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https://www.say.org/for-parents/

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Welcome Parents

Over 70 million people stutter on a daily basis - including 5% of all children - and young people who stutter can face unimaginable fear and cruelty from a world that doesn't understand them.

Over time, children may pull back from the world, silencing themselves to hide the stutter, the embarrassment and the shame.

For Parents

As a parent of a child who stutters, you understand the impact that diminished confidence and self-esteem can have on a child, and how important it is for young people to be better equipped with the tools they need to more effectively navigate the everyday world and overcome obstacles and fears. Children who stutter can also feel isolated and alone if they do not know other young people who stutter.

We are here to give you the support you need to help your child continue to grow and succeed. In addition to this broad range of programs created especially for children and teens who stutter - we want you to access the support that you need as well.

Be sure to sign up for our emails (below) to receive SAY news & updates and programs, added support and so much more.

Download our new brochure.

Support & Education

SAY offers parent groups that meet for two hours, once per month. These groups are designed to provide parents of school-age children and teens with a broad range of education and support.

Each group meeting gives parents the opportunity to express their concerns, fears, accomplishments and goals. Groups also enable parents to network with other parents of children who stutter, to share strategies and stories, and to discuss pre-determined topics, led by a professional in the field. Past discussions have been led by luminaries such as Lee Caggiano, Dr. Heather Grossman, Dr. Scott Yaruss and accomplished adults who stutter on topics that include:

Stuttering 101

How to advocate for your child in school

Q&A with a panel of successful adults and teens who stutter

Advice from world renowned Speech-Language Pathologists with important Q&A

Every child deserves to live each day with acceptance, compassion and joy.

As a father who has raised two sons who stutter, you witness first hand the pain stuttering children endure daily. Both of our sons became involved in SAY, and the changes in their lives have been dramatic. SAY gives my boys, as well as all the other children who participate, confidence, self-empowerment, and the love of the SAY family.

Joseph
Parent

I am the proud mother of two beautiful sons who have stuttered since a young age. I know first hand all the pain, frustration, and anxiety that they endure due to their stuttering. SAY has been a godsend for Joe and Brendan, and I am grateful our family discovered this organization that has made such a profound impact on my sons' development.

Kate
Parent

I can honestly say my son Terrell did not break out of his shell until he became a part of the SAY family. SAY helps shape and mold our children for the future of tomorrow, because tomorrow, they inherit adulthood. SAY will surely live on forever; everyday they engrave their love, sincerity, and compassion onto the walls of these young souls.

Suzette
Parent

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Welcome Parents Over time, children may pull back from the world, silencing themselves to hide the stutter, the embarrassment and the shame. For Parents As a parent of a child who stutters, you understand the impact that diminished confidence and self-esteem can have on a child, and how important it is for young people to be better equipped with the tools they need to more effectively navigate the everyday world and overcome obstacles and fears.

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https://www.stutteringtherapyresources.com/pages/free-resources

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Our free Practical Tips Handouts and Videos and Practical Thoughts Blogprovide the information you need to help people who stutter. Print them, copy them, share them, pin them, and use them however you like! More information about all of these topics can be found in our books and therapy guides.

To request a tip on a specific topic, email Info@StutteringTherapyResources.com. We post new Practical Tips often. Subscribe to our newsletter and follow us on social media to be alerted when we post new content.

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Our free Practical Tips Handouts and Videos and Practical Thoughts Blog provide the information you need to help people who stutter. Print them, copy them, share them, pin them, and use them however you like! More information about all of these topics can be found in our books and therapy guides .

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https://westutter.org/families/parents/

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YOU ARE NOT ALONE!

You have a wonderful young person to guide and nourish through the child and adolescent years. The NSA is here to be a source of support, education, information for both you and your child. The NSA supports children, young adults, and parents through the myriad of challenges that you may encounter. We are here for you; you are NOT ALONE!

The NSA is Here to Help

One of the benefits of being involved in the NSA is that you and your child will be exposed both to adults and to peers who have achieved professional and academic success in spite of - and in some cases because - they are people who stutter (PWS). The NSA is comprised of PWS who demonstrate daily that living a successful, fulfilling, and happy life is the norm, not the exception, regardless of their speech. For more information and ways to get involved, contact our Family Programs Co-Chairs Kristine Short and Steve Ernst.

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Parents - National Stuttering Association

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You have a wonderful young person to guide and nourish through the child and adolescent years. The NSA is here to be a source of support, education, information for both you and your child. The NSA supports children, young adults, and parents through the myriad of challenges that you may encounter.

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What Is Stuttering?

Many young kids go through a stage between the ages of 2 and 5 when they stutter. This might make them:

repeat certain syllables, words, or phrases

prolong them

stop, making no sound for certain sounds and syllables

Stuttering is a form of dysfluency (dis-FLOO-en-see), an interruption in the flow of speech.

In many cases, stuttering goes away on its own by age 5. In some kids, it goes on for longer. Effective treatments are available to help a child overcome it.

What Causes Stuttering?

Doctors and scientists aren't completely sure why some kids stutter. But most believe that a few things contribute to it, such as a problem with the way the brain's messages interact with the muscles and body parts needed for speaking.

Many believe that stuttering may be genetic. Kids who stutter are three times more likely to have a close family member who also stutters, or did.

What Are the Signs of Stuttering?

The first signs of stuttering tend to appear when a child is about 18-24 months old. At this age, there's a burst in vocabulary and kids are starting to put words together to form sentences. To parents, the stuttering may be upsetting and frustrating, but it is natural for kids to do some stuttering at this stage. Be as patient with your child as possible.

A child may stutter for a few weeks or several months, and the stuttering may come and go. Most kids who begin stuttering before the age of 5 stop without any need for help such as speech or language therapy.

But if your child's stuttering happens a lot, gets worse, or happens along with body or facial movements, seeing a speech-language therapist around age 3 is a good idea.

Usually, stuttering lets up when kids enter elementary school and start sharpening their communication skills. A school-age child who continues to stutter is likely aware of the problem and may be embarrassed by it. Classmates and friends may draw attention to it or even tease the child.

If this happens with your child, talk to the teacher, who can address this in the classroom with the kids. The teacher also might decrease the number of stressful speaking situations for your child until speech therapy begins.

When to Get Help

If your child is 5 years old and still stuttering, talk to your doctor or a speech-language therapist. Check with a speech therapist if your child:

tries to avoid situations that require talking

changes a word for fear of stuttering

has facial or body movements along with the stuttering

repeats whole words and phrases often and consistently

repeats sounds and syllables more often

has speech that sounds very strained

Also talk to the therapist if:

you notice increased facial tension or tightness in your child's speech muscles

you notice vocal tension that causes rising pitch or loudness

you have other concerns about your child's speech

Most schools will offer testing and appropriate therapy if stuttering lasts for 6 months or more.

How Can Parents Help?

Try these steps to help your child:

Don't require your child to speak precisely or correctly at all times. Allow talking to be fun and enjoyable.

Use family meals as a conversation time. Avoid distractions such as radio or TV.

Avoid corrections or criticisms such as "slow down," "take your time," or "take a deep breath." These comments, however well-intentioned, will only make your child feel more self-conscious.

Avoid having your child speak or read aloud when uncomfortable or when the stuttering increases. Instead, during these times encourage activities that do not require a lot of talking.

Don't interrupt your child or tell him or her to start over.

Don't tell your child to think before speaking.

Provide a calm atmosphere in the home. Try to slow down the pace of family life.

Speak slowly and clearly when talking to your child or others in his or her presence.

Maintain eye contact with your child. Try not to look away or show signs of being upset.

Let your child speak for himself or herself and to finish thoughts and sentences. Pause before responding to your child's questions or comments.

Talk slowly to your child. This takes practice! Modeling a slow rate of speech will help with your child's fluency.

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Many young kids go through a stage between the ages of 2 and 5 when they stutter. This might make them: repeat certain syllables, words, or phrases prolong them stop, making no sound for certain sounds and syllables Stuttering is a form of dysfluency (dis-FLOO-en-see), an interruption in the flow of speech.

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What is articulation (pronunciation and talking)?

Articulation (pronunciation and talking) is the ability to physically move the tongue, lips, teeth and jaw to produce sequences of speech sounds, which make up words and sentences.

Why is articulation (pronunciation and talking) important?

Articulation is important to be able to produce sounds, words and sentences which are clear and can be easily understood and interpreted by others in order to be able to express basic needs and wants, right through to being able to engage in complex conversations.

Depending on the extent of the difficulties, unclear speech can impact significantly on how well a child can interact with adults and their peers and can affect the development of language and social skills. A child who is having difficulties being understood can become frustrated and angry which may lead to behavioural issues. Articulation is also important in literacy skills such as reading and spelling out of words.

What are the building blocks necessary to develop articulation (pronunciation and talking)?

Attention and concentration: Sustained effort, listening and doing activities without distraction and being able to hold that effort long enough to get the task done (e.g. being able to attend to speech and sounds long enough to be able to process the information).

Hearing: For detection of speech sounds.

Good middle ear functioning most of the time (e.g. a child with on-going ear infections, 'glue ear' or colds which block the ears may have fluctuating hearing levels which can affect speech).

Process speech sounds, identify and hear differences between sounds.

