Learning is a rapid, ongoing process for a child, not confined to the times of day that we set aside to teach. There are many ways you can use your child’s play to encourage their language growth and build their vocabulary.

In most cases, a child will produce her first word around the time of her first birthday, but the foundation for communication comes much earlier.  By about 8 months of age, a child has developed the concept of object permanence, the ability to understand that an object exists even if she can no longer see it.  If you hide her toy under a blanket at this point, she will look for it.  At this stage, games such as peek-a-boo reinforce this concept as well as demonstrating the turn-taking aspect of conversation. 

First words tend to be nouns—people or things that are familiar.  As children develop improved oral motor skills, pronunciation will become more precise.  In the early stages of speaking, it is important to pay attention to the intent as much as to the production. 

Routines provide comfort through predictability in a world that is just beginning to make sense. When you do the same thing the same way time after time, your child learns what to expect in a given situation. If you always kiss your baby’s toes when changing her diaper, she’ll begin to put her feet up for a kiss at diaper changing time. This is an early form of expressive communication. She is inviting you to play the game. When you play along and kiss her toes, you have reinforced her communication and shown her that you understand what she has asked. In this way, you have laid a foundation for conversational give and take in the future.

Getting on the child’s level is an important step. Play, and the communication that goes along with it, is enhanced when you partner with your child. That means side by side on the floor or at a kiddie table or anywhere that puts you eye to eye.

When planning for play, let your child take the lead. Look at her interests and introduce a play scenario that you know she will find interesting. Expect that she may deviate from the plan and follow her lead as she explores new ways of interaction.  Remember that a child’s attention span will lengthen as she grows.

Encourage her attempts at communication by talking about your play. Give her time to respond. Talk back to her in a conversational style. Include appropriate hand motions, animal noises, actions and facial expressions to help her understand what you are saying as well as to give her an alternate means to communicate back to you the same information.

Developmental stuttering often sounds like a child is repeating a whole word.  For example if a child wants to say “We go store,” it might start out “We, we, we, we go store.”  Children at this age and stage seem unaware of disfluency.  Developmental stuttering usually appears and disappears before age 3. 

Stuttering becomes cause for concern when there is a familial history of stuttering, when the child has other speech and language difficulties, and when the child is showing signs of frustration in his attempts to speak.  Facial grimacing, tension around the mouth, and rapid body movements which are unrelated to speaking are known as secondary characteristics.  The presence of secondary characteristics should prompt an immediate referral to a speech-language pathologist.

 Modeling  good communication techniques is a good idea for any developing child.  Your speech should be slow and deliberate, but not stilted, especially when talking with your child.  Listening with eye contact is extremely important in making a child feel secure enough to develop better communication skills. Take time each day to listen without distraction and without rushing your child.  If your child expresses frustration with communication, reassure her that everyone has trouble talking sometimes.

Consult a professional. 

Speech-language pathologists evaluate and treat children with speech, language and swallowing difficulties. Audiologists diagnose and manage hearing and balance disorders. 

Look for an audiologist or speech-language pathologist who holds the Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association. 

To find a professional in your area, visit www.asha.org or www.aappspa.org.  

By federal law, free or low-cost early intervention services are available to children age 0-3 who have a demonstrated language delay.

Private insurance plans may cover certain language disorders as well.  

University programs which have a program in speech-language pathology and audiology have clinics where evaluation and treatment are provided by supervised graduate students.  Services are often low-cost or free.

Public schools provide assessment and therapy services to children who qualify.

Listen for sounds that are repeated in a given context. For example, if your child says “mmmmmm” whenever she holds up a cow, consider that a “moo” and respond to it as such. Simply repeat what it was you think she was telling you and acknowledge it or comment on it. “Oh, yes, the cow says ‘moo’.” The key is to treat it as conversation, not insist that she say each sound in each word correctly.

