EARLY COMMUNICATION
EARLY COMMUNICATION
Before children learn to talk they need to develop their early communication skills,
such as: looking, joint attention, taking turns and listening. These skills are regarded
as the foundation to speech, language and communication development.
This section includes relevant resources and advice to support the development of
early communication skills.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012
Language Development Pyramid
Skills at the bottom have to be in place before the
skills above them can be developed
pronunciation
talking
Adult / child
interaction
understanding
play
looking and listening
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Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
Development of Play
Children learn best through play because it is fun. Children will learn best when they are interested
and when they can lead the play. This means letting them choose how to start playing and then
joining in the game.
You can help a child learn through play by providing the toys and opportunities, watching how he
plays and showing him how to play in new ways. This will help him build new skills.
There are several different types of play which a child will learn gradually as he develops.
 People Play
 Sensory & Exploratory Play
 Cause and effect Play
 Physical Play
 Construction Play
 Creative Play
 Pretend Play
Learning through play is vital for the development of a child’s communication skills.
Play can improve social interaction skills such as eye contact, turn taking and copying sounds and
actions. It can also help develop understanding, use of language and gesture, concentration and
listening and imagination.
Play can also help develop other new skills such as physical and movement skills, general learning
and problem solving.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
1
Developing Pretend Play
Why is Pretend Play important?
Pretend play or symbolic play is important for several reasons:
1. Developing understanding of what objects are used for.
2. Developing the concept that a word can represent/symbolise an object just like a toy can
be used to represent a real object.
3. Developing flexible thinking and imagination.
4. Learning about real-life situations and acting them out.
5. Language often develops alongside pretend play.
First Stage – pretend play with real objects. This shows that a child understands what objects
are and what we do with them.

Before drink time get out the child’s empty cup and pretend to drink
from it and encourage the child to do the same, and then go ahead
with drink time.

Collect several everyday items in a box for example, a hat, hairbrush, toothbrush, key,
cup, toy phone, and blanket. Produce them one at a time, pretend to use them and
encourage/help the child to do the same, for example, putting the phone to their ear,
pretending to sleep with the blanket. Make appropriate symbolic noises such as a phone
ringing sound or “shhh” with the blanket.

Once the child has learned how to use the objects themselves, encourage them to relate
them to other people, for example, help the child to brush your hair.
Second Stage – Playing with teddies and dolls.

Pretend to use the familiar objects on a large doll /teddy or toy character such as Peppa
Pig. Help the child to do the same, you could feed teddy, brush doll’s hair, put teddy to
bed, wash baby or make a teddy’s tea party. Use appropriate sounds and words such
asshh, mmm, snoring noises.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Third Stage – sequences of pretend play

Encourage the child to copy everyday activities at home such as sweeping,
washing cups, cooking, washing clothes.

Model and encourage pretend play with everyday objects: teddy, dolly,
bed, table, food, and blanket. Extend the play into short sequences of
play, for example, brush doll’s hair then wash doll’s face or give teddy a
cup of tea then make him go for a walk. Continue to extend these
sequences as the child becomes more confident.
Fourth Stage – small world play

Make the transition to small world toys such as dolls’ houses, garages or farms so
that play becomes more
imaginative and less
dependent on the real
objects.

Encourage the child to make small world figures or dolls interact with each other, for
example, making a figure kick a football to another.

At first you may need to lead the play and
encourage the child to join in and copy. Later, the
child might start the play; if so, respond by following
his lead.

Around this time, you can help the child start to use
objects
symbolically,
pretending
something is
something else,
for example,
pretending a
banana is a phone.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Fifth Stage – encouraging complex symbolic play and role play.

Make the transition to miniature toys of all sorts – dolls’ house material, matchbox
cars, play people, farm and zoo animals, soldiers etc – so that real life situations
can be acted out and stories can be made up

Extend the child’s storylines by introducing new ideas, for
example, your car crashes into his car, so you get an
ambulance and give him the breakdown lorry.

Increase the amount of spoken
interaction alongside the physical
interaction between the toys, for example, the police car
arrives and you act out the policeman asking him, the
driver, why the crash happened.

Increase the imaginative element, so that there is a shift away from the real to the
make believe for example, dressing up games and role play such as police officer,
turning empty boxes into boats, cars, houses.

Create opportunities for children to act out feelings and emotions, describe
situations, ask questions, give instructions, and act out the real world.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Physical Play
Physical Play helps develop movement and coordination. It also helps children develop their
independence. Physical play is particularly good for active children, and children who struggle to
concentrate.
Below are some ideas for physical play:
Sing and act out
action rhymes with
child such as, ‘Row
Row Your Boat’.
Take the child to the park or
outside play area to enjoy
the swings, slide and
climbing frames.
Play ball games at a level the
child can enjoy.
Encourage young
children to splash
and kick at bath
time or in puddles.
Play hide-and-seek and
chase games.
Use push-along toys to
encourage walking.
Visit a soft-play centre or
include a soft-play area in
your setting.
Lie child across a large gym
ball and rock them
backwards and forwards.
Bounce young children
on your knees or lift
and rock them in your
arms.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
People Play
How to Help
Children need to learn how to engage with, and play with people before they
play with toys. Children usually, instinctively, turn to faces and voices and are
far more interested in you than they are in a toy.
People play is the first kind of play that children learn to do and is fundamental
for the development of interaction, communication and learning.
People games are games without toys, just involving you and the child in an
easy relaxed environment where you are both enjoying each other’s
company. These games work because they have a predictable and repetitive
element that all young children enjoy.
The first interactions that usually make a small baby smile are tickles, soft
repetitive voices with varied intonation and physical movement – so these are
the strategies that we recommend using with any child who is struggling to
develop their basic interaction and communication skills.
Repetitive tickle games and rough and tumble play are the best ways to
encourage a child to become giddy and excited, to anticipate what is going to
happen next and then to request more of the same activity.
Play games like:
“I’m coming to get you….”
“1…2…3…tickle…”
“Ready, steady…….”
“I’m going to tickle your… nose/toes/tummy/hand”
Or throw your small child in the air, bounce them on the bed or trampoline,
spin them round, and then wait and watch for their response; if they are
enjoying it – they will come back for more.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Play games such as:
Round and round the garden.
This little piggy went to market.
Peek a boo.
So big.
Try to build the anticipation of the tickle or fun part, and give the child a smile
or a cuddle at the end to indicate the rhyme has finished. Repeat, repeat,
repeat! Lots of repetition of the rhyme will help the child to learn it.
When the child is familiar with the rhyme or song, build in a
pause and wait. Wait for the child to indicate that they want
you to continue – this may be in the form of a look, a sound, a movement of
their own or your hands, a smile. This is the child’s turn in the interaction and
is the basis of turn-taking and communication with people.
Let the child lead the interaction and have fun playing with them.
Children need to learn to succeed at these people games before they will be
successful communicators.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Cause and Effect Play
Cause and Effect is an important stage in a child’s development of play and learning. This kind of
play helps the child to learn that their actions can have an effect in or on something else and
encourages the beginnings of problem solving.
The activities below all help to develop cause and effect skills:
Pull and push along toys
Give the child toys
they can squeeze
and shake
Stack cups or blocks into a
tower then knock them down.
Play with musical toys such as
shakers, drum, keyboard,
xylophone, musical push-button
toys.
React to the child’s actions and
sounds with a fun familiar
response, for example, every time
the child drops a toy, say “uh oh!”
Lift the flap books and books
that make noises.
Play with pop-up toys such as
a jack-in-a-box, pop-upanimals.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
1
Construction Play
Construction Play helps a child to,
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develop hand-eye coordination and movement skills
understand how parts fit together
improve memory through practice
It also gives a sense of achievement!
Play posting
games.
Play with shapesorters.
Do jigsaws. The
easiest kind are
simple inset puzzles.
Build towers, bridges
and houses out of
bricks.
Use chairs and sheets to
make dens.
Play with stacking rings and
stacking cups.
Put things in and out of containers
and bags.
Hide toys under cloths or boxes or bury
objects in sand.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Creative Play
Creative play helps a child to:
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develop hand movement
encourage imagination
experiment with different materials
experience feeling different textures
Ideas to try:
Cook together –
make biscuits then
decorate with
coloured icing,
make faces with
raisins!
Make animal masks
from paper plates.
Try potato printing – cut out
patterns then print using
paints.
Make collages by sticking
materials on to card. You
could use sweet wrappers,
glitter, bottle tops, magazine
pictures, string, tin foil,
uncooked pasta and other
food items.
Make pictures using
paints, pens, crayons
and chalks.
Use jam, chocolate spread,
peanut butter, honey etc for
finger painting.
Make play dough – model
into shapes.
Try drawing around hands
and feet.
Make models from old food
packets, containers and
boxes.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Sensory & Exploratory Play
Sensory and Exploratory play helps children to learn about the world around them. It also,

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helps children become more accepting of new sensory experiences including food
helps children to develop movement and coordination
helps children learn that they can have an effect on the things around them
Activities to encourage sensory and exploratory play that you could try:
Support child in putting safe
objects to their mouth.
Help child to bang, shake,
examine, drop and throw
objects.
Give child toys they
can squeeze and
shake.
Gather together objects that
have different textures, such as
rough, smooth, spiky, feathers
for the child to feel and
explore.
Explore sounds using bells,
rattles and musical toys.
Use baby oil to massage
a child’s hands and feet.
Encourage the child
to try a range of
tastes and smells
through messy play
with food.
Play with toys and objects
that are brightly coloured,
shiny, lit-up.
Help the child explore touch
and feel books.
Play with a range of messy
activities such as sand,
water, play dough.
Make shakers out of pots
filled with dried pasta or rice.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Non-Verbal Skills: Communication without Words or Signs
What are Non-Verbal Skills?
Surprisingly, during our conversations and interactions a large part of our communication is extra
to the words or signs we are using. These skills are the non-verbal skills that children usually
start to develop from an early age.
Non-verbal skills are the very important skills that children start to develop before they learn how to
talk. They are the building blocks for learning how to talk and communicate and they continue to
develop as the child learns.
These skills include:
 attention and listening
 eye-contact
 turn-taking
 copying
 knowing that you need to communicate (communicative intent).
 using facial expression
 using gestures such as pointing
 using sounds and tone of voice
 understanding the non-verbal communication of others
How to Help
All these skills can be developed through interaction and play with the child. It is important that
these skills are initially developed through people games – games without toys (action songs,
rough and tumble etc) and then developed through the activities with toys.
Your speech and language therapist will discuss with you the most appropriate activities you can
do, or games you can play, to focus on some or all these areas.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
1
Characteristics of Attention and Listening Difficulties
Children with attention and listening difficulties may have some of the
following characteristics:

Appear to ignore you

Cannot sit still

Talk when should be listening

Cannot tell you what you have been talking about

Do not appear to know what to do and can have difficulty following
instructions

Can only concentrate on one thing

Are easily distracted

Do not settle with one activity, but tend to flit from task to task
Typical Developmental Stages of Attention Skills:
The six stages of attention and listening development are:
Development of Attention Skills
STAGE ONE: Very distractible,
attention is focused on whatever is
their current interest and will be quickly
shifted to any new stimulus.

