HOW I GROW UP AND DEVELOP
WHAT I NEED
FROM PEOPLE WHO LOOK AFTER ME
MY WIDER WORLD
SUPPORT
THE HEALTH VISITING PATHWAY
13 - 15 MONTHS
NHS EDUCATION FOR SCOTLAND
SPEECH, LANGUAGE AND COMMUNICATION
GIVING CHILDREN THE BEST POSSIBLE START IN LIFE
Uses gestures or pointing (sometimes with words) to indicate what they want e.g. waves bye bye.
Single words are emerging although may only be recognisable to familiar people.
Says around 10 recognisable words by 18 months.
Particular words may have different meaning in different contexts.
May use babble between real words.
Uses a simple range of sounds e.g. b, d, m, n.
Imitates sounds, attempts to copy sounds made by another person.
Beginning to play imaginatively eg pretending to speak on a toy phone.
Can follow simple instructions eg ‘bring me teddy’.
Points to body parts.
Can understand/identify familiar objects when they are named e.g. car.
Can attend to adult led activities for short a time (2 minutes).
Joint attention developing.
Enjoys social/people games such as peek-a-boo.
SPEECH, LANGUAGE AND COMMUNICATION DEVELOPMENT KEY
LOOK OUT FOR
- Shows very little intention or motivation to communicate
- Lack of interest in social play and interaction with family members
- Lack of eye contact
- Child does not respond to language (and a hearing test has confirmed normal hearing)
- Little or no babbling/experimentation with sounds
- Doesn’t use gestures like waving “bye bye” or shaking head for “no”
- Doesn’t respond to her/his name
- Doesn’t communicate in some way when s/he needs help with something
- Doesn't understand and respond to words like "no" and "up"
- No attempts at words by 15 months
- Doesn’t point to things of interest
- Parental concern
PROMOTING INTERACTION
- Proximity: Children will communicate more when they are face to face with an adult
- Following a child’s interests encourages them to communicate about what is important to them.
- Waiting: Allow pauses and waiting expectantly for child to communicate.
- Pace: Using a slow rate of speech which allows time for children to initiate communication.
- Taking turns when playing games such as peek-a-boo will help child learn about turn taking in conversations.
- Be careful with questions - Asking too many questions or questions to ‘test’ a child can affect the interaction e.g. ‘what colour is the bus?’
PROMOTING LANGUAGE
- Repetition is very important to the acquisition of language. Infants and young children need to hear words over and over again before they will attempt to use them.
- Responsiveness: recognising and responding positively to a child’s attempts at communication is vital.
- Repeating words back to show you have understood and so the child hears good examples
- Context Sensitivity: Pointing and labelling objects that a child shows an interest in and responding to a child’s initiations
- Gestures - Using actions and gestures will build shared attention and understanding.
- Interpret messages – Provide labels for things the child shows an interest in. Put into words what the child is trying to tell you. This will build vocabulary development
- Commenting: Talking to baby as often as possible. Linking language to what child sees and what they are doing. Use short, simple sentences.
- Labelling – Name a variety of vocabulary. Emphasise and stress words.
OPPORTUNITIES
- Offering choices - e.g. milk or juice. This helps a child understand and label new vocabulary and provides opportunities to practice words
- Reading provides opportunity for interaction, communication and sound play.
- Singing rhymes and songs: wait at times to see if the child will fill in the action.
- Play provides many opportunities for communication development. (see Play at home book).
ENVIRONMENT
- Attempts to control/minimise distractions/background noise - it can be helpful to have a quiet time each day for communication.
- Avoid excessive use of dummies.
Research has shown that the type of toys that are played with can effect the adult – child interaction. It found that interaction is harder to achieve with electronic toys and that most interaction is achieved through traditional play and books. (Sosa 2015)
Excessive use of dummies may reduce talking and experimentation with sounds.
The amount of words a child hears can affect their speech, language and communication development. At age five a vocabulary gap of 13 months exists between most and least affluent in society. Sosu et al 2014
Health Visitors and Family Nurses play a key role in prevention and early identification of Speech, Language and Communication Needs. Below are some suggested ways of supporting families and signposting them to relevant support services.
- Consider any support a parent with Communication Support Needs may require. Parents with CSN may be less able to access additional supports and information that could assist with their child's development. Ensure you are aware of parents communication preferences and can respond appropriately to these.
- Ensure all information is ‘communication accessible.’
- Demonstrate and discuss positive interaction skills.
- Parents with mental health issues, including postnatal depression and postnatal post traumatic stress, may need more support and encouragement to interact sensitively with their children – but trying this even a little can be a great help to them. Be aware that postnatal mental health issues can affect both mothers and fathers.
- Where there are capacity issues for parents, consider other family members who might be able to help – grandparents, older siblings – and give them key messages
- Signposting: Attending local bookbug sessions, infant massage, toddler groups or other community resources can support the attachment and communication process.
- Tips and advice on effective strategies to support language and social development for sharing or signposting with parents can be found on the bumps to bairns website. Subjects include Play and Talk and Language and Interaction
- Parents have access to developmental guidelines relating to early communication skills through the Red book, Ready Steady Baby and Ready Steady Toddler.
- Play at home Toddler book contains many ideas to support language and communication development- see first words and play at home to see which activities are directly linked to communication.
- Play, Talk, Read website contains many ideas and examples of positive interaction.
- Use of evidence based tools to profile the child’s speech, language and communication abilities and needs.
- Consider Motivational Interviewing/ Health Coaching Strategies: Health Behaviour change e-learning suite
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Using the elicit-provide-elicit model of sharing information and checking understanding.
- Elicit - what the parent/carer knows already
- Provide - fill in any gaps or misconceptions
- Elicit - Explore what fits with family life
- Using open-ended questions, active listening, reflecting back and summarising. (For more information on these techniques see NES Motivational Interviewing resource).
- Using a collaborative communication style - working in partnership with families, empowering them to solve issues and make decisions
RESOURCES
FOR PARENTS
National Literacy Trust: Tips for Talking to your baby and young child
Words Up – parent-friendly posters explaining development and key messages
The Communication Trust: Through the eyes of a child: video for parents 1-2 years
Sosa, A.V. (2015). Association of the Type of Toy Used During Play With the Quantity and Quality of Parent-Infant Communication. JAMA Pediatrics, 170(2), 132-138
Sosu, E. and Ellis, S.(2014) Rowntree Foundation; Closing the Attainment Gap, Scotland 2014
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OTHER LINKS
- NES website
- The Portal
© NHS Education for Scotland 2018. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES.