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Speech vs. Communication Devices


What should the speech therapist be doing to help my 2 ½-year-old daughter start talking? My daughter has been seeing a speech therapist since birth. We would like to know if the therapist is doing the best that she can for my daughter. My daughter can say “mamama” and “nanana”. My daughter can vocalize and she also stares at your mouth when you talk to her. The therapist wants to use a communication device but we want her to speak instead. What are your suggestions?

Answer of our experts

In response to your question, I am wondering if your daughter is using “mamamam” and “nananan” as names for specific people or does she say these utterances somewhat randomly and in response to various kinds of situations. If she is using these utterances only for specific people or items, this is a good sign that she will develop other words. If not, I would recommend the caregivers use, or continue to use, parallel talk and self talk. Parallel talk is using short sentences to describe what the child is doing, and self-talk to describes what the parent is doing. These short descriptions of behavior help to build a child’s ability to understand language

If upper-limb malformations do not limit the possibility to use sign language, then before considering a communication device, I would try sign language or gestures. All of us have used gestures and signs before we were able to talk and research shows that these nonverbal behaviors facilitate oral communication. Please know that I am not suggesting that your daughter only be taught sign language. I am suggesting that these forms of communication be incorporated with attempts to stimulate the spoken language. Can your daughter imitate any non-speech sounds, such as a cheer or rude noises? If she is able to imitate other sounds, this is also a good sign for the development of speech

MG/TK 7-13-10

Your daughter is only 2 years and 5 months old and it sounds like she does have potential for vocal speech. I understand that she is able to vocalize "mamama” and “nanana". I would begin by trying to get these vocalizations to be meaningful such as using "mamama" for mama and "nanana" for Night/night or banana etc.

Along with working on these vocalizations I would start teaching your daughter a few signs such as: more, all done and help. These signs should always be accompanied by a verbal model of the word because the ultimate goal would be a verbal response. It is important that your daughter’s SLP have information on language development for kids with CdLS. They do develop language much later than their peers and also at a slower rate, but they do make progress with the right therapy.

It would be great if your daughter’s SLP could also incorporate oral motor exercises as part of her speech therapy, as most children with CdLS have an Apraxia component to their speech.

The use of a communication device at such a young age, in my opinion, should be discouraged at this time. It is important to find an SLP that is interested in working with you and willing to learn more about the potential of children with CdLS.

NM/TK 7-13-10

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Communication and language

When assessing communication, vision and hearing problems, speech impairments, intellectual disability, difficulties in social interaction and social anxiety should be considered. Video observations can be very useful.
Developmentally appropriate communication strategies (such as speech therapy, augmented communication input) should be implemented within the first 18 months of life.

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