On the surface, this seems to be supported by the experience of many families: they have a toddler with a communication delay who understands much of what is said, but still doesn’t produce much language at all. The parents can speak to the child in long, complete sentences, and the child understands and follows directions. Because the child can follow directions (when he or she feels like it, of course), figures out difficult problems with ease (like how to load the VCR), and has advanced social knowledge (like exactly how to aggravate his or her sister), parents know their toddler is a smart cookie. But the child still isn’t producing any words! Sometimes this is interpreted as stubbornness or laziness on the child’s part. But what’s really going on here?
The reason why a child can understand much more than he or she produces is because language actually develops at two different levels. One kind of language skill—what speech-language pathologists call receptive language— refers to a child’s ability to understanding what you say to him. This kind of language development may be happening at a normal (or near normal) pace. What is delayed for the child described above is what is called expressive language. Expressive language refers to the child’s ability to produce words and phrases. So let’s look again at the advice that parents receive about how to talk to their child who has a communication delay. When people talk to their child as if he or she were an adult, they are talking to the child’s receptive language level. This is appropriate and good, if one is interested in addressing receptive language or cognitive skills. The question is: what will help to develop the child’s expressive language skills? What I encourage parents to do is talk to his expressive language level rather than to the child’s receptive language level. If the goal is to get more expressive language cooking, then it is here that our efforts should be focused.
If parents follow the advice above, never to use “baby talk,� they will always be talking at the child’s receptive language level. The problem with speaking at the child’s receptive level is that it doesn’t work very well for increasing the child’s expressive language level. Why? Well, adult language is not well designed when it comes to helping a toddler to use more words. It’s too fast, too complex, and most of the time it’s not really about what toddlers want to talk about. Thus, it requires an adjustment on the part of most adults to change the way we talk when we are trying to help a toddler to use more words. Talking slowly, using fewer words, and making the meaning clear, are all techniques that will help a child to improve the expressive language skills. While the following chapters will tell you more about how to make this adjustment, let’s start with an overall picture that helps to explain what we’re doing.
Here's an analogy that I find useful when thinking about how to adapt language for a toddler: consider the way children learn how to play baseball. A young player doesn’t start out in the big leagues, swinging at big-league pitches. Rather, the child starts out in the back yard with the t-ball (a device that allows the child to hit the ball suspended motionless, directly in front of him). Then the child progresses to swinging at a moving target: i.e., mom or dad pitching in the back yard. How do mom and dad pitch? They adjust the speed and the delivery of the pitch—much slower, perhaps underhand—so that the child can see the ball. You would try to place the ball just where the child usually swings the bat. You might also make an exaggerated wind-up, so that the child knows exactly when the ball is coming and he can time the swing. Then comes gradually more challenging ways of playing (for example, having the coach do all the pitching), and finally to a stage where our developing player can perform in a “real-world� situation: little league. The point is: t-ball is constructed to make it easier for little people with developing motor abilities to play. If you really want the child to make contact with the ball, you have to simplify the process. A young child doesn’t have the coordination to be able to hit a big-league fastball. If you want the child to be successful, you make pitches that he can hit.
Adult language is like a fastball from Randy Johnson. Zooming in at 100+ mph, it is impossible even for most big league hitters to touch, let alone someone with immature motor skills. For example, it is not uncommon for adults to produce to 8, 10, 12, even 15 words at a time. Some people talk so fast that you sometimes wish you could put the brakes on. To make matters worse, adults tend to use big words, the bigger the better, in conversation. So if you want to help a child with a language delay, the most significant thing you can do is to slow down, use single words, and simplify.
Now, if you’ve picked up a book on language development, chances are that it says something like the following: “In order to increase your child’s language ability, you should speak to them in full, complex sentences. Introduce lots of new words that will expand the child’s vocabulary.� You will also read advice like: “Ask lots of questions that will stimulate the child to use his or her language skills.� Unlike the advice stop using baby talk, this recommendation is not totally off base. But since this is the exact opposite of what I’ve just been telling you, I feel some need to explain.
The fact is that the advice to use lots of new and complex language is correct, but only for those children that are not experiencing a communication delay. It is good advice, but only for children that are on track in developing language. It doesn’t work so well for children that have gotten off track. For children with communication delay, the goal is to get things moving. In order to do so, the language that we use must be simple and focused. This means that in order to begin using their very first words, children with an expressive language delay must be exposed to a small set of words in very meaningful contexts. Using more complex language just increases the problem for the toddler with an expressive language delay: it makes it even harder to find anything in the adult language that he or she can imitate. Don’t misunderstand. When I say, “use simple language,� I don’t mean “speak less often.� I want you to use language more often when interacting with your child. What I mean is “use fewer words to say what you mean.� And don’t despair—there will be a time when you will have to be concerned about expanding the vocabulary for your child. That time is in the future. Here is an example of using simple language while I stack blocks with a toddler:
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One final point before we get down to the actual strategies: the recommendation to speak in simple language does not mean that you can never use anything larger than a three word phrase with your toddler. As noted above, it simply means that when you want to target expressive language, you must simplify the language. There will be times when you want to target other areas, such as when you’re helping your child with problem-solving, emotional development or just plain safety issues (e.g., “Never put anything in the electrical outlet.�). At such a time, it is necessary to use more complex language with your toddler. This is appropriate, as long as you know that such language is not likely to help the child to produce more expressive language. Thus, you may have different goals in mind when addressing a child with an expressive language delay, and the language you use should reflect those different goals.
Here’s an example of how goals (and hence, the language) might be different, even for the same child with the same activity. Imagine that you are sitting on the floor with a simple puzzle (animals), and your toddler comes up wanting to play. If you want to focus on expressive language, the right approach will be to use single words such as “bear!�, “chicken!�, and “dog!.� Now assume that you want to target the child’s cognitive ability. In this case, you might say “Do you see the dog? Where’s the dog?� Or, “Where does the chicken go? Does it go here?� Notice how different the language is? See how much more complex the language is when addressing knowledge of animals and where to put the puzzle pieces? Notice how simple it is when modeling words that the child can imitate?
The chapters that follow will provide more specific information about these techniques. The chapters are divided into parts, with each part addressing a specific set of issues. The parts are ordered with respect to the level of intervention that each entails, beginning with the simplest and easiest to implement, and gradually increasing in complexity and difficulty. The parts are also ordered with respect to the developmental level of the child, with the early chapters addressing children at the one word level, and the later chapters addressing children who are producing single words, but not yet producing phrases.
