Mary Lynn Taschereau-Park, B.A., B.Ed., CDA
Communicative Disorders Assistant
CHEO Connects!
February 6, 2012
Agenda
Participants will familiarize themselves with:
• Speech and Language milestones for children between the
ages of 0 and 5 years
• How to refer children to First Words, the Preschool Speech and
Language Program in Ottawa
• Strategies to use in daily activities and routines in order to
promote speech and language development
About First Words…
 Funded by Ministry of Children and Youth Services
 PSL in Ottawa
 Lead agency: Pinecrest-Queensway Community
Health Center
 Partners: CHEO, OCTC, City of Ottawa, AndrewFleck, IHP, BLV
 committed to raising awareness
 0 to 5 – eligibility to SK
Children’s early learning experiences have a
profound effect on their development. These
early interactions directly affect the way connections
are made in the brain. Early learning
experiences are crucial to the future well-being of
children, and establish the foundation
for the acquisition of knowledge and skills that will
affect later learning and behaviour.
The Kindergarten Program, 2006
Ministry of Education of Ontario
Communication … the foundation !
• Language is the greatest predictor of a child’s
success later in school / in life
• Communication development may be the best
indicator of a developmental delay
(Wetherby & Prizant, 1996).
Why We Do What We Do....
So children can grow up to be successful
adults!
Prevalence of speech and language
disorders in preschool children
Approximately 10% of all preschool children have a
speech and language disorder in the absence of a
sensory, cognitive and/or neurological
impairment:


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language disorders (60%)
articulation and phonology disorders (20% – 25%)
fluency disorders (5% to 15%)
voice disorders (1%)
Many of these children first present as
LATE TALKING TODDLERS.
Early Identification & intervention:
it happens BEFORE 30 months!
The developmental “scoop” :
Earlier is better!
• Early experiences and early environment are responsible for
brain development ("use it or lose it" principle) (Carnegie Task Force on
Meeting the Needs of Young Children, 1994; Ounce of Prevention Fund, 1996).
• Ages 0 to 3 provides the greatest window of opportunity to affect
neurological and behavioral growth and impact (Rossetti, 2001)
• Direct correlation – the more stimulation:
= +++connection between parent & child
= +++ more brain development
(Early Years studies – Dr. Fraser Mustard)
Early Experiences, identification and
intervention make a difference
• Early ID and intervention may
– provide better and faster outcomes for the child (early
experience affect brain structure, “use it or lose it”
principle),
– prevent a cumulative delay,
– prevent or decrease the severity of language delays in
preschoolers,
– enhance school readiness,
– and increase later academic success in school.
SETTING THE PATH
EARLY FOR LANGUAGE…
Know the milestones
Language : risk factors or not?
•
•
•
•
•
Hearing Loss
Family history
Medical conditions
Weak muscles
Lack of stimulation
Risk factors
•
•
•
•
Tongue-tied
Laziness
Birth order
Being a twin (except if
there were prenatal or
post-natal risk factors)
• Learning two
languages
Not a cause
WHY and HOW children communicate
Just a few of the reasons why…..
• To connect socially
• To get attention
• To request an object
or action
• To copy you
• To tell something
• To show feelings
• To get information
And how!.....
NON-VERBAL
• Eye gaze/signal
• Giving
• Showing
• Pointing
• Pulling
• Pantomime
VOCAL/VERBAL
• Noises
• Vowels
• Consonants
• Sounds for words
• 1 or 2 words (total)
• Many single words
• Joins 2 words
• Links 3 or more words
together
First Words
Communication Development Quick Reference Chart
Page 1
RECEPTIVE
LANGUAGE
6 months
Watches your face
as you talk
Understands
Turns to source of
sound
Startles to loud or
sudden sounds
EXPRESSIVE
LANGUAGE
Spoken
Vocabulary
6 months
1 year
1 step directions:
“sit down”
Looks at something
you point to
Understands “no”
Responds to name
2 step directions:
“go get your book
and show it to
grandma”
Points to many
body parts on
request
3 years
WHO/WHAT/
WHERE questions
Remembers
familiar stories
4 years
3 step directions:
“get paper, draw a
picture and give it
to daddy”.
