Tuesday, February 4, 2014

Identify the Signs - Does Not Combine Words (starting at 2 years)



Combining words into phrases and then later into sentences helps make what your child wants to say more precise. If a child say "ball" does he want to play with a ball, kick the ball, show you the ball, ask you where his ball is? But once he starts putting words together you get a better understanding of what he is thinking. Starting at 2 years old, your child should be combining words for conversational purposes. Here is some information on typical expressive language development, things you can do at home as well as some red flags to watch out for!


Typical Development of Expressive Language

Around your child's first birthday, he should have one or two real words. A real word is a combination of sounds that he consistently uses for that object or person. A good example is "baba" for bottle. If he says "baba" every time he wants his bottle then that is a real word. If sometimes he says "baba" and other times "moma" and other times he says something else, then that is not a real word for him (yet).

Throughout his next year, he will begin to name many objects in his environment and begin to combine words together. He may say "want ball" or "more juice" or "where mama?" In the beginning of this year, he may start to use intonation to indicate a question "milk?"

By his second birthday, he should be consistently putting two words together.  The word combinations should be a variety of noun-actions (doggie run, mommy go, book fall), action-nouns (drink juice, eat cookie, want car), adjective-noun (no milk, more snack, pretty leaf) or possessive-nouns (my toy, mommy spoon).

Between the ages of 2 and 3, your child will start to put 3 words together. "I go home" and "I want juice" and "more cookie, please" will be the types of simple sentences or phrases that you should begin to hear. Two word phrases are still fine for a 2 year old, but as your child approaches his 3rd birthday you'll want to hear longer sentences.

One easy way to see if your child is on track is to make sure that the majority of his sentences have as many words as he is years old. So, your 3 year old should say 3 word sentences. Your 4 year old should say 4 word sentences. Now, I am not saying that your 18 year old should only speak in 18 word sentences! But for young children this is a good rule of thumb to follow!


What You Can Do at Home

For your young child, you'll want to label the items that he comes into contact with. So, while you are getting a clean diaper, say "diaper! Diaper! I've got a clean diaper! Here's a diaper." You can show it to him and let him hold it while you get ready to put it on him. But the focus should be on the single word "diaper." The best thing to do for language development is to take where your child is and increase the difficulty by one step. Model that next language step. For example, my son only has a few signs and one word (his 1st birthday is next week), so he is needing me to model single words for him. We point to things as we go around the house or community and I name them for him. If he holds up a toy (or other object that he's found) I name that. If he attempts to say something in return I praise his effort.

Last night we went to get ice cream for my husband's birthday and there was a car next to ours with some little dogs in it. They were barking and drew our attention, so I said "dog! Look at the dogs! Dog. Dog. Dog. Do you hear the dogs? Arf! Arf!" Baby W was very interested in the dogs but did not respond or attempt to communicate anything. On our way out, the car of dogs was still there and they barked at us again. Again, I did a little labeling, then got him buckled into his car seat. He looked over at the car and made a little barking noise three times. We cheered and made barking noises, too!

Praising your child's attempts at communication is very important to let them know that you heard and applied meaning to what they said.

The next step is combining words. It's best to start with the single words that they say and add a word to it. If you child knows the word "milk" you can add "want." So your child says "milk" you reply "want milk!" While I love the word "please" and think that socially it is a very important word, it is not the most important word to add to your child's vocabulary at first. Add an action to a noun. Or add a noun to an action. Later, when he is combining 3 words you can add "please" to say "want milk, please."

There are lots of words that you can teach your child that go along with the words that they already have. I am working with a little boy right now who knows "car" so we are adding actions to that noun. I say "push car" "get car" "want car" "drive car" "beep car" and "go car" while we are playing with cars. I model what I want him to say. When he says "go car!" as we are racing around the room I praise him and I give him opportunities to tell me what he wants. I may collect all the cars and put them up out of his reach and wait for him to say "want car" (right now it's "want" with a reach to the car, so I have him say "want" then "car"). Don't make your task super frustrating but do give your child opportunities to need to ask for what they want.

Once your child is combining two words consistently (at least 50-70% of the time), you can model the next step which is 3 words! "I want milk." or "Get car, please" or "Mommy, throw ball" Don't talk like this all of the time -you do want to demonstrate correct grammar - but during select times you can really focus on modeling the next step. The best way to model the next step is right after your child says something. So if he says "read book" you can say "I read book" or "please read book" If your child repeats the longer sentence, let him know he did a great job.

The next step is 4 word utterances. This is where your sentences will sound more grammatically correct! And you'll feel like you are actually speaking in sentences instead of that almost telegraphic speech from earlier. You can add in "the" and "to" and "a." Your child's sentences will start to sound more grammatically correct, too, which makes what he is telling you easier to understand! If you notice that your child is leaving out words, repeat the sentence back to him with all of the words that should be in there. So if he says "I go McDonald's" you can say "I go to McDonald's"

Just keep modeling what you want your child to be saying. Know where he is and what the next step is and you'll be on your way!


Red Flags

Infant - not making sounds
Toddler - not labeling objects or combining two words together
Preschooler - not combining 3 or 4 words together
School Age Child - making sentences that are missing many of the little words (a, the, to, on)


If you are concerned with how your child is using words or is not putting words together as he should, talk with your child's pediatrician and seek out a certified speech language pathologist. If you are in the central Florida area, feel free to contact me (here). If you are not, or if you'd like more reference information, please check out the American Speech-Language Hearing Association's pro-search page and their website (here).







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