Muscle coordination: The ability to move and coordinate the muscles involved in producing sounds (e.g. diaphragm, lips, tongue, vocal cords, jaw and palate).

Understanding that sounds convey meaning.

How can you tell if my child has problem with articulation (pronunciation and talking)?

If a child has difficulties with articulation they might:

Become overly frustrated when communicating with others.

Produce speech that is difficult to understand even for familiar listeners.

Have difficulty linking together more than one or two sounds.

Tend to use only vowel sounds (very open mouthed noises).

Produce speech that is unclear alongside dribbling and messy eating skills.

Produces speech that is less clear than other children of the same age.

Produce an interdental lisp (e.g. tongue protruding between the teeth when saying a /s/ or /z/ sound) if over the ages of 3.5 - 4 years.

Be school aged and still having difficulty saying several sounds.

What other problems can occur when a child has articulation (pronunciation and talking) difficulties?

When a child has articulation difficulties, they might also have difficulties with:

Social skills: Unclear articulation can impact the ability to engage in reciprocal interaction with others (either verbally or non-verbally), to compromise with others, and be able to recognize and follow social norms.

Expressive (using) language: Using language through speech, sign or alternative forms of communication to communicate wants, needs, thoughts and ideas. The child may reduce the length of their sentences or use familiar words to help with being understood.

Self confidence: A child's belief in their ability to perform a task.

Fluency: The smoothness or flow with which sounds, syllables, words and phrases are produced when talking.

Independence: The child may be "clingy" or always want a parent/carer to be around to translate or help with their communication.

Behaviour: A child may become overly frustrated due to not being understood.

Reading and spelling which rely on sounding out the words.

What can be done to improve articulation (pronunciation and talking)?

Play: For the young child, engage in play where you model and use lots of different sounds while playing (e.g. saying "ch ch ch" as the train passes by, "baa" goes the sheep).

Talk to your child often throughout the day to model correct pronunciation of words.

Reduce background noise: Turn off background noise in the home (e.g. television, radio, music) when engaging with your child to minimise distractions.

Look at the child when they are speaking and encourage them to look at you so that they can imitate how to say words or sounds correctly.

Read to the child.

Listen and respond to the child's message (not the exact pronunciation of the words).

Repeat the child's sentences if their speech is not clear (e.g. child: "Dat my deen tar." adult: "Yes, that's your green car."). By repeating what your child has said you are producing a good language model and you are also showing that you have listened to what the child has said.

Show: Ask the child to show you what they are talking about if you don't understand what they have said. Ask for ONE repetition and try to have a guess. Don't be afraid of saying you can't understand what the child has said.

What activities can help improve articulation (pronunciation and talking)?

Naming items together when completing tasks such as looking at a book, in the car, looking outside, while playing and during shopping.

Copying facial expressions in the mirror (e.g. smiling, kissing, licking lips).

Playing something together that the child really enjoys and throughout the game model words with which they are having difficulty.

Modeling and using different sounds during interactions and in play (e.g. "s" is the snake sound, "sh" the baby is sleeping).

Listening to and identifying sounds in words (e.g. "shoe" starts with the "sh" sound).

Correcting: If a child says a word incorrectly, model the correct production back to them but there is no need to make them say it again (e.g. child: "Look at the tat". adult: "Yes, it's a cat" and then continue with the conversation). This helps to provide a subtle, positive correction by modelling the correct response rather than highlighting that the child has said it incorrectly.

Why should I seek therapy if I notice difficulties with articulation (pronunciation and talking)?

Therapeutic intervention to help a child with articulation difficulties is important to:

Improve a child's ability to produce clearer speech.

Improve a child's ability to be understood by others.

Improve a child's ability to engage positively with other children and adults.

Facilitate a child's interactions with familiar (e.g. family members, peers) and unfamiliar individuals.

Reduce frustration in a child who struggles with getting their message across.

Improve spelling and/or writing.

If left treated what can difficulties with articulation (pronunciation and talking) lead to?

When children have difficulties with articulation, they might also have difficulties with:

Forming friendships and engaging in positive social interactions with peers.

Completing higher level education tasks.

Being understood during interactions such as when meeting new people, playing with friends or talking to the teacher.

Developing literacy skills such as reading and writing.

What type of therapy is recommended for articulation (pronunciation and talking) difficulties?

If your child has difficulties with articulation, it is recommended they consult a Speech Therapist.

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Articulation (Pronunciation and Talking) - Kid Sense Child Development

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Speech Pathology helps a child with articulation to ensure they are able to express their needs and wants as well as engage in more complex conversations.

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Speech Buddies Blog: Speech, Language & Pronunciation Guides

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You've probably had this experience before: you're at a playgroup or birthday party with your child, and you're trying to converse with the other little ones there. But the kid's speech is difficult to understand, and you have to call his parent over to interpret. Or maybe you have to guess a few times before you can figure out what your own child is saying. It's perfectly normal for a young child to pronounce "room" as "woom" and "sun" as "thun." Some children master most or all sounds by five years of age, while others master articulation by the age of eight. If you believe your child might be struggling with articulation, you can request an evaluation by a speech-language pathologist (SLP). If the SLP diagnoses your child with a speech disorder or delay, speech therapy can help improve articulation. You can also use some simple, fun activities at home to encourage proper articulation.
Modeling Correct Speech
One effective method of improving articulation in your child is to model correct speech. Avoid correcting your child when he makes a mistake. Instead, repeat the words correctly. For example, your child might say, "Toy in my woom." You can say, "Yes, Billy, your toy is in your room. Will you please go to your room to get your toy so we can play?" Avoid speaking too quickly, but use a natural rhythm.

Maintaining a regular flow of conversation around your child helps him learn speech and language. For example, describe how you are making a salad or putting on your child's shoes. It is also beneficial to set aside certain blocks of time to encourage vocalization. For example, every evening at dinner, make a habit of having each person discuss what they liked best and least about their day. The convenient thing about modeling correct speech as a speech therapy technique is that it requires no equipment; you can take it anywhere. So the next time your family is enjoying a fun ecotourism vacation, remember to incorporate speech therapy into your conversations.
Speech Buddies
In addition to modeling correct speech, consider using Speech Buddies. These tools provide a target within the mouth so that your child can feel for the right way to pronounce a sound. Just a few minutes of work with Speech Buddies per day can help your child learn correct tongue placement for the sounds that he struggles with.
I Spy
Play I Spy with your child. Challenge your child to name objects around the room that contain the sounds that he's working on. For example, if he's working on the "p" sound, challenge him to find the apple or the pastry. If your child loses interest in this quickly, play a game of pretend in which you're both private investigators hunting for certain objects around the room.
Treasure Hunt
Treasure hunts are pretty similar to I Spy. Hide objects around your child's room that will prompt him to repeat target sounds. Then, give him clues as to the item's whereabouts. This is also a great opportunity to work on prepositions. Instruct your child to ask you for hints, like "Is it in my toy box? Is it on the shelf? Is it under the bed?"
Flashcard Road
Get a large poster board and draw a curvy road on it made up of two parallel lines. Segment the road into blocks and write a word on each block that contains a target sound. Play cars with your child. Each person has to say the target word as he drives the car over it.
Mother May I
Create your own version of Mother May I. Instruct your child to take a step forward every time he hears a target sound that you speak. For example, tell your child to take one step forward every time he hears you say a word with the "r" sound. As your child masters this game, make it a little harder. Tell him to take one giant step forward when he hears the "r" at the beginning of the word, and one small step forward when he hears the "r" at the middle or end of the word.

Pronunciation & Lisps Speech Therapy Techniques

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You've probably had this experience before: you're at a playgroup or birthday party with your child, and you're trying to converse with the other little ones there. But the kid's speech is difficult to understand, and you have to call his parent over to interpret.

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Articulation and phonology ( fon-ol-oji) refer to the way sound is produced. A child with an articulation disorder has problems forming speech sounds properly. A child with a phonological disorder can produce the sounds correctly, but may use them in the wrong place.

When young children are growing, they develop speech sounds in a predictable order. It is normal for young children to make speech errors as their language develops; however, children with an articulation or phonological disorder will be difficult to understand when other children their age are already speaking clearly.

A qualified speech pathologist should assess your child if there are any concerns about the quality of the sounds they make, the way they talk, or their ability to be understood.

Signs and symptoms of articulation and phonological disorders

Articulation disorders

Articulation refers to making sounds. The production of sounds involves the coordinated movements of the lips, tongue, teeth, palate (top of the mouth) and respiratory system (lungs). There are also many different nerves and muscles used for speech.

If your child has an articulation disorder, they:

have problems making sounds and forming particular speech sounds properly (e.g. they may lisp, so that s sounds like th)

may not be able to produce a particular sound (e.g. they can't make the r sound, and say 'wabbit' instead of 'rabbit').

Phonological disorders

Phonology refers to the pattern in which sounds are put together to make words.

If your child has a phonological disorder, they:

are able to make the sounds correctly, but they may use it in the wrong position in a word, or in the wrong word, e.g. a child may use the d sound instead of the g sound, and so they say 'doe' instead of 'go'

make mistakes with the particular sounds in words, e.g. they can say k in 'kite' but with certain words, will leave it out e.g. 'lie' instead of 'like'.

