www.thecenterforcd.com/specialized_therapies/sos–feeding–therapy
Below is a brief description of SOS feeding therapy:
The Sequential Oral Sensory (SOS) approach is a developmental feeding therapy that allows the child to interact with the food in a playful, non-stressful way. It helps increase the child’s comfort level by exploring different properties of foods, including the color, shape, texture, smell, taste and consistency. The SOS approach follows a systematic hierarchy to feeding, from tolerating foods in the room, interacting with foods, smelling, touching, tasting and eventually eating the food.
Okay….so back to another red-light challenge question:
5. Spell your first and last name backwards…..and tell me the first sound in your first name and the first sound in your last name.
Back to the regular questions…not red light challenge questions:
6. Name five animals
7. Name five Zoo animals
8. Name five Farm animals
9. Tell me which one does not belong in the group and why: apple, shoe, banana
10. Name the four seasons
This was probably the most fun Gregory and Katie had in the car….in the next few weeks I will make a list of “cash car” questions….and keep adding to the list….and will have them saved under the categories link-under Cash Car.
And when we got home from shopping…Katie and Gregory counted out all of the money…what a great math lesson!
“Cash Car” challenge…..see if your little ones can come up with the questions…and you have to answer them…..this is definitely more challenging. Can they come up with the red light challenge questions…understanding what it means to make a question more challenging?! Use the silly mama strategy….find under the teach me to talk page….so…… make mistakes when answering the questions….and ask your little one to edit your answer and help you to get it right!
I thought I would start posting what a typical speech therapy session for me looks like….so that you can help your little one at home. So for today’s post I have focused on improving a child’s understanding of language and use of language. By this I mean….the session below is an example of what I would be doing with a little one that is having difficulty in her understanding of words and also in her use of words to make her needs known. I hope that you find this post helpful….and I will continue to add posts that describe a typical therapy session.
Melissa and Doug’s products are definitely a favorite of mine….above is a puzzle that I frequently use during my sessions.
With the puzzle board in front of the child….and all of the pieces removed and not in the child’s sight…..I would hold up two puzzle pieces. So maybe the pig would be in my right hand and the cow in my left hand. Showing the little one both pieces…I would say:
“Do you want pig?”(bringing the pig closer to her as I say the word pig)
“Do you want cow?” (bringing the cow closer to her as I say the word cow).
Now a few things may happen….she may not have words just yet to say cow or pig…so she may just look at the cow…indicating that she wants the cow….or she may point to the cow…if she is able to understand….that by pointing (a non-verbal way to communicate) she is able to obtain a what she wants. So whether she points to the cow…or just looks at the cow….I would then say:
“Cow…want cow.”….and hand her the cow as I am saying the words ”Cow…want cow.”.
I would continue this play activity….showing her two choices…and asking her the same question…..now the goal is for your little one to eventually understand the words: Do you want cow. Do you want pig?…and the goal really is for her to eventually understand the phrase: Do you want?….the more you tie the visual (puzzle piece of the cow) with your words: Do you want cow?…..the more you are helping her to understand the language that is tied with the visual.
Parents will often tell me….she knows what a cow is….or she knows what a ball is…..or she knows what a cup is…..BUT…does she understand the language that is attached to the word BALL….when the entire sentence is: Do you want the BALL?….children that present with processing concerns, receptive language concerns or understanding concerns…often have a difficult time in understanding these simple directions.
So what often happens to children when they don’t understand the language? In my experience…when they do not understand langauge…and you are asking her questions…or placing a verbal demand upon her…or giving her a consequence or expectation such as: You can not have the cookie until you eat your dinner. First eat your dinner…sit in your chair…and then you can have the cookie. OH BOY….that was way too much language for a little one that does not understand language. My experience has been this….at this point your little one…MAY have a melt-down…a tantrum….fall to the floor and start crying and screaming…WHY…..it is NOT because she is a “bad girl”…and I never like to use language that says “she is a bad girl”…her behavior may not be acceptable…but she is not bad. In this case though…her behavior is not acceptable…because she is NOT understanding language….poor thing.