STAGE TWO: Can concentrate on a
task of their own choosing. Children do
not have the ability to focus on more
than one task. It is difficult for an adult
to direct the child.

STAGE THREE: Attention is still single
channelled but the child is now able to
shift their attention away from the
current task and then go back to the
original activity with adult support.


Practical Ways to Help
Use the child’s interests and
incorporate these into the
different areas of play eg, Peppa
Pig figures in the water tray.
Allow the child time to complete
an activity of their own choosing
You will need to use the child’s
name and/or a physical prompt
such as touching their hand to
gain their attention.
Say the child's name before
giving any instructions or
expecting a response.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012
STAGE FOUR: Start to be able to
control their own focus of attention.
Children are now able to shift their
attention to and from tasks more easily
and require less adult support

STAGE FIVE: The child is usually
entering school at this stage. They can
now perform an activity whilst listening
to the teacher giving instructions. This
is called dual channelled attention.
Concentration span can still be quite
short, however, children can cope with
group situations.

STAGE SIX: Attention skills are now
flexible and sustained for lengthy
periods. The child can integrate visual
and auditory information with ease.


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Let the child know when it’s time
to listen.
Use visual prompts such as
hands in the air or clapping to
gain whole group attention.
Use an introductory phrase,
gesture or non-verbal prompt.
Give information in a clear
sequence.
Encourage active listening.
Encourage active questioning
and processing of information.
Adapted from: Cooper, J., Moodley, M. and Reynell, J. (1978) Helping Language Development: A
Developmental Programme for Children with Early Learning Handicaps. London: Edward Arnold
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012
The Importance of Developing Attention and Listening
Why is attention important?
Children have to learn to focus their attention on to different things. This usually starts with
attending to people, then to objects, then being able to share their attention between people and
objects.
Children need to develop their attention skills before they learn to understand words and learn
to talk.
Children need to be able to attend and concentrate so that they can learn new skills, including
how to communicate.
Why is listening important?
Children may hear what you say but not listen to what you say. Listening to language involves
hearing the words, attending to them and thinking about them.
Children need to be able to listen to and recognise the sounds that make up words and
sentences so that they can learn to understand and use words and sentences themselves.
The different sounds we use in our speech can sound very similar to one another when children
are learning language.
Children often need to practise listening to a range of different sounds to develop this skill.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
1
Strategies to develop Attention
What helps?

Reduce distractions. This might include removing other toys.

Turn the TV or background music off.

Choose a time of day when you and the child are fresh and
in a good frame of mind.

Watch the child to see what interests them and follow their lead. Join in with what they are
doing.

“People games” (tickles, singing, rhymes etc) are often the best type of activity to start with
to get a child’s attention.

If using a toy, play with one toy at a time in many different ways to keep the child’s interest.
Don’t be concerned about using the toy in a different way from usual. Using the toy in an
unusual way might just be the thing to get the child’s attention.

Keep activities short and stop when the child loses interest.

Keep your play exciting by using your tone of voice and facial expression.

Using pauses during play can build in an element of anticipation. For example pausing
before ‘go’ in ‘ready, steady, go’ games, and waiting for the child to indicate that they want
the next step to happen.

Follow the child’s lead throughout the play. Play with what interests them.

Try to get the child to the end of an activity even if it only lasts a few seconds. For games
with a definite end point encourage the child to complete the final step, even if you do the
rest of it, for example, you do most of a jigsaw and let them put the last piece in.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
2
Games and Activities to Help Develop
Attention and Listening

‘Ready, Steady, Go! Games The child is encouraged to wait until you’ve said “go”
before each turn. Increase the length of time (s)he has to wait for the word, “go”.
Ideas to try
 Roll a ball/car between you and child.
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Build a tower of bricks or stacking cups together and knock it over,
Child pinches the end of an inflated balloon and waits for “go” before they let go
of the balloon
Play with a click clack track/ garage. Child waits for “go” before sending the
car down the chute/track.
Use shakers or drums. Child waits for you to say “go” before they can play the
instrument.
Child waits for you to say “go” before they can run to pop the bubbles.
Take turns in simple games. Increase the amount of time the child will sit to take turns.
Ideas to try
Take turns to……
 add a brick to a tower.
 put a piece in a jigsaw.
 post pictures in a post-box.
 roll a ball to each other.

Hide and seek
Ideas to try
 Hide things that make a noise (e.g. a wind-up toy, musical box). See if child can
find the toy by listening to the sound.
 Hide behind a chair and make a sound such as a giggle. See if child can find
you.
 Fill yoghurt pots with different things, e.g. rice, bells, shake them and listen to
the different sounds. If you have two the same, play a game at finding the
ones that have the same sound.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013

Action songs and rhymes
Ideas to try
 Sing songs together such as “Wind the Bobbin Up” or “The Wheels on the Bus”
and encourage child to join in and copy the actions.
 Leave pauses in the song so that child has a chance to fill in the gaps.
 Use a wooden spoon to bang different surfaces, for example, the bottom of a
plastic mixing bowl, bottom of a pan, the floor, a metal table leg. Listen to the
different sounds. Bang along to the rhythm of the song.

Play listening games
Ideas to try
 Use sound lotto games. You can download applications on some mobile
phones, look on the internet or you could buy/make one. Play the sounds and
see if the child can point to the picture that matches the sound.
 Make noises with rattles, keys, instruments and see if the child turns to the
noise.
 Go for a Listening Walk- talk about all the sounds you can hear, such as birds
singing, cars brrruming, people chattering, phones ringing.
 Use musical instruments. See if the child can copy the number of beats or
shakes.
 Play ‘Musical Bumps’- dance to the music then bump to the floor when the
music stops.

More games
Ideas to try
 Stories - look at books together and encourage the child to sit and listen and
join in with their favourite parts of the story.
 Play “Simon says….” Encourage the child to listen to the instruction before
carrying out the action, for example, clap your hands, touch your nose, stamp
your feet.
 Play musical statues - the child listens for when the music stops and then
stops dancing.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Games and Toy Ideas for Young Children
Attention and Listening
Sound shakers and noisy toys - take turns to make and copy sounds. You could hide
a musical box or noisy toy for the child to find.
Threading beads - see whether your child can copy a pattern
that you have made.
Turn-taking activities - e.g. take turns to put a brick on a
tower then knock it down,
roll a ball to each other, take turns to put pieces in a simple
inset puzzle.
Age appropriate books - have ‘story time’ where you share a
book with your child. Ask them to find objects in the book.
Nursery rhymes - Sing songs and do the actions together. Lots
of books come with CDs that you could use for this.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Dolls, teddies, TV characters and play Getting involved in your
child’s play is an excellent time for developing language and play
skills. Play alongside your child. Comment on what they are doing
e.g. “Oh look, Peppa’s jumping”, “Look, Woody’s eating”. Model
simple pretend play such as putting Buzz to bed or giving a banana
to Mr Potato Head and see if they can follow simple instructions
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Activities to Develop Attention and Listening in Foundation Stage

READY STEADY GO GAMES - Encourage the child to sit and wait for ‘go’ before
they do an activity e.g. building / knocking down towers, passing a ball, rolling a car,
the child pinching the end of an inflated balloon and waiting for ‘go’ before letting
go.

TURN TAKING - Sit in a circle and take turns to play motivational games such as
posting, fishing, lotto, feely bag, passing a clap or hand squeeze around a circle.
Older children could say their name or favourite food when a
ball or beanbag is thrown to them.

ANIMAL ANTICS - Put a selection of familiar animals in front
of the child. Make the sound of one of the animals and let the
children take turns to find it.
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ACTION SONGS AND STORIES - Encourage the child
to sit in a group and join in with songs or stories. Pause
before the ends of sentences and wait for the child to fill
in the gaps “the wheels on the ….(bus)” or “we’re going
on a ……(bear hunt)”.
Sound Games

Hear the beat - Use shakers, drums etc to make two or three sounds in a sequence to be
copied by the child.

Listening walks - (DfES Letters and Sounds) – listen to the sounds around the nursery /
school. Talk about the different sounds that you can hear. Make a list or a drawing of all
the sounds the child can remember e.g. children talking, water splashing, door shutting,
aeroplane, birds etc.

Music games - Play musical statues or musical bumps and when the music stops the
child has to do an action e.g. clap hands, stamp feet etc.

Sound lotto - Make your own or use a commercial package. The child listens to the
sounds and puts a counter on the matching picture.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012

RED, AMBER, GREEN – This game is fun to play outside!
Let the child run around and listen for the colours. When
you say green the child can run. Red means stop and
amber means sit down or clap hands.
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FOLLOW THE LEADER - Sit in a circle. The leader asks the group to carry out
simple actions. The child must wait until they hear “go”, e.g. “touch your toes…go”
“jump up and down…..go”. Leave a pause between the instructions and “go” and
gradually increase this time. Once the child is confident, make the instructions
harder e.g. “stamp your feet and then shout your name…go”.

START/FINISH BOXES - These can be used to extend the amount of time the child
can sit and attend to an adult led task. The use of boxes / baskets helps the child
visually see what they are expected to do before a reward e.g. a sticker / free play.

USE TIMERS - e.g. sand or egg timers to visually show the child how long you want
them to listen or join in for.
Stories/Books
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Silly Stories - Read a familiar story and see if the child can spot any
mistakes e.g. using the wrong character name or wrong action to the
picture.
Story games - Read a short story to a small group. Change
characters names to the children’s names in the group – let the
children stand up if they hear their name.
Look at books, pictures or photos - Encourage the child to talk
about them, describe what is happening and find objects in the
pictures.
For further activities to develop attention and listening skills please use
 Letters and Sounds: Principles and Practise of high quality phonics. Primary
National Strategy, DFES (2007)
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Activities to help Auditory Processing Skills
The following games and activities can be used to help improve your child's
listening skills. Remember to keep the activities fun and to only spend a short
amount of time on any specific activity (5-10 minutes maximum).

Listening Walk: The purpose of the walk is to listen to sounds,
particularly those they may not have been aware of previously.
Before the walk you can suggest sounds to listen for or you can
call the child's attention to sounds as you walk along. After the
walk, see how many sounds your child can remember and
encourage him/her to describe them.

Practise listening to environmental sounds and guessing where
the sounds are coming from and what is making them.

With their eyes closed ask your child to identify different noises
e.g. clock ticking, coins rattling, squeaky toys, paper rustling,
kettle boiling etc.

Have your child close their eyes and then move to different
positions in the room. Call out to your child and see if they can
guess from which direction your voice is coming from.

Play listening games such as "Simon Says". Simon says can
also be
played with your child imitating your speech sounds, volume
changes,
changes in pitch and rhythm changes.




Play games such as "Eye Spy" or see how many things they can
see in
the room that begin with a certain letter. Play matching games
where the children have to match pictures of objects that have
either the first or last sound the same.

Encourage your child to focus his attention on particular sounds.
For example, read a simple story with background noise created
by a radio playing softly. Before beginning the story tell the child
to listen for specific pieces of information in the story (e.g. the
main characters name). Gradually increase the difficulty of the
information the child is asked to listen for.

