How to Teach Speech Delayed Children

hi this is Ming here from agentsofspeech.com today we'll talk about how to teach child who is speech delayed from probably zero all the way to speaking and able to go to Primary School elementary school whatever you call it so in this video it's going to be little longer because want to cover as much as can at any time if you want to skip ahead but it's better that you listen to all the nuances all right don't see lot of videos on YouTube that tell parents from like nothing to something and something that's actionable so first of all people talk about language levels and how old your child is or whatever I'll tell you there's spectrum of therapy training think there's conception about how this therapy is very rigid like ABA it sucks whatever it's traumatizing or whatnot and there's like all the way over here that's like floor time is the best it's very naturalistic or Montessori is the best type of teaching or whatever so whatever vehicle that you are taking your child on for in terms of therapy is that doesn't matter because all of these therapies have spectrum of how naturalistic and how structured it is and to illustrate this naturalistic just means how much of the thing is the child's idea and the lead and who's taking the lead so naturalistic is more child-led whereas over here it's structure task is more clinician or parent-led all right so why does that matter because if it's always us giving the orders that's not very naturalistic in the world yeah and when we do lot of naturalistic approaches the the goals cannot be as clear and as fast and as quickly implemented to impact child's development right so there's it's like it's like dilemma but it's not zero to one it's always spectrum and it's always someone who's someone who's doing therapy like myself or you at home you're always swinging for different goals you're doing different things right it's not set in stone all right and there's no one size that fits all so we talked about this little bit deeper now so in general in turn there's three right number one is like the naturalistic approach over here in the middle is something what we call melee or don't know how to really pronounce it so sorry if I'm butchering it and also structured tasks all right so for every type of therapy and it's speech therapy ABA we will do these ones these and any of these right we will set them down to do structure tasks we will tell them to do some commands we will tell them to do go through some flash cards right at the same time we also do lot of naturalistic things that we follow child's lead We Roll on the floor with them we play on the Seesaw with them whatever and we play with toys and we look at what the child likes or don't like and provide language models or whatever right and then the middle is that creating some sort of opportunity in the ABA Community they call it communication Temptation right communication temptation is when you tempt the child to say something or in the speech therapy world you call it creating language intent right creating opportunities for child to actually want to communicate with you right so it doesn't matter so in the middle is where you have all those advice about putting something on top of somebody child cannot reach and create communication opportunity so to speak right lock things up or whatever those are kind of more more milieu or Malu don't know which one to be very honest with you obviously it's not English right anyways so in this spectrum at agents of speech when we teach parents to do any type of training in the beginning we always lean towards structure task why do we do that isn't that not nice well the thing is the parent yourself you need the structure because if we give you and tell you to do naturalistic approaches that's actually the hardest type of therapy to do out there right even for if let's say we're training up junior therapist who just started work doing naturalistic approach is very hard I've been through that it's very very difficult you know like you're trying to play with kid whilst not trying to get them angry whilst you're trying to push your own agenda at the same time think about how to play with toy that's you know like car that you can only roll and you have to think of like 10 Ways to Think to play with it without imposing or superimposing onto the child's wants and needs or whatever that's hard right I'm not even going to sugarcoat it it's some of the hard stuff and when you see seasoned therapy I'm not even that good myself when you see someone who is able to do naturalistic approach whilst doing assessment while giving therapy and right and also like write down on data and stuff that's crazy not lot of people can do it in this world right so when we are teaching parents and we teach something such naturalistic approach which needs someone to be so clear-headed being able to play with children right have the communication goals or whatever goal you have in mind yeah and also be one upping your child's interests and making it fun for them so lot of times when you see Miss Rachel right on YouTube which we'll talk about probably in the video very soon is that the way it actually talks to Children is on the naturalistic approach side and you can also use it all the way in the structured tasks right and it's just way of communicating with children okay so naturalistic approaches are great but you cannot always use it because if you always use it you won't see results and you'll give up and can tell you this because have data to back it up most of the parents in the beginning when tried to teach no matter inside the clinic or online right if try to teach some naturalistic approach only parents are going to give up and you know say dude don't even know what's going on especially Asians right they're like I'm just playing with the kid what's going on I'm not teaching anything and this is where cultural differences come in right cultural differences is that more Asian people Asian Earth people like myself parents who are resigning in this part of the world who have this kind of culture they tend to lean toward structure task and they don't care so much about naturalistic approaches or meeting the child in the middle okay so have to understand all therapy training All Therapy has spectrum it goes from here to here and it depends on the child's mood it depends on the child's capabilities their language level right now their behavior so on and so forth these are all things that we have to be careful about all right after that want to talk about the general rule of thumb of providing therapy for children in terms of their ages right so below two is where you want to learn lot more like parent training instead of bringing your child to therapy center of which your child has like attention span of like five minutes and they sit for five minutes and then they walk off and then they roll around and that's that's your 30 minutes and that's your you know don't know how much money it is for 30 minutes or how you won't even get public service at below two for sure this must be eat private So Below two if you're trying to learn something at home or with the therapist or whatever it must be parent training as number one because you can provide if you know how to communicate with with children well then it doesn't matter how you do things it doesn't matter what goal you have because if you communicate in way that is effective with kid and the children actually like speaking