So what do we do???? It is my job to help you help your little one to understand language. I often use the words: “First and Next“…..and when I say the word FIRST….I put up my index finger…indicating that she has to do something first..whether it is clean up her toy…eat her breakfast…..and after I point my one finger up….I put to what I want her to do…..and say: “clean up”….as I am pointing to the toys I want her to clean up…..and then I say: “Next“……as I point two fingers….and then say…”Next get cookie”….as I point to the desired choice..what she wants….pointing to the cookie. Eventually your little one will understand FIRST and NEXT…she will begin to understand language…consequences…expectations…..and become less FRUSTRATED….become more compliant….flexible…and adapt to the demands of language.
Okay…..so let’s go back to our therapy session. If your little one has the language to point to the cow…and also say cow….GREAT!!! Let’s use the expansion strategy (found on the teach me to talk page)….to expand her sentence….so when she says COW….this is what I would say:
“I want……(now point to the COW…and prompt her to fill in the blank (this is a carrier phrase…find more about this under the word finding page). She should be able to fill in the blank…and say cow.
Now the goal is for her to eventually say the entire sentence: “I want cow”. The more you repeat the above activity…using the carrier phrase…the easier it will be for her to make a request using the longer sentence.
Expand this to your daily routine with your child….if she is requesting: “juice”…..and you know this because she pulls you to the refrigerator…and points to the refrigerator……and you know FOR SURE…that she wants juice….take out the juice and an UNDESIRED CHOICE…such as milk….she does not like milk…and would never request it…..now let’s go back to the above strategy and use it in this scenario:
Hold the milk in one hand the juice in the other….ask her…
“Do you want juice?” (bring the juice closer to her) Do you want milk?” (bring the milk closer to her)
Now in my experience…child with understanding concerns…often will say the word they last heard….because they KNOW they have to answer a question….they know they have to say something….but what was just said to them may sound like this: dkjdlksjdf kdjalskjdflksj klkroue milk. So she has NO idea what you said…but heard milk…so is going to say milk. Your next step would be to give her the milk in a cup…..she will not want it…..go back again and ask:
Hold the milk in one hand the juice in the other….ask her…
“Do you want juice?” (bring the juice closer to her) Do you want milk?” (bring the milk closer to her)
Eventually…your little one will understand the language that is attached to the visual….and she will answer the question…whether it is with a word…pointing…or looking at the desired choice.
Remember…if she points to the juice or looks at the juice….give her the juice and say: “Juice…want juice.”
Back to the therapy session:
Finish the play activity with the puzzle….now it is clean up time..let’s work on understanding again:
Show her two puzzle pieces…any two that you have now taken out of the completed puzzle….put the two pieces on the table…the cow and pig….work on the following directions…with her mom next to you to help.
So the set up is this:
Mom next to child…two puzzle pieces on table…Ziploc bag to put the pieces bag in…tell child: “Give pig to mom“…if she does not understand…..tie a visual with your language….point to the pig…then point to mom…and say: “Give pig to mom“. If she still does not understand use the READY, SET, ACTION! strategy……this means…you will help her to pick up the pig and give to mom (hand over hand)….as you say: “Give pig to mom“. Then give her a verbal direction and say: “Put pig in bag.” Continue until clean up is finished. Change your directions…sometimes asking her to give a puzzle piece to mom…sometimes she is to put the piece in the bag.
I hope this post was helpful….I will continue to add “speech at home” posts…so you can learn how to help your little one….please post any questions.
I wanted to write a post specifically about how music and movement can help your little one in her understanding of language. This post is specifically in reference to your 2-3 year old (however if your four-year old is still struggling with simple directives please read) and in her inability to follow even the simplest of directions: come here (with your hand extended)…sit down (with your hand touching the floor indicating that you want her to sit down)…give me a kiss (with your lips puckered). These are simple directions that she has heard over and over again…however still does not grasp.
Some children have a difficult time in understanding of language….the processing of the words they hear is just too complex for them….how very frustrating…how will they understand any sort of consequence…..how will you discipline…how will you set rules and boundaries…when she can not even understand a very simple direction.
