Language

I have a 31 month-old son that still doesn’t speak. We are living in Italy and I speak in English and my husband in Italian and sometimes the local dialect. He seems to understand us both and uses his hands and certain sounds to communicate with us but no words. How will speech therapy help him? What exactly is involved? I ask because I think we might need to bring him to a speech therapist eventually. Thanks.

Many people think that speech therapy is just about how to pronounce words but it covers a whole range of other issues as well including:
- The absence of speech or not reaching speech milestones at an appropriate age
- dyspraxia (words or sentences don’t come out right)
- Not using language in a functional way (eg. my daughter had good speech and a very large vocabulary but did not use her speech to ask for things or to tell me if something was wrong etc)
- Language comprehension issues
- Auditory processing issues (when they hear and understand individual words but may have difficulty following instructions etc)
- Social issues (how they relate to others)
- Eating issues and oral motor issues
…and much more.

Depending on your child’s issues the speech therapist will use a range of techniques to help them develop their speech. With a very young child a good speech therapist will use mostly games and fun activities to encourage them to speak and use their language in an appropriate way; the games are usually designed or reworked to maximise the language skills that you are working on.

A good speech therapist will also work with you as much or even more than your son. They will understand that at this age his primary relationship is with you (and your husband) so they will teach you how to teach him. Most speech therapists will give you some things to work on at home but a really goods speech therapist will teach how to incorporate these lessons into your everyday life (eg. I never have to sit down to do speech practise with my daughter, it is incorporated naturally into our conversations and play time)

Some examples (these were done at various stages over the last 3.5 years) :
To encourage my daughter to ask for things we did blowing bubbles. She could say the word "bubbles" and would say it if she saw them but she never asked for them. To get her to ask I would hold the wand in front of my mouth ready to blow but wouldn’t actually blow until she said "Bubbles"; I then blew lots of bubbles for her to play with which rewarded her for asking.

Another thing we did was to put all her toys away in see-through plastic boxes. She couldn’t get her toys without asking for them. This worked particularly well for things that had lots of pieces (eg. blocks) because I could give her just one at a time which would encourage her to ask over and over again to get all the blocks.

To encourage my daughter to take turns speaking (she would often speak without listening to the person she was talking to) we played lots of games where you took turns. Once she understood how to take turns we talked about "your turn" and "my turn" in conversations.

To encourage her to listen better to what people were saying we would play a listening game where she had to follow all my instructions (without me having to repeat myself) and at some point one of the instructions would be "Go and get a cookie" (or other treat). This made her listen really well!

All these sound really simple but they were VERY effective and my daughter’s speech therapist has a never ending supply of ideas like this. We started speech therapy at 16 months and I have never regretted the decision to start so young. Her specific condition means that the she will probably be in speech therapy for some time to come but she is doing much better than other kids of the same age with the same condition because we started so early.

Good luck

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