4 to 5 Years Communication Milestones

By the age of 4-5, a child should exhibit the following language skills:
 

RECEPTIVE LANGUAGE:

•  Pays attention to a short story and answers simple questions about it.
•Hears and understands most of what is said at home and in school.

EXPRESSIVE LANGUAGE:

•Makes voice sounds clear like other children's.

•Uses sentences that give lots of details (e.g., "I like to read my books").
•Tells stories that stick to topic.
•  Communicates easily with other children and adults.
•Says most sounds correctly
•Uses the same grammar as the rest of the family.

WHAT CAN I DO TO ENCOURAGE EXPRESSIVE &  RECEPTIVE LANGUAGE DEVELOPMENT?
•Talk about spatial relationships (first, middle, and last; right and left) and opposites (up and down, big and little).
• Offer a description or clues and have the child identify what you are describing.
•Work on forming and explaining categories (fruits, furniture, shapes).
•Follow the child’s directions as she or he explains how to do something.
•Give full attention to the child when he or she is speaking, and acknowledge, praise, and encourage him or her afterward. Before you speak to the child, be sure to get his or her undivided attention. Pause after speaking, allowing him or her to respond to what you have said.
•      Build on the child' s vocabulary. Provide definitions for new words, and use them in context: "This vehicle is riding on the highway. It is a car. A bus is another kind of vehicle. So are a train and an airplane."
•     Encourage the child to ask for an explanation if he or she does not understand what a word means. 
•      Point out things that are the same or different. Play games incorporating these concepts that he or she will encounter later in the classroom in reading readiness.
•      Sort items into categories. Now try to sort them by pointing out more subtle differences between objects (e.g., rocks that are smooth vs. those that are rough, heavy vs. light, big vs. small). Again, have the child identify the object that does not belong in a given category, but now ask him or her to explain why the item does not belong.
•      Expand on social communication and narration skills (telling a story) by role-playing. Play house, doctor, and store using dialogue, props, and dress-up clothes. Do the same with a dollhouse and its props, acting out scenarios and making the dolls talk.
•      Read stories with easy-to-follow plots. Help the child predict what will happen next in the story. Act out the stories, and put on puppet shows of the stories. Have the child draw a picture of a scene from the story, or of a favorite part. You can do the same thing with videos and television shows, as these also have plots. Ask "wh" questions (who, what, when, where, or why) and monitor his or her response.
•      Expand on the child' s comprehension and expressive language skills by playing "I Spy"
•      Give the child two-step directions (e.g., "Get your coat from the closet and put it on")..
•      Play age-appropriate board games. (e.g., "Candyland" or "Chutes and Ladders").
•      Have the child help you plan and discuss daily activities.

2.5 to 3 Years Communication Milestones

By the age of 2.5, a child should be able to demonstrate the following communication milestones:

RECEPTIVE COMMUNICATION:

• Understands the use of objects; for example:

•  Show what you use to cook food or Show me what you watch.

•  Show me what you can ride or Show me what you wear on your feet

•  Understands part/whole relationships, for example:

•  The wheel on the bike
•  The tail of the cat

•  Understands descriptive concepts, such as “big” “wet” and  “little”
•  Follows 2 step related and unrelated commands, without cues:

•  Get the cup and give it to me
•  Take off your coat and hang it up.

EXPRESSIVE COMMUNICATION:

•  Uses Plurals, such as “horses” or “blocks” or “babies.”

•  Combines 3+ words in spontaneous speech.
•  Answers “What” and “Who” Questions
•  Uses Verb + ing.

• For example, “The girl is playing.”

•  Uses a variety of nouns, verbs, modifiers and pronouns in spontaneous utterances.
• Uses prepositions
•  Understands the concepts of one vs. all. For example,

•  Give me just one block.

•  Put all of the blocks in the box.

PLAY:

•  Performs longer sequences of play activities

•  Acts out familiar routines

•  Pretends to perform the caregiver/parent routines.

Story Telling: A Chatterboxes Parent’s Handout

When talking with your child as he or she tells you a story or relays an experience, try the following techniques and strategies:

• When your child is trying to tell you a story, relieve his/her stress by sitting with your child and maintaining eye contact and interest. Be an active and interested listener!

• Cue your child in to the sequence of the story e.g. 'That sounds great! Now, tell me again, what happened first? Then what happened? What happened at the end?'

• If your child goes off at a tangent, keep bringing her/him back to the topic e.g. 'Hang on, what happened after you did...?'

• Ask your child specific questions e.g. 'Tell me what happened when you first got to school?' rather than 'What happened at school today?'

• Lead your child's story e.g. 'And after Mrs. Smith said hello to the new boy, she said...?'

• Use the first sound to help your child find the correct word if he/she is struggling e.g. 'a ssss sound...' for a word starting with 's'

• Correct your child by giving a choice of 2 words e.g. 'Did you mean he threw the ball, or he caught the ball?'

• Give your child the opportunity to retell their story to a new listener (e.g. Dad, then Grandma). This allows them to practice and improve their story-telling skills with familiar material.

