Speech Therapy for Toddlers: Enhancing Communication Skills Through Play
Amanda Unrau Speech-Language Pathologist
July 26, 2023
What is Speech Therapy | Milestones | Signs and Symptoms | Causes of Speech Issues | Techniques and Activities | Tips | Parental Involvement | Language-Rich Environment at Home | Using Forbrain | Expectations in Speech Therapy Sessions | FAQs
As your child grows, they are constantly learning new skills in different areas of development, one of the main areas being communication. Young children learn how to pronounce sounds, produce words and sentences, listen to and understand others, make requests, ask and answer questions, interpret facial expressions and gestures, and so much more. If you have concerns about your child’s ability to do these things, speech therapy for toddlers can help.
The development of speech and language skills impact a toddler’s learning and development in all other areas, including working memory, cognition, literacy, focus and attention, and social and emotional skills. Therefore it is important that toddlers receive support in the form of toddler speech therapy if they exhibit a delay in their communication skills. Targeted early intervention can greatly improve a toddler’s overall development. Identifying normal communication development as well as warning signs helps you know when to seek assistance for your toddler’s speech and language skills.
What is Speech Therapy for Toddlers
Toddler speech therapy assesses and treats specific speech and language disorders. The goals and objectives of speech therapy for toddlers may include:
- Improving their receptive language skills (their ability to understand language)
- Improving their expressive language skills (their ability to use language)
- Increasing their vocabulary
- Improving their social communication skills
- Improving their production of specific speech sounds
- Reducing the use of filler words
Speech and Language Milestones in Toddlers
While each child develops at his/her own rate, there are speech and language milestones that most children reach within a specific age range:
By 12 months:
- Understands words for familiar people and items
- Begins to respond to simple words and requests (e.g., “no,” “come here,” “more?”)
- Uses gestures and vocalizations to gain attention
- Babbles long strings of sounds (e.g., bababa, mimi)
- Imitates different speech sounds
- Says one or two words, but may not be clear
By 2 years:
- Follows one-step directions
- Responds to simple questions (e.g., “Where’s your hat?” “Who is that?”)
- Points to named body parts or pictures in a book
- Says many new words
- Uses /p, b, m, h, w/ sounds
- Begins naming pictures in books
- Asks simple questions (e.g., “What’s that?” “Where’s daddy?”)
- Combines 2 words (e.g., “more banana,” “no sleep,” “daddy hat”)
By 3 years:
- Follows two-step directions
- Understands new words quickly and uses a word to represent almost everything
- Uses /k, g, f, t, d, n/ sounds
- Are understood by familiar listeners
- Combines 3 words
If your child does not exhibit the above milestones by their corresponding ages, consider consulting a speech therapist.
Does My Child Need Speech Therapy? Signs and Symptoms
If you have concerns, but aren’t sure if your child is exhibiting speech or language delays, there are some signs you can watch for. When you meet with a speech therapist, they will ask you about your concerns, so these are things to make note of.
A child who needs speech therapy may exhibit several of these signs:
- By 12 months:
- Not babbling
- Not interacting with others (smiling and playing)
- Not using gestures such as waving or pointing
- Making only a few sounds
- By 18 months:
- Not understanding what others say
- Saying only a few words or no words
- By 2 years:
- Using less than 50 words
- Not combining 2 words
- Difficulty understanding what others say
- Errors in production of the following sounds: /p, b, m, h, w/
- By 3 years:
- Difficulty interacting with peers
- Errors in production of the following sounds: /k, g, f, t, d, n/
Keep in mind that exhibiting any of these signs does not automatically indicate that your child has a speech or language disorder. Please seek out a professional speech therapist for a consultation and/or evaluation.
When to Start Speech Therapy for a Toddler
If your child is exhibiting any of the above signs, or if you have other concerns, don’t wait. It is better to seek help early than wait and see what happens. Seek out a licensed speech language pathologist to have your child evaluated.
Causes of Speech Language Issues
Speech and language disorders in toddlers can have various causes. Children with medical, genetic, or developmental conditions often have speech or language disorders. Examples of these conditions include:
- Autism
- Down syndrome
- Cerebral palsy
- Traumatic Brain Injury
- Hearing loss
- Childhood apraxia of speech
- Cleft palate
If your child has been diagnosed with any of these conditions, the medical professional involved will often recommend speech therapy services.
It can also be helpful to consider whether you as the parent or another of your child’s relatives stutters or received speech therapy services in the past. Children with a family history of speech or language disorders are also at higher risk of having a communication disorder.