Play games that encourage listening for differences between
words. For example, ask your child to listen to a group of four
words and tell you which ones rhyme or which ones begin or
end with a different letter. For younger children, ask them to tell
you if two words are the same or different, you can use word
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pairs such as by/pie, mat/pat, fish/wish. Older children can listen
to short lists of consonant sounds that contain one or more
repetition e.g. b, d, k, f, d. They tell you the sound that is
repeated.

Clap in simple rhythmic sequence and then ask your child to
imitate the sequence.

Give your child a series of directions (e.g. two hops and one
step) and ask them to follow your directions. You can gradually
increase the length of the sequence as your child masters each
stage.

Read an unfamiliar story to your child. Afterwards ask questions
about the sequence of events (e.g. what happened first, who
went out to play etc). Continue to ask questions until the events
in the story have been reviewed. Another strategy is to ask the
child to predict likely events in the story.

Present well-known stories, rhymes or songs with one or more
parts omitted and the child must supply the missing information.
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Modifications to the Environment:
A student with auditory processing difficulties would benefit from the following
modifications in the classroom:
A classroom setting with as low level of background noise as possible:
o A single classroom rather than a double classroom
o The use of curtains, carpets and soft wall hangings help reduce
noise and reverberation
o The classroom should be away from roads, high traffic areas within
the school (e.g. the main entrance) or noisy areas within the school
(e.g. the music room)
Preferential seating:
o Close to the teacher so the student can hear the teacher's voice
clearly and see their face - looking and listening is much more
effective than listening alone
o If possible, seat the student between two quiet children who are on
task
o Away from sources of noise such as fans, vents, windows, pencil
sharpeners
o Away from sources of visual distraction - if a child is visually
distracted, less attention will be given to auditory information
o If the audiologist has identified a 'weaker' ear on assessment, seat so
that the better ear is favoured
Helpful Teaching Techniques:
1. Ensure that the student is attending before giving oral directions/
explanations:
a. Call the student's name &
b. Get the child to look at you
2. When speaking:
a. Speak in a clear animated voice
b. Slow down the rate of speech
c. Speak using an appropriate volume
d. Speak in short simple sentences with plenty of pauses and repeats
3. When giving instructions/directions:
a. Give clear, concise and succinct instructions - avoid lengthy and
multiple-part instructions
b. Provide a purpose for the activity to prepare the student
c. Information is presented in simple steps or chunks e.g. sit down get your book out
d. Limit the amount of verbal information given at one time
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e. Stress the relevant parts of the instruction/explanation by altering
your pitch, inflection, rate or volume of your voice.
f. Avoid giving instructions when there is a high level of background
noise
4. While you explain what is being taught, use visual aids to help the student
understand. The child should be encouraged to use both visual and auditory
input to maximise comprehension:
a.
b.
c.
d.
e.
f.
g.
Written instructions on the board
Write key words on the board
Write examples on the board
Provide written frameworks for note-taking
Display models, diagrams, overheads, charts, pictures or real objects
Provide written notes/instructions beforehand to the student
Nominate another student to act as note-taker (i.e. Avoid asking the
child to listen and write at the same time)
h. Use facial expressions and gestures to convey meaning unless they
become distracting
5. Monitor the message:
a. Recognise 'blank' or 'puzzled' looks
b. Watch for signs of lack of concentration, understanding or attention
c. Watch for signs of fatigue as students with auditory processing difficulties
tend to tire more quickly if the activity is language or listening based. Short
intensive periods of instruction with regular breaks tend to be much more
effective.
d. When repetition doesn't work, rephrasing the material often helps
e. Ask the student questions or to repeat or paraphrase what has been said
f. Encourage the student to ask questions if something is not understood
6. Compassion:
a. Let the student know you understand their struggles and are willing
to listen and brainstorm about strategies that will help the student
manage in the classroom
7. Encourage the student to:
a. Use gestures, meaning and intelligent guessing to fill in any gaps
b. Become an active listener i.e. monitoring and checking their own
listening comprehension
c. Ask relevant questions to obtain the extra information that they
may need e.g. present part of a story with a question. The child is
then helped to paraphrase what he has read and identify what extra
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d.
e.
f.
g.
information he needs to answer the question. The child can then
be shown how to use this skill to improve his understanding of what
he hears
Use visual imagery e.g. visualise themselves doing a task as an
aid to memory
Rehearse facts and complex information. Auditory memory is aided by
association with rhythm, so facts can be put to simple rhythms and tunes.
Use their language/metalinguistics knowledge to assist listening
comprehension.
Repeat instructions to themselves.
8. Remember this mnemonic: SPEECH
S - State the topic to be discussed
P - Pace your conversation at a moderate speed with pauses for comprehension
E - Enunciate clearly without exaggerating lip movements
E - Enthusiastically communicate with speech, facial expression and gesture
CH - Check for comprehension
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Eye Contact
Why is eye-contact important?
Eye-contact is a very important part of communication and interaction. Babies are naturally
attracted to faces, and have usually learned to give eye-contact by only a few weeks old.
Looking at faces gives babies and children the chance to learn about other people, as they
begin to understand facial expressions, body language and how sounds are made. Looking and
watching another person is also the first step for a child learning to copy actions and sounds
and leads on to good listening and good conversation skills.
As the child becomes increasingly skilled at non-verbal communication, eye-contact can
communicate powerful messages without words: for example a child may request an object, or
draw an adult’s attention to it, simply by looking at the object, looking up at the adult and then
looking back at the toy.
Some children find eye-contact very difficult and uncomfortable. It is best taught through
games and enjoyable activities. Never force a child to give eye contact.
How to develop eye-contact: general advice
Keep it fun! If a child is excited or enjoying themselves, they are more likely to join in and look
at you.
When playing, get down on the child’s level so you are face-to-face. This makes it easier for
them to look at you. This may mean sitting or even lying on the floor!
When you are playing, remember to include little pauses where you stop what you are doing
and wait for a couple of seconds. This is a good chance for the child to give you eye-contact to
show that they want you to carry on.
Repeat each game a few times, so that the child slowly learns what it is you want them to do,
and understands what is coming next.
If the child does not look at you or show any interest in what you are doing, you could try
copying their actions and sounds. This may encourage them to stop and take note of you. (See
Intensive Interaction information).
As the child finds it easier to redirect his or her attention, it may help them to look at you, if you
gently call their name.
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Activities to encourage eye contact

Bubbles: Wait for the child to look at you each time before you blow any bubbles. If
necessary, call their name and hold the bubble pot up to your eyes. Enjoy looking at the
bubbles and popping them together.

Peek-a-boo: Hide your face with a scarf or bib, then pull it off. Keep smiling and
looking at the child as you surprise them. You can use lots of different objects to
hide behind: a towel at bath-time; a bib at tea-time; a book or duvet at bed-time;
a hat, or sunglasses when out and about.

Balloons: Blow up a balloon and pinch the end to keep the air in. When the child looks
at you, let the balloon go so it flies
around the room.

Tickles: Tickle the child’s tummy until they begin to giggle, then stop and wait for eye
contact before carrying on.

Mirror games: Smile and look at the child in the mirror. Pull funny faces, wave or tilt
your head to keep their attention and make it fun. If the child has learned
to copy, they may be able to pull funny faces too. Don’t forget there are
suitable mirrors all around – in the car, at home, and even shop windows.

Chasing games and Hide and Seek: Peek out at each other around
corners.

Action Songs: Sing songs together such as ‘Round and Round the Garden’, ‘Row,
Row, Row Your Boat’ or ‘Incey Wincey Spider’. Once the child is familiar with the song,
stop singing occasionally and wait for eye-contact before continuing.

Noisy/Wind up toys: Make a noise with a toy or wind the toy up and watch it moving
together. Encourage the child to give you eye contact before you wind it up again.

Funny faces: Use funny glasses, hats and masks. Put them on and off yourself and the
child and encourage the child to look at you and in the mirror.
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

Binoculars/Telescope: Make binoculars or a telescope from old cardboard tubes. Look
at each other through the tube.

“Ready Steady Go” games: Encourage the child to look at you before you/they do an
action such as pushing them on a swing, rolling a ball, knocking a tower of bricks over,
sending a car down a click clack track.
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Eye Contact Activity Ideas
Eye contact is a very important skill when communicating. Eye contact shows that you are
listening and can be used to gain people’s attention. Looking at things together is also an
essential part of communication. Here are some activities to try to help develop eye contact.
Bubbles: use bubbles
to encourage your child
to look at you. When
your child looks at you,
blow some more
bubbles.
Balloons: when
your child looks at
you let go of an
inflated balloon
then try and catch
Peek a Boo: play
peek a boo with your
child. Use different
objects to hide your
face e.g. hands,
cushion, scarf.
Other activities
 People games - play tickling games, chase, rough and tumble - stop the activity and wait
for your child to look at you before continuing the game.
 Action songs - sing songs together. Stop singing occasionally and wait for eye contact
from your child before continuing the song.
 Noisy/Wind up toys - make a noise with a toy or wind the toy up and watch it moving
together. Encourage your child to give you eye contact before you wind it up again.
 Fingers puppets - hold the puppet near your face and make it move and talk.
 Funny faces - use funny glasses, hats and masks. Put them on and off your child and
encourage him to look at you.
 Binoculars - make binoculars for old cardboard tubes. Look at each other through the
tube.
 “Go” games - let your child look at you before you/they do an action i.e. push them on a
swing, roll a ball, knock a tower of bricks over, send a car down a click clack track.
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Eye Contact Activity Ideas for Older Children

Poor eye contact can affect social interaction skills. Improving this skill
will help the child to interpret the speaker’s gestures, facial expressions
and body language.

Use a visual prompt for “good looking” to
cue the children in and remind them to use
appropriate eye contact.

