Case Study

Linda and Jeff: Parents of a 26 Month Old Boy Slightly Behind in Talking

Parents, especially first time parents, are eager to see each communication developmental landmark arrive, including first words (12-14 months) and two word phrