The 6 C's of Communication

While living in south Florida since the beginning of the pandemic was fun, I have
FOUR grandchildren now, 3 who were born in the years I was away. This grandmother
just can't stand living 15 hours away from them anymore... so I'm going home where I
can be a part of their everyday lives. I know those of you who have grandchildren will
certainly understand, and so will those of you who are moms and dads fortunate
enough to have help from your own mother, your mother-in-law, or a grandmother
stand-in. This "LaLa" is very excited about this next season of my life!
But back to business...
Today I want to begin talking about The 6 C's of Communication which are really the
foundational pieces of early language development. It's an easy way to help parents
understand that communication is much more than talking. Here's a summary with a
direct cut and paste from one of the handouts in The Late Talker Workbook. If you
want to know 'how the book sounds' or 'what's in the book,' here's an example:

The 6 C’s of Communication

Connecting is the real reason any of us learn to talk! Talking is the natural extension
of what comes before words—Connecting. Before a child begins to use words, he
establishes a consistent connection with another person. He makes eye contact and
everything about him says he‘s listening to you and sharing that experience with you.
He looks at things you try to show him and even brings things to show you too.
Here’s why Connecting is so important… Communicating always involves at least two
people. If a child doesn‘t routinely respond and interact when you try to talk with him,
play with him, etc., he‘s not Connecting with you, and it‘s highly unlikely he‘s
learning. So, talking begins with Connecting. It‘s the essential first piece.
Conveying is often referred to as communicative intent. This means that a child
intentionally uses a gesture, facial expressions, body language, verbalization, or a word
to deliver or convey a message. A child may reach for something and look at you so
that you know they need assistance. They may approach you in frustration and pull you
to see what‘s caused their turmoil. A toddler may turn her head, snarl her nose, or hold
up her hand to reject what you‘ve offered. When a child can‘t locate an object, she may
hold her hands out as if to ask, ―Where‘d it go?‖ She has something she wants you to
know, and she uses whatever means she can to make sure you understand.
Here’s why Conveying is so important… Until a child learns to share a message with
you, there‘s no communication going on.
Comprehending another person‘s words begins to happen as a baby nears his first
birthday. This means that a child links meaning to the words he‘s hearing. There‘s
evidence that he now understands what you‘re saying because he begins to complete
what you ask him to do. In toddlers, receptive language is virtually inseparable from
cognition. Cognitive skills are how a child thinks, learns, remembers, and pays
attention. When a child struggles with cognitive development, he‘s going to have
difficulty learning to understand what words mean. Anytime a child doesn‘t understand
a word, he‘s not going to be able to use that word. One of my main catch phrases is
that a child must understand words before he begins to use words to talk.
Here’s why Comprehending is so important… Toddlers who don‘t understand very
much don‘t say very much either.
Copying means that a child imitates what he sees and hears other people do and say.
This ―watch and do‖ process is how all of us learn just about anything. We pay
attention while someone else does something and then we try it too. Language
development is no exception. Although we‘re primarily thinking about how a child
learns to copy the words you say, the process of imitating does not begin at this level.
Imitation begins very early, even in infancy, when a baby learns to copy your actions
and your sounds before they learn to copy your words. Toddlers begin to talk after they
become proficient imitators.
Here’s why Copying is so important… Children begin to talk by Copying what other
people say.
Communicating with Single Words in this list means that a child begins to use words
spontaneously and purposefully to share messages with other people. This is much
different from the previous skill of copying. Now toddlers can tell you what they want
without hearing you say the word first. Typically, first words emerge between 9 and 16
months and a child‘s vocabulary grows to between 50 and 300 words by 24 months.
There‘s a wide range of normal. The most important thing is that kids get there, even if
it‘s not until later! Late talking is very different from not talking at all.
Here’s why Communicating with Single Words is so important… Talking is the most
efficient way we communicate.
Combining Words means that children combine words to produce phrases, which
usually happens between 18 and 24 months. The most important factor in a child‘s
ability to create phrases on their own is not age, but that they have a large enough
vocabulary base. That magic number is generally recognized as 35–50 words. Before
children begin to combine words verbally, they learn to join ideas during play as well
as combine gestures or simultaneously produce gestures with a vocalization.
Here’s why Combining Words is so important… Combining is an important step for
language acquisition because we see that a child‘s language is becoming more
complex.
1.Connecting:
The first C is for Connecting, which includes how your child interacts with other
people. This first step is so important for communicating, and frankly, it‘s the ONLY