I am a speech and language consult for a few of the children I see…these children have an Autism Spectrum Disorder…..and I collaborate with the team on many aspects of speech and language development….oral motor feeding, language develoment…receptive language…processing…..depending on their level and what their needs are. It is great to collaborate with the entire team to really brain-storm…so we can come up with the best plan for the little one.. some of the children that I see as a consult are not on the spectrum, however, are very low with regard to their understanding of language. So whether the little one has an autism spectrum disorder…or a significant language processing concern…..I like to start off with encouraging the understanding of a gross motor movement….when I say understanding…..that they understand that we are asking them to: clap hands, give a kiss, do so big, jump in place….etc. Remember for children that are having difficulty in their understanding of language…just hearing the words means nothing…they need to hear the words tied with action (a motor movement)….and I like to tie it with song too….remember music is on the right side of the brain and language is on the left…so let’s tie them together to help your little one to understand the words she is hearing….and now let’s tie a motor movement with it…when singing the wheels on the bus…you remember how the song starts off….be sure to tie the motor movement of your hands moving round and round…as you are singing the song….sing the entire song…about the wipers…the babies crying, the windows going up and down, the doors opening and closing…etc.
So sing this song with your little one….and show her the motor movements…and see if she will start to imitate you….this is a good starting point for working on following directions and understanding of language….once we see that she is beginning to understand motor movements…specifically that we want her to imitate what we are doing….she may start to understand other directions such as pointing to pictures upon request…follow a simple routine directive with a cue…then following the simple routine directive without a cue…then following a novel directive…then some more complex directives.
So have fun singing with your little one…and be sure to encourage her to follow along with the motor movements.
You can also sing:
The Itsy Bitsy Spider
I’m Bringing Home a Baby Bumble Bee
If Your happy and You know it
HOW TO TEACH BODY PARTS:
In young children presenting with a language delay…the understanding of and the labeling of body parts may be very difficult for the language impaired child. She may have difficulty with her ability to find her body parts upon request (a receptive language task…this means when you say: Where’s your nose?…..she may be unable to point to her nose)……or name her body parts(this is an expressive language task….you point to her nose and say: What is this…and she may be unable to say: NOSE).
Depending upon her skill level…there are many factors that come into play. For example…your little one may know that her feet are her feet…she may know that her head is her head….however…once the question: Where is your head? is asked…she is unable to locate her head. This MAY be because she is having trouble understanding language. Or it may be…..when you ask: What is this?…..when pointing to your head….it may be that she does not have the expressive ability to say the word: HEAD. A little confusing….so the goal of this post is to help you help your little one with both the receptive and expressive components of understanding and locating body parts.
As a speech and language pathologist…administering standardized tests for the little ones in early intervention….I ask children to find: nose, eyes, head, hands, feet, ears, hair…..and I also ask them to label body parts upon request….as I point to the doll’s: nose, eyes, hair, mouth….I ask: What is this? Now most children learn just by hearing language (incidentally)….they do not need a therapeutic approach to using and understanding of language. They hear language…and they eventually learn to use it and understand the words they hear. However, some children do not learn incidentally…..and these are the children that may end up qualifying for services and need a therapeutic approach to learning.
So how do we teach children to understand and name their body parts…..using the strategies of self talk and parallel talk….are both great strategies to help your little one with body parts:
Self-Talk: This is a fancy way of saying you can talk as you do something, just like one
of those TV chefs who say every step of what they’re doing. “It’s time for lunch.
Now I’ll put the forks on the table. Now I’ll put the spoons next to the forks.”
(During this one-sided conversation, pause after each statement so that Your child can respond.)
Parallel-Talk: You can use parallel talk so when Your child puts that book on the shelf
you can talk about what he’s doing. “Your child, you put the books away so carefully.
I see you put the big red book on the bottom shelf.”
