HOW I GROW UP AND DEVELOP
WHAT I NEED
FROM PEOPLE WHO LOOK AFTER ME
MY WIDER WORLD
SUPPORT
THE HEALTH VISITING PATHWAY
27 - 30 MONTHS
NHS EDUCATION FOR SCOTLAND
SPEECH, LANGUAGE AND COMMUNICATION
GIVING CHILDREN THE BEST POSSIBLE START IN LIFE
Uses from 50 to 300 words.
Rapidly learning new words.
Sings parts of familiar nursery rhymes.
Beginning to link two words together.
A familiar adult understands speech most of the time.
Speech may not be clear - child may use-p,b,t,d,n,m,w,h.
At this stage the child may occasionally repeat words at the beginning of a sentence. They are usually trying to share their ideas before their language skills are ready.
Participate in pretend play e.g. give teddy a drink.
Beginning to use objects imaginatively e.g. pretends that a box is a car or bed.
Likes to watch other children play and will play alongside them.
Still learning rules of interaction.
Follow simple instructions in context e.g. put teddy on the bed.
Two step command- can understand an instruction with has two important words e.g. give some juice to teddy.
Can give you objects without you pointing to it.
Understands objects by use e.g. which one do we sit on?
Starts to understand concepts such as: in, on, under, big, little, more.
Can point to body parts.
Can understand simple who, what, questions.
Understand simple action words e.g. drink, sleep- can do a simple action when asked eg jump up and down.
Attend to joint activity for around 5 minutes.
Listen to a story with pictures.
Attend to simple conversations.
Recognises familiar sounds in their environment e.g. animal noises, noises in the home.
Take turns in simple games e.g. rolling a ball.
SPEECH, LANGUAGE AND COMMUNICATION DEVELOPMENT KEY
LOOK OUT FOR
- No attempts at single words
- Has less than 50 words, no attempts at joining words together
- Doesn’t show understanding of simple commands e.g. ‘don’t touch or simple questions – where’s your shoe?
- No response to name
- Lack of interest in communicating with others
- Lack of response to adult initiation of social interaction
- Lack of use of eye contact in interaction
- Doesn’t pretend with toys eg feeding doll
- Regression of skills
- Speech is very difficult to understand, even to a familiar adult - e.g. numerous vowel errors, frequent deletion of initial consonants, frequent use of ‘h’ for a variety of sounds, backing (eg ku for two) and deletion of final consonants.
- Parental concern
- Hoarse voice
- Dysfluency (stammer)
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: Allowing time for children to respond. Pausing for a few seconds to allow time for child to communicate.
- Pace: Using a slow pace which allows time for child to respond.
- Taking turns when playing games and singing rhymes
- Be careful with questions - Asking too many questions or questions to ‘test’ a child can affect the interaction e.g. ‘what colour is that?’
- Praising attempts at communication. Correcting a child’s speech may affect the interaction. Focus on what the child is saying, not how they are saying it. Provide a correct model for the child to hear.
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 models.
- Expanding - Adding and extending the child’s utterances. Add one or two words to the child’s sentence. If they say ‘car’ – you could say ‘red car.’
- Context Sensitivity: Pointing, labelling and describing a variety of vocabulary that a child shows an interest in
- Interpret messages – Provide labels and descriptions for things the child shows an interest in. Put into words what the child is trying to communicate. This will build vocabulary development
- Commenting: Use short, simple sentences. Talk about what your child is doing and what they are interested in.
- Labelling – Name a variety of vocabulary. Emphasise and stress words.
OPPORTUNITIES
- 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 @ home book for ideas).
- Routines (such as bed, bath time) provide good opportunities for children to anticipate what is happening next and develop the language around this.
- Activities which promote sound play are particularly important for young children who are learning how words and phrases work, and the fine speech discrimination skills necessary for linking sounds to meaning.
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.
- Consider how screen time is influencing child’s opportunities for interaction.
At two years old, children’s understanding and use of vocabulary as well as their use of two-three word sentences predicts their performance when they begin primary school. (Roulestone et al 2011)
Work with parents is vital. ‘Growing up in Scotland’ 2015 longitudinal research has found that progress in language amongst 3-5 year olds was most affected by factors in the home environment.
The Growing up in Scotland research (2015) also found that undertaking frequent home learning activities was positively associated with high vocabulary scores at age 3.
Pre-school provision will provide new experiences and increased opportunities for communication. Evidence suggests that attending an early years setting improved children’s academic and social outcomes. An early start (before aged three) and attending a high quality setting are particularly beneficial. (Taggart et al 2015)
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 promote language and social development for sharing or signposting with parents can be found on the bumps to bairns website, for toddlers and for older children
- Effective sharing of information and a co-ordinated multi agency approach, especially around the child’s transition to a pre-school educational setting.
- 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. (e.g ASQ 3)
- 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 PROFESSIONALS
Useful articles for parents and professionals about language development
Building Language and Literacy
FOR PARENTS
Words Up – parent-friendly posters explaining development and key messages
Communication Trust: Through the eyes of a child- videos for parents of children from 2-3 years
REFERENCES
Roulstone, S et al (2011) Investigating the role of language in children’s early educational outcomes
Growing up in Scotland 2015: Longitudinal Study
Brenda Taggart, Kathy Sylva, Edward Melhuish, Pam Sammons and Iram Siraj (2015) Effective pre-school, primary and secondary education project (EPPSE 3-16+) How pre-school influences children and young people's attainment and developmental outcomes over time
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