thing you should address with a child when a child is not consistently engaging with
other people.
Most of the time, difficulties interacting often lead to difficulties in learning to
communicate with both understanding and using words. When young children don‘t
regularly engage with other people, they‘re missing opportunities to learn what words
mean and then use those words to talk and communicate.
However, this is something you can address, and a child‘s parents are in the best place
to do that. I have seen children blossom right before my eyes when their parents make
connecting, not talking or anything else, the main focus for their families.
QUESTIONS FOR CONNECTING:
• Does your child smile and enjoy himself when someone plays with him?
• Will he look for you when he hears you coming?
• If you‘re not there, how does she react? Does she fuss or try to find you?
• Does your toddler consistently respond to his or her own name?
• Do you hear him attempt to respond to your questions, even without words?
• When you talk, does your child actively listen to you by looking at you?
• Is she regularly ―checked out‖ or does she appear to be uninterested in other people?
• Do you think your child seems to ignore language?
• Does he prefer objects or things like TV or apps on a tablet or phone over people?
• Is she unresponsive when someone talks to her?
• Does she interact fine with you but avoids, ignores, or ―blows off‖ others?
• When you play a little game with her like Peek-a-boo or Patty Cake, does she try to
keep it going by doing something to let you know she wants to play again?
• Does your child take turns with you when you‘re both playing with toys?
• Can your child use any hand motions with you during songs or anything else that‘s
―their part‖ of a game or play routine?
• Is a child able to listen and respond to you when he‘s busy with something else?
• When you point to something, does your child look at it?
• Does she seem too occupied or distracted to listen to you or look at what you‘re
trying to show her?
• When you show a child something new, is he able to listen to you and turn his
attention to include that new thing?
• Do you seem to disappear to the child when you bring out her favorite food, a
preferred toy, or some kind of screen?
• Does the child often lock his eyes on items he wants but never looks back at you?
After reading through this list a few times, please jot down a summary of your
thoughts and answers. Does your child consistently connect with other people? Are
there any weaknesses or concerns about your child‘s ability to connect? Do you notice
other ways a child is connecting that may not be so obvious?
In our neuro-divergent kids, we should carefully look for other signs of connecting. Do
they demonstrate an understanding of the words you're using, even if you're not seeing
eye contact or taking turns? Do they "light up" for the things they love? Will they do
something that lets you know, Hey, I'm with you here, even when you're not seeing
obvious signs of connecting?
More about Connecting…
Children who connect with other people may or may not make eye contact, but you
know they're "with" you. They smile during interactions, alert to their own names, and
respond, even without words, when someone is talking with them. Late talkers who
connect with others take their turn during a conversation by using facial expressions,
gestures, and even some sounds, before they begin to use words. They listen and look
at you when you try to show or tell them something, and even when they don't, there's
evidence they've heard what you've said.
Therapists often refer to Connecting skills as reciprocity and joint attention.
Reciprocity is the back-and-forth flow during interactions between two people. Joint
attention is when a child understands that you both are looking at and talking about the
same thing. The child can shift his attention between you and the object as you talk
about it. Both of you understand that you are looking at and talking about the same
thing.
Both reciprocity and joint attention are integral to learning to understand what words
mean and then beginning to talk. When a child does not include another person during
sustained interactions, then he is likely not able to link meaning to the words he‘s
hearing other people say, and consequently, he won‘t be able to use those words either.
Sometimes parents characterize children who don‘t respond to others with descriptions
of personality traits such as shyness, being a loner, or keeping to themselves. They
may say, ―She really likes to do her own thing.‖ Or they may say, ―He has always been
such a good baby. He barely makes a peep and never wants to bother anyone.‖ These
kinds of statements always leave me with knots in my stomach. Typically, toddlers are
social, even demanding. They want adults to notice them and cater to their every
whim. When we don‘t hear that a child wants to be with his mother or another primary
caretaker almost constantly, it is a concern.
Connecting with other people is essential for language development. Honestly,
Connecting is so critical for overall development that I believe it should be the top
priority for every parent and all therapists and teachers, regardless of their field or
title!
Some toddlers connect with their parents, siblings, and other close family members or
friends but avoid and tune out people they don‘t know as well. While shyness is
common in young children, a consistent pattern of ignoring and avoiding interaction
with others is not. When a child has lots of difficulty interacting with people outside
their inner circle, you‘ll need to begin noticing the other ways a child may be
connecting and find ways to strengthen those skills.

