Monday, February 17, 2014

Identify the Signs - Says Only a Few Sounds, Words or Gestures (18 months to 2 years)

Babies' cooing and early babbling is one of the most delightful sounds in the world.  I remember saying "oooo" to my daughter when she was just a few months old and she said "oooo" right back. I cried. But as they grow older, their sounds should increase in number and frequency, words should develop as well as the use of gestures to help very young children communicate. Here is some information on early communication skills, some ideas of what you can do at home as well as some red flags to watch out for.

Typical Development of Early Sounds, Words and Gestures

Your infant (0-3 months) will begin to make little sounds like cooing and gooing that are soft and sigh-like. These sounds have no meaning and are just part of the way he is figuring out his mouth and how it makes noises.

After a few months (4-6 months), he will start to make clearer consonants, specifically p, b and m. Usually these sounds will be used in nonsense babbling like "muh-muh-muh" or "bah-bah-bah-bah." You'll probably notice different noises that indicate pleasure (giggles and chuckles) or displeasure. It was around this time that I told my husband that our son "found his voice!" He began to do a high pitch shriek that started off low and grew higher pitched. He began to play with the volume of his voice as well.

In the second half of his first year of life (7-12 months), he should start to combine different vowels or consonants in his syllables. You may hear short strings of babbling "be-buh-buh" "da! da!" or longer strings "da-bah di-di-buh-duh" It is in this stage that he will begin to use his voice purposefully. He will use these speech combinations and other sounds (not crying) to get your attention. My son likes to say "yah yah yah" when he wants something out of his reach.

This is also the stage where children use gestures more purposefully as well. He may lift his arms up to indicate he wants to be held. Or he may reach for something that is obviously out of reach to indicate that that is the item he wants. He may wave or gesture "bye-bye!" when he is leaving someone.

As they finish up this first year, right around his first birthday, he should have one or two real words. Some common examples are "mama" (more likely "dada!"), "baba" for bottle, "hi!" and "ball." He'll also be more able to imitate your sounds and babbling. If you say "buh-buh" he should repeat "buh-buh" if you switch to "buh-buh-buh" he should also switch to saying it three times.

After his first birthday, between ages 1 and 2, he'll go from those nonsense syllables to meaningful syllables (bah-bah to mean blanket, or mama to mean mom) to single words (doggie, duck, apple) to two word phrases as he approaches his second birthday. For more information on that check out this post on Combining Words (click here).

What You Can Do at Home

For your infant, one of the best things you can do is talk to him. Tell him stories as he is sitting in his bouncer or swing. I remember telling my 2 month old daughter the story of how my husband and I met (maybe I was bored or lonely that day, but I told her the whole story!) It is also important to just get right in their faces and make good eye contact and make silly sounds! It is a bonding experience first and a speech activity second :) I love it when my son has his hands on my face and explores my mouth and lips and teeth. He is focused on me and the sounds that I am making.

For your 4-6 month old, imitate his sounds. If he is making a "yah yah yah" sound, you make it right back. Be excited to be communicating back and forth with him. When you repeat him, you are acknowledging that he said something important.  You can also just converse with him as if he is saying something that you understand. If he says "yah yah yah" you can respond with something like "yeah! I like that idea. Let's play with cars!" Or if he says "dadadada" you can say "I miss dada too, he's at work. He'll be home soon."

As his sounds increase in complexity (between 7 and 12 months), you can name items that sound like what he is saying. If he says "buhbo" you can say "Bubbles! That's a great idea" or "ge-dih" you can say "Get it! Ok, I'll get the car!" Name the toys, foods, people and objects that are around him. You can use single words as you come across them. For example, if a firetruck drives by you can say "Firetruck! Look at the firetruck!" or if you are rolling a ball with him, each time you get the ball or roll the ball you can say "ball!"

From his first birthday to close to his second birthday, he'll be saying more and more, so he will need you to be telling him the names of all of the items he encounters. You can talk about actions and categories like foods or animals. Baby W received a few wooden puzzles for his 1st birthday. One of them has pets, so I say something like "Look at the pets! Bird. Bunny. Hop! Hop!" (while I pull the bunny out of his mouth and make it hop on the rug). I try to name the pieces that he is grabbing (and trying  to eat).

To be completely honest, I find that it is more difficult for me to work on encouraging gestures than it is for me to work on words - so this is taking purposeful action on my part! When Baby W wants to be picked up and he is just fussing I can say "up! Want up?" and then although his crying is telling me yes, I lift his arms and say "up!" then I pick him up. I do with his arms what I want him to do, then I follow through as though he did it to tell me.

It is also important to tell them how you know what you know. Kids don't get how you know what they are thinking. You'll have to tell them something like "I know that you want the cup of water because I see you are reaching for it." or "I see you looking at the book, I can tell you want to read it!"

As he gets closer to his second birthday, you'll want to take those single words that you've been saying and add action words to them. So if you've been playing with the ball, you can say "get ball!" or "roll ball" (you can add the word "the" at this point so you don't feel funny saying these incomplete phrases but remember that is what he'll be saying soon and you want to model the next step not modeling two or three steps down the road). If he is using action words, add a noun. So if he says "jump!" you can say "I jump!" or if he says "drink" you can say "drink water." You can also add an adjective (red car or green ball or jump up or more drink).

Red Flags

Infant - not making sounds
Toddler - not saying more than 5-10 words, not using gestures
Preschooler - not combining words

If you are concerned with your child's communication skills, if he is only using a few sounds, words or gestures, talk with your pediatrician and contact 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 would like more resources, please check out the American Speech-Language Hearing Association's pro-search feature and web page (here).

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