early intervention speech therapy

Early Intervention Speech Therapy: Why Does It Look Like Just Playing?

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Many parents are surprised when their child begins early intervention speech therapy, and the therapist comes to their home and starts playing with their child instead of sitting down at a table and practicing flash cards of new words.  Parents may be concerned because their child is not talking, but what may be of more concern to an EI Speech therapist is that their child is not imitating.  The ability to imitate is key to communication development because it involves the idea that “I see you do something and then I can do it too,” including imitating sounds and words.  For a child to be able to imitate, they need to be socially connected and pay attention to the other person involved in the activity as well as having the motor and cognitive abilities to imitate the action.  Many young children that we work with are not developmentally ready to start working on single words because they have not mastered the skill of imitation, and therefore we need to back up and work on the beginning levels of imitation.

Developing a Child’s Ability to Imitate

An EI speech therapist may first start by developing a child’s ability to imitate actions with familiar toys, such as shaking a rattle, pushing a car, rolling a ball or hugging a doll.  The important part of these activities is encouraging the child to copy the action that you are doing.  These activities will not only help develop play skills but they will also encourage the child to attend to what you are doing and share in that activity.  The EI speech therapist may also start encouraging the imitation of simple gestures during play and daily routines such as clapping hands, stomping feet, waving, shaking head yes/no and reaching up to be held or carried.  The ultimate goal of all of these play activities is to socially connect with the child and to teach them that “you do, then I do”.

After a child has started to imitate basic actions and gestures the therapist may start encouraging the imitation of simple sounds during play such as ‘Ah’ or ‘Oooo’, squealing, grunting, snoring, fake cough or car noises.  The speech therapist may also start encouraging the use of exclamatory words during play such as “uh-oh, eeew, whoa, mmmm or ouch”.  These types of imitation activities are bringing more attention to the child’s mouth and the purpose is to have the child imitate the same noise as the adult.  After the child appears to be able to imitate simple play sounds and exclamatory words the therapist may start to incorporate set phrases or verbal routines such as “ready, set, go!”, “1, 2, 3”, “peek-a-boo” or simple childhood songs.  Using these set phrases during multiple play activities allows for predictability and memorization of vocalizations.

Once a child has developed the ability to imitate actions, sounds and verbal routines in play then the EI speech therapist may start to encourage the child’s production of real words.  By this point the child should have a better understanding of the concept “you do it, then I do it” and may be more receptive to imitating new words modeled for them.  We all understand that children learn best through play and all of the above activities are best done during play routines where the adult is thoroughly engaged and exciting to be around.  This will make the child more excited about what is going on and will encourage them to be involved in the interaction.

So the next time your child is imitating you marching around the house, playing peek-a-boo, waving good-bye or saying “uh-oh!”, remember that these are the foundational skills we work on in early intervention speech therapy and the skills needed for the child to begin to speak!

By: Michelle Searock, SLP