The bottom line for Connecting is this:

Relationships and fun, loving connections are the foundation for learning to talk
and communicate.
2. Conveying:
Conveying is the second C, and professionals may refer to this as communicative
intent. This means that a child intentionally uses a gesture, facial expression, body
language, verbalization, or a word to deliver or convey a message. A child may reach
for something and look at you so that you know they need assistance. They may
approach you in frustration and pull you over to see what‘s caused their turmoil. A
toddler may turn her head, snarl her nose, or hold up her hand to reject what you‘ve
offered. When a child can‘t locate an object, she may hold her hands out as if to ask,
―Where‘d it go?‖ She has something she wants you to know, and she uses whatever
means she can to make sure you understand.
Just to be clear, communicative intent can also be unintentional. When a newborn
cries, it‘s reflexive. Her tummy might hurt, she could be sleepy, or she may be
hungry—or pick any of the other twenty-five different reasons why a baby cries. Even
though her parents won‘t know the exact cause until they‘ve investigated, her cry has
let them know that something is wrong and she needs their assistance. As a newborn,
she didn‘t turn on the tears purposefully. That won‘t happen for another few months,
but her parents respond to the cry as they interpret her message, Please pay attention to
me right now! Learning to deliberately convey a message is a big part of learning to
talk.
QUESTIONS FOR CONVEYING
• Does a child intentionally use any facial expressions or body language to convey
messages to you?
• Will she reach for or point to objects she wants and then look at you for assistance?
• When you ask your child a familiar question like ―Do you want some milk?‖ will
your child shake his/her head for ―yes‖ or ―no‖?
• Do you hear your child make any purposeful noises like grunting or squealing to get
your attention?
• Does your child have a ―code‖ for things he wants? For example, do you know that
every time he uses a low grumble, he wants to go outside and play with his dump
trucks and tractors? Does he act out things for you so that you‘ll know what he needs?
• Has your child learned any simple sign language to communicate with you? Does she
use those signs on her own or do you have to cue her?
• Does your child try to tell you, even without words, when something is wrong, or do
you have to figure it out for yourself?
• How often does your child approach you or other adults for assistance?
• Can a toddler use any sounds or words to tell you what they want?
• Is she persistent in getting you to understand her messages?
After reading through this list a few times, please jot down a summary of your
thoughts and answers. Does your child consistently convey messages to other people,
even without words? Are there any weaknesses or concerns about your child‘s ability
to convey?
If Conveying is something you should strengthen with a child, begin to fill in your
ideas in your Weekly Planning form for Plan C on page 184. Remember that you‘ll be
planning specific times to work on helping your child learn to convey messages.
More about Conveying…
Children who convey their own messages find a way to make their wishes known,
even without words. It may be with very intentional body language or their little faces
so that you can read their expressions. It may be with gestures like pointing or ―gimme
fingers‖ to direct your behavior to do something for them. They can show you things,
even if they can‘t tell you things yet. A late talker may already be using purposeful
sounds and noises to get and keep your attention. Certainly, when a child begins to use
first words deliberately, they‘ve learned to convey!
If after reading this you realize that your child needs help to work on Conveying,
please check out the plan in The Late Talker Workbook. It will help you work on this
first foundational C and get language moving in your little one! In the manual, I
explain 3 distinct approaches for late talkers all with step-by-step instructions for
therapy... with plans A, B, and C.
Plan A is All About Talking and is a fantastic method for FAST results for toddlers
with primarily expressive language delays. Use strategies and a game plan based on the
Vault method, during therapy sessions at home or in a clinical settings. Read step-by-
step instructions for selecting target words and planning for one-on-one therapy
sessions using structured "sit down" therapy activities. This method teaches you all
you need to know to do evidence-based direct therapy sessions with toddlers.
Plan B is Building Language at Home with 11 of the best strategies to teach parents to
use to build language at home in every day activities like bath time, meals/snacks,
changing time, playing with toys, and during household chores. Plan B is a parent
education plan so that you can walk parents through what research and decades of
working with families and toddlers tells us really works to help late talkers learn to
talk. Plan B is a fantastic "package" for teaching strategies not only to parents, but to
new therapists, our colleagues in other fields, and teachers... all in one place with
questions for helping guide your coaching sessions with parents. If you're struggling to
know how to pull together your coaching scripts, this is a wonderful method with
simple questions to ask parents during your sessions followed by lots of practical ideas
to help them implement strategies during their every day routines at home.
Plan C or The 6 C's of Communication (which we're discussing in this email) teaches
the foundational pieces of early language development with loads of questions and
recommendations to guide parents and therapists in developing your plan for a child.
This method is a condensed version of looking at pre-linguistic skills through teaching
early words and combining words to phrases and useful for therapists and very
committed parents. It's also the "back up plan" when Plans A and B are not as
successful with a child. It covers all the bases of working with toddlers who may have
more challenges learning to communicate.