Use stickers and reward charts when the
child shows “good looking”.
Activities
WHO WINKED? The children sit in a circle. One of the children goes out of the room, the
others decide who is going to wink. The child comes back into the room and watches the
other children to see if they can work out who is the winker. If a child is winked at they are
out and have to close their eyes.
FACES FUN The children sit in a circle and take turns to look at the child sat next to them.
They talk about their partner’s eye colour, hair colour and eyebrows. You could introduce
drawing to this activity and ask the children draw each others faces.
COPY CAT One child is the leader and carries out a series of actions and facial
expressions. The other child has to copy them. The children take it in turns to swap roles.
GUESS THE FEELING Put a selection of emotion photos into the middle of a circle. The
child chooses a picture and mimes the emotion to the others. Take turns to guess how the
child is feeling. To make this harder the children could guess why the child is feeling happy,
sad, scared etc.
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Importance of Turn-Taking
Why is Turn-Taking important?
Interaction with another person is two-way. We take turns a lot during an interaction. This may be
through words, gestures, body language etc. The majority of games and group activities involve
turn taking. It is essential to learn how to take turns to develop
communication skills and be able to interact and have fun with other people.
How to help
Switch off or move right away from the TV, radio, phone, iPad, computer
Remove general distractions from the room or area– this may include other toys.
Watch to see what the child wants to do/play with.
If the child has not chosen toys, sit opposite them and copy their actions or sounds. When you
have copied the child a number of times try to incorporate pausing into the game, to encourage the
child to wait for you. If you are copying actions, label whose turn it is, for example, ‘Jake’s turn’,
‘Daddy’s turn’.
If the child has chosen a toy, initially spend time watching them. If the child involves you in any
way, for example by looking at you, try and join in with the child’s play by quickly having a turn in
their game and saying whose turn it is, for example, ‘Mummy’s/Mrs Smith’s turn’, ‘Josh’s turn’.
Try to increase the number of times you are able to have another turn.
Gradually increase the number of people who are taking turns.
Once the child has the idea of taking turns try to develop this into other games. Some ideas might
be,

rolling a ball to each other

building a tower together

jumping together

banging a drum – start with a beater each and then develop to
having one beater to share.

taking turns to post pictures or shapes or to put in a piece of an
inset puzzle
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Turn Taking
Turn taking is the basis for two way interaction i.e. conversation. Children
need to learn to take turns with everyday activities before moving on to turn
taking with sounds and then words. Here are some activities to develop turn
taking skills.
Play Peek a Boo
or hiding. Hide
behind a cushion
or your hands
and take turns to
say “boo!”.
Build a tower of
bricks or stacking
cups. Take turns
to add bricks to
the tower. Have
fun knocking it
over.
Roll a ball or a
car to each other.
Increase the
amount of time
your child will sit
to take turns.
Other Activities





People games - play tickling games, chase, rough and tumble. Take turns to
be the chaser or tickler. Occasionally pause and wait for your child to initiate
their turn.
Copying games - take turns to copy each others sounds/words/funny
faces/actions e.g. ahh, beep, babble and facial expressions.
Games - take turns whilst playing with toys, e.g. posting, puzzles, fishing,
skittles and colouring.
Hiding games - take turns to hide and find favourite toys under cushions,
beds, chairs etc.
Music games - use shakers, drums, pans and wooden spoons to take turns
making noises. Encourage your child to wait for their turn. Have fun making
loud and quiet sounds
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Copying
Why is copying important?
Children need to learn to copy so they can learn new skills from other people.
Learning to copy things they can see and hear helps children to develop communication skills such
as gestures and speech.
Children often need to see or hear things many times before they are able to copy them.
How to develop a child’s copying skills
Join the child when they’re playing with a favourite toy.
Copy what they do with your own set of toys.
When the child notices that you are copying them, change your play slightly and encourage them
to copy you.
Children find it easier to copy things they can see rather than things they can hear. Start by
practising copying with toys and actions before copying with speech.
Activities:
Toy Bricks
Start by copying what the child does with the bricks. If (s)he bangs 2 bricks
together you do it too.
Then try something slightly different with the bricks, for example, hold them up
above your head and bang them, then low near the floor or bang them on
different surfaces.
Copying Actions
Play games like ‘How big are you? …. So big”- raising your arms in the air. Encourage the child to
copy.
Sing or say songs and rhymes that have actions. Encourage the child to copy the actions. Help
them to move their hands or pause to see if they do the action to make you continue.
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Action Songs
Some favourite action songs:




Incy Wincy Spider
Wind the Bobbin Up
Twinkle Twinkle Little Star
Row Row Row your boat
Copying faces
Make faces in the mirror together. Copy the child and encourage them to copy you by making a
face then waiting.
Copying sounds
Make funny sounds such as raspberries, wobbling your tongue from side-to-side or saying “boo”.
Make sounds to go with play and pictures, such as animal sounds, “nee naw” for a fire engine,
“brrrm” for a car, “tick tock” for a clock.
Copy any sounds that the child makes.
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Creating the Need to Communicate
Provide the opportunity for children to communicate by not anticipating all of their needs, by changing a
familiar routine and by offering them choices.
Remember that communication is not just about “talking”. It may be signing, an attempt at a word, a noise,
a gesture, or any other attempt to get your attention.
Always try to wait for the child to initiate communication.
You can try the following ideas to encourage attempts to communicate:
Requesting an Object:

Make “silly” mistakes. Put on one shoe but not the other. During painting/drawing give them the
paper but no paints/crayons. Wait for the child to let you know what’s missing.

Put a favourite toy, snack or drink out of their reach but still in sight. Wait for them to request the toy
by looking/pointing/vocalising before giving it to them.

Offer a choice of 2 objects, showing them and naming them at the same time, for example ‘juice or
water?’ and wait for a definite response from the child before giving them the chosen item – a look,
reach, sound or change in body posture may be the way the child indicates they want something.
Requesting an Action:

Close the door to the garden/outside area so they need to ask for the door to be opened to play
outside.

During physical games get the child to join in with lots of different actions e.g. kicking a ball,
jumping, spinning. Then stand still and wait for them to request the next action. Give them your full
attention and wait expectantly so you are ready to pick up on any cues your child gives.

Sing action rhymes with the child and stop at an appropriate point so that they have to request
continuation of the action e.g. The Wheels on the Bus, Incey Wincey Spider, Round and Round the
Garden – stopping before the tickle / favourite part is a great way to encourage the child to join in.

Open a jar of bubbles; blow the bubbles and then stop. Wait for the child to request more/again - in
any way they can, and then blow more bubbles.

Blow up a balloon and let it deflate slowly. Hold the deflated balloon in your mouth and wait for the
child to request that you to blow it up again.
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Requesting Assistance/Help:

Put the child's favourite food or toy in a clear container that they can't open whilst they are watching.
Put the container in front of them and wait for a request for help

Put a favourite toy on a shelf out of reach and bring it to the child’s attention. Wait for them to let you
know they want the toy.
Requesting Recurrence/ More/ Again:

Only give the child a small amount of juice or snack (one crisp or one raisin)and wait for them to
request more

Begin playing a favourite activity such as building bricks. After a few turns hold all the bricks in your hand.
Wait for the child to ask for more bricks.

Pause at a crucial moment in rough and tumble games e.g. chasing, tickling, swinging round and wait for
the child to indicate that they want you to complete the routine.