Phonological disorders and phonemic awareness disorders (the understanding of sounds and sound rules in words) have been linked to ongoing problems with language and literacy. It is therefore important to make sure that your child gets the most appropriate treatment.

It can be much more difficult to understand children with phonological disorders compared to children with pure articulation disorders. Children with phonological disorders often have problems with many different sounds, not just one.

When to see a doctor

If you (or anyone else in regular contact with your child, such as their teacher) have any concerns about your child's speech, ask your GP or paediatrician to arrange an assessment with a speech pathologist. You can also arrange to see a speech pathologist directly; however, the fees may be higher.

Treatment

A qualified speech pathologist should assess your child if there are any concerns about their speech. A speech pathologist can identify the cause, and plan treatment with your child and family. Treatment may include regular appointments and exercises for you to do with your child at home.

With appropriate speech therapy, many children with articulation or phonological disorders will have significant improvement in their speech.

Brain injuries

Articulation or phonological difficulties are generally not a direct result of brain injury. Children with an acquired brain injury may have different difficulties with their speech patterns. These are generally caused by dyspraxia or dysarthria. Some children with acquired brain injuries may also have difficulties with literacy and language. See our fact sheets Dysarthria and Dyspraxia.

Key points to remember

Articulation and phonology refer to the making of speech sounds.

Children with phonological disorders or phonemic awareness disorders may have ongoing problems with language and literacy.

If there are any concerns about your child's speech, ask your GP to arrange an assessment with a qualified speech pathologist.

With appropriate speech therapy, many children with articulation or phonological disorders will have a big improvement in their speech.

For more information

Developed by The Royal Children's Hospital Paediatric Rehabilitation Service and Speech Pathology department. Adapted with permission from a fact sheet from the Brain Injury Service at Westmead Children's Hospital. We acknowledge the input of RCH consumers and carers.

Reviewed July 2018.

Kids Health Info is supported by The Royal Children's Hospital Foundation. To donate, visit www.rchfoundation.org.au.

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Speech problems - articulation and phonological disorders

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Articulation and phonology ( fon-ol-oji) refer to the way sound is produced. A child with an articulation disorder has problems forming speech sounds properly. A child with a phonological disorder can produce the sounds correctly, but may use them in the wrong place. When young children are growing, they develop speech sounds in a predictable order.

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Parents often struggle thinking of creative and fun ways to keep their child engaged in articulation practice. Here are some great games that you can utilize even if your child has trouble sitting still!

If your child is getting articulation therapy in the school setting, this means they are working on specific sounds that are not coming out clear when they communicate.

If your child has difficulties with certain sounds, here are the articles that can help you with speech therapy and articulation activities ideas:

Articulation Therapy Activities with Speech Blubs

Getting help from professionals should be parents' first choice, but don't forget about Speech Blubs! Our app has games and speech activities especially designed with the help of speech therapists to get your child practicing while you're waiting to see a therapist or even between sessions!

As a private speech therapist, I always give my families handouts and worksheets that they can do at home, but those can get boring and redundant after a while. How to keep them entertained while learning? Check our list of articulation games below!

1. Fortune Tellers

These little games are also called Cootie Catchers. If you grew up in the last several decades, then you are probably familiar with the folded up version that helps you find out who your next boyfriend or girlfriend will be. Pick a number and count, then pick a color and spell it out. Open up the flap to reveal who your next crush will be. Remember them?

Remember there? Use them as your articulation game!

Fortune tellers can now be made into a simple and fun articulation game to be used with speech language clients and students. They are simple to make, and can be engaging and fun for both the Speech-Language Pathologist and the student. Plus, you already have the materials at home, so they are inexpensive and readily available.

You can create fortune tellers for practicing R, L, S, Z, SH, CH, TH, R-blends, L-blends, S-blends in each position: beginning, middle and end.

2. Flip Books

These will require a little more time, but are still a relatively simple activity to do with your kids. Flip books are easy to make and ready at a moment's notice when a Speech-Language Pathologist or parent needs an activity in a pinch. Whether you make your own or purchase one of the many options available, flip books provide a simple way for those working on providing articulation learning activities.

If you want to make your own, but don't know where to start, Amazon actually sells flip book kits that you can do with your child.

If you are artistically inclined, which I am not, feel free to draw them yourself. Make sure to put pictures with the sounds that you are targeting and that the sound is in all positions of the words. As your child progresses, you can use the same books to work on phrases, sentences and conversation so you can keep and reuse them for a while!

3. Articulation Battleship

Older students will love this articulation version of the Milton Bradley game Battle Ship. Using a template provided by Sublimespeech.com, the coordinates of the board are made up of articulation words.

Students take turns saying two words which provide coordinates for their guess. As the parent, you can create different boards for different sounds and provide those boards specific to the student's needs.

4. Articulation Bowling

Some children struggle with sitting still through an entire articulation therapy session. For these students, having a more physical game can be beneficial for learning - that's where Articulation Bowling comes in.

When a child needs more physical activity, think of more active ways to include language.

To play, you will use a set of articulation cards for the sounds being worked on that day. The cards will be set up in the formation of bowling pins. You can google articulation cards for whatever sound that your child is working on and a ton will pop right up! A plastic bowling pin will then be placed on top of each card. Once the student throws the plastic bowling ball at the pins and knocks them over, the student will then read the words on the cards for each pin that was knocked over. Check out Amazon for cheap bowling pins and use whatever ball you have at home!

This game is great because it keeps students moving and learning at the same time. In addition, because the student gets a higher score for knocking over more pins, they will then get more word practice as well.

5. Pizza Delivery

This is another great articulation game for students who need to be more physical. Pizza Delivery combines several other types of learning along with articulation. While setup for this game may take a bit more work on the front end, the tools can be laminated and incorporated over and over. If you don't have a laminator, they sell sheets online that are basically the same thing, but you won't need the machine.

Using masking tape or painters tape, develop a series of "roads" on the floor. Then create houses and street signs. Each street can be named using words with sounds the student is currently working to master. If you don't want to do that, then use different objects in your house to represent the houses and street signs.

Using a toy car, the child must "deliver" a pizza to the correct house using the directions given and pronouncing the street names as he drives on them. For complete instructions visit Notimeforflashcards.com.

The author's views are entirely his or her own and may not necessarily reflect the views of Blub Blub Inc. All content provided on this website is for informational purposes only and is not intended to be a substitute for independent professional medical judgement, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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6 Articulation Games Your Child Will Love | Speech Blubs

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Parents often struggle thinking of creative and fun ways to keep their child engaged in articulation practice. Here are some great games that you can utilize even if your child has trouble sitting still! If your child is getting articulation therapy in the school setting, this means they are working on specific sounds that are not coming out clear when they communicate.

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About the Author

About the Author

The Understood Team is made up of passionate writers, editors, and community moderators. Many of them learn and think differently, or have kids who do.

Reviewed by

Reviewed by

Sheldon H. Horowitz, EdD is senior director of learning resources and research at the National Center for Learning Disabilities.

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Trouble With Expressive Language: What You're Seeing

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The Understood Team is made up of passionate writers, editors, and community moderators. Many of them learn and think differently, or have kids who do. Sheldon H. Horowitz, EdD is senior director of learning resources and research at the National Center for Learning Disabilities.

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Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

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Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52. Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds.

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Your baby is able to communicate with you long before they speak a single word! A baby's cry, smile, and responses to you help you to understand their needs. Learn how children communicate and what to do when there are concerns about delays in development.

Milestones during the first 2 years

Children develop at different rates, but they usually are able to do certain things at certain ages. Following are general developmental milestones. Keep in mind that they are only guidelines. If you have any questions about your baby's development, ask your child's doctor-the sooner the better. Even when there are delays, early intervention can make a significant difference.

By 1 year most babies will

Look for and be able to find where a sound is coming from.

Respond to their name most of the time when you call it.

Look where you point when you say, "Look at the _________."

Babble with intonation (voice rises and falls as if they are speaking in sentences).

Take turns " talking" with you-listen and pay attention to you when you speak and then resume babbling when you stop.

Say "da-da" to dad and "ma-ma" to mom.

Say at least 1 word.

Point to items they want that are out of reach or make sounds while pointing.

Between 1 and 2 years most toddlers will

Follow simple commands, first when the adult speaks and gestures, and then later with words alone.

Get objects from another room when asked.

Point to a few body parts when asked.

Point to interesting objects or events to get you to look at them too.

Bring things to you to show you.

Point to objects so you will name them.

Name a few common objects and pictures when asked.

Enjoy pretending (for example, pretend cooking). They will use gestures and words with you or with a favorite stuffed animal or doll.

Learn about 1 new word per week between 11/2 and 2 years.

By 2 years of age most toddlers will

Point to many body parts and common objects.

Point to some pictures in books.

Follow 1-step commands without a gesture like "Put your cup on the table."

Be able to say about 50 to 100 words.

Say several 2-word phrases like "Daddy go," "Doll mine," and "All gone."

Perhaps say a few 3-word sentences like "I want juice" or "You go bye-bye."

Be understood by others (or by adults) about half of the time.

When milestones are delayed

If your child's development seems delayed or shows any of the behaviors in the following list, tell your child's doctor. Sometimes language delays occur along with these behaviors. Also, tell your child's doctor if your baby stops talking or doing things that he or she used to do.