3. Comprehending:
Comprehending means that a child assigns meaning to the words he hears regularly.
Examples of early receptive language skills include identifying familiar people and
objects, consistently responding to their own name, pointing to body parts and familiar
pictures in favorite books on request, and most importantly, following routine
commands like ―Come here‖ and ―Sit down.‖ Routine commands also include tasks
such as, ―Put your arm in,‖ during dressing, ―Open your mouth,‖ as you feed them or
brush their teeth, along with requests to retrieve items, such as, ―Go get your ____.‖
These commands, and assessing a child‘s response to them, are a good place to begin
when determining a child‘s ability to understand what he hears.
Toddlers with typically developing language skills, and many late talkers, understand
much more than they can say. That‘s why lots of people miss it when a toddler doesn‘t
understand very many words. We expect young children to pick up language and begin
to learn what words mean as we go about our everyday routines.
Therapists refer to comprehension as receptive language skills. If we were dividing
language into two big categories, receptive language would be the input piece and
expressive language, or talking, would be the output piece. Sometimes I explain the
connection between receptive and expressive language to parents by saying, ―You‘ve
got to have good input before you get good output.‖ That‘s what this whole section is
about…making sure a child receives good input.
Here‘s the reason receptive language is so important:
When there are receptive language delays, we can expect expressive language delays
too. This is not a real word, but I tell parents that late ―comprehenders‖ are always late
talkers.
I don‘t want to alarm you, but I‘d be seriously neglecting my responsibility if I didn‘t
tell you that receptive language delays are much more serious than a delay in
expressive language only.
Like most other problems in life, the earlier we address it, the better our outcome will
be. When we don‘t, even a mild receptive language delay can spiral out of control so
that it will be extremely difficult, if not impossible, for a child to catch up. For this
reason, and for the best possible trajectory for that child, we must identify and treat
receptive language issues early, even before we would think about talking. Here‘s how
I describe it to parents:
If a 1½-year-old isn‘t following very familiar commands, it‘s a real concern. This issue
is more significant when a child is over the age of 2 and does not consistently complete
simple requests. When a child reaches the age of 3 and doesn‘t follow directions, there
is unquestionably a serious language and/or developmental disorder.
If the late talker you‘re working with does not consistently respond to verbal
directions, helping him improve his ability to comprehend words should be one of your
top priorities.
The bottom line for Comprehending is this:

 Late talkers must understand words before they use them to

communicate.
 Even a mild delay in a child’s ability to understand and process language
can result in a cascade of other developmental issues including late talking.

Now I know what some of you are thinking... what about presuming competence?
That's a real buzz phrase in our field. Many SLPs are now not working on receptive
language at all.
Respectfully, I disagree with that position.
I think ignoring receptive language can be dangerous for toddlers with language
delays. Over the years, I've seen so many soooo many EI therapists completely miss
receptive language delays and focus so much on talking that the child never makes any
real progress in either area.
While this may be a controversial position in this day and age, this is what I believe in
my head and in my heart after 30+ years of working with toddlers and their families.
When we ignore receptive language, it's as if a parent doesn't get the full scope of
what's happening with their child's language development. To me that's like teaching a
child multiplication when they haven't demonstrated understanding of adding and
subtracting. We're putting the cart before the horse...
If I worked mostly with preschoolers and school age children, I might have a different
opinion.
If I worked exclusively with older children with autism, I might have a different
opinion.