to you it's just matter of time until the child actually likes and learns the things you're trying to like teach them all right the second thing is you need to do lot more naturalistic approaches so anything that is like floor time related or you know learning how to play learning how to talk some something from the Hannon program is very good and the problem with like telling you to look at Hannon program what not is that these things you require someone to look after you when you're doing it someone needs to give you feedback someone needs to like listen in and look at what you're doing and give you direct feedback about where you're losing the kid where you're saying too many words where is that you are putting too much pressure on the kid and so on and so forth that's why parent training is very important all true of child's from what we call preschool right from two to six years old okay so that's below two if you go to two to three years old you still need lot of parent training and lot of naturalistic approaches right by the same time you're starting to do some Milo stuff right meaning that you are sabotaging the environment not sabotaging but like kind of creating an environment where the child has to talk to you okay lot of times when you see us work on agents of speech is that we put things in containers right we we create situations where the child is supposed to find the next thing the next don't know next puzzle next body part of Mr Potato Head you know we removed the dice remove something and it creates communication need that the child has to talk to you in order to get what they want and so at two to three years old is where it's okay for you to start trying this kind of methods to try and tell your child that there's means to an end to communication is that if they do something whether if it's like imitating something you know doing gesture looking at you you know just rolling over getting closer to you that will allow the child to get what they want quicker all right that's communication in the very beginning which we'll talk about later on as well all right so if your child is over three years old it's more on the structured task because then the child has lot more attention span to sit down and we can teach boom boom boom and sitting we go we go really quickly in short span of time structurally so that we can teach as much as possible so that they can catch up right we also need lot of milio in the inside as well so this milio is more about like establishing play routines sequential play right of which we talked about lot in this channel so you can go check it out don't want to repeat myself and then you still need naturalistic approaches of which it's not only just to like follow your child's lead anymore but in everyday situations you think about how to communicate effectively with your kid right think about how to do activity together where you're taking you're let allowing the child to to take the lead but at the same time provide lot of language models when your child is doing it so example for if your child likes to make sandwich with you or coffee with you or is that he likes to wait for your term when you guys are brushing teeth those are also very good opportunities to provide lot of language models right when say language models and naturalistic approaches you're not supposed to ask your child for any language back because naturalistic approach is more of giving you're always giving and the language boom boom boom over there over here keep on talking narrating everything and stuff but you also need milio and structure tasks so that you're actually asking for that language back and making sure that your child understands okay so other than that you still need parent training it's lot easier if your child is over three years old because then it's actually okay for you to ask for more help because now you can it's actually worth your money to put your child inside of therapy center and you know like you're getting your money's worth whereas lot of times if your child is below two they're just rolling around like and doing nothing and the therapist cannot like push them because if they do push the kid the kid goes into bad mood and then it ruins everything and you need to start all over again all right so now let's after we talked about like the ages now let's talk about the language levels think we talked about this before in previous YouTube videos where I'll summarize it here all right so first of all what do you do with non-verbal children the most important thing when you're dealing with nonverbal children from my perspective when I'm teaching parents and I'm doing my therapy on my own is establishing verbal imitation that's the most important thing for me the reason why I'll tell you why right is because if don't do verbal imitation would not know whether this whole thing is only language related or is it speech related so if don't have verbal imitation down cannot go on or you cannot go down the rabbit hole of assessing whether this is there's speech disorder component to this and we have to address it right which means there might be like some sounds that the child cannot produce or whatever and we just saw one of the parents in our poaching program for non-verbal children is that after we got the kid to start imitating words we found out she doesn't have any of the consonants that's why she wasn't speaking that much right and the reason was she wasn't very good at making sounds in the very beginning and she knows it so that's why it's important for me to establish verbal imitation first okay there are other therapists like I'm not saying anyone is wrong as long as it's working for you and it's basically like verbal imitation is also one of the pre-linguistic skills that you should Target anyways but what happens lot is like parents get sidetracked and think about need to teach joint attention need to do like eye contact or whatever need to do matching would do whatever but all these things they don't matter as much because it doesn't give you plan of action so to speak so what you got to do now is to say think about how you can teach verbal imitation to non-verbal children so you can think about why there was non-verbal situation in the very first place okay that's number one second of all is the play skills so if you're not targeting play skills then that's going to be problem down the line if you don't have enough context to communicate with your kid and it's always it's always to do with using Rewards or trying to bribe or trying to like that's how you get stuck with like want sentences later on and that's because you don't have enough play contexts to Target more language down the line so you have to build it up during the non-verbal phase and your your target shouldn't be to get your child to talk is to get your child to play that's it okay so then when after your child gets through non-verbal phase and then we go on to like one two three word phrase level right so we kind of like teach play routine right and we also teach lot more play skills so why do we do this is because most of the time from our case right children who cannot do we're combining to make sentences or phrases is because they don't have enough vocab and this is where parents will say no my kid knows like 150 words they know like all the planet names animals or whatever but the problem is this can you put two planet names together and make sentence you cannot right what do you need you need different