Doesn't cuddle like other babies

Doesn't return a happy smile back to you

Doesn't seem to notice if you are in the room

Doesn't seem to notice certain noises (for example, seems to hear a car horn or a cat's meow but not when you call his or her name)

Acts as if he or she is in his or her own world

Prefers to play alone; seems to "tune others out"

Doesn't seem interested in or play with toys but likes to play with objects in the house

Has intense interest in objects young children are not usually interested in (for example, would rather carry around a flashlight or ballpoint pen than a stuffed animal or favorite blanket)

Can say the ABCs, numbers, or words to TV jingles but can't use words to ask for things he or she wants

Doesn't seem to be afraid of anything

Doesn't seem to feel pain in a typical fashion

Uses words or phrases that are unusual for the situation or repeats scripts from TV

Delays in language

Delays in language are the most common types of developmental delay. One out of 5 children will learn to talk or use words later than other children their age. Some children will also show behavioral problems because they are frustrated when they can't express what they need or want.

Simple speech delays are sometimes temporary. They may resolve on their own or with a little extra help from family. It's important to encourage your child to "talk" to you with gestures or sounds and for you to spend lots of time playing with, reading to, and talking with your infant or toddler. In some cases, your child will need more help from a trained professional, a speech and language therapist, to learn to communicate.

Sometimes delays may be a warning sign of a more serious problem that could include hearing loss, developmental delay in other areas, or even an autism spectrum disorder (ASD). Language delays in early childhood also could be a sign of a learning problem that may not be diagnosed until the school years. It's important to have your child evaluated if you are concerned about your child's language development.

What your child's doctor might do

Sometimes more information is needed about your child before your child's doctor can address your concerns. The doctor may

Ask you some questions or ask you to fill out a questionnaire.

Interact with your child in various ways to learn more about his or her development.

Order a hearing test and refer you to a speech and language therapist for testing. The therapist will evaluate your child's speech ( expressive language) and ability to understand speech and gestures ( receptive language).

Refer your child for evaluation through an early intervention program.

What to expect after the doctor's visit

If your child's doctor tells you not to worry (that your child will "catch up in time") but you are still concerned, it's OK to get a second opinion. You can ask your child's doctor for a referral to a developmental specialist or a speech and language therapist. You may also contact an early intervention program for an evaluation if your child is younger than 3 years, or your local school district if he or she is 3 or older.If what your child says ( expressive language) is the only delay, you may be given suggestions to help your child at home. Formal speech therapy may also be recommended.

If both what your child understands ( receptive language) and what he or she says are delayed and a hearing test is normal, your child will need further evaluation. This will determine whether the delays are caused by a true communication dis order, generalized developmental delays, an ASD, or another developmental problem.

When an ASD is the reason for language delays, your child will also have difficulty interacting with other people and may show some or all of the concerning behaviors listed previously. If there is concern your child might have an ASD, your child will usually be referred to a specialist or a team of specialists for evaluation and treatment of an ASD or a related disorder. The specialist(s) may then recommend speech therapy and may suggest other ways to improve social skills, behavior, and the desire to communicate.

Programs that help children and families

If your child has delays or suspected delays, your child's doctor will probably refer you to an early intervention program in your area. The staff there might do additional evaluations and reassure you that your child's development is normal or tell you that your child would benefit from some type of intervention. Your child does not need to have a diagnosis of a developmental problem to receive services through this program.

If your child is younger than 3 years, the referral may be to an early intervention program in your area. Early intervention programs are sometimes called "Part C" or "Birth to Three" programs. Early intervention is a federal- and state-funded program that helps children and their families. You may also contact the early intervention program yourself.

If your child qualifies for services, a team of specialists will work with you to develop an Individual Family Service Plan (IFSP). This plan becomes a guide for the services your child will receive until 3 years of age. It may include parent training and support, direct therapy, and special equipment. Other services may be offered if they benefit your child and family. If your child needs help after 3 years of age, the early intervention staff will transition your child to services through your local school district.

If your child is 3 years or older, the referral may be to your local public school. You may also contact the local public school directly. If your child is eligible, the school district staff will, with your input, develop an Individual Education Plan (IEP). This plan may provide some of the same services as the early intervention program but focus on school services for your child. The level of services also may be different. If your child continues to need special education and services, the IEP will be reviewed and revised from time to time.

Remember

As a parent, follow your instincts. If you continue to have concerns about your child's development, ask for a reevaluation or referral for additional formal testing.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned on this page. Web site addresses are as current as possible, but may change at any time.

More information

Is Your Toddler Communicating With You? (Copyright © 2019 American Academy of Pediatrics)

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Language Delays in Toddlers: Information for Parents

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Delays in language are the most common types of developmental delay. One in 5 children will show a developmental delay in the speech or language area.

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Are you concerned that your child might have expressive language disorder?

It can be worrying when your child's language abilities seem to be behind those of their peers. The more you learn about expressive language delay, the sooner you can take action and do what's best for your child. Understanding more about the symptoms of language delay will make facing it less scary.

In this guide, we've put together everything you need to know if you think your child has expressive language delay. Keep reading to learn what this means and what to do about it.

What is Expressive Language Delay?

Expressive language delay, or expressive language disorder, means that children have a hard time providing information using speech and other forms of communications. They might have a hard time expressing themselves with sign language, gestures, and writing, as well as speech.

Sometimes, children will be too young to write but will show their difficulties with expression in other ways.

At times, you might find that your child misses certain language milestones in the first three years of life, but is able to catch up with their peers later on. Missing some milestones isn't a surefire sign of expressive language disorder. Your child could simply be what's called a "late talker."

However, if your child keeps having trouble with expression later on, they'll likely be diagnosed with expressive language disorder.

Expressive Language Disorder Signs

When children have expressive language delay, they'll usually have a hard time correctly putting words together into sentences or phrases.

For example, they might not use the right verb tense at the right times, or they might accidentally leave important words out of a sentence. They'll often speak in much shorter sentences and phrases than other children their age do and use a smaller vocabulary.

Here's a closer look at some of the issues children with this disorder tend to have.

1. Sequencing

Children with expressive language issues will often have a hard time putting language together in the logical order. They'll have a difficult time putting events in the right order when they recount a story or struggle to correctly order the steps of an activity.

Conversations with these children are often hard to follow because of these issues. However, you can use games and activities to help your child become better at sequencing.

2. Correctly Using Adjectives

Children with this type of language delay also have a hard time using descriptors the right way. Words like adverbs and adjectives are used to make language more interesting, as well as more clear. However, children with a language delay may never use these words at all, or not use them right.

3. Grammar

Using correct grammar is another problem you'll see in children with a language delay. They might use grammatical markers wrong, or leave them out completely.

Grammatical markers are the word parts and small words that go between longer words to make sure sentences have meaning. Without grammatical markers, speech can be choppy and sentences tend to be short.

You can teach a child proper grammar to help them put together sentences that are easier to understand.

4. Social Skills

Many children with expressive language disorder also have issues with social skills, sometimes called pragmatics. They might not know how to use language to properly interact with other kids.

5. Asking Questions and Giving Answers

It takes a lot of language skill to ask questions and give appropriate answers.

First, comprehension is needed to understand the meaning of the question. Then, the child has to put together the appropriate answer to the question. Last, they have to say the answer out loud.

Children with language delay issues usually have a hard time throughout this process.

6. Vocabulary

Limited vocabularies can make it hard for children with a language delay to say what they want to say. They'll probably need more assistance to learn new words than other children will, and they might have a difficult time remembering the words they need.

7. Figurative Language

Children with an expressive language delay struggle to understand figurative sayings, such as metaphors, similes, and idioms.

8. Inferences

These children usually have a hard time drawing inferences from the things they see around them, or from what they read.

9. Mutism

Many children with a language delay will refuse to speak in some settings. Selective mutism refers to when a child has the ability to speak, but won't do it in settings such as at school or in public. They will still speak in some situations, such as when they're at home.

Selective mutism can be treated. However, the treatment for selective mutism differs greatly from other types of treatment for language delay and speech issues.

What Causes Expressive Language Delay?

In most cases, it's not really clear what the cause of these language delays is.

Some children only struggle with their language development, and progress normally in all other areas. Others have other developmental issues, such as autism, Down syndrome, or hearing issues.

Expressive language disorder often goes alongside receptive language disorder, which means they have a hard time understanding language, in addition to using it.

Sometimes, expressive language issues start at birth, as a developmental issue. Other times, the impairment is acquired later in life, after some normal development has already occurred. Trauma can cause expressive language issues, such as a blow to the head. Medical issues can also cause expressive language delays.

Sometimes, expressive language disorder seems to span across family members or generations, indicating that these delays can sometimes be genetic.

What To Do Next?

If you think your child has expressive language disorder, based on the above symptoms, you should take them to a speech pathologist or speech therapist for a diagnosis. You should also make an appointment with an audiologist to test their hearing.

You don't need a doctor's referral to make these appointments. A speech pathologist will conduct assessments to figure out the types of language use that are hard for your child. These assessments are fast and easy and will help you know how to move forward.

One of the best solutions for treatment is online speech therapy that you can easily do at home.