And if we're talking about one specific child, I certainly might have a different
opinion.
But I don't and we're not!
I work with babies and toddlers with language delays and disorders.
The truth is ALL babies and toddlers -- our population in early intervention -- are
learning what words mean. To ignore receptive language in a child who rarely
demonstrates understanding of words, concepts, and following directions is a real
disservice to a child who is not yet talking.
Even when a parent reports, he understands everything, I want to get a sense of that
myself before I completely rule out targeting language comprehension.
Let's agree to respectfully disagree if you have a different opinion : )
If after reading this you realize that your child needs to work on Comprehending,
please check out the plan in The Late Talker Workbook. It will help you work on this
third foundational C and get language moving in your little one!
More info in case you've missed it...
I can help you plan therapy for a late talker based on what works
for YOU and your priorities.
Each of the three plans in The Late Talker Workbook contains:

 A detailed discussion of the plan so you understand the main components of

using that approach with a late talker. (If you‘re a therapist, this is the
information you‘ll need to share with parents!)
 Detailed instructions for implementing the strategies with TONS of examples
so that you‘ll know ‗how to play and what to say.‘.
 Extensive lists of questions in ―workbook‖ format so that you can jot down
your answers for contemplation during planning. (If you‘re a therapist, you can
use these questions with parents during sessions to select family-driven
strategies and decide ―what comes next.‖)
 Step-by-step directions for choosing early goals (like first target words!) and
lots of activity suggestions with fantastic ideas for therapy all specifically for
 toddlers and preschoolers. If you need better "plans" for therapy, this workbook
will be a delight for you!
 Troubleshooting and what to try if things aren‘t working and you need to ―back
up.‖
 Guidance for knowing when a child needs a new approach or when it‘s best for
you to stick with the plan for a while longer.

4. COPYING:
If your late talker occasionally imitates words, you may be tempted to skip this area
and move on to the next area. Do not do that! Until a child can quickly, even
automatically, copy your words, learning to talk will be a slow, laborious, and tedious
process. We know that when a child can‘t imitate words easily, his skills are probably
weaker at an earlier level. When we go back and target those earlier levels, imitating
words will become easier. I‘ve seen this happen with many, many, many late talkers
who had a handful of words when a therapist or parent wisely ―backed up‖ and worked
on strengthening the previous levels. Once they did that, a child was able to begin
imitating words much more consistently, and finally, they began to talk on their own.
Over the next several pages, I‘ll teach you how to do that too! Be sure to add any idea
that you want to incorporate into your Weekly Plan.
Continuum for Copying
Like every skill we learn, there‘s a continuum for learning to copy what a child hears.
I‘ve written a couple of examples so that you can take a look and find the one that may
resonate with you for the late talker you‘re working with to give you some ideas for
starting points.
Example 1: When discussing imitation with a late talker’s mom during his first
meeting with his SLP, she can’t come up with any examples of when her son
copies actions or sounds. However, his therapist notes his mature play skills as he
operates a Hot Wheels race track by putting three cars in their individual lanes and
then pushing the correct button on a remote control. When the therapist marvels at his
ability, his mother says, ―Oh, he learned that from his brother.‖ Slowly, the mother
begins to smile as she realizes, yes, my child understands how to imitate!
Focus for Therapy: Since this child understands how to imitate complex actions,
move on to helping him learn to imitate sounds. Since he demonstrated interest and
advanced proficiency in operating that Hot Wheels race track, model vehicle noises
and exclamatory words as you play with the race track as you entice him to copy you.
As you play, excitedly copy any play sounds the race track makes and see if the late
talker will join in. Listen for any sounds (or words!) he says or imitates during play.
Many times, parents of late talkers underestimate their ability to use these kinds of
early "words" and a child may already be using a few of them. So instead of starting
with "real" words, try play sounds with the car like "Vroom!" or "Wow!" or "Whee!"
or "Beep beep!" This is a wonderful starting point for therapy for many late talkers.
Example 2: A late talker’s mom reported that her little girl likes music and is
trying to copy hand motions for her favorite songs like ―If You‘re Happy and You
Know It‖ and ―The Wheels on the Bus.‖ Her mom knows music should be a good way
to help her child develop speech, but she‘s not sure how to proceed.
Focus for Therapy: That should be music to our ears! Anytime a child is interested in
music and trying to copy hand motions, we know they are primed to learn to copy and
imitate. Begin with a child‘s favorite songs to ―meet them where they are‖ and get
success going right away. Add a new motion or verse with a new round of hand
motions to an existing song if you can. Move on to new songs with new hand motions.
If a child has difficulty, select songs with similar hand movements. For example, you
clap in ―Patty Cake‖ and ―If You‘re Happy and You Know It," as well as at the end of
songs. Remember that repetition is the key to teaching songs and motions. Kids have to
hear it over and over before they are able to join in with the motions or words.
Anytime a child is learning words to songs, go ahead and introduce verbal routines.
Songs are just that—verbal routines. By learning words to a song, a child is practically
telling you, ―If there‘s a pattern, I can learn it!‖ So, get repetitive and help a child
develop some verbal routines. I‘ll list several ideas to get you started in the next
section.