Activate a wind-up toy or one that the child cannot operate on their own, deactivate it and wait for the
child to request it again.
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James D. MacDonald’s ‘Steps to Communication’
Dr James MacDonald is a clinician, researcher and director of the ‘Communicating Partners
Centre’ in Ohio. MacDonald’s findings indicate that children learn more from adults who are their
‘play and conversation partners rather than only caretakers or directors’, and recent research
supports this.¹
Children develop their communication skills in stages or steps, by having access to an
environment that supports their communication method and adults that are responsive to it. The
adult needs to be aware of the child’s stage of development and of strategies which will
keep the child motivated and eventually help him or her to move on to the next level. It is
useful to observe how and why a child communicates and then reflect back the same idea in a
slightly more advanced way; for example, if the child is pointing to a bird, then the adult models the
word ‘bird’. You can look at this as steps to communication; if a child communicates mainly at the
level of one step, the adult communicates mainly at the level of the next step up so that the child
has a chance to understand and copy. If you are not sure, please speak to your speech and
language therapist.
MacDonald’s steps to communication
INTERACTOR MIGHT TEND
TO COMMUNICATE HERE
COMMUNICATION GAP
Sentences and complex signing
Phrases and sign combinations
Words and signs
Sounds with gestures
Sounds (symbolic) e.g. ‘broom broom’ for car
Gestures (symbolic) e.g. waving ‘bye’
INTERACTOR SHOULD
COMMUNICATE HERE
CHILD’S
COMMUNICATION SKILLS
Sounds (signals) with communicative intent
Gestures (signals) actions with communicative intent
Sounds / no communicative intent
Actions / no communicative intent
From Dr James MacDonald: Communicating Partners
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Examples of how to use ‘MacDonald’s Steps’ in your everyday communication
1. Interaction
Child: coughs (sound with no communicative intent)
Adult (models next step): coughs back and holds eye-contact (sound with intention of
starting interaction)
Child: is amused and coughs again on purpose (this time with eye-contact) and waits for
adult’s response.
What is the child learning?
If I make a noise I might get a response. It’s fun to copy each other and take turns.
2. Interaction
Child: reaches for beaker on table and opens and closes hand, while looking from object to
adult and making a sound like ‘er’ (sound and gesture (signals) with communicative intent)
Adult (models next step): makes sign for drink, says ‘Drink… you want your drink.’ and
gives to child saying, ‘Here’s your drink.’ (words and signs)
What is the child learning?
Every time I point at that beaker I see the same sign and hear the same set of sounds… ‘dri-nk’. Next time I hear the word ‘drink’ I will have a look to see if my beaker is there and I
might even have a go at signing it or saying it myself and see what happens.
3. Interaction
Child: uses Makaton sign for ‘sit down’ and says ‘chair’, using her own pronunciation.
(words and signs)
Adult (models next step): copies sign for ‘sit down’ and then combines sign for ‘sit down’
and ‘chair’ saying, ‘Sit down?… You want to sit down on the chair?’
What is the child learning?
I could communicate two ideas together (action and place) using signs and words I already
know.
4. Interaction
Child: says ‘car go' (phrase)
Adult (models next step): says ‘Yes, the car’s going fast!’ (sentence)
What is the child learning?
I could communicate even more ideas at the same time. Also, we sometimes add an –ing
to ‘go’ to make ‘going’. After a lot of examples I might notice the -ing ending on different
words when we are talking about something happening now.
¹Ruston, H. P. & Schwanenflugel, P. J. (2010). Effects of a Conversation Intervention on the Expressive
Vocabulary Development of Prekindergarten Children. Language, Speech and Hearing Services in Schools,
41, 303-313
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*Refer to the ‘Language Development Pyramid Poster*
Attention and listening, play and understanding of language all need to be in place before a
child can be expected to use language and pronounce words correctly. Children need
support at these early levels. Consider the following strategies and ideas at home and at
nursery:
Attention and Listening
 Engage the child in ‘ready steady go’ activities where the child needs to look at you/
make a noise before you carry out an action e.g. blowing bubbles, rolling a ball down
a marble run, pushing a ball down a slide etc.
 Sing nursery rhymes with the child. Once the child is familiar with one you could stop
and wait for them to look at you/make a noise before carrying on
 Play quick and simple turn taking games with the child e.g. sitting opposite each other
and rolling a ball.
Play
 It is very important to get involved in the child’s play.
 Play alongside the child.
 Make a commentary using simple language about what the child is doing e.g. talk
about the different objects… ‘car’, ‘pushing’, ‘big wheels’, ‘red car’, ‘big car’.
 Let the child take the lead - don’t interrupt the child or tell them to do different things;
the child will involve you as they want to.
Understanding
 Carefully consider your language and the environment.
 Keep your own language simple; break down instructions into short phrases
containing only one piece of information and repeat instructions if needed.
 Give instructions in the order in which they should be completed, e.g. instead of
saying ‘Before you go out to play, put on your coat’ you could say ‘Put your coat on.
Then go out to play’.
 Keep equipment at nursery in the same place, clearly labelled with words, pictures or
symbols.
 Help understanding by giving visual cues to support verbal instructions, e.g. books,
pictures, modelling, gestures etc.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012
Talking
 Children need to hear new words from others before they will use them by
themselves. Name objects and talk about what is happening around the child, e.g.
 At mealtimes talk about what the child is eating. Name everything they have to
eat. If they can choose then hold them up and give them a choice - “Do you
want milk or juice?” If they point to an option, say it yourself - “You want juice?
Here’s your juice”.
 When shopping talk about what you are buying. Talk about the items as you
put them away.
 Point out things you see when you are out - cars, birds, animals etc.
 If the child requests something, e.g. says ‘more’ then give them what they have
asked for and model the words back, e.g. ‘More bubbles’. Remember it is not
important for the child to be saying ‘please’ and ‘thank you’ at this stage.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012
Communication: Means, Reasons and Opportunities
Children and babies learn to communicate when they have a means, a way,
of communicating, opportunities to communicate and reasons to
communicate. They also need adults who are responsive to how they
communicate.
MEANS
-
speech
signs
symbols
facial
expression
gesture
touch
behaviour
-
vocalizations
written word
objects of reference
eye contact
body movement
physical posture
How?
OPPORTUNITIES
-
time and space
real choices / options
responsive people and
environment
shared ‘language’ and
interests
When?
Where?
Who with?
REASONS
-
basic needs - request / refuse
express feelings - get
attention
want something to happen or
not!
give and receive information
make and maintain
relationships
pleasure of chat – socializing
Why?
Money
oney,D.(
,D.(1997)
1997) adap
adapted by
by Leeds SLT Ser
Service
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Means to communicate
Communication can be verbal, for example, babbling, making noises, saying
words and sentences or non-verbal, for example, crying, facial expressions,
showing emotions, pointing, signs, gestures, pictures, symbols. It is important
for all adults in the child’s environment to be aware of the child’s preferred
method of communication whether it is verbal and/or non-verbal. If you are
not sure, please speak to your speech and language therapist for advice. It is
important that the child has access to an environment that supports their
communication method; for example, staff that are trained in Makaton sign
language or the Picture Exchange Communication System (PECs) and/or
symbols around the classroom.
Reasons to communicate
We all need a reason to communicate. The first reasons young children
usually communicate are being hungry, tired or happy or feeling poorly. Later,
they learn to communicate to convey a range of intentions, for example, to
make requests, reject, comment or share an interest. They could do this nonverbally and/or verbally, for example by shaking the head and by saying, “No!”
Adults can provide lots of reasons to help their child communicate by creating
little obstacles and then waiting and looking expectantly for the child to
indicate what they need or want: for example by, placing favourite toys out of
reach, giving the child a paintbrush but no paints, giving them half of an
orange/biscuit or by not filling the glass to the top with milk/water.
Opportunities to communicate
The child needs opportunities to communicate with others in order to develop
their communication skills. It is important that adults give the child time to
respond to and to initiate interaction. Where possible, try to ensure that
others, such as siblings or close peers, do not communicate for the child.
Peers may often interpret what a child wants, for example, they may approach
the adult to say, ‘He wants a drink’, which then means that the child’s
opportunity to communicate has been taken away. Children need access to
adults and peers who understand their method of communication and will
respond at the correct level.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Examples of how to use Means, Reasons and Opportunities in your
everyday communication
1. Situation: The adult has blown some bubbles and has then waited to
give the child a chance to respond.
Means: The child usually communicates by reaching for the object he
wants but with encouragement he can also give brief eye-contact and
vocalise.
Reason: The child wants more bubbles
Opportunities: The child reaches for the bubbles but the adult holds
them out of reach and waits a little longer for eye-contact. As soon as
the child attempts to communicate by giving eye-contact and
vocalising, the adult responds by modelling ‘bubbles’ and blows the
bubbles.
2. Situation: The adult has placed the milk on the table but purposefully
not given the child a straw.
Means: The child can communicate non-verbally by pointing and is
starting to use a few single words.
Reason: The child is thirsty and she has got her milk but not a straw.
Opportunity: The adult waits for the child to initiate interaction. The
child points at her milk and the adult then gives the child a choice: ‘Do
you want a straw or a plate?’, showing the objects. The child points to
the straw and the adult gives her the straw, modelling the next step by
emphasising the single word ‘Straw, you need a straw’. The child is
not expected to repeat the word at this stage.
3. Situation: Adult and child have gone outside together and the child is
choosing what to play on first.
Means: The child communicates verbally with single words and learnt
phrases.
Reason: The child has spotted a favourite activity, the slide, and wants
to share her intention to go on it.
Opportunity: The adult is bent down at the child’s level, watching her
and giving her a chance to communicate. The child points to the slide
and says ‘up’. The adult prompts a little more language by saying, “Up
the……?’ and the child says “slide”. If the adult had said, “Do you want
to go on the slide first and then go on the swing?” this sentence would
have been too long and the child may not have understood it. Later, the
adult uses the child’s play to model more two word phrases, ‘Up (the)
steps!” as the child climbs, and “Whee! Down (the) slide!” as the child
slides down.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
4. Situation: Adult and child are playing alongside each other with the
train set.
Means: The child is starting to try to copy sounds and to use specific
sounds in play
Reason: Sharing knowledge, interest and pleasure and hoping to get
a response.
Opportunity: During play the adult does not ask questions but
watches and listens to the child. The child then makes a noise like ‘ch’
for the train and looks up at the adult. The adult listens and when the
child makes eye-contact copies ‘ch, ch’ and adds “ train”. The child is
not asked to repeat at this stage. If the adult had modelled a sentence
such as, “The train is going fast on the train track” this sentence would
be too long for the child to understand and attempt to copy.
5. Situation: The child sees another child drawing a picture
Means: The child can use a variety of Makaton signs, often vocalising
at the same time.
Reason:
The
child
wants
to
draw
a
picture.
Opportunity: The child vocalises and makes the sign for ‘pencil’. The
adult understands Makaton sign language and goes with the child to
get a pencil, modelling the next step: a two sign combination, alongside
speech ‘(You) want a pencil?’ The adult then waits for the child to
request paper and the child does so, using gaze, eye-contact and
vocalisation. The adult responds by saying and signing “paper”. The
adult then comments on the child’s intention, in a simple way, using
sign and speech ‘(you’re going to) draw a picture.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
The style of the ‘teacher’ is relaxed and responsive,
allowing the ‘learner’ to take the lead, joining in with
them in their chosen activities.
Intensive Interaction is based on research on how all of us
develop the early communication skills upon which all of our
relationships, knowledge and expertise as human beings are
founded...
Intensive Interaction
...but
most of all…it’s enjoyable learning for both parties!!
Useful sources of further information:
Nind, M. & Hewett, D. (2001) A Practical Guide to Intensive Interaction.
Kidderminster: BILD Publications.
“Valuing People Now” Government White Paper, January 2009
www.intensive interaction.co.uk
www.sense.org.uk
www.bild.co.uk
www.leedspft.nhs.uk
There is also an Intensive Interaction discussion forum on Facebook ‐ www.facebook.com
For further information about using Intensive Interaction and training
opportunities please see website and/or speak to your Speech and
Language Therapist:
A practical approach to interaction and
learning for people with learning
disabilities who do not find it easy
communicating or being social
Leeds Speech and Language Therapy Service
St Mary’s Hospital
Greenhill Road
Leeds
LS12 3QE
0113 3055307
© Leeds Community Healthcare NHS Trust, September 2012
What is Intensive Interaction ?
Fundamentals of Communication Intensive Interaction is an approach to interacting with and
teaching early communication and interaction skills to those
who do not find it easy communicating or being social.


Developed by Dave Hewett PhD and Melanie Nind PhD in the
1980s, it aims to teach the basic Fundamentals of
Communication as well as helping develop sociability,
cognitive abilities and emotional well being.
Intensive Interaction supports the person with
learning disabilities to develop competence and
confidence as a communicator.
We can use Intensive Interaction at any time and in any
place, taking opportunities as they arise.
Enjoying being with another person

Developing concentration and attention span


Developing the ability to attend to that
person
Learning to do sequences of activity with
another person
Taking turns in exchanges of behaviour
 Sharing personal space

Understanding and using eye contacts
Who is Intensive Interaction for ?
Intensive Interaction has been developed for those whose
communication and learning disabilities are more severe or
complex. It is particularly useful when communicating and
relating is made more difficult by additional physical or sensory
impairments and/or autism.
Intensive Interaction is also useful to those with some speech
and language ability, who would still benefit from further
learning and development in the area of the 'fundamentals of
communication' – see over
The approach is used by a wide range of professionals, support
staff as well as families and friends.
 Understanding and using facial expressions

Understanding and using physical contacts
 Understanding and using non-verbal
communication

Using vocalisations with meaning
Intensive Interaction works by gradually developing enjoyable
and relaxed interactive sequences between the interaction
partner and the individual doing the learning. During these
sequences the Fundamentals of Communication are rehearsed
and learned in a free-flowing manner. © Leeds Community Healthcare NHS Trust, September 2012 Intensive Interaction Record Sheet
Interaction partners:
Venue /situation:
Content of interactive experience (examples)
SHARING PERSONAL SPACE: sitting/lying quietly together,
touching or apart
PHYSICAL CONTACT: holding hands, squeezing each other’s
hands, clapping hands together, hand-over-hand games,
massaging hands/feet, tickling, lying/sitting together, walking
arm in arm
IMITATION: over/dramatised imitation of participant’s activity –
echoing vocalisations / physical behaviour, laughing together
EYE CONTACT: peek-a-boo, pulling faces, dramatic glances,
looking in the mirror, staring at each other
JOINT FOCUS: e.g. looking at/exploring objects together
(materials, photos, toys…), looking in the mirror, watching
bubbles, moving objects through the participant’s field of
vision/hearing, listening to sounds together
JOINT ACTION: sharing physical rhythm, playing with musical
instruments, ball play, passing objects, chanting/singing the
participant’s name, making up songs, running commentary of
participant’s actions, noise escalation games (humming,
whistling…), playing with water
BURST-PAUSE SEQUENCE: the activity is followed by a
pause, leaving space for a response. Builds tension, anticipation
and expectancy. Any activity can use this: activity/expectant
pause – activity/expectant pause – activity…
Date:
Time:
Description of session
Response to Interaction
ENCOUNTER: participant is present without any obvious
awareness of its progression – e.g. a willingness to tolerate a
shared social atmosphere
AWARENESS: participant appears to notice or briefly focus on
an event / person involved in the interaction – e.g. by briefly
interrupting a pattern of self-absorbed movement / vocalisation
ATTENTION & RESPONSE: participant begins to respond
(although not consistently) to what is happening in the
interaction – e.g. by showing signs of surprise, enjoyment,
frustration, dissatisfaction
ENGAGEMENT: participant show consistent attention to the
interaction – e.g. by sustained looking / listening or repeatedly
following events with movements of head / eyes / other body
parts
PARTICIPATION: participant engages in sharing or taking turns
in a sequence of events during the interaction – e.g. by
sequencing their actions with another person or by passing
signals back and forth repeatedly
INVOLVEMENT: participant makes active efforts to reach out or
consistently join in with the interaction – e.g. by sequencing their
actions and speaking, signing, vocalising or gesturing in a
consistent and meaningful way
PARTICIPANT INITIATED INTERACTION: the participant
independently starts an interaction and engages with another
person in the activity with social intent (an activity that cannot be
described as repetitive or self-absorbed behaviour)
GENERAL COMMENTS (mood, behaviour, anything remarkable or
exceptional) :
EXCHANGING FACIAL EXPRESSIONS: smiles, winks, tongue
poking, touching foreheads, rubbing noses
TURN TAKING: facial expressions, making noises – vocally /
with objects, passing things back and forth
SESSION ENDED BECAUSE: non-responsive / avoided /
rejected / ‘natural’ end / ended by interaction partner
(circle as appropriate)
© Leeds Community Healthcare NHS Trust, September 2012
Multi-Sensory Support
We all use multi-sensory prompts, especially visual ones, every day: for example logos, road signs
maps and lists but also title music or even the smell of bread in the bakery department of a store.
They help us to understand information in a quick and easy way.
Children usually find it easier to understand things they can see and experience before words, for
example, they will usually recognise a photo of a dog before they understand the word “dog”.
In addition to helping a child understand what you are trying to communicate to them, visual and
multi-sensory supports can help develop understanding of actual words.
There are several different types of visual support we can use, to help children understand what
we are saying such as:







Real objects (See Objects of Reference handout)
Photos
Dolls’ house (small world) versions of real objects
Coloured or black and white pictures
Line drawings and symbols such as Boardmaker or Makaton symbols
Gestures, or sign language such as Makaton
Written words
Introduce visual supports gradually, one at a time. Use them repeatedly so the child gets plenty of
practice.
Examples of other types of multi-sensory support are:
 Textures (for example for children with a visual impairment)
 Sounds and music
 Sensory experiences (for example a plant-watering spray to symbolise a shower)
Some of these multi-sensory supports are easier to understand than others. Discuss with your
speech and language therapist which will be best for any particular child.
Some examples of how multi-sensory supports can be used are:
Timetables- a sequence of pictures to help a child understand what he is
doing and what will happen next (see Social Communication –Visual
timetables)
Photo albums of familiar people and objects
Building understanding of pictures and symbols by attaching visual supports to the things they
represent
Adding ‘sound effects’ and gestures to stories and rhymes
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Objects of Reference
What are objects of reference?
Objects of reference are objects which have special meanings for the user. If the child cannot
see what is happening or where they are going and cannot hear or understand what you are
telling them, objects give an alternative way of communicating this information to the child.
Objects “stand for something” in the same way words or signs do for children who can
understand them.
Why use them?
There are several reasons why a child might need them and the reason for using objects may
be different for different children.
 Behaviour – may reduce behaviours caused by fear, frustration or the insecurity of not
knowing what is happening next or where they are going.
 Multisensory skills– encourages children to use all their available senses (touch, smell,
sound, sight) to explore objects. This is particularly useful for children who are tactile
defensive. (very sensitive to touch)
 Object recognition - leads on to the use of senses to recognise and differentiate between
objects.
 Association - develops the ability to associate objects with a specific activity/room.
 Understanding - Once they know what the object stands for, their understanding of
language may develop as they repeatedly hear the word relating to that object and
activity/place.
 Expression - some children may quickly learn the meaning of the objects and use them
to tell us a message either by their reaction when given an object (they may pull a face or
refuse to take an object if they know it means an activity/place they don’t like), or by
choosing between objects to show what they want.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
How to use Objects of Reference
Choose objects which are only used in a certain activity/routine. For example, use a favourite toy
to show playtime, but only if the child would not have the toy at other times such as to cuddle in
bed .
Try and keep the objects in a box when they are not in use so they are easily
accessible.
Before taking the child to an activity, give them the object to hold/touch. Allow
them time to explore it and talk to them about what it means. If the object makes
a noise, help the child make the noise.
After the activity has finished put the object away in the box. Draw the child’s attention to the fact
that the object has gone and the activity has finished, for example, ‘drink finished’
Try to use real objects at first, although you may build to the use of some miniatures or objects
with more abstract associations, for example, a star for song time
Be consistent in your use of the object, even though the child will not understand at first.
Some suggestions of the type of objects to be used.
PLACE/ ACTIVITY
Drink
Mealtimes
Bedtime
Going out
Playtime
Music
Nappy changing
Going in the car
OBJECT
Cup
Spoon
Pyjamas/teddy/dummy (if not used
for rest of day)
Coat
Ball/rattle/favourite toy
CD (old one)
Nappy
Key (an old one)
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Encouraging Early Sounds
Why is it important to encourage early sounds?
Learning to make noises and sounds is an important stage in learning to communicate and talk.
Children may use sounds to express themselves before they use words.
How to develop early sounds
Copy the
sounds/vocalisations
the child makes
such as coughs and
yawns as well as
babble. Pause and
give them time to
repeat the sound
back and then do it
again.
Play Peek-a-Boo
using hats, scarves,
sunglasses or clothing
when dressing
Choose an exciting
toy, such as a popup toy, the child
likes. When they
vocalise, make the
toy work.
Further activities include the following:






Play with balloons, blowing them up and letting them go. Copy the noise they make.
Using sounds in play,
e.g. “mmm” when eating, “ahhh” when hugging a teddy, “oh-oh” when toy cars crash,
animal noises, “brrm” for cars, “knock, knock” on a door.
Making silly faces and noises in the mirror.
Using microphones, boxes, tins, cardboard tubes which echo or make interesting sounds
when you vocalise into them.
Popping bubble wrap or bubbles in the bath or water tray and making the sound- “pop”.
Singing action songs which have fun sounds in, you could try,
“Row the Boat”- “if you see a crocodile don’t forget to scream! Aargh!”
“Five Fat Sausages”- “one went Pop!
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
1
Ideas To Develop Early Language

Talk to the child when you are playing together.

Have fun with nursery rhymes and songs, especially those with actions.

Encourage the child to listen to different sounds in their environment such
as cars, animals and the telephone.

Gain the child's attention and eye contact when you want to talk together.

Encourage the child to communicate in any way, not just through words e.g.
pointing, copying actions/noises.

Name what the child points to.

Give the child choices e.g. 'Do you want the juice or milk?'

Talk about things as they happen e.g. playing in the home
corner, daily routines-bath time, mealtimes

Use short sentences

Listen carefully and give the child time to communicate.

Take turns to speak.

Always give a response when the child tries to communicate.

Add one or two words to the child’s sentence e.g. child says 'ball',
adult replies 'Yes, it’s a big ball'

Model the correct pronunciation or use of language if the child says
something incorrectly e.g. 'Goggy bited it', the adult says 'Yes the dog bit it'

Have a special time with the child each day to play with toys and picture books.

Use lots of repetition e.g. shoes off, blue shoes, mummy’s shoes etc.

Set up situations to encourage the child to make a request e.g. put the biscuits out
of reach.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012
How to include simple language in daily activities
Simple everyday routines helps children begin to anticipate or expect to hear the familiar words or
phrases. They begin to respond to the words and phrases and may attempt to use the words
themselves to start the routine with you.

‘Mummy kiss’. You could say and do this when the child is sitting on your lap facing you, or
just after he/she has been put to bed.

‘Wave bye-bye’. Encourage the child to wave their hand when he/she sees someone
leaving your house or when he/she is leaving someone else’s house.

‘Coat on’ (or ‘shoes on’) – say this when getting ready to go out.

Repeat the same words or phrases over and over again when dressing e.g. when dressing
– ‘pants on’, ‘vest on’, ‘top on’, ‘trousers on’
- ‘Sarah’s shoes’, ‘Mummy’s shoes’,

Talk about what the child can see or what they are playing with by labelling objects with
single words e.g. ‘ball’, ‘cat’, ‘car’, ‘jump’, ‘walk’, or items on the dinner table ‘ spoon’, ‘plate’,
‘apple’, etc