word classes meaning you need places you need adjectives and you need verbs the most important thing of all all right and if you look at how we linguists I'm not linguist but if you see how linguists will like break down the structure of sentence the huge truck is called verb phrase and that's because the verb creates or like kind of embeds the whole not embed that's the wrong word the verb leads charge of all the words that come in sentence and stand corrected to any linguist here you can say whatever that you need to to educate me but I'm just saying if you don't have verbs you cannot glue words together man it's just impossible what are you gonna say bunch of nouns in one go that's impossible so that's why in the one two three word phrase level we teach lot more play and we try to teach verbs while whilst we're doing the play and we're like we're very targeted at those action words all right and that's what what has been working for us because then those words actually mean something instead of It's Always want whatever or like give me whatever which what we call Carrier phrase which is not cool mean do lot more play skills so that we can expand later on all right we will and we do teach with flash cars and stuff for sentence production what we call and speech therapy so for instance if they learn that in play then maybe we can do it in 2d and it'll be faster right so as was telling you naturalistic approach is always slow because you're always waiting for the kid to kind of respond to whatever you're trying to give in naturalistic way but structured way is always the fastest because just it's direct order whereas the milio is where all the playing is that's even structured plays kind of immediately right you're trying to play and then you try to take the language out once the child understands the context right so one from like one to three word level we will do flash cards and like pictures and whatnot just so that we can accelerate the process once the child gets enough verbs and understands how to put words together and we can do it in structure test boom boom boom and do it quickly right and you must be thinking then then when do we do naturalistic well the thing is once you establish skills and structure tasks and then right in the middle for milu and then you try to bring it across to the naturalistic plane where you're doing something together naturalistically and you provide these at the same language models of what you were teaching in the structured task and that would make sense for the kid to start generalizing those words to real life okay and the next one we'll talk about is sentence level so sentence level is where the kid is most probably little mature and they're able to speak in sentences and therefore you can bargain with them little bit and tell them what they're supposed to do and at this level we don't play around we give them bunch of teaching materials that are 2D like flash cards pictures don't know you know even on the iPad to save time because we want to get to the problem at sentence level we want to give as much practice as we can so there's lot of times the 2D materials are cards that are sequencing cards that for instance is like boy puts on shoe the boy ties shoelace the boy goes out of the door whatever ever so if you don't know what it is just search on Google sequencing cards speech therapy and you'll see bunch right okay so other than sequencing at the sentence level we start to the milieu for this is that we don't just do toys we do board games the reason why is because there are specific sentences and different structures like if then because whatever that we can Target and teach them to use and at the same time we want to also teach some game rules so that they can do some verbal reasoning and we can ask them why questions okay so that's sentence level and how do we do naturalistic approach with sentence level well it's very easy you try to speak with again with the sentences that you have taught in the in the structured task and that milieu right and you bring it every day and you keep on repeating it to them when you're playing around with them doing chores or whatever you say it to them and repeat and give language models that's it okay at story level is which children are starting to form multi utterances so another rinse is just in one breath how much they can say right they go like this is an orange cat like the one you saw that was going back and forth that's one utterance and then the next utterance would be he was walking around that was another utterance and the next utterance would be he was disturbing my YouTube video right that's the last audience so there's multi utterance and once we get here of which we've been doing already in the sentence level with like sequencing cards or sequencing activities or sequential play or explaining game rules and board games and whatnot at story level we try to make it as as long as possible so then we have something called story elements which to be honest I'm not 100 very comfortable with with teaching and stuff because I'm also learning how to teach this at this moment in time all right to parents that's why mean can do it myself with children can teach story elements to children but teaching story elements to parents is still something that I'm not 100 comfortable with because I'm still thinking about how to do things so you have teaching stories to how stories are elements in the story won't go into it you can do Google search inferencing is something that we do and that's for instance if you see picture and you have to do higher language level kind of explanation about something right so for instance if you see that the ice cream was on the floor right you asked what happened and the chart has the inference someone dropped it but it wasn't explicitly stated in the picture right and how did he notice because there was bite in the ice cream right and then the ice cream fell on the floor and it melted that's about it okay so you have the inference from non-literal things and this is where lot of children on the Spectrum have lot of difficulty because they can only see things that are literal right and we also do lot more higher language targets so for instance we do stuff like synonyms right antonyms or whatever and we also do like word definition and those are high level language targets that I'm not going to talk about right now and slowly as I'm teaching parents how to do this and asking for help from other therapists to teach parents how to do this at home once am comfortable with way of like how teach non-verbal to like one to three word phrase level things to parents then I'll talk about it but right now I'm not at this moment of this video I'm not that comfortable with talking about it right now we're still working out with our our coaching clients and once we do have something and know how to say it in way that will make you understand then we'll talk about it all right so thank you for this for listening to this whole video and if you haven't please go to agentsofspeech.com checklist to grab list of tools and toys that we recommend you getting okay the tools and toys will now reside inside of our online community so once you sign in with your email what's going to happen is that you'll get access to somewhat of private Facebook group and you can see all the resources there alright thank you so much hope to see you very soon inside of that community and I'll see you in the next week on another video bye