Example 3: A therapist begins seeing a child for therapy and quickly identifies
that he repeats a few holistic phrases he’s picked up from his favorite YouTube
videos. She tells his parents that since he ―obviously knows how to talk,‖ they should
have him request items before giving in. She begins therapy by having him request
items before she will give him a toy. This results in frequent crying throughout the
session, which upsets the child and his mother, but the therapist encourages Mom and
Dad to continue since they know this child can talk. After several weeks, she gets a
phone call from the service coordinator telling her the family has requested another
therapist.
Focus for Therapy: Although it might seem like this child is ready to copy the
therapist‘s words since he can say a few phrases, something is missing. This child is
likely a gestalt language processor and may need to learn more holistic phrases or
gestalts as you play together, rather than focusing on using single words to make
requests.
Another way to approach treatment with a child like this is to use the imitation
hierarchy to determine the lowest level where a child begins to have difficulty
imitating. Strengthen that area first, moving up the levels so that the child begins to
copy all kinds of things—from actions with toys, to hand motions in songs, to play
sounds, to words in verbal routines—easily and consistently before you solely focus on
Copying words. Look at these levels and examples again in the next section.
To summarize...
Until a child learns to easily and effortlessly copy what you say, he's not going to
learn to talk.

5. Communicating with Single Words:

Communicating with Words, My guess is that you already realize how important
talking is, but I‘ll reiterate it here. Talking is the easiest, most efficient way to
communicate with other people, and I know that‘s what you want for your late talker.

In case no one has reminded you of this, most late-talking children do learn to talk,
including those who have a medical diagnosis that predisposes them to communication
delays such as Down syndrome or cerebral palsy, a developmental diagnosis like
autism, a speech-language diagnosis like apraxia, and especially plain ole‘ late talkers.
That is a very positive reality that I want you to hold onto throughout this process.
However, no child learns to talk until they establish the foundational pieces. No matter
what you hear from the neighbor down the street or the cashier at the grocery store or
even your pediatrician, children don‘t just wake up one day and talk. They all go
through predictable stages, even when their language development is delayed or
atypical.
The broad stages are just what you‘ve learned in this manual…Connecting,
Conveying, and Comprehending, Copying, and finally, Communicating with Words,
and then Combining Words. These overall skills are the ones that will determine if and,
to a lesser degree, when a child will begin to talk. Nothing else.
As we‘re discussing a child‘s ability to communicate with words, we must make sure
we‘ve set the stage for success by shoring up any weakness in the first 4 C‘s we‘ve
reviewed. I know you‘re doing that (or are on your way to doing that!) by your
commitment to get this far in this therapy manual!
There are a few special circumstances about communicating with words that warrant
additional discussion, so let‘s talk about those now.
Listen carefully for early word attempts.
Occasionally when I meet a new child and their family, I identify word attempts that a
parent misses. For those families, I focus on helping parents recognize when their child
is trying to talk. Most of the time, this happens when a child‘s speech sound system is
significantly delayed or disordered and his vocalizations are highly unintelligible. A
child may be missing many or most sounds in the word or substituting sounds to the
degree that his parents haven‘t discerned any recognizable patterns, especially when a
child is not trying to immediately imitate the word.