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Child With Expressive Language Disorder? - Great Speech

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Are you concerned that your child might have expressive language disorder? It can be worrying when your child's language abilities seem to be behind those of their peers. The more you learn about expressive language delay, the sooner you can take action and do what's best for your child.

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What is expressive language disorder?

Children with expressive language disorder have difficulty conveying or expressing information in speech, writing, sign language or gesture. (For preschool children, the difficulty expressing themselves in writing is not evident, as they have not started formal education.)

Some children are late in reaching typical language milestones in the first three years, but eventually catch up to their peers. These children are commonly referred to as 'late-talkers'. Children who continue to have difficulty with verbal expression may be diagnosed with expressive language disorder or another language impairment.

Symptoms of expressive language disorder

Children with expressive language disorder have difficulties combining words to form accurate phrases and sentences. For example, a child may not use the correct form of the verb tense (they might say 'I goed' when they mean 'I went') or they might omit important grammatical words (they might say 'I going' when they mean 'I am going').

They typically produce much shorter phrases and sentences than other children of the same age, and their vocabulary (the number of words they know and use) is smaller and more basic.

Children with expressive language disorder are usually below the average level for their age in:

putting words and sentences together to express thoughts and ideas

recalling words

using language appropriately in a variety of settings with different people (for example, at home, in school, with parents and teachers).

Specific examples of expressive language impairment include:

a seven-year-old child being unable to join sentences with words like 'and', 'but' or 'if' (such as 'I went to the movies. I had popcorn' instead of 'I went to the movies and had popcorn' which is a more mature form of expression

a three-year-old child who speaks in two-word phrases only (such as 'mummy car' when they mean 'That's mummy's car.').

Symptoms of expressive language disorder differ from one child to the next and depend on the child's age and the degree of the impairment. Common symptoms include:

making grammatical errors, leaving out words and using poor or incomplete sentence structure (for example, 'He going work' instead of 'He's going to work' and 'I talk' instead of 'I can talk').

using noticeably fewer words and sentences than children of a similar age

using shorter, simpler sentence construction than children of a similar age

having a limited and more basic vocabulary than children of a similar age

frequently having trouble finding the right word

using non-specific vocabulary such as 'this' or 'thing'

using the wrong words in sentences or confusing meaning in sentences

relying on standard phrases and limited content in speech

sounding hesitant when attempting to converse

repeating (or 'echoing') a speaker's words

being unable to come to the point, or talking 'in circles'

having problems with retelling a story or relaying information in an organised or cohesive way

being unable to start or hold a conversation

not observing general rules of communicating with others

having difficulty with oral and written work, and school assignments.

Treatment for expressive language disorder

Treatment options depend on the severity of the impairment. Treatment may include:

group sessions with a speech pathologist

individual therapy sessions with a speech pathologist

school-based language intervention programs

assistance from special education teachers

teacher's aide support for children with severe language impairment

speech pathology sessions combined with home programs that parents can use with their child.

Cause of expressive language disorder

For many children, the cause of expressive language disorder is not known. Some children experience difficulties in language development alone, while other areas of their development are progressing as expected. For other children, expressive language disorder is associated with known developmental difficulties or impairments (for example, Down syndrome, autism or hearing loss).

Many children with expressive language disorder will have an accompanying 'receptive' language disorder, meaning that they have difficulty in understanding language.

Expressive language disorder can be a developmental impairment (from birth) or an acquired impairment (occurs after a period of normal development). It can be the result of trauma (such as a knock to the head) or a medical condition. Research suggests that, in some cases, expressive language disorder occurs in more than one family member, and across generations.

Diagnosis of expressive language disorder

If your child is having difficulties with speaking or using language to express themself, it is important to:

have their language skills assessed by a speech pathologist (sometimes referred to as a speech therapist)

have their hearing tested by an audiologist

as soon as possible.

(You do not need a referral from your doctor to make an appointment with a speech pathologist or audiologist, although you can ask for one if you prefer.)

Speech pathologists perform specific assessments to identify the areas of language that a child finds difficult. These assessments are not stressful for the child, and parents are usually present during these consultations.

Speech pathologists may also recommend:

an auditory processing test (this is different to a standard hearing test)

a test for learning difficulties (for school-aged children)

an assessment of cognitive function (thinking and intelligence) by a registered psychologist.

Where to get help

Content Partner

This page has been produced in consultation with and approved by: La Trobe University - School of Allied Health - Speech Pathology

Page content currently being reviewed.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

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Children with expressive language disorder have difficulty conveying or expressing information in speech, writing, sign language or gesture. (For preschool children, the difficulty expressing themselves in writing is not evident, as they have not started formal education.) Some children are late in reaching typical language milestones in the first three years, but eventually catch up to their peers.

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How do speech and language develop?

The first 3 years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills. These skills develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.

There appear to be critical periods for speech and language development in infants and young children when the brain is best able to absorb language. If these critical periods are allowed to pass without exposure to language, it will be more difficult to learn.

What are the milestones for speech and language development?

The first signs of communication occur when an infant learns that a cry will bring food, comfort, and companionship. Newborns also begin to recognize important sounds in their environment, such as the voice of their mother or primary caretaker. As they grow, babies begin to sort out the speech sounds that compose the words of their language. By 6 months of age, most babies recognize the basic sounds of their native language.

Children vary in their development of speech and language skills. However, they follow a natural progression or timetable for mastering the skills of language. A checklist of milestones for the normal development of speech and language skills in children from birth to 5 years of age is included below. These milestones help doctors and other health professionals determine if a child is on track or if he or she may need extra help. Sometimes a delay may be caused by hearing loss, while other times it may be due to a speech or language disorder.

What is the difference between a speech disorder and a language disorder?

Children who have trouble understanding what others say (receptive language) or difficulty sharing their thoughts (expressive language) may have a language disorder. Developmental language disorder (DLD) is a language disorder that delays the mastery of language skills. Some children with DLD may not begin to talk until their third or fourth year.

Children who have trouble producing speech sounds correctly or who hesitate or stutter when talking may have a speech disorder. Apraxia of speech is a speech disorder that makes it difficult to put sounds and syllables together in the correct order to form words.

What should I do if my child's speech or language appears to be delayed?

Talk to your child's doctor if you have any concerns. Your doctor may refer you to a speech-language pathologist, who is a health professional trained to evaluate and treat people with speech or language disorders. The speech-language pathologist will talk to you about your child's communication and general development. He or she will also use special spoken tests to evaluate your child. A hearing test is often included in the evaluation because a hearing problem can affect speech and language development. Depending on the result of the evaluation, the speech-language pathologist may suggest activities you can do at home to stimulate your child's development. They might also recommend group or individual therapy or suggest further evaluation by an audiologist (a health care professional trained to identify and measure hearing loss), or a developmental psychologist (a health care professional with special expertise in the psychological development of infants and children).

What research is being conducted on developmental speech and language problems?

The National Institute on Deafness and Other Communication Disorders (NIDCD) sponsors a broad range of research to better understand the development of speech and language disorders, improve diagnostic capabilities, and fine-tune more effective treatments. An ongoing area of study is the search for better ways to diagnose and differentiate among the various types of speech delay. A large study following approximately 4,000 children is gathering data as the children grow to establish reliable signs and symptoms for specific speech disorders, which can then be used to develop accurate diagnostic tests. Additional genetic studies are looking for matches between different genetic variations and specific speech deficits.

Researchers sponsored by the NIDCD have discovered one genetic variant, in particular, that is linked to developmental language disorder (DLD), a disorder that delays children's use of words and slows their mastery of language skills throughout their school years. The finding is the first to tie the presence of a distinct genetic mutation to any kind of inherited language impairment. Further research is exploring the role this genetic variant may also play in dyslexia, autism, and speech-sound disorders.

A long-term study looking at how deafness impacts the brain is exploring how the brain "rewires" itself to accommodate deafness. So far, the research has shown that adults who are deaf react faster and more accurately than hearing adults when they observe objects in motion. This ongoing research continues to explore the concept of "brain plasticity"-the ways in which the brain is influenced by health conditions or life experiences-and how it can be used to develop learning strategies that encourage healthy language and speech development in early childhood.

A recent workshop convened by the NIDCD drew together a group of experts to explore issues related to a subgroup of children with autism spectrum disorders who do not have functional verbal language by the age of 5. Because these children are so different from one another, with no set of defining characteristics or patterns of cognitive strengths or weaknesses, development of standard assessment tests or effective treatments has been difficult. The workshop featured a series of presentations to familiarize participants with the challenges facing these children and helped them to identify a number of research gaps and opportunities that could be addressed in future research studies.

What are voice, speech, and language?

Voice, speech, and language are the tools we use to communicate with each other.

Voice is the sound we make as air from our lungs is pushed between vocal folds in our larynx, causing them to vibrate.

Speech is talking, which is one way to express language. It involves the precisely coordinated muscle actions of the tongue, lips, jaw, and vocal tract to produce the recognizable sounds that make up language.

Language is a set of shared rules that allow people to express their ideas in a meaningful way. Language may be expressed verbally or by writing, signing, or making other gestures, such as eye blinking or mouth movements.

Your baby's hearing and communicative development checklist

Birth to 3 Months

4 to 6 Months

7 Months to 1 Year

1 to 2 Years

2 to 3 Years

3 to 4 Years

4 to 5 Years

This checklist is based upon How Does Your Child Hear and Talk?, courtesy of the American Speech-Language-Hearing Association.