Play simple games e.g. ‘peekaboo’, ‘tickles’, ‘ready, steady, go’. Decide what simple
vocabulary to use during the games and repeat these words regularly during the games.
For example during peekaboo : - ‘boo’, ‘ where’s ……?’, ‘more’
If you use words and phrases like these on a regular basis in a range of daily situations the child
should gradually begin to understand and respond to them appropriately.
BOO!
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
The Early Words Checklist: Explanation
The Early Words Checklist helps you to record which words a child is able to understand and say.
It is useful to fill the form out accurately so you have a true reflection of what the child is
understanding and saying.
Understanding
Children are good at picking up on visual cues to help them understand what you are telling them.
This needs to be taken into account when deciding whether a child understands a word.
A child truly understands a word if they can follow an instruction e.g. ‘where’s your coat?’ and the
instruction is given in the following ways:
1) In an unusual situation. For example, if you ask a child to get their coat just before you are
going out and you have already put on your coat or shoes they may just be understanding
the routine not the word, if you ask them to do this at a random time of day you may see a
different response.
2) Without any visual cues. Be aware of whether you have pointed to the object with your
finger or looked towards it.
3) With a choice of possible objects/actions. Was there a choice of at least 3 objects that
you could have been asking the child to find?
4) Several times: Can the child respond to the same instruction when repeated at different
times?
Once you know that a child understands the word, record it on the sheet.
Saying
When recording the words the child says, make sure that the words are used spontaneously and
not copied from you. You may want to record if the child is able to copy words but this does not
necessarily mean that the child understands them or can use them spontaneously.
Some words may not be clear but if you know what they mean then it counts as them ‘saying’ the
word.
REMEMBER!
It may take time to find out what words a child understands and says.
How to help
Once you have found out which words the child understands, choose some words he/she needs
help to learn. It is helpful to work on one category at a time and to choose just a few words to focus
on over a period of time. Once the words have been decided on, choose fun activities during which
the target words would be repeated frequently.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
1
EARLY WORD CHECKLIST FOR PARENTS/CARERS
Single Words That The Child Can Understand
Please put a tick next to any of the words that your child can understand
Food
Apple
Banana
Juice
Milk
Water
Body Parts
Eye
Nose
Ear
Hands
Feet
House
Keys
Book
House
Home
TV/Telly
Furniture
Bed
Chair
Table
Bath
Biscuit
Chocolate
Dinner
Sweets
Mouth
Hair
Toe
Tummy
Teeth
Spoon
Telephone
Brush
Cup
Bottle
Transport
Bus
Car
Boat
Lorry
Animals
Clothes
Outside
Social
Flower
Tree
Sun
Bag
Buggy/Pushchair
Hi / Hello
Bye
Thank you
No
Yes
Cat
Dog
Bird
Hat
Socks
Shoes
Coat
Nappy
This list was compiled by Margaret Agostinho & Sarah Kellett, Leeds Speech and Language Therapists
January 2009
Based on the research by Lederer 2006, Fenson 1994, Rescorla 1989, 2001 & 2005, Locke 1985, & Gillham 1981.
© Leeds NHS March 2009
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Please put a tick next to any of the words that your child can understand
People
Toys
Location
Describing
Mummy
Daddy
Me
Baby
Grandma
Grandad
Teddy/ Bear
Doll
Bricks
Bike
Bubbles
Toy
Book
Ball
In
On
There
Up
Down
Off
Out
Wet
Tired
Hot
Good
All gone
All done
More
Mine
Actions
Open
Eat
Give
Go
Make
Family Words:
Look
Come
Get
Walk
Wash
Want
Throw
Sleep
Cry
Kiss
Stand
Brush
Run
Sit
Drink
Brother/Sister’s name:…………………………….
Family Pet:………………………
Special words………………….
This list was compiled by Margaret Agostinho & Sarah Kellett, Leeds Speech and Language Therapists
January 2009
Based on the research by Lederer 2006, Fenson 1994, Rescorla 1989, 2001 & 2005, Locke 1985, & Gillham 1981.
© Leeds NHS March 2009
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
EARLY WORD CHECKLIST FOR PARENTS/CARERS
Single Words That A Child Can Say
Please put a tick beside any word that your child can say
First Words and Sounds
Daddy
Mummy
Milk
Uh-oh
Woof
Moo
Bye
Dog
Hi
Ouch
Meow
Baa
Early Words
Ball
Cat
Cheese
Nose
No
Baby
Up
Book
Duck
Banana
Thank you
Key
Grandma
Down
Balloon
Juice
Bottle
Peekaboo
Truck/lorry
Grandad
Bath
Bubbles
Apple
Eye
Night night
Boat
Shoes
Bird
Biscuit
Ear
Yum yum
Hot
Hat
Later Words
Toy
Tree
Water
Door
Chair
Out
Open
Train
Bear
Bread
Window
Bed
Off
There
Bus
Flower
Spoon
Phone
Table
In
All gone
Swing
Buggy/pram
Bathroom
Cup
TV
What
Wet
Bike
Slide
Toothbrush
Bath
Please
Dirty
Good
Doll
Plane
House
Blanket
Hello
Cold
My
Teddy
Bunny
Home
Potty
Yes
More
Me
This list was compiled by Margaret Agostinho & Sarah Kellett, Leeds Speech and Language Therapists
January 2009
Based on the research by Lederer 2006, Fenson 1994, Rescorla 1989, 2001 & 2005, Locke 1985, & Gillham 1981.
© Leeds NHS March 2009
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Please put a tick beside any word that your child can say
Action Words
Go
Sit
Run
Eat
Walk
Look
Kiss
Give
Hug
Drink
Cry
Brush
Get
Sleep
Throw
Wash
Two Word Phrases
More biscuit
Daddy home
Wash hands
Go bed
Coat on
Dinner hot
Special words
Pet’s name………………………………………
…………………………………………….
Family words…………….......................
…………………………………………….
Favourite character……………………...
…………………………………………….
This list was compiled by Margaret Agostinho & Sarah Kellett, Leeds Speech and Language Therapists
January 2009
Based on the research by Lederer 2006, Fenson 1994, Rescorla 1989, 2001 & 2005, Locke 1985, & Gillham 1981.
© Leeds NHS March 2009
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Toy Bags
Toy Bags are an exciting way to introduce children to objects and toys and their names. You can
fill the bags with a range of toys and objects depending on what vocabulary you are focusing on.
You could fill them with a range of toys which have an associated noise.
How to use a toy bag
1) Choose a few objects/toys to focus on and place them in a bag.
2) Encourage the child to take objects out of the bag one by one and talk about it. Make any
sounds linked with your toy, e.g. “brrm” for a car, “moo” for a cow. Follow the child’s lead
and play with the object. You may want to show them the action that usually goes with a
particular object. For example, the child may bang a brush: show them how to brush their
hair as well.
3) Listening game: Choose toys which have a sound associated with them. Pull out 2 objects
and make the sound associated with one of them, for example ‘ring ring’ for telephone,
‘ssss’ for snake. Decide together which one makes which sound.
4) You could take it in turns to take objects out of the bag. If there are other children this game
could be extended by passing the bag around a circle with music on. When the music stops
an object could be pulled out of the bag.
5) You could play this as a game with a group of children where you pass the bag around the
group and sing a “magic bag” song – when the song finishes the child holding the bag gets
to look inside
Toys/objects
Associated noise
and
Dog
Phone
Cow
Sheep
Cat
Car
Clock
Snake
Train
Woof
Ring ring
Moo moo
Baa
Meow
Brum brum
Tick tock
Sssssss
Choo choo
toy.
Some toys for learning what objects do:
Brush
Keys
Flannel
Cup
Phone
Spoon
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
choose
a
Creating the Need to Talk
Provide the opportunity for the child to request things by not anticipating all of
their needs, by changing a familiar routine and by offering them choices.
Requesting an Object:

During painting/drawing give them the paper but no paints/crayons

Put a favourite toy out of their reach but still in sight. Wait for them to
request the toy by looking/pointing/vocalising before giving it to them.

Offer a choice of 2 objects, name them either e.g. juice or water and
wait for a definite response from the child before giving them the
chosen item.
Requesting an Action:

Close the door to the garden/outside area so they need to ask for the
door to be opened to play outside

During physical games get the child to join in with lots of different
actions e.g. kicking a ball, jumping, spinning. Then stand still and wait
for them to request the next action.

Sing action rhymes with the child and stop at an appropriate point so
that they have to request continuation of the action e.g. The Wheels on
the Bus, Incy Wincy Spider, Round and Round the Garden.

Open a jar of bubbles, blow the bubbles and then stop. Wait for the
child to request more/again and then blow more bubbles.

Blow up a balloon and let it deflate slowly. Hold the deflated balloon in
your mouth and wait for the child to ask you to blow it up again.
Requesting Assistance/Help:

Blow bubbles and then close the jar tightly. Give the closed jar to the
child and wait for them to ask for help opening it.

Blow up a balloon and let it go down. Then give it to the child and wait
for them to ask for help to blow it up again.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, September 2012

Put the child's favourite food or toy in a clear container that they can't
open whilst they are watching. Put the container in front of them and
wait for a request for help
Requesting Recurrence/ More/ Again:

Only give the child a small amount of juice or snack and wait for them to
request more.

Pause at a crucial moment in rough and tumble games e.g. chasing,
tickling, swinging round and wait for the child to indicate that they want you
to complete the routine.

Activate a wind up toy or one that the child cannot do on their own,
deactivate it and wait for the child to request more.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, September 2012
First Words: GONE
There are lots of activities that you can use to encourage a child to say ‘GONE’ – here are some
ideas – encourage them to say ‘GONE’ as each item disappears.

Posting Games : Post toys, pictures, or shapes into a box

Bubbles: Blow them, and then pop them!

Balloons: Blow them up and let them go so they buzz off round the
room or blow them up, tie a knot and burst them!

Toys: As you put them away say ‘gone’ or play a throwing
game and say ‘gone’ as you throw them into a box

Peek-a-boo: say ‘gone’ as you hide, or as your child hides

Disappearing toys: e.g. Put a car in the garage

Hide Teddy: Hide teddy under a cloth, say gone and then let
your child find him!

Books: as you turn the page …. Gone!
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
First Words Activity Ideas
It is helpful to choose just a few words to focus on over a period of time.
Repeat your chosen words in lots of different activities.
Here are some ideas to make learning new words fun.
Do not put pressure on the child to copy or say words. Have fun with the activity and don’t worry if
it’s you saying all the words. Your child will be listening!
1. People’s Names
Often a child’s first words are the names of the people close to them, e.g. Mummy, Daddy, Nana.
o Look at photographs/videos of the family and talk about who you can see and what they are
doing.
o Repeat people’s names lots of times, e.g. ‘It’s Mummy!’, ‘Look at Mummy’, ‘Mummy’s eating
an ice-cream’.
o Don’t forget pets’ names.
o Take turns with ball games, bubbles or building bricks. Use repetitive phrases to name the
person whose turn it is, e.g. ‘Mummy’s turn now’, ‘Daddy’s turn now’, ‘Jonny’s turn now’.
o When out for a walk/shopping, talk together about the people and families you can see, e.g.
‘There’s a baby’, ‘Baby’s with her Daddy’.
2. Social Words
‘Hello’ and ‘Bye bye’ are easy words to practice:
o Whenever anyone comes into view, or leaves a room. It will help to do an action like waving
as well as saying the word.
o Say ‘Hello’ and ‘Bye bye’ to the toys when you get them out or put them away, e.g. ‘Hello
bricks’, ‘Bye bye dolly’.
o Use a toy phone to encourage greeting words.
‘Thank you’ or ‘ta’
o Play give and take games. Say ‘thank you’ or ‘ta’ as you take the object or toy. Ta is easier
to say than thank you. Children that start saying Ta easily move on to saying Thank you
when they are ready.
‘Boo!’
o Take turns to hide behind something. Say ‘Boo!’ as you reappear.
‘Go!’
o Ready, Steady, Go: Play games which involve ‘ready, steady go’ e.g.
ball rolling, car rolling, running, building towers and knocking them down.
Try and build the anticipation to make the ‘GO!’ really exciting
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
3. Making Requests
‘More’ is a very useful word for children to learn as it can be used in lots of different
situations.
o Snack-time/dinner-time. When your child reaches out, or
pushes his/her plate towards you to ask for some more, say
‘More’, ‘More please!’ as you give them more. Later pause
before you give them more to see if they attempt the word.
o Play bubbles, making sure you only blow a few at once. When
your child looks or makes a noise say ‘More bubbles?’
o Choose a favourite toy which your child needs your help to use
properly, e.g. a spinning top. When it stops, ask ‘More?’
4. Making Comments
‘All gone’ or ‘gone’
o During snack-time/dinnertime give small amounts of food so that your child finishes
what’s on his/her plate. Say ‘All gone,’ and offer more.
o With shape sorters/posting boxes, post pieces and say ‘All gone’.
o When someone leaves the room, e.g. Daddy, say ‘Daddy gone’.
‘Uh oh’
o Drop a toy off a surface or your head. As it falls, say ‘uh oh!’ with lots of facial
expression and anticipation that your child might laugh / try to copy.
5. Common Objects and Toys
Repeat familiar words during your day
o ‘Drink’, ‘bottle’, ‘nappy’, ‘dinner’, ‘car’, ‘bed’
o ‘Ball’, ‘teddy’, ‘book’,
6. Body Parts
o During lap play, point out and name your child’s body parts, e.g. ‘eyes’, ‘nose’, ‘tummy’
o Name parts of the body as you wash or dry them, e.g. ‘Where’s your nose?’, ‘Let’s wash
your nose’
o Sing ‘Head, shoulders ,knees and toes’ and carry out the actions.
o Put stickers on various body parts of teddies/dollies/your child. Say the name of the body
part as you do it.
o Read books focusing on body parts e.g. ‘Eyes, Nose, Toes Peekaboo’.
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013
Encouraging First Words: Understanding
Learning about first words means learning to understand words and then being able to say them.
A child’s first words are likely to be names of family members, familiar toys or social words such as
‘hiya’, ‘bye-bye’, ‘all gone’. Usually, first words are the ones the child hears over and over again.
Children usually learn to understand words before they attempt to say them.
Strategies to develop understanding of words

Encourage the child to listen to different sounds in the environment such as cars, animals
and the telephone.

Gain the child’s attention, get down to their level and exchange eye contact when you
want them to listen.

Use simple language
Talk about what the child is doing or playing with using single words or short phrases.

Repeat, repeat, repeat
e.g. “Let’s post the letter. Here’s the letter. You post the letter.”

Emphasize the important words
If using short phrases put an emphasis on key words:
‘It’s your dinner’,
‘Where are your shoes?’

Use the names of objects
Instead of using words like ‘it’ and ‘that’ use the object’s name:
‘Let’s post the letter’ rather than ‘Let’s post it’.