Oral Motor Tools for Feeding

 Try these tools for at-home feeding therapy:

Tool:	Use for:	How to use:
Chewy tube	Chewing skills Jaw gradation	1)    Place chewy tube on molars.  Have the child chew in sets of 5-10 reps on each side.        2)      Start with smallest chewy tube and build up to large chewy tube.
Nuk brush	Tongue lateralization	Dip in puree and have child reach the target. Place at corners of the mouth and inside of cheeks.
Toothette	Tongue strength Tongue range of motion	Dip in liquid and place on side of tongue. Have child push against the target.
Lollipop	Tongue lateralization	1)      Place on center of tongue and have child move it to molars 2)      Place on molars and have child move it to center of mouth   3)      Place on inside of cheek and have child move it to center of mouth
Popsicle	Tongue strength Tongue range of movement	Place popsicle in front of or on sides of mouth and have child lick the popsicle.
Frosting	Tongue strength Tongue range of movement	1)      Have child lick off frosting placed on upper lip, lower lip, and corners of the mouth. 2)      Have child lick frosting off of the back of a spoon.
Dissolvable solids (Cheese puffs, ice cream, graham crackers, etc.)	Chewing skills Jaw gradation Tongue lateralization	Place dissolvable solids on molars and have the child chew.

Child Nutrition

Nutrition is critical in children's early years of development. In these years, children are learning a growing a great deal, and they require adequate nutrition in order to do so. It can be a distressing experience when your child is not receiving proper nutrition due to delay in feeding skills or persistent food refusal. Strategies for improving your child's nutrition include:

· Try to expose your child to a variety of food types, textures, and flavors to facilitate comfort level with a variety of healthy foods.

· Aim to offer your child the most nutrient rich, natural foods. Consider buying organic foods, which contain less harmful chemicals and pesticides.

· Read product labels before buying foods. Don't just read through the calorie and fat content. Rather, study the list of ingredients to be sure that you are offering healthy choices for your child. Try avoiding foods that contain artificial colors or flavors. 

· Offer foods that will provide rich sensory experiences. These include foods with stronger and/or distinct tastes. It is preferable to use adult foods (e.g., graham crackers, bananas, avocados) rather than baby/toddler food products.

· Try to offer a well-balanced meal that includes the following three components: a whole grain, a protein, and a fruit/vegetable.

· If your child is not getting adequate nutrition from foods in his diet, consider adding a nutritional supplement, such as Pediasure, or a multivitamin. 

· Be sure to make nutrition the number one goal for your child. In a feeding therapy program, nutrition should be prioritized over other goals such as use of utensils or advancement to solids.  

· If your child is not getting adequate nutrition and has a dangerously low weight for height, short or long term implementation of a feeding tube may be indicated. Most children who have a tube in place, unless medically contraindicated, are able to continue with an oral feeding therapy program.

DIR®/Floortime

Chatterboxes’ speech-language pathologists are trained to provide DIR®/Floortime™ to their patients when appropriate.

DIR®/Floortime™ is a framework which helps parents, clinicians and educators complete comprehensive evaluations and develop treatment programs customized to the unique strengths and weaknesses of children with developmental challenges, including Autism Spectrum Disorders (ASD), among others. The DIR®/Floortime™ model aims to build the underpinnings for social, emotional, and intellectual capabilities, rather than focusing on individual skills and behaviors.

D = Developmental: Functional developmental capacities that integrate the most essential cognitive and affective processes

I = Individual Differences: Biologically-based differences in sensory processing, modulation, muscle tone, and motor planning and sequencing

R = Relationship: Affective interactions build social and emotional development, intelligence, and morality

Basic Principles of Floor Time:

1) Follow the child’s lead
2) Join in at the child’s developmental level and build upon his/her natural interests
3) Open and close circles of communication
4) Create a play environment
5) Extend the circles of communication
6) Broaden the child’s range of interactive experience
7) Tailor the interaction to the child’s individual differences
8) Simultaneously attempt to mobilize the six functional developmental level

For more information on the DIR^®/Floortime™ Model, please visit: www.icdl.com.

The Language of a Meal

The language you use in reference to foods can influence your child's perceptions about

foods. You can improve your child's eating attitudes and behaviors by teaching your

child about foods and being thoughtful about how you talk about foods.

• Avoid categorizing foods as healthy and not healthy. Many people associate healthy foods as not tasting good or as not being as fun as non-healthy foods. Instead, consider calling healthy foods "strong foods" or "growing foods" to create positive associations with these foods.
• Modify the language allowed to be used with reference to food. Don't allow your child to say, "I don't like it!" Instead encourage phrases such as "It's a new food," or "It's not my favorite."
• Use first-then language. Let your child know that he may have a preferred food after eating/interacting with a novel/non-preferred food.
• Use positive directives. For instance, instead of telling your child, "Stop banging your spoon," instruct your child, "Put your spoon on the table."
• Offer task specific praise. For instance, say, "Nice bite!" or "Good chewing!" rather than more general phrases such as "Good job!" so that your child knows exactly why he is being rewarded.
• Children have a natural desire to be in control. Offer your child choices when appropriate. These may include choosing which plate or cup to use and may also include choosing which vegetable to eat. When offering children choices, be sure that you will be happy with either choice.
• Talk about the foods you are eating. You can teach your children about where foods comes from (e.g., Apples grow on trees). You can also discuss what the foods look, taste, or feel like (e.g., Frozen yogurt is cold! Chicken soup is hot!).
• Read books about foods to increase your child's understanding and familiarity with foods. For younger children, look for board books with colorful pictures of foods or even search out books that are scented like the foods. For older children, seek books that teach about where foods come from or how foods are cooked. There are also lots of silly books about food available at any book store!

Links:
Parent's guide to feeding strategies & positive mealtime behavior
Chatterboxes feeding therapy
Feeding therapy FAQ