Where can I find additional information about speech and language developmental milestones?

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

Use the following keywords to help you find organizations that can answer questions and provide information on speech and language development:

For more information, contact us at:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: nidcdinfo@nidcd.nih.gov

NIH Publication No. 00-4781
September 2010

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Speech and Language Developmental Milestones

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How do speech and language develop? The first 3 years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills. These skills develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.

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There are many simple activities that you can do with your child to develop their speech and language skills.

1. Be a good model - speak clearly and slowly and face your child when speaking. If your child says a word or sentence incorrectly, rather than correct them or ask them to repeat it, just say the word / sentence back to them correctly to show you have understood. This way your child always hears the correct version. This is how children learn language.

2. Remember your language level - don't use words or sentences that your child will not understand. Speak to them using language they can understand, and explain any new words.

3. Make time to sit down with your child - even if it is just for a few minutes a day (although the more one-to-one time the better), spend some quiet time with your child, away from distractions. Look at a book together and talk about the pictures.

4. Turn off the TV and take out the pacifier/dummy - children do not learn language and social skills by watching TV, and new evidence shows that too much TV watching prior to starting school can affect listening and attention skills, which will impact on their learning once they start school.

5. Observe and comment - when you are playing with your child, take a step back, do not feel that you have to fill the silences, just comment on the things your child is doing so they can here (and learn) the new vocabulary.

6. Let your child lead - let your child lead the play, let them be the boss of play. This can build self-confidence and does not put pressure on them to talk and respond to the adult all the time.

7. Books, books, books - books can be used in many ways to develop language and early literacy skills. Evidence shows that children that have more exposure to books prior to schooling often find it develop early literacy skills earlier.

8. Sing songs and nursery rhymes - songs and rhymes contain rhythm and rhyme, skills that help with speech and literacy development.

9. Feed language in, don't force it out - comment and expand on your child's words and sentences, rather than asking them to repeat words. If your child says "car", respond with "big car" or "yellow car" or "fast car". This is how children learn words, by hearing new vocabulary and linking it to the items or events they are focussing on.

10. Make every opportunity a language learning activity - if it's a trip to the shops, or bath-time, you can make every activity a language learning activity. Point to things, name them, sing a nursery rhyme, or ask a question. You don't have to set aside a specific time of day to learn language, every activity is a language learning activity.

Speech and Language

The first few years of a child's life are key to the development of speech, language and cognitive skills. For this reason it is important to create an environment that helps to develop speech and language skills that give them all the stimulation, positive role modelling and human contact that they need. For a normally developing child, learning is easy and creating opportunities for learning is also not difficult. Through play, simple daily interactions and experiences, we can help the child acquire new language and skills.

Adults do not need special training to be able to provide a child with a positive start in life. There are a few simple building blocks that you can put in place to help your child grow, and as a parent, you just need to provide the time to interact with your children. By playing and allowing your child time and space to explore and interact in their own way, you allow your child to develop and learn in a fun and safe environment.

Speech and language skills do not just evolve on their own. They are part of a bigger picture involving social interaction, play, observation, manipulating objects, listening and attending. All these factors are working together and often, without one, it is difficult to develop another. Below, we have listed a few simple ideas that are fun and easy to do at home, remember, always praise your child for making any attempts at communication.

How children learn speech and how to encourage speech

If you want to encourage speech development, or your child is a little late with producing their first words, there are lots of activities that you can do to develop your child's speech and help them produce more words.

First of all - TAKE THE DUMMY OR PACIFIER OUT OF THEIR MOUTHS!!!
Good modelling
An important aspect of learning speech is listening. A child learns new sounds and words by listening to those around him. This is why it is important to provide good speech for your child to listen to. Say words clearly and slowly and use plenty of intonation. If your child attempts a word and it is not pronounced correctly, praise him/her for trying. Do not try and get your child to repeat the word or correct it. Repeat the word back yourself to show you have understood and to give your child a good version of the word.

To find out more about good modelling and other activities to develop speech and language development go to the

Symbolic sounds
These are easy words and sounds to introduce to your young child when they are just starting to attempt some words, or when recognisable words seem a bit late in their development. Symbolic sounds often sound like, or refer to a sound that is related to the word e.g. " moo" for a cow, or " beep beep " for a car. These are fun sounds that you can incorporate when playing games or looking at books. Symbolic sounds are usually short one syllable sounds and words that are easy for the child to produce. They encourage vocalization, imitation, and early vocabulary building.

Motivating sound games
Sometimes, using games can motivate your child to make sounds. For instance play the game - ready... steady.... GO!! Blow up a balloon, hold it, then say "ready....steady....GO", and let the balloon go. Do this a few times and then pause after you say "ready...steady...." and see if your child steps in and says "GO".

Communication temptations
Often by tempting your child with something motivating you can elicit some speech or a vocalization. For instance, holding onto the biscuit tin, but not opening it until he vocalizes a request, or only blowing bubbles when you get a vocalization from the child. In the early stages the child does not have to use the correct words or sentences, but just vocalize or make an approximation of the word. We want the child to learn that he can use his voice as a tool to initiate and request.
Listening, attention and observation
Listening and attention skills are the building blocks of speech and language development. The acquisition of these skills is vital in the early years if you want your child to be successful at school. The development of these skills is facilitated by interaction with others, with having a shared focus, and playing in an environment that is free of distractions. Listening, is not the same as hearing. A child can have perfect hearing, but be a very poor listener. Children with Autism, Attention Deficit and Hyperactivity Disorder or Auditory Processing Disorders will have difficulties with listening, remembering, and following verbal instructions. Children that have had a lack of social interaction or poor role modelling in the early years of their lives may present with listening and attention difficulties. Studies are also showing that over exposure to television from a young age can have detrimental long term effects on listening and attention skills.

Some children find these skills more difficult to master than others. There are lots of ways to enhance your children's listening and attention skills, not least by turning off the television and spending some quality time with them. Try to find activities that share your attention that you can both enjoy and focus on together. Also, don't forget to praise good listening and good looking.
Observation skills
These skills require the child to stop and focus on a particular task. Having a shared focus helps this process. A shared focus means looking at things together and talking about what you are looking at. The activities mentioned below require your child to focus on a something for a few minutes and really use their observation skills. These tasks can be done at a table-top as a shared focus activity, or during an everyday activity.

If you think your child has a speech delay or disorder, see our sections to give you an idea of the normal rate of speech development. If you continue to be concerned about your child's speech and language development visit your local speech and language therapist / pathologist.

To find out more about activities that you can do with your child to develop their skills - go to the

Language - how to develop language skills

There are lots of activities you can use throughout the day to develop your child's language skills.
Remember your language level
One of the biggest things to be aware of when using language around your young child is the level of language you use. This means using words and sentences that your child can understand and avoiding complicated words, long sentences and difficult instructions. Remember, with young children just use key words, and if you use a small sentence emphasize the important words. Talk slowly and point to what you are talking about.
Watching, waiting and listening
You can enhance your child's development of language by sometimes taking a step back during play and letting them take the lead. This gives the child control of their environment and builds their confidence. Although you are still involved in the play you are not dictating what is happening. However, you can still be feeding language into the play as it is happening, by commenting on what they are doing. So the takeaway here is not to feel you have to fill in any gaps of silence, just watch and listen and add language.
Adding language
Adding language is an easy thing to do and can be done in all types of different situations, not just play. You comment on what the child sees, commentate on what your child is doing, or expand on what they have said e.g.
The child puts a marble under a hat
Adult: " you're putting it under the hat "
The environment
The environment in which your child learns also has an impact on how they learn. Try and reduce distractions and background noise - TURN OFF THE TV!!
A busy household with lots of children will be noisy, but allows lots of play opportunities for the young child. However, sometimes you cannot beat some adult time, and if you get half an hour to have some one-to-one quality time with your young child then make the most of it.

To find out more about ways to encourage speech and language skills during play and everyday activities go to the Child Development Section of the Resource Centre.

Games & Play

Games and playtime activities are great opportunities to develop your child's speech and language skills.
Simple Games
There are lots of simple games you can play and indirectly work on speech and language. Games can played while driving in the car from Kindergarten, or when you are at the park or in the supermarket. Learning language does not have to be done in a structured environment. Don't forget when you are playing games to focus on speech and language, you will also be working on social skills, turn-taking, observing, listening and attention, so it's a win win situation.
Toys
Toys are fun and great for involving your child. Even with the simplest toys you can create fun activities and provide lots of situations for learning and developing speech and language. Imagine building a tower with wooden blocks - a simple game, but with loads of opportunities:
Building a tower
Speech and Language opportunities: adjectives (higher, up), verbs (fall down, build), preposition (on-top), nouns (colours, numbers)
Communication and Social skills: turntaking, joint focus, sharing, listening, attending, observing
Here we can see even a simple game with wooden blocks involves all sorts of language and play skills.
Look at books
Books are great for having a shared focus and for learning new words. Books can also play a key part in developing early speech and literacy skills. There are many ways to use books and the pictures to focus on language. You can focus on books with symbolic sounds for early speech or storybooks to focus on language. Books are a great way to work on lots of skills and children love them. Look at the books together, name the pictures, ask questions, and talk about the story.
Role play
Dressing up is great fun and playing different roles will expand your child's imagination. In fact you do not even have to dress up to do role play. Games involving different characters will allow you to introduce lots of new related language and stretch your child's creative play skills. For instance, if you pretended to be firemen putting out a fire, think how many related words you could use" fire, fireman, fire engine, ladder, water, hose, burning, building, driving, climbing, up, down, smoke, hat, boots, jackets, save, squirt, bucket, fire out, hero, etc etc etc. Role play is great for expanding your child's imagination and introducing new vocabulary.

