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Chapter 5

πŸ—£οΈ Speech & Language

Building the bridge between a child's inner world and the words they need β€” one interaction at a time.

What does speech/language delay look like?

Language profiles vary widely β€” a child may speak in full sentences yet struggle to hold a conversation, or have strong vocabulary but poor narrative structure.

πŸ”€ Expressive Delay

  • Limited vocabulary for age
  • Short, telegraphic sentences
  • Difficulty finding words ("tip-of-tongue")
  • Relies on gestures or echolalia

πŸ‘‚ Receptive Difficulty

  • Doesn't follow multi-step instructions
  • Misunderstands jokes, idioms, sarcasm
  • Needs instructions repeated often

πŸ’¬ Pragmatic / Social

  • Difficulty initiating or maintaining topics
  • Talks at peers rather than with them
  • Misses turn-taking cues in conversation

πŸ“– Narrative Weakness

  • Stories lack beginning/middle/end
  • Jumps between unconnected details
  • Cannot retell a simple event sequentially
πŸ’‘ Key principle: Follow the child's lead. Language grows fastest when an adult expands what the child has already said rather than correcting or redirecting. If the child says "dog run" β€” you say "Yes, the big dog is running fast!"

4 Core Strategies

Joint Attention Routines

Joint attention β€” sharing focus on the same thing at the same time β€” is the bedrock of language development. Children who struggle to point, show, or follow a gaze need systematic practice at this pre-linguistic skill.

  1. Sit at the child's eye level during play.
  2. Follow their gaze or point to what they are looking at, and name it: "Oh! You're looking at the red truck."
  3. Add an animated comment to invite their response: "It's zooming so fast!"
  4. Pause expectantly β€” leave a gap of 5–10 seconds for the child to respond in any way (word, gesture, look).
  5. Expand whatever they give you: gesture β†’ word β†’ phrase β†’ sentence, one step above their current level.
Pre-linguisticSocial attentionLanguage modelling

Sabotage Technique

Intentionally create situations where the child needs to communicate to get what they want. Natural communication beats drilled responses every time.

  1. Give the child a jar they cannot open β€” wait for them to request help.
  2. Start a favourite game and then "forget" a key piece β€” pause and look expectant.
  3. Put a desired item in clear sight but out of reach β€” wait for a request.
  4. Offer a tiny portion of a favourite food β€” wait for "more" or a fuller request.
  5. Accept any communicative attempt (word, sign, point) and immediately reward it with the desired item.
Motivated communicationNaturalistic teachingAAC-friendly

Aided Language Stimulation (ALgS)

Adults model language by pointing to symbols on an AAC board or picture strip while speaking naturally. The child sees language represented visually, reducing decoding load and building symbol understanding.

  1. Create or download a core vocabulary board (20–30 high-frequency words: more, stop, go, want, help, like, no, yes, I, you).
  2. During any activity, point to the relevant symbols as you speak: "I (point) want (point) the ball (point)."
  3. Do not ask the child to use the board β€” just model, model, model.
  4. After 4–6 weeks of consistent modelling, the child will typically begin using the board spontaneously.
  5. Gradually expand the vocabulary to 50–80 core words.
AACVisual supportCore vocabulary

Language Expansion

Consistently recast and expand the child's utterances one developmental step above their current level β€” the most evidence-based strategy for closing expressive language gaps.

  1. Listen carefully to the child's spontaneous speech without interrupting.
  2. Immediately after, restate what they said with one added element: "Ball" β†’ "Big ball" β†’ "Throw the big ball" β†’ "I'm throwing the big red ball."
  3. Do not ask the child to repeat you β€” just model and continue playing.
  4. Target one grammatical feature at a time (e.g., adding "-ing" endings for 2 weeks).
  5. Keep a tally: aim for 20–30 expansions per 30-minute play session.
RecastingGrammarMean length of utterance

4 Structured Activities

πŸ—ΊοΈ Barrier Games

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⏱ 15 minπŸ‘₯ Pair🏠 Indoors

Two players sit on opposite sides of a barrier. Each has an identical set of objects or a blank grid. Player A gives instructions; Player B follows them β€” without seeing Player A's arrangement. At the end, they compare and discuss differences.

  1. Prepare two identical sets: 6 small objects (car, tree, house, dog, ball, flower) and a 3Γ—3 grid mat.
  2. Player A places objects in their grid and describes exactly: "Put the red car in the top-left corner."
  3. Player B follows only by listening.
  4. Remove the barrier and compare β€” celebrate matches, discuss mismatches: "What word would have helped?"
  5. Swap roles. Target language: prepositions, colour, size, number words.
πŸ’‘ Tip: Start with 3 objects on a 2Γ—2 grid and build complexity gradually. Mismatches are valuable β€” they create authentic motivation to be more precise.

πŸ“š Story Retelling with Props

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⏱ 20 minπŸ‘€ Individual or small group🏠 Indoors

Reading a story and then retelling it with physical props develops narrative structure (beginning–middle–end), sequencing language ("first… then… finally…"), and vocabulary in context.

  1. Read a short picture book together (5–8 pages).
  2. Lay out simple props or picture cards representing key events.
  3. Ask: "Can you tell me the story using these?"
  4. If stuck, prompt with sequence cues: "What happened at the start? What happened next?"
  5. Record the child's retelling (phone/tablet) β€” play it back together and celebrate the storytelling.
πŸ’‘ Tip: Use a 3-section story mat labelled "Beginning / Middle / End" so the child can physically place props in sequence.

🎡 Phonological Awareness Play

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⏱ 10 minπŸ‘€ Individual🏠 Indoors

Rhyming, clapping syllables, and identifying initial sounds are the building blocks of reading and expressive language. Make it playful β€” the child should be giggling, not drilling.

  1. Rhyme hunt: "Can you find something in the room that rhymes with 'cat'?" (mat, hat, bat…)
  2. Syllable clap: Clap each syllable as you say the child's name and names of favourite objects. "Oc-to-pus β€” 3 claps!"
  3. Sound sorting: Lay out picture cards and sort into groups by their starting sound.
  4. Tongue twisters: Repeat one slowly, then faster β€” laughter counts as engagement.
  5. End with the child's favourite: let them choose which game to repeat next time.
πŸ’‘ Tip: For children with articulatory difficulties, focus on perception (hearing the difference) before production (saying it correctly).

πŸ’¬ Conversation Scripts

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⏱ 10–15 minπŸ‘₯ Pair🏠 Indoors

Many autistic and language-delayed children benefit enormously from scripted conversation starters β€” not to make them robotic, but to give them the floor plan of an interaction so they can focus on content rather than structure.

  1. Write a simple script on a card: "Greeting β†’ Ask a question β†’ Answer their question β†’ Give a compliment β†’ Say goodbye."
  2. Role-play the script with the child using a favourite topic (e.g., Minecraft, dinosaurs).
  3. Practise with the card visible, then face-down, then without it.
  4. Video-record a practice run β€” watch it back together and identify one thing they did really well.
  5. Gradually fade the script: first remove the goodbye prompt, then the compliment, etc.
πŸ’‘ Tip: Scripts work best when they're built around the child's genuine interests β€” a script about their favourite game will be rehearsed voluntarily at home.
πŸ’¬ Want to build a speech and language routine?
Tell Mitra how many words your child currently uses and she'll guide you through Joint Attention, Sabotage, and Language Expansion step by step.
Ask Mitra β†’