The health visiting pathway: 13-15 months
How I grow up and develop
HOW I GROW UP AND DEVELOP
ATTENTION AND LISTENING
- Can pay attention to adult -led activities for short a time eg looking at a book together.
- Listens to and enjoys patterns in rhymes and stories.
PLAY AND INTERACTION
- Enjoys social/people games such as peek a boo.
- Beginning to play imaginatively e.g. pretending to speak on a toy phone.
- Copies your actions (in songs etc).
- Takes turns in back and forth interactions and play.
RECEPTIVE LANGUAGE (UNDERSTANDING)
- Can follow simple instructions e.g. ‘bring me teddy’.
- Points to body parts.
- Can understand/identify familiar objects when they are named e.g. car.
- Understands everyday words and actions.
EXPRESSIVE LANGUAGE (USE)
- 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.
- May use babble between real words.
- Says around 10 recognisable words by 18 months.
- Particular words may have different meaning in different contexts.
- Gets your attention by pointing, making noises, using words.
SPEECH SOUNDS
- Uses a simple range of sounds e.g. b, d, m, n.
- Imitates sounds, attempts to copy sounds made by another person.
- Speech isn’t clear yet.
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.
What I need from people who look after me
Promoting Interaction
- 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.
- Allow pauses and wait expectantly for baby to communicate with you.
- Using a slow rate of speech which allows time for your baby to initiate and respond to communication.
- Take turns when playing games such as peek-a-boo – this will help baby to 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.
- Recognising and responding positively to a child’s attempts at communication is vital.
- Repeating words back to show you have understood and helps your baby to hear good examples.
- Point and name objects that a child shows an interest in.
- Using actions and gestures will build shared attention and understanding.
- Interpret your babies messages. Provide names for things the child shows an interest in. Put into words what the child is trying to tell you. This will build vocabulary development.
- Talk to baby as often as possible. Linking language to what they see and what they are doing. Use short, simple sentences.
- Name a variety of vocabulary. Emphasise and stress important.
Opportunities
- Offer choices - e.g. milk or juice. This helps a child understand and label new vocabulary and provides opportunities to practice words.
- Reading provides opportunities for interaction, communication and sound play. Try reading one of the books from your Bookbug Toddler Bag more than once. Hearing the same stories again and again helps to develop your little one's language and social skills.
- Singing rhymes and songs are important opportunities for language development: wait at times to see if the child will fill in the action or words in the song.
- Play provides many opportunities for communication development (see play at home book for lots of ideas).
Environment
- Try to reduce any distractions or background noise -eg with TV turned off. It can be helpful to have a quiet time each day for communication so baby can tune into your voice.
- Avoid excessive use of dummies, especially when baby is bright, alert and trying to communicate.
My wider world
Speech, language and communication skills are central to improving educational attainment, mental health, well-being and long-term life outcomes, including employment and social mobility.
Support
Health visitors and family nurses play a key role in promoting early language development and in the prevention and early identification of speech, language and communication needs. Below are some suggested ways of supporting families:
- Promote positive interaction skills by role modelling talking, listening, playing and reading with baby.
- Consider other family members who might be able to help – grandparents, older siblings – and give them key messages around talking, singing, reading and interacting.
- Parents with mental health issues, including postnatal depression and postnatal post-traumatic stress, may need more support and encouragement to talk with their babies and use a tuneful voice – but encouragement to try this even a little can be a great help.
- Parents with communication support needs may require additional support in communicating and interacting with baby. Ensure you are aware of individuals communication preferences.
- Signposting: Attending local Bookbug sessions, infant massage or other community resources can support the attachment and communication process and can be a great source of support for families.
- Bookbug Sessions in libraries and community venues are a great way for families to spend quality time together and meet other families. They also help to build children’s social skills and support their speech and language development.
- Parents have access to developmental guidelines relating to early communication skills through the Red book, Ready Steady Baby, Ready Steady Toddler and Parent Club.
Resources
For professionals
- Parent Club website is the host for the Chatting Together messages for bumps to babies, and toddlers to young children and has accompanying videos to share with families.
- Chatting Together Messages | National Early Language and Communication (NELC) Project.
- Bookbug for the Home training: Fully funded training available for midwives and health visitors who are working closely with families and would like to use stories songs and rhymes on a one-to-one basis to support families.
- Dolly Parton’s Imagination Library: If children are Looked After when they are born or are care-experienced at any point between birth and 5 years, they will be eligible for Dolly Parton’s Imagination Library. Professionals can make families/carers aware or ensure that children are signed up through their local social work department.
- The Scottish model of infant participation: Key Messages for Best Practice: 2 - Voice of the Infant: best practice guidelines and infant pledge - gov.scot.
For parents
- Parent Club website is the host for the Chatting Together messages for bumps to babies, and toddlers to young children and has accompanying videos to share with families.
- Chatting Together Messages | National Early Language and Communication (NELC) Project
- CBeebies Parenting Activities for babies, toddlers and children.
- You can also find books and resources in the baby bookbug bag and many recordings of popular songs and rhymes on the free Bookbug app.
- Ready Steady Baby has lots of information and resources to support early development.
- Solihull free resources for parents (using code TARTAN) inourplace | Solihull Approach – Scotland | inourplace.
- Understanding your baby
- Understanding your child: from toddler to teenager
- Understanding your child with additional needs
- Understanding your child's feelings
- Understanding your child's mental health and wellbeing
- Understanding the impact of the pandemic on your child