Name the thing you child points to or is interested in
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
Encouraging First Words: Speaking
Strategies to encourage your child to say words

Use choices
Give the child choices whenever possible. E.g. ‘banana or grapes’, ‘milk or juice’, ‘a book or
a ball’.
Show him/her the options and name them. He/she may point / reach to what they want then
you can name it e.g. ‘oh you want a banana’

Encourage any attempt at a word
Say the word back to the child even if it is unclear e.g. Child: says ‘gi’ Adult says: ‘yes it’s
your drink’, don’t correct the child, just repeat the right word for them to hear.

Listen carefully and give the child time to communicate. Have your turn and the pause and
wait for them to communicate back verbally or through gesture.

Take turns to speak and always give a response when the child tries to communicate.

Encourage the child to communicate in any way not just through words e.g. pointing,
copying actions/ noises. You can then interpret and say back to the child what they would
have said if they could. Next time they might copy you or attempt a word.

Add one or two words to the child’s attempts to extend their language e.g. child says ‘ball,’
adult replies ‘you want the ball’ or ‘here’s the big ball’

Set up situations to encourage the child to make a request e.g. put the biscuits in view but
out of reach. Wait for your child to communicate they want one. Use the strategies above
to model and extend their language.

Have a special time with the child each day. Five to ten minutes where you play with toys,
look at picture books or just talk about what you are doing. Use this time to focus on using
the strategies to support early language development.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
Encouraging First Words: Activities
Activities to Develop Early Language

Feely Bag
Fill a bag or shoe-box with a few objects. Encourage your child to pull out each object, play
with the item while you name it and talk about it.

Pretend Play
Play with toys such as teddies, tea sets, cars, trains, shops etc. Talk about what your child
is doing using single words or simple phrases.

Simple repetitive games
Play simple games such as rolling a ball to each other, blowing bubbles,
tickles, ‘peekaboo’ and repeat the same phrases again and again e.g.
‘mummy’s ball’, ‘Ben’s ball’, ‘again’, ‘more’

Daily Activities
During daily activities (e.g. getting dressed, washed, brushing teeth) repeat the same words
and use simple phrases each time you do the routine e.g. ‘coat on’, ‘gloves on’, ‘hat on’,
‘wash tummy’.

Singing Nursery Rhymes
Singing nursery rhymes with the child is fun. Do actions as much as possible as these help
the children understand what they are singing about. Also use an
object
to that shows them what they are singing about.
‘Twinkle, twinkle’ – have a toy star shape
‘Wheels on bus’ – have a toy bus
‘Incy, wincy, spider’ – have a toy spider
Leave a pause at the end of a line and wait for the child to fill in with either an action or a
word.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
Activities to develop first words using pictures

Books: Share books with the child. Look through them and talk about what the child points
to or turns the page to. Don’t worry about reading the words / story at the moment, just
enjoy sharing the pictures.

Posting Box Game: Use simple flashcards or pictures cut up from catalogues/old greetings
cards etc. Make a post box from an old cardboard box or ice-cream tub. Encourage the
child to pick up the pictures and post them in the box. Talk about the pictures as you look at
them together. Say the single words, for example, “sock”, “bye bye sock”.

Scrap Book: Make a scrap book from old catalogues/ calendars/ greetings cards. Talk
about pictures you stick in the book. Group the pictures together into categories, like
animals, food, clothes. Try using your own photos of people and toys the child knows.

Fishing Game: Use pictures stick onto the shape of a fish. Pretend to go fishing and pick
up the pictures with your hand or make a fishing rod from a magnet and put paperclips on
each picture. Take it in turns to pick pictures and talk about them.

Lotto game/matching pairs: Buy a simple lotto game/matching pairs game or make one
using pictures from the internet using everyday object pictures. Enjoy playing the game and
talking about the pictures. Use games with only a few pictures to begin with and extend it as
the child succeeds.

Simple wooden puzzles (inset puzzles): Choose one with just a few clear pictures. Name
the pictures as you take them out and put them back in.

Object/picture matching: Use some pictures of everyday objects/toys around the house or
setting. Encourage the child to pick a picture and then go to find the real object. Make the
pictures very familiar at first such as a favourite soft toy, a car or a ball but try and make
them gradually harder, such as keys, a spoon or a cup.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
1
Adding Language
Repeating and adding words to your child’s sentences helps them to develop their
talking. By doing this your child will hear words that they can use to expand their
sentences, you will be praising your child for their attempt at talking and your child
will hear how to say the words clearly.
Child:
“Car”
Adult:
“Mummy’s
car”
Child:
“Hands”
Child:
“Baby”
Adult:
“Shh, baby’s
sleeping”
Adult:
“Oh dear, dirty
hands”
Activities to try at home
Add describing words to your child’s
talking
e.g. child says-“dog”, you could say “big
dog” or “black dog”





Use colours: red, yellow, blue
Use size words: big, little, tall short
Talk about shapes: round, square
Use other describing words:
hot/cold/ wet/dry clean/dirty
Talk about feelings: happy, sad
Add action words to your child’s
talking
e.g. child says “bubbles” you could say
“blow bubbles” or “bubbles pop”
Child says “juice”, you could say “drinking
juice”
 Drink
 Sit
 Build
 Look
 Walk
 Eat
 Run
 Sleep
 Read
 Play
 Wash
 Brush
 Sing
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, September 2012
Strategies and Activities to Develop Verbs
These games can be used with a small group of children or with a child on
their own. Verbs are action words like run, brush, sleep.
Action Songs
Sing action songs like The Wheels on the Bus or
“This is the way we…” – sung to the tune of “Here we
go round the Mulberry Bush”.
“This is the way we BRUSH our hair,
BRUSH our hair, BRUSH our hair.
This is the way we BRUSH our hair, on a cold and frosty morning.”
“This is the way we JUMP up and down,
JUMP up and down, JUMP up and down.
This is the way we JUMP up and down, on a cold and frosty morning.”
“This is the way we go to SLEEP,
Go to SLEEP, go to SLEEP.
This is the way we go to SLEEP, on a cold and frosty morning.”
Add more verses of your own. When you are singing it with the child, do lots
of actions and gestures and encourage them to copy you.
Running Commentaries
Whenever you are playing with the child or they are watching you do things
around the house, make sure you comment on what you are doing. Giving a
running commentary will provide plenty of opportunity to emphasise ACTION
WORDS.
e.g. “Mummy’s WASHING the dishes. WASH, WASH, WASH. I’m
WASHING the dishes – they’ll be nice and clean. Oh, WASH, WASH,
WASH.”
Let’s Make Teddy…
Use a teddy bear or the child’s favourite character toy and
demonstrate different actions e.g. teddy kick, teddy sleep, teddy jump. Then
ask the child to make the teddy do different things, e.g. “Lets make teddy fall”.
Take turns to give the instructions so the child gets to practice using some
action words.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
Simon Says
Play a simplified version of Simon Says with the child. Give him/her
instructions like: “Emma RUN”; “Emma HOP”; “Emma SWIM”; “Emma SIT”.
 Encourage them to act out what you say.
 Reverse the game so that the child becomes the
teacher and has to tell you what to do – they’ll love
bossing you around!
 This is a great game to play with a group of children –
they will have to listen for their name and the action in
order to do what you say.
Teddy Simon Says
Play the game but use a teddy and a dolly with moveable limbs. The child has
to make the toys do the different actions.
What Did Teddy Do?
Make the child’s toy do different actions then ask the child “what’s it doing?”
e.g. “sleeping”. To develop the child’s language, say the action in a sentence
e.g. “teddy is sleeping” Carry on the game by using other action words.
Modelling language in this way helps children understand and later use
important words like verbs.
‘Getting ready for School’
You will need: a teddy or a doll (or the child’s favourite soft toy).
a flannel (for washing)
a hairbrush
a bowl
a spoon
Tell the child that you are going to get the toy ready to go to school. Give the
child directions like:
FEED teddy
WASH teddy
BRUSH teddy
Reverse the game so that the child is the teacher again and tells you what to
do to teddy.
Outdoor Play / Obstacle Course
Name the actions the child is doing at the park, in the garden, playground e.g.
swinging, throwing, kicking, climbing, running, crawling. Give them instructions
“ready steady…run” “ready steady …jump”.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
Action Picture Scrapbook
Look through some old magazines with the child for pictures of people doing
things. Tell the child what the people are doing. Cut them out together and
make up an action picture scrapbook. The child will love flicking through the
pages with you and telling you all about the pictures.
Posting Game
Create a fun posting box e.g. a shoe box with a monster picture stuck on the
front. Cut a hole out of the monsters mouth for pictures to be posted in to.
Have a selection of action cards in front of the child. Start off with a choice of
3 and then build this up to 6 as the child becomes more confident. Ask the
child to find a picture e.g. ‘who is sleeping?’ then
encourage the child to post the picture into the box. Let the
child become the “teacher” by naming the action for the
adult to find.
Charades
Have a selection of picture cards for different actions, look at the picture, say
the word and mime the action. Once the child is familiar with the pictures, take
turns to act out an action so the other person guesses the word.
Everyday strategies



Talk about actions as they are happening around you,
e.g. “look that dog’s walking” “mummy’s eating” “baby’s
sleeping” “you’re jumping”
Talk about what others are doing in real life situations or
in story books
Use actions during PE/dancing/songs or in playtime
games, asking children to ‘jump’, ‘turn’, ‘clap their
hands’ etc, then ask the children what they are doing.
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
Lip & Tongue Exercises
These activities are a fun way to encourage a child to use their lips and tongue to make
movements which can help with making speech sounds.
1) Lip & Blowing exercises
These aim to improve lip rounding, lip protrusion and control of the flow of air out of the mouth.
Make different shapes with
your lips in front of a mirror
and encourage the child to
copy you, for example,
“oo” “ah” “ee” “mm”
Blow bubbles
through a straw into
water
Puff out your cheeks and
try to keep the air in by
keeping your lips closed –
see if the child can copy
you!
Make different lip
shapes one
straight after
another, such as,
“oo- ee-oo-ee-oo”
Blowing Games :
Blow pieces of tissue,
feathers or ping pong
balls – try with a straw
too!
Give kisses to
each other and to
teddy/dolly!
Toys : use whistles or blowing
toys with rounded mouth pieces
to encourage lip rounding – and
blow to make a noise . Make
sure the toys are held with lips
not the teeth!
Children’s Speech and Language Therapy Service
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© Leeds Community Healthcare NHS Trust, July 2013
2) Tongue Exercises
Useful tongue movements include sticking the tongue out, licking things, lifting tongue tip up,
lowering tongue tip down and moving tongue sideways. Try the following ideas:
Practise copying
the suggested
tongue
movements in
front of the mirror
Put motivating food like jam
on the child’s top lip, chin
and sides of the mouth for
them to lick off
Put food on a spoon, or lollipop
stick and hold it so the child
has to make the tongue
movements (up, down, to the
side) to taste the food.
Gradually move the spoon/lolly
stick further away
Practise licking
around the lips
Eat a sugary donut
without licking your
lips until the end!
Licking ice
creams and
lollies
Food ideas: hundreds and
thousands, jam, chocolate
spread, peanut butter (if no nut
allergy)
Children’s Speech and Language Therapy Service
www.leedscommunityhealthcare.nhs.uk/cslt
© Leeds Community Healthcare NHS Trust, July 2013