Most types of interaction through play will have a positive effect on speech and language acquisition. The child's social skills will also benefit because they will be using eye contact, turn-taking and listening skills. By letting your child take the lead in a game, they will gain confidence in communicating and feel that they are in control, so be relaxed in the communication environment.

Depending on your child's language competence you may want to set a goal for each game, although it is important not to make it too structured because we want the game to be led by the child. Any goal should be simple and flexible. Language needs to be fed into the game, rather than trying to encourage the child to say particular words. This means we don't want to be continually saying to the child "what is he doing?" or "what are you doing?" or "say running, say running". Children do not learn language this way, children learn language by hearing it first and making associations between the word and the action. As adults we want to just feed the language in at the appropriate times.

Example of a language role play game:
Bus Driver game: Let your child be a bus driver and you can be the passenger. Set up some chairs for a bus and act the roles. As an example, just look at all the verbs you might use in this game: steer the bus, press the horn, ring the bell, sit down, pay the driver, drive the bus, find the change, walk down the aisle. If your child finds a game complicated, you could be the bus driver first and model it for your child, then your child can take a turn and you add language to the situation.

Music
Music is also a great way to involve your child and can be used in many ways to enhance speech and language. Music is good for getting your child to listen, and experiencing a shared focus. You can read books and follow music singing the songs as you point to the pictures. Songs also focus on intonation and stress and have a beat to them which helps with aspects of speech development. These are skills we all use when talking and syllable awareness is important when learning to talk. Music can be used to enhance language and some songs can be sung involving actions and thus creating the link between words and actions.

Using everyday activities as a language learning opportunity

Using everyday activities can be a great way to practice and develop speech, language and literacy skills. These activities can also change a mundane event into a pleasurable one. The child may also not realise that you are practicing speech and language skills because the activity will be fun.
Using everyday tasks to promote speech and language is relatively easy, you just have to use your imagination:

Bathtime - Use lots of vocabulary during bath-time, talk to your children, and model the words for them. Introduce vocabulary: Verbs: wash, scrub, rinse, clean, brush, dry, splash, sink, float. Nouns: soup, towel, water, tap, flannel, bath, sink, body parts. Sing songs in the bath.

Cleaning the bedroom - Play "I-spy" to practice initial sound awareness (good for speech and language development).

Talk about what the people on the street are doing (e.g. walking, working, riding etc) to focus on verbs, or name as many different occupations that you can see (driver, policeman, road-worker, shopkeeper etc). These are just simple ways to use everyday opportunities to find entertaining and simple ways to focus on speech and language.

Remember, if you make speech and language sessions into games your child enjoys it more, is more motivated and may not even see it as speech and language practice, but as a game. Children like games and are motivated when it becomes competitive. This means you can create ideal situations away from the table-top activities to work on speech and language. Just use your imagination because almost any daily event can be turned into an educational game.

Recommended Reading

For a wider range of books, click here to see our Bookshop.

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Activities to develop Speech and Language Skills

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This section describes a number of activities to develop speech and language skills, such as good modelling, using toys, music and books

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Individuals with a receptive language disorder may have difficulty understanding spoken language, responding appropriately, or both. This leads to substantial difficulty communicating and often leads to problems in school.

What Is a Receptive Language Disorder?

A receptive language disorder is a type of learning disorder affecting the ability to understand spoken, and sometimes written, language. It is believed to involve differences in language processing centers of the brain. These disorders can result from inherited conditions or may be caused by brain injuries or stroke. Receptive language issues can also be a symptom of developmental disorders such as autism and Down syndrome.

A receptive language disorder is not, itself, a learning disability but instead a medical issue that can cause children to fall behind in academics. If the disorder isn't easily or quickly resolved, the learning gap can expand. Thus, children with a receptive language disorder may need special academic support even though they don't have an "official" learning disability.

Problems in Language Comprehension

Children with receptive language disorders often have difficulty organizing their thoughts while trying to understand others, which creates problems in communicating verbally or organizing their thoughts on paper. They have difficulty with language processing and the connection between words and the ideas they represent. Some may also have problems with the pronunciation of words and speech/sound production.﻿﻿

Expressive Language Difficulties

In some cases, children will have difficulty with both expressive and receptive language.﻿﻿ Expressive language is the ability to use spoken or written speech correctly, appropriately, and effectively. Issues with expressive language may have their basis in a variety of challenges ranging from neurological issues to muscle control problems to cognitive disabilities.

People with a receptive language disorder may appear less capable than they really are because they do not effectively express themselves. However, in some cases, their understanding of language and subjects in school is often as well-developed as that of other learners their age. They may simply be unable to express that understanding.

Sometimes, children with speech disorders continue to struggle with communication over time. Even when children with speech disorders "catch up" to their peers in terms of their communication skills, the increasing demands of school and social interaction may cause them to struggle.

Issues with receptive language can be hard to spot in very young children, and it isn't until it is time for them to start talking that parents may notice a problem.

Other signs include:

If you believe you or your child has a receptive language disorder, contact your school principal, school counselor, or school district office for information on how to request an assessment.

Having your child evaluated for a hearing problem is also recommended, as hearing issues are a common cause of language problems.

Parents of young children should be aware that language comprehension begins before the age of three or four years old.﻿﻿ Kids with developmental language disorders usually start speaking later than other children their age. At your toddler's well visits, keep your pediatrician up-to-date about the number of words your child can say prior to each visit and whether you have any concerns about delays in speech.

The next step is to work with a speech-language pathologist or speech therapist to develop an effective individual education program for your child. This may involve at-home or in-school speech therapy sessions, providing ways for your child's teacher to help them in class, and/or the presence of a speech therapist in a language-based classroom.

Typical strategies focus on language therapy to develop the important connections between letters, sounds, and words. Vocabulary development, rehearsal, and practice of using language in social situations may be helpful. In severe cases of receptive language problems, therapists may use multisensory techniques and whole language approaches.

For students in college and vocational programs, their school's advising office can assist with finding resources to help ensure success.

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What You Should Know About Receptive Language Disorders

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Individuals with a receptive language disorder may have difficulty understanding spoken language, responding appropriately, or both. This leads to substantial difficulty communicating and often leads to problems in school. A receptive language disorder is a type of learning disorder affecting the ability to understand spoken, and sometimes written, language.

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default - Stanford Medicine Children’s Health

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Stanford Medicine Children’s Health A language disorder in a child means he or she has trouble understanding words that he or she hears and reads. Or the child has trouble speaking with others and expressing thoughts and feelings.

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There are two major types of language disorders: receptive language disorders and expressive language disorders. An expressive language disorder is one in which the child struggles to get their meaning or messages across to other people. A receptive language disorder is one in which a child struggles to understand and process the messages and information they receive from others. Some children have a mixed receptive-expressive language disorder in which they have symptoms of both types of disorders.

What causes language disorders or delays?

Frequently, a cause for a child's developmental language disorder cannot be identified. Other times, it can be a symptom of an underlying developmental delay or disorder.

What are the symptoms of a language delay or disorder?

Children with language delays and disorders can struggle in social and academic situations. Those struggles can result in problems with behavior and acting out. It is important for caregivers discuss any concerns regarding a child's language development with the pediatrician. Caregivers who suspect a child has a language delay should refer to the speech and language milestones development chart by clicking here. While not all children will develop at the same rate, it serves as a good guide as to the development caregivers should see in children as they grow. Additionally, children with a receptive language disorder may have some or all of the following symptoms:

Difficulty understanding what people have said to them.

Struggle to follow directions that are spoken to them.

Problems organizing their thoughts for speaking or writing.

Children with an expressive language disorder may have some or all of the following symptoms:

Struggle to put words together into a sentence or may not string together words correctly in their sentences.

Have difficulties finding the right words while speaking and use placeholder words like "um."

Have a low vocabulary level compared to other children the same age.

Leave words out of sentences when talking.

Use tenses (past, present, future) incorrectly.

How is a language disorder diagnosed?

Children with a suspected language disorder undergo a comprehensive assessment to to identify the specific delay and disorder. The assessments may include an interview with the parent or caregiver regarding the child's medical history, unstructured play with the child to see how the child uses and understands language in a natural environment, and several standardized tests. These tests help the child's treatment team determine the presence or severity of a child's language disorder.

How is a receptive or expressive language delay treated?

Specific treatment for dysphagia will be determined by the child's health care team based on the following:

The child's age, overall health, and medical history.

The extent of the swallowing disorder.

The child's tolerance for specific medications, procedures, or therapies.

Expectations for the course of the swallowing disorder.

The family's opinion or preference.

The child's therapist will put together an individualized treatment plan based upon the results of the child's assessments. Through books, games and play, components of language are taught and practiced. A therapist will continue to work with a child until the child is able to produce and understand language naturally in a conversation without cues or until the child reaches their best potential for language.