Toddler Speech Therapy Techniques and Activities
The best way to facilitate toddler speech therapy sessions is through the use of interactive and play-based activities. Speech therapists will use a variety of exercises during their sessions that parents can continue to use at home. Examples of these activities include the following:
Reading Picture Books
This activity targets a variety of speech and language goals. While reading, parents can ask questions about the story and the pictures, point to and label specific items, and pause while reading familiar books to allow your child to complete the sentence. These tasks can help improve vocabulary, comprehension, and grammar.
Blowing Bubbles
Pair this task with words or simple phrases, such as “bubble,” “blow,” “more bubble.” After multiple models, stop and wait, encouraging your child to use the word or complete the phrase in order to request more bubbles.
Playing with Toys
Playing with toys such as farm toys, cars, and trains. Incorporate sounds of the vehicles and animals: “beep beep, choo choo, moo, baa, etc.” You can also introduce phrases such as “Ready, set, go!” After multiple models, stop after saying “ready, set…” to encourage your child to complete the phrase.
Singing Nursery Rhymes and Songs with Actions
Music and movement are great for language and literacy development. Focus on one or two songs at a time so your child can learn them and participate with you.
Incorporating Sign Language
Demonstrating and teaching simple signs, such as “more,” “please,” and “all done” give your child a way to communicate before they can speak verbally. Responding to their attempts to use these signs shows toddlers that words have meaning and they can use them to get what they want or need. It is never too early to introduce sign language!
Narrating Daily Tasks
You can start doing this the day your baby is born. Talk through what you or your child are doing. For example, if you take your child to the grocery story, you can tell them what you are going to do there: “First, let’s get a grocery cart. You can sit inside and I’ll push. What do we need to buy? Let’s check our list. Let’s start in the produce section and get some bananas. Your favorite! Mommy also needs broccoli for dinner. Once we find everything we need, we have to pay up front and carry our food to the car. You are a great helper!”
Modeling Age-Appropriate Language
Your child learns language from those around him. You can help your toddler by using simple words, phrases, and sentences with correct sentence structure. You can also expand on what your child says. If they use one word, add another word or two to make it a complete phrase or sentence. When your toddler labels a toy (”ball”) or asks for food (”apple”), respond by saying “blue ball” or “more apple.”
Placing Desired Items Out of Reach
Placing highly desired items out of reach to model and practice requesting. If your child has access to everything he or she wants or needs, they will have less of a need to communicate. If they are unable to access certain items, they will need to ask for them. To avoid frustration, begin with modeling the request (”I want ball” or “Ball please”) and then give them the item with no expectations. After multiple repetitions, encourage them to imitate the request by waiting to give them the item until they ask. This helps your child understand that his or her communication has meaning!
Tips on How to Choose a Speech Therapist for Your Toddler
There are several methods you can use to find a speech therapist for your child:
- Bring up your concerns to your child’s pediatrician or family doctor. Your child’s doctor has a list of recommended providers and can refer you to a local speech therapist.
- Check with your health insurance. They may have a list of in-network providers.
- Look for a speech therapist that is certified by ASHA, the American Speech-Language-Hearing Association. ASHA has a searchable online directory of providers.
- Seek out recommendations. Check with teachers or school staff. Ask friends or family members whose children have received speech therapy.
- A good therapist will be skilled and qualified. Therapists need to hold a state and national license and keep up to date with new research. They adhere to a code of ethics and are willing to try new methods and materials in order to help your child succeed.
- Search by specialization. Many therapists specialize in a certain area, such as articulation disorders, language disorders, fluency disorders, Childhood Apraxia of Speech, autism, etc. Look for a speech therapist that has experience in your child’s area of need.
Collaborating with Speech Therapists and Parental Involvement
It is essential for the speech therapist and parents or caregivers to collaborate in order to achieve successful outcomes in toddler speech therapy. Formal speech therapy sessions are short, so collaboration is important. Usually, the speech therapist will include you in planning the goals for your child and expect your input. Here are some things you need to be involved in:
- Communicating what your child currently can and cannot do, what skills they struggle with, when they become frustrated, what you would like them to be able to do, etc.
- Parent coaching or training should be a component of each speech therapy session. This occurs after the clinician models a technique or works on a skill with your child. They will then explain how you can recreate a similar activity or target the same skill at home.
- Ask questions. Use the parent training as a time to ask questions and learn how to support your toddler’s speech and language development at home.
- You will receive regular progress updates on how your child is doing. This is often given in both written form and face-to-face.
- If you have specific concerns or if your child presents differently at home, record your child at home and share the video or audio with the speech therapist to show how your toddler behaves at home and how practice is going.
