Speech Therapy Tips for Minimally Verbal Preschoolers
How do I get my child to talk? What can I do at home to help my child communicate what they want and need? If my child isn’t talking, is there anything I can do?
These are some initial questions that I hear when I first see a minimally verbal child for a speech and language evaluation. Although it is important for intervention (speech therapy) to be tailored to the individual child, there are some intervention techniques that are helpful for all children.
How do I get my child to talk? What can I do at home to help my child communicate what they want and need? If my child isn’t talking, is there anything I can do?
These are some initial questions that I hear when I first see a minimally verbal child for a speech and language evaluation. Although it is important for intervention (speech therapy) to be tailored to the individual child, there are some intervention techniques that are helpful for all children. Some experts (Fish, 2016; Velleman, 2003) suggest intervention for young children include the following (modified from article by Megan Overby, PhD, CCC-SLP original article Sharon Gretz, M. Ed.):
Learning to imitate gross motor skills
Large motor movements (such as clapping, hands up to be picked up)
Actions with objects (banging two blocks together)
Imitating vocal play (i.e. raspberries, tongue clicks)
Imitating oral-facial movements (i.e.,puffing cheeks out, blowing kisses)
Vocalizing visible early sounds such as /m/, /b/, or /d/ (e.g., /mmmm/, “muh” or “buh”)
Vocalizing to get attention (e.g., “uh” and pointing to a cookie)
Sound effects: animal noises (e.g., “grr” for a tiger, vehicle sounds)
As children start using more of the above and begin to use more sounds imitatively and spontaneously, focus can include more functional vocalizations:
Words with distinctive pitch patterns (e.g., “uh-oh,” “wow,” “whee,” “yay”)
Words with strong emotional meaning (“no”, “up”)
Vocalizations that can be paired with actions (e.g., “whee” as a car goes down a track, “hi,” with a wave and “oops” when an object falls)
Sound effect words (e.g., “woof’, “beep,” etc.). There are great books that use sound effects (see Blog post, 13 Tips for Choosing Books for Preschoolers)
Verbal routines and singing (e.g., songs like “5 Little Monkeys Jumping on the Bed,” favorite predictable books like “Brown Bear Brown Bear What Do you See”) : (see Blog post, 13 Tips for Choosing Books for Preschoolers)
Words with very early consonants and simple syllable shapes (e.g., “hi,” “me”, “mama”, “oh no”)
Some helpful speech therapy tips:
Use sounds already in the child’s repertoire to build simple productions (e.g., if a child has /p/, can they learn to say “pop” “up,” or an approximation of those words)
Hold toys or objects of interest near the speaker’s mouth to direct the child’s attention to mouth movements during imitation tasks.
Use movement during practice (push a car down a track to work on “wheee” or build a tower and place block on top and practice “up” then “uhoh” when they fall down.
Make it fun and incorporate play with stuffies or whatever the child is interested in to elicit speech and language (i.e. let your child see you “hiding” toys in the room and have them find them)
Books and music are extremely helpful to facilitate skills.
Keep in mind, once a child begins to use sounds, it is more important to expand their sound and syllable repertoire than to have them accurately produce the sounds ( that will come later!)
The more repetitions you can get the better! Using target vocalizations in play is not only fun for the child, but also encourages the most engagement and in turn increased repetitions.
The primary goals for children who are exhibiting minimal communication skills are (modified from Davis and Velleman, 2000):
Help the child establish a consistent form of communication. This could include sign language, pointing to pictures, using approximations of words, pointing to what a child wants, gestures and facial expressions (or a combination of these!). It is important that the child and the people in their environment agree what a gesture, sound, picture, or word approximation represents or means.
Using alternative communication such as sign language, gestures, or pictures can help move a child toward verbal communication by relieving frustration and establishing a consistent, reliable means of communication (Fish, 2016).
Once my child/student starts vocalizing, where do I go from there?
A hierarchy is suggested for working on production of syllable shapes for children with Childhood Apraxia of Speech (modified from Fish, 2016 and Velleman, 2003) but can also be applied to minimally verbal children. I have include the initial steps in this hierarchy:
CV (Consonant plus a vowel) (“me”)
VC (vowel plus a consonant “up”)
Reduplicated CV.CV (“bye-bye” or “no-no”)
CV.CV with a vowel change (“mommy”, “nehnuh”)
Variegated CV.CV (“bunny”)
CVC (“pop”)
CVC with different consonants (“top”)
These are techniques and suggestions that speech language pathologists use in therapy and caregivers can use at home to elicit some speech and language skills. If you are concerned about your child’s speech and/or language development, it is recommended that you contact a speech-language pathologist through your local county or early intervention or preschool program to have a thorough communication evaluation to determine if speech therapy is required.