1 year
2 years
3 years
4 years
Uses 3 - 5 single
words consistently
(*20 single words
by 18 months)
Uses 100 - 150
words
Uses 500 - 2000
words
Uses 2000 + words
Grammar
Length of Utterance
2 years
1 word
Uses some
pronouns
(me/mine/you)
Uses plural, present
progressive (“truck
going down hill”)
2-4 word phrases
“truck go down”
“daddy go”
5 - 8 word
sentences
Uses adult type
grammar
Tells stories with
clear beginning/
middle and end
Complete
sentences
5 years
Follows
“If….then…” and
group directions
e.g, “If you have
green socks then
raise your hand”
5 years
Describes past,
present and future
events in detail
First Words
Communication Development Quick Reference Chart
(Page 2)
SPEECH
6 months
1 year
2 years
Speech Sounds
Imitates coughs
and few sounds
ah/eh/buh
Combines sounds
as if talking “abada
baduh a bee”
Uses a variety of
sounds such as
(p,b,m,n,d,g,w,h)
40%
50-60%
80%
100%
100%
1 year
2 years
3 years
4 years
5 years
Reaches to be
picked up
Imitates others
actions
Waves “bye”,
Shakes head “no”
Points with one
finger
Can pretend play
with toys (gives
teddy a drink)
Intelligibility of
Speech
COMMUNICATION
Gesture
6 months
Different cries for
needs
Enjoys social
games “peek a boo”
Play
Social
Starts to imitate
sounds/smiles of
others
LITERACY
6 months
Pre-Literacy Skills
Brings toys to show
others
Performs to get
attention
1 year
Shows interest in
simple picture
books
3 years
4 years
Uses almost all the
sounds of their
language with few
errors
Tells stories with
clear beginning,
middle and end
Scribbles with
crayon
Combines multi
steps in pretend
play (puts blocks in
train and drives
train to new spot to
unload blocks)
Complex
imaginative play
Enjoys being with
other children
Shows affection for
playmate
Talks to try to solve
problems with
adults and other
children
2 years
3 years
4 years
Holds book right
way up and turns
pages
5 years
Recognizes signs
and familiar logos
(e.g stop sign)
Begins to be aware
of rhyme
Matches some
letters with their
sounds (e.g., letter
“t” says “tuh”)
Increasing
independence in
friendships
5 years
Knows all letters of
the alphabet
Identifies sounds at
beginning of some
words e.g, “baby
start with ‘buh’
sound”
Typical Pattern of Speech Sound Development
p, b, h
n, w, m
t, d, ng
k, g, y
f, s, z
sh, ch, l
j, v
r, th
It is important to refer late talking toddlers…
TODDLERS
Who are either slow to say their first words
OR slow to combine words
should receive the services of a speech-language
pathologist
Language is Important
during the PRESCHOOL YEARS
• Preschoolers need to use language to regulate their
play and to interact with peers. Expressive language,
allows them to….
– protest, request and negotiate their play,
– role-play
– learn about the world around them
Language is Important for
SCHOOL READINESS & SUCCESS
• Children with a history of language impairments and/or delayed
articulation or phonology skills are AT RISK of delays in early
literacy requisites/skills.
• Children with good awareness of sounds patterns and language
patterns become better readers
• Children with poor awareness of sound and language patterns,
are at risk for delayed reading acquisition.
SUMMARY OF RED FLAGS
signs for immediate further referral
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•
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No babbling at 12 months
No gesturing (pointing, waving bye-bye) by 12 months
No single words by 16 months
No 2 word combination spontaneous
phrases by 24 months
Unintelligible speech at 3 years
Limited number of consonants at 2 years
Simplified grammar at 3 ½ years
Difficulty formulating ideas and using vocab at 4 years
Language not used communicatively
– Any loss of ANY language or social skills
– at ANY age
Act Early. Know the signs
 Studies demonstrated that early identification and
intervention can help children
 We don’t’ have to “wait and see”
 Early identification starts with knowing and looking at
the child’s language milestones and skills
Know the signs
• Use tools specific to LANGUAGE:
– First Words milestones brochures
– On-line: www.firstwords.ca – (parent portal), “HOW IS MY
CHILD DOING? “ (online screening tool)
Where to Refer: First Words
•For children (0 to SK):
•Families can attend any of the First Words Community
Screening clinics (613) 580-6744 ext. 28020
•OR
•Fax direct request to the First Words Intake office at
(613) 738-4893
For more info about First Words, families may also contact the
Ottawa Public Health Information line: (613)580-6744
What can I do?