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Receptive and Expressive Language Delays - CHOC Children's, Orange County, California

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There are two major types of language disorders: receptive language disorders and expressive language disorders. An expressive language disorder is one in which the child struggles to get their meaning or messages across to other people. A receptive language disorder is one in which a child struggles to understand and process the messages and information they receive from others.

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What is receptive language (understanding words and language)?

Receptive language is the ability to understand words and language. It involves gaining information and meaning from routine (e.g. we have finished our breakfast so next it is time to get dressed), visual information within the environment (e.g. mum holding her keys means that we are going to get the car, a green light means go), sounds and words (e.g. a siren means a fire engine is coming down the street, the word ball means a round bouncy thing we play with), concepts such as size, shape, colours and time, grammar (e.g. regular plurals: cat/s, regular past tense: fetch/ed) and written information (e.g. signs in the environment like "no climbing", written stories).

Some children who have difficulty understanding oral language (words and talking) may appear to be understanding because they may be able to pick up key words and get visual information from the environment or from gestures.

Why is receptive language (understanding words and language) important?

Receptive language is important in order to communicate successfully. Children who have understanding difficulties may find it challenging to follow instructions at home or within the educational setting and may not respond appropriately to questions and requests. Within the school setting, difficulties in understanding may lead to attention and listening difficulties and/or behavioural issues. As most activities require a good understanding of language, it may also make it difficult for a child to access the curriculum or engage in the activities and academic tasks required for their year level of school.

What are the building blocks necessary to develop receptive language?

Attention and concentration: Sustained effort, doing activities without distraction and being able to hold that effort long enough to get the task done.

Pre-language skills: The ways in which we communicate without using words and include things such as gestures, facial expressions, imitation, joint attention and eye contact.

Social skills: Determined by the ability to engage in reciprocal interaction with others (either verbally or non-verbally), to compromise with others, and be able to recognize and follow social norms.

Play skills: Voluntary engagement in self motivated activities that are normally associated with pleasure and enjoyment where the activities may be, but are not necessarily, goal oriented.

How can you tell if my child has problems with receptive language?

If a child has difficulties with receptive language they might:

Have difficulty attending and listening to language.

Not pay attention within group times at kindergarten and school.

Not follow instructions that others the same age would be able to follow.

Respond to questions by repeating what you say instead of giving an answer.

Find it difficult to listen to stories.

Give unusual answers to questions.

*These difficulties may vary depending on the child's age.

What other problems can occur when a child has receptive language difficulties?

When a child has receptive language difficulties, they might also have difficulties with:

Attention and concentration: Sustained effort, doing activities without distraction and being able to hold that effort long enough to get the task done.

Behaviour: The child's actions, usually in relation to their environment (e.g. a child becoming disruptive within the classroom because they are unable to "access" or understand what the teacher is saying or talking about).

Literacy: Reading and writing.

Social skills: Determined by the ability to engage in reciprocal interaction with others (either verbally or non-verbally), to compromise with others, and be able to recognize and follow social norms.

Sensory processing: Accurate registration, interpretation and response to sensory stimulation in the environment and one's own body.

Executive functioning: Higher order reasoning and thinking skills.

Expressive (using) language: The use of language through speech, sign or alternative forms of communication to communicate wants, needs, thoughts and ideas.

Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result.

Auditory Processing: Ability to hear sounds, distinguish between similar sounds or words, and separate relevant speech from background noise.

What can be done to improve receptive language?

Eye-contact: Obtain the child's eye contact before giving them an instruction.

Minimal instructions: Refrain from giving too many instructions at once.

Simplify the language you use with the child so it is at a level that they can understand (i.e. usually just above their expressive language level or how much they are saying).

Chunk verbal instructions into parts. Instead of "Go and get your lunchbox and your hat and go outside", say "Get your lunchbox." When the child has followed that instruction, say "Now get your hat" then "OK, now you can go outside".

Repeat: Ask the child to repeat the instruction to ensure that they have understood what they need to do (e.g. "Go and get your bag then sit at the table. What do I want you to do?").

'First/then': Use this concept to help the child know what order they need to complete the command (e.g. "First get your jacket, then put on your shoes").

Clarify: Encourage the child to ask for clarification if they forget part of the instruction or have trouble understanding what they need to do. Encourage them to ask for the command to be repeated or clarified (e.g. "Can you say that again please?").

Show: Physically show the child what to do when giving them an instruction so that they can 'see' what the concept within the instruction looks like.

Visual aids (e.g. pictures, gestures, body language, facial expression) can be used to assist the child's comprehension and recall of the instruction.

Describe: In everyday activities describe to the child what they are doing (e.g. when the child is packing up their toys you might say: "Put the toys in the box" or when dressing/undressing you might say: "Take your shoes off/Put your shoes on").

Emphasise the word you want the child to learn about and repeat the concept in a variety of situations or settings so that the child sees the different ways in which a concept can be used (e.g. "Lights on"vs. "The book is on the table").

Play: For the young child engage in play on a regular basis, model how to play with toys, follow the child's lead and talk about what they are doing with the toys.

Reduce background noise: Turn off background noise in the home (e.g. television, radio, music) when engaging with the child to reduce/minimise distractions.

Face-to-face: Get face to face with the child when talking.

Visuals such as signs or pictures can be used to facilitate and support a child's understanding.

Books: Look at books which interest the child and talk about the pictures and the story. Get the child to predict what might happen next or explain why something might have happened in the story.

What activities can help improve receptive language?

Name items together when completing tasks, such as looking at a book, in the car, looking outside, while playing or when shopping.

Day to day activities: When going shopping and visiting places, such as the park, zoo or museum encourage the child to talk about what you did and saw and possibly even draw or act out what happened.

Model new words: Play activities with the child that they really enjoy and throughout the game model new words and phrases.

Explain new concepts in different ways (e.g. looking at the concept of "wet": use water to wet things and talk about things that are wet and dry; look at pictures of things that are "wet"; if it rains, or the child is in the bath, talk about the concept of being "wet"; make up sentences and stories about being wet/dry).

Simon says: Take turns with the child in following and giving instructions. Also, gradually increase the length of the command that is provided (e.g. 'Simon says touch your toes'; 'Simon says first touch your toes, then clap your hands'; 'Simon says before you shout hurrah, count to 10'). Additionally, reinforce body parts (e.g. pat your head, pull your ear) and simple verbs (e.g. jump, shake) when playing the activity.

Obstacle course: Put together an obstacle course in the house or outside in the backyard. Take turns with the child in following and giving instructions. Gradually increase the length of the command that is provided (e.g. run to the sandpit; first run to the sandpit then crawl over to the bikes).

Feely bag game: Place different everyday items/objects (e.g. toothbrush, car, cup, block) into a bag. Take turns with the child in taking an item out of the bag. Encourage the child to:

Reach into the bag and try to guess what the item is before taking it out.

Describe characteristics about the item once they have pulled it out of the bag (e.g. colour, shape, use/function).

Answer questions about the item that they have pulled out (e.g. Is it round? Can you eat it?).

Guess the item that you have pulled out of the bag by asking you questions (e.g. Is it round? Can you eat it?).

Books: Look at picture books with the child. Take turns in asking each other questions about the pictures (e.g. Who is in the picture? What is the girl/boy doing?). Try to think about what might happen next in the story and different possible endings.

Why should I seek therapy if I notice difficulties with receptive language in my child?

Therapeutic intervention to help a child with receptive language difficulties is important to:

Strengthen and develop the child's ability to:

engage effectively in a classroom/academic setting (e.g. following instructions appropriately, completing academic tasks).

communicate appropriately with their peers (e.g. having a conversation about shared topics of interest using specific language, asking and answering questions).

communicate appropriately with adults and unfamiliar individuals (e.g. retelling events, sequencing ideas, answering questions appropriately).

Improve a child's ability to understand and respond appropriately to questions.

Develop a child's understanding of concepts.

Improve reading and writing skills.

Develop alternative forms of communicating (e.g. sign, picture exchange communication system, voice output devices) if verbal language is not developing.

Help reduce frustration in a child who struggles with comprehending in the home or school environments.

Facilitate expressive language development.

If left untreated what can difficulties with receptive language lead to?

When children have difficulties with receptive language, they might also have difficulties with:

Forming friendships and engaging in positive social interactions with peers.

Completing tests, exams and academic tasks in higher level education.

Applying for jobs in both an interview and written application and answering questions during job interviews.

Developing reading and writing skills.

Following and giving directions to find unfamiliar or new places.

What type of therapy is recommended for receptive language difficulties?

If your child has difficulties with understanding words and language, it is recommended they consult a Speech Therapist.

If there are multiple areas of concern (i.e. beyond just understanding words and language) both Occupational Therapy and Speech Therapy may well be recommended to address the functional areas of concern. This is the benefit of choosing Kid Sense which provides Occupational Therapy and Speech Therapy.

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Receptive Language (understanding words and language) - Kid Sense Child Development

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What is receptive language (understanding words and language)? Receptive language is the ability to understand words and language. It involves gaining information and meaning from routine (e.g. we have finished our breakfast so next it is time to get dressed), visual information within the environment (e.g.