HOW CAN YOU USE THE ABOVE STRATEGIES TO HELP WITH THE UNDERSTANDING(RECPETIVE) AND LABELING (EXPRESSIVE) OF BODY PARTS:
Bath-time is perfect for working on this skill. As you are washing her hair…say: washing hair.….or just the word hair….say it many times as she is in the tub. As you wash her body parts….label them and describe what you are doing with simple sentences (wash feet, wash belly)…..go through all of her body parts. After you have done this for a week or so….the next time she is in the tub….say to her: Wash belly…where’s belly? Does she look to her belly to show her understanding…..does she point to her belly…..look to see if she shoes any signs of understanding this question.
Dressing is also a great opportunity to work on this skill. Use the self talk and parallel talk strategies to help develop this skill. If she is putting her socks on her feet…..you can say: On feet….as you touch her feet….or say: socks on feet. Label her body parts for her as she is dressing or as you are dressing her. These strategies do not place any language demands on the little one. You can bombard her with the words she needs…..so that she will eventually start to use them and also to understand them.
If she is still struggling to understand the questions: Where is your head?….or Show me your feet?…..or Point to your belly?….keep using the above strategies to help her to understand the language and eventually use the words. If you continue to just ask her questions…she may become frustrated because she does NOT yet understand the language.
Parents somtimes say to me….I have been trying….I keep saying…..say CUP if you want your CUP….and she won’t do it…I keep asking her but she is not saying anything. Well of course not….if the word is not yet in her vocabulary….how can she possibly say it? If you wanted a cup of coffee….but had to ask for it in Mandarin….but do not have that word in your vocabulary….and are unable to say the word just yet…even when it is imitated for you….you probably will never get that cup of coffee. So….rather than questioning….use the self talk and parallel talk strategies to help her.
****First work on the body parts that she can see on her own body….for example….target: hands, feet, belly, and legs first….she can see these on her own body….she can not see her hair…so this makes it more challenging.
***Use a mirror for the body parts that she can not see
***Use Mr. Potato Head as a fun play activity to work on body parts
***Use play-dough to work on making your own Mr. Potato Head and work on body parts
***A baby doll or stuffed animal are also helpful to address body parts
HOW TO IMPROVE YOUR CHILD’S ABILITY TO FOLLOW A GROSS MOTOR DIRECTION:
“If you’re happy and you know it“
Everyone is familiar with this song…I think it is pretty safe to say…..and what a great song to work on following a gross motor directive (as well as body parts….read more below to find out why). When working on following a direction….specifically your child’s ability to understand the language she hears….it is important that she is able to follow a gross motor direction. WHY?….because before I can expect her to understand and follow a direction such as: give me the ball….or go get your shoes….I want her to be able to follow a gross motor direction. When I say follow….I mean that she actually understands the language…the words that she hears…they have meaning to her…and they make sense…the words make sense. Some little ones have difficulty even with a gross motor direction such as “clap hands”….even with the visual…you clapping your hands while saying “clap hands”….tying your words and action together….some little ones still have difficulty in understanding the verbal language.
So….when I am working with a little one…and she presents with delays with regard to her receptive language…her understanding of language…I look to see if she is able to follow a simple gross motor direction such as clap hands…or so big (asking her to extend her arms above her head)….and if she is not able to follow these directions….then I like to incorporate movement and music-tying them both together to help with understanding of language.
So singing the song If your happy and you know it will help her to understand and follow a gross motor directive….and by the way….Gregory is happy in the picture seen above…why?….because he is eating chicken wings…an absolute favorite of his…and if you want to know where they have the best chicken wings ever….Grumpy Jacks…http://grumpyjacks.com/Grumpyjacks/Home.html. And Jack…was nice enough to share the recipe with me….he was not so grumpy that day!
Anyway…back to If you’re happy and you know it…try adding variation to the song:
If you’re hungry and you know it rub your belly
If you’re tired and you know it close your eyes
If you’re mad and you know it stomp your feet
If you’re happy and you know it clap your hands
If you’re happy and you know it touch your head (and vary with other body parts)
If you’re happy and you know it make a kiss
If you’re happy and you know wave bye-bye
If you’re silly and you know it stick out your tongue
If you’re happy and you know it say mommy
If you’re happy and you know it say daddy
If you’re happy and you know do so big (pick your arms up over your head)
Remember tying music, action and words together will help you help your little one to understand language and follow directives.