REFER TO FIRST WORDS
EARLY
USE AND MODEL LANGUAGE
RICH STRATEGIES
USE LANGUAGE RICH
STRATEGIES ALL DAY,
EVERY DAY !
To stimulate speech and language, you
need:
Interaction
Information
Interaction strategies
 Be face-to-face
 Establish eye contact
 Observe
 Wait – to see the child’s interest
 Listen
 Follow the child’s lead
 Take a turn
Information strategies
 Talk slowly
 Short sentences
 Repeat and/or emphasize key words
 Add a gesture or symbol or visual cue
 Repeat often
 Be face-to-face
THE 4 S : What to do to make your language easy
to understand
Say Less
•
Short sentences
•
Simplify messages
Stress
•
Emphasize key words
•
Vary and exaggerate tone of voice
•
Repeat
Go Slow
•
Speak slowly
•
Use longer pauses between words
Show
•
Talk about familiar things / here-and-now
•
Use objects or point to the object
Excerpt taken from “Learning Language and Loving it” (Hanen Centre)
Songs … linking it to language
• Use nursery rhymes to let children hear the rhythm
and flow of our their language
• Sing simple songs with your child and use ‘call and
response’ activities
• Use body language in songs, stories and in everyday
activities
Join in and play
• By joining in and playing together, you create many
opportunities for the child to learn more language and
to practice talking with you.
• Pretend play is important for language development.
Model simple pretend actions (e.g., feeding, combing
hair, sleeping, dressing, washing,etc.) for the child.
Playing with your child
Instead of.....
Try to.....
Insisting that your child play with a
toy of your choice....
Watch to see what toys they child
finds interesting, then play along.
Watching the child play from the
sidelines.....
Get your own toy and copy what the
child is doing with that toy (if
appropriate)
Telling your child what to do with the
toys.......
Get a toy and show him/her how to
play with it. Model simple pretend
actions
Asking questions about their play...
Just make comments on the play
activity and what your child is doing
Feeling reserved or self-conscious
when playing with your child.....
Forget about how you look and be
playful! You are the best toy in the
house 
Games
• Focus on social people games
• Focus on interaction
• Be clear and consistent – how we start, play the
game and finish the game
BOOKS and TELLING STORIES
Through storytelling, we are activating
language and literacy!
• Children learn through experience and repetition- Reading
books offers both!
• Reading BOOKS and telling stories:
– helps children learn NEW LANGUAGE (new words and sentence
structure)
– shows how a book works (orientation, page by page, pictures give
clues to the story)
– makes them more aware of PRINT (words on a page equals spoken
language)
– helps children LEARN TO READ
READING to children fosters
a LOVE of READING in children
MAKE IT INTERACTIVE
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•
•
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Add pictures
Add a song
Add a game
Add a craft
Add an experience
Do it again
Talk throughout your day
Take home messages
• Know the signs
• Act Early and Refer
• Read, sing and play
• Talk … throughout the day, with your child.
Questions
Eastern Ontario Infant Hearing Program
Services provided to:
• newborn up to 3
months (for those not
screened at birth)
• child up to 2 years with
a hearing concern
(except for otitis media)
• or child diagnosed with
a permanent hearing
loss.
• By phone: (613) 6883979 or 1-866-432-7447
• By fax:( 613) 820-7427
• If not eligible for IHP,
child is referred to CHEO
Audiology or to
community Audiology
clinics for follow up.
Eastern Ontario Blind - Low Vision Early
Intervention Program (BLV)
–for children 0 to 6 who are diagnosed with blindness or
low vision by an ophthalmologist.
–Children of any age should be referred to CHEO
Ophthalmology or a community Ophthalmologist for
assessment and diagnosis.
–If a child is diagnosed with blindness or vision loss, the
child can be referred to BLV.
–By phone: 613-688-3979 or 1-866-432-7447.
–By fax: 613-820-7427
Contact information
• Mary Lynn Taschereau-Park
• taschereau@cheo.on.ca
• First Words Preschool Speech and Language
Program of Ottawa
• www.firstwords.ca
• First Words (613)688-3979
REFERRING CHILDREN:
WHY?
• When a child is talking very
little, others may
communicate less with that
child.
• The interaction of ‘less talk –
less input’ has long term
negative effects
WHEN?
 When a child does NOT
meet developmental
milestones
 When a child presents with
high risk indicators
 When a parent is concerned
 When there is a positive
family history of speech or
language delays