As children learn to express themselves, they incorporate combinations of pointing, grunting and jabbering to tell you what they are asking for. When these attempts at conversation are encouraged and responded to, the child learns that communication has value.  Words can manipulate her world.

A child takes life as it comes. There are no deadlines, no bills, no strict schedules. Any experience can be play.  Imitating our work can be a joy to a child.  When your child follows you around dusting, sweeping or trying to clean the mirror, it is play to the child.  Your words and actions will enforce that concept

and encourage her.  Take a moment from your chores to demonstrate what you are doing and talk about it, keeping your vocabulary at her level.  Praise your child for her contribution.

Childhood is a wondrous time, a time of exploration, learning, and delight.  Each day, look for ways to see the world through your child’s eyes. Take a moment with your child to talk about what she sees, how it feels, how it smells, what it does.  Explore.  Encourage. Play. Listen. Learn.

To make the game more challenging, and to introduce the concepts of category matching, try using pictures of things that go together. You might have a picture of a broom and the match would be a dustpan. Or you could have a fork in one picture and a spoon in the other. Photos don’t have to be perfect, either. The most important thing is to keep your child’s interest and keep the game on their level.

A few simple steps now will maintain optimal hearing in the future.Seek medical help when your child has an ear infection to reduce the risk of long-term damage.

Be aware that loud toys can cause irreversible damage to a child’s inner ear.

Hearing protection should be used to prevent hearing damage around loud machinery or other loud noises.

Headphone use should be monitored and children should be taught to keep the volume low.

To find out more about protecting your child’s hearing, go to www.asha.org.

Precision is important when it comes to learning to speak clearly.  Imagine, if you will, that you enroll in a class to learn a foreign language.  When you arrive, the instructor informs you that you must wear earplugs during class. In a similar way, an ear infection acts as an “earplug” to a child who is trying to sort out a vast array of sound combinations.  When fluid is present for months at a time, your child is missing out on hearing sounds clearly all that time.

Children have more ear infections than adults do because of their anatomy.  There is a tube, called the Eustachian tube, that connects the middle ear to the back of the throat.  When you go up or down in elevation, you have probably had the sensation of your ears “popping”.  That sensation is actually your Eustachian tube opening and allowing the pressure in your middle ear equalize with the air pressure around you.

In a child, the Eustachian tube is more horizontal. As the child grows and matures, the Eustachian tube begins to tilt downward so that any excess fluid in the middle ear naturally drains into the back of the throat.  Sometimes, the Eustachian tube opening in the back of the throat can be blocked by enlarged adenoids.  In this case, the doctor may recommend a tonsillectomy and adenoidectomy to remove the blockage.

Inserting pressure equalization (PE)  tubes is a relatively simple procedure in which the physician uses a surgical microscope and makes very small incision in the child’s eardrum and inserts very small tube in that hole.  PE tubes allow any excess fluid to drain out from the child’s middle ear into the outer ear canal.  This also helps to equalize the pressure in the middle ear.  When a child has PE tubes, there may be discharge from the ear as the fluid drains out.

The risks associated with PE tube placement are minimal.  In rare cases, hearing can worsen.  In a very small percentage of cases, the eardrum can fail to close after the tubes come out, a condition that can be repaired easily. The benefits to tube placement nearly always include increased hearing acuity.  In addition, equalization of pressure and reduction of middle ear fluid can dramatically relieve ear pain and reduce the risk of further infection in the hearing mechanism.

PE tubes usually stay in for several months. Sometimes they are removed by the doctor, but quite often they fall out into the outer ear canal on their own over time. If the tubes fall out too soon, or if a child continues to have ear infections after the tubes are removed, it may be necessary to put a new set in.

In general, PE tubes are hassle free, but you should check with your doctor first to find out any special precautions for bathing or swimming.  In most cases, ear plugs will protect the middle ear when your child is going to be getting wet.

Children who have PE tubes installed usually enjoy a rapid spurt of language growth very soon after the tubes start doing their job.