One little girl I worked with like this years ago had only vowels and they weren‘t even
close to what she should have used. No wonder her parents had a hard time deciding if
she was really talking, but she was trying from time to time, and those sweet little first
attempts needed to be reinforced. If you think this might be the case for your child,
follow the specific recommendations coming up for you in the Practical Strategies
section.
Increase the frequency of the words a child already uses before you teach new
words.
When we discussed communicating with words in the introduction, I focused on
vocabulary size because that‘s the most common way that we begin to separate
children who need further assistance in learning to talk from those who don‘t.
Vocabulary size matters, but maybe not as much as you think for a late talker.
Frequency, or how often a child says the words she can, is a much better gauge, in my
opinion. A child who uses only 10 different words but says each of them 10+ different
times all day long is much different than a child who says 10 different words once or
twice each over the course of a whole week!
For some late talkers, I don‘t focus on teaching them any new words at the beginning
of therapy. Instead, we target how often and how appropriately (meaning in context)
they use their words. If your child says only a few words, but you don‘t hear them very
often, you should focus on increasing the frequency of those words before trying to
teach new words. Do that for a couple of weeks to try to solidify those words. Your
child will be in a much better position to move forward, and I bet you‘ll begin to
breathe a sigh of relief when you hear his or her first words more often.

Combining Words:

Moving to phrases is a significant milestone in expressive language development, but

some parents, and even some therapists, rush this process before a toddler is ready.
Listed below are things that usually come first before a child is developmentally ready
to combine words on his own so that you can read through the list to quickly gauge if a
child meets these criteria. If not, you have your next goal or list of goals. We‘ll discuss
the details following the list to be sure you know why each of these
prerequisites is important for phrase production. Instead of waiting for the strategies in
the next section, I‘ll go ahead and list them here so you can look at the problem and
your solution at the same time.

Before a child can combine words on his own, he or she usually needs to:
• Possess a large core vocabulary of at least 35–50 words.
• Understand and use words from a variety of categories including nouns, verbs,
prepositions, modifiers/descriptive words.
• Sequence two syllables.
• Include a variety of syllable shapes.
• Imitate two-word phrases.

Practical Ways to Strengthen Combining

Always try to model phrases using words from a child’s existing vocabulary.

Don‘t include new words when you‘re trying to help a toddler learn to use phrases.
Choose high-frequency words (words a child hears and says all the time) along with
words a child can already pronounce (words that are easily understood). Model those
combinations and encourage a child to imitate and then use them himself.
This is a little more difficult when a child‘s vocabulary is mostly nouns, but it can be
done. Immediately, you may think about possession as in ―Mommy(‘s) brush,‖ but
most of the time, toddlers‘ two-word phrases represent many ideas as they can‘t
include all the words just yet. Let‘s take the example we just used with ―Mommy
brush.‖ A child may mean, ―That‘s Mommy‘s brush,‖ or ―Mommy, brush my hair,‖ ―I
want Mommy‘s brush‖ or any other meaning you may imply.

Practice expansion.

When a child says a single word, add a relevant word, then model the new phrase for a
child to imitate. For example, when a child says, ―Go!‖ say, ―Go car!‖ If she says,
―Book,‖ say, ―Read book.‖ If you want more information about expansion, it‘s
included as the 11th strategy in Plan B. Take a look at that section for more ideas to
implement in everyday routines.

Introduce anchor words.

Pick a high-frequency word a child says easily and then combine it with words she can
already say. This will be easier for a child since she‘ll only need to change one word of
the phrase. This strategy works well for mass practice, meaning an activity set up for a
child to produce the same kind of target many times. For example, if you‘re cleaning
up toys, you could use ―Bye‖ as your anchor word and cue a new phrase each time you
toss a toy into the basket, such as, ―Bye car, bye truck, bye boat, bye plane, bye choo-
choo, etc.‖

Try holistic phrases.

Sometimes late talkers can imitate or ―pop out‖ a holistic phrase and then it becomes
part of their core vocabulary. Gestalt language learners who have used jargon seem
especially prone to imitating these kinds of phrases first, too. Good ones to try are:

I did it I got it There it is Here you go See ya No way

I do it Right there Right here That one This one Aw man!