Creating a Language-Rich Environment at Home
If your toddler has delayed speech and language skills, do not leave everything up to the professional. Ask your child’s speech therapist how you can set up a supportive environment at home. Here are some ideas to get you started:
Respond to Your Child’s Facial Expressions, Gestures, and Words
Repeat what they say and make faces back to them. If your child smiles or laughs, mirror them by smiling or laughing back to show that you share their joy. Expand their utterances by adding on to what they say. If your child says, “Daddy go,” you can expand on that by saying “Yes, daddy goes to work.”
Talk to Your Child
Narrate mealtime, bath time, and other daily routines. Tell them what you will do and who they are going to see. Speak clearly and model good speech.
Read a Lot
Keep books in sight and within reach. Read to your child daily, pointing out specific items and asking them questions about the pictures.
Learn New Words Together
Introduce new words to expand their vocabulary. Name items and use specific details to describe the items.
The Benefits of Using Forbrain in Speech Therapy
Forbrain is an auditory stimulation headset. This is a complementary tool that can be used at home to support formal speech therapy. Forbrain uses bone conduction technology to improve auditory processing. This can in turn improve several components of speech and communication in toddlers, including sound discrimination, voice quality, toddler stuttering, and early literacy skills.
What Should I Expect in a Speech Therapy Session for Toddlers
Depending on the services available in your area, your child’s speech therapy session may take place at home, in a school, at a clinic, or via telepractice. You will be an essential part of each session. Since you are your child’s primary caregiver and spend the most time with your child, you have the potential to make the biggest impact on their communication skills.
Each speech session typically includes treatment, practice or coaching, and homework discussion components. Toddlers learn through play and everyday activities. A toddler speech therapy session is play-based. After the speech therapist reviews your child’s speech and language goals with you, they will use toys and fun age-appropriate activities to target those goals. The provider will also model and teach you how to practice the same skills with your child at home and give you activities to work on.
FAQs About Speech Therapy for Toddlers
How do speech therapists help toddlers talk?
Speech therapists begin with evaluating toddlers to determine their needs. They then use the information from this assessment to plan therapy activities that build on their strengths while addressing their weaknesses. Areas of delay are targeted through play activities to elicit the child’s expressive language, practice specific speech sounds, or work on improving comprehension. Providing age appropriate models and repetition of activities leads to improvement of communication skills in toddlers over time.
How effective is speech therapy for toddlers?
The most effective speech therapy outcome is achieved when children are young. Their brains are ready to learn and pick up new information, and potential bad habits have likely not been engrained yet. Most skills can be taught and acquired through play, so they won’t even know they are working hard!
How do I help my 2-year-old with speech therapy?
Since your toddler will have limited time with the speech therapist, your support is crucial to their success. Ask your child’s speech therapist what you can do at home in between sessions. Talk to your child throughout the day, respond to them, discuss new words, and read to them daily!
How to evaluate a 1-year-old for speech therapy?
During your toddler’s evaluation, the speech therapist will complete a thorough and comprehensive evaluation. This usually includes an interview with you where they will ask about your toddler’s medical history, your concerns, and your goals for your child. The speech therapist may conduct an oral-motor examination in which they look inside your child’s mouth to determine whether the structures needed for speech are functioning correctly. The therapist will also engage your child in a variety of play activities in order to assess their communication skills in a natural context. They may also administer a formal speech or language evaluation if your child is able to participate. The speech therapist will use all of this information to make recommendations on if speech therapy is needed and how often.
Final Words
Early intervention in speech therapy can have a positive impact on the lifelong development of your child. As parents, it is important to seek help from a professional speech therapist at a young age if you have any concerns about your toddler’s communication skills.
References
ASHA. “Activities to Encourage Speech and Language Development.” ASHA, Accessed 18 June 2023. https://www.asha.org/public/speech/development/activities-to-encourage-speech-and-language-development/
ASHA. “Early Identification of Speech, Language, and Hearing Disorders.” ASHA, Accessed 18 June 2023. https://www.asha.org/public/early-identification-of-speech-language-and-hearing-disorders/
ASHA. “How Does Your Child Hear and Talk?” ASHA, Accessed 19 June 2023. https://www.asha.org/public/speech/development/chart/
ASHA. “Speech Sound Disorders.” ASHA, Accessed 18 June 2023. https://www.asha.org/public/speech/disorders/Speech-Sound-Disorders/#:~:text=Your child may have speech problems if he,damage%2C like cerebral palsy or a head injury.
ForBrain. “Discover the Science Powering ForBrain.” ForBrain, Accessed 19 June 2023. https://dev.forbrain.com/how-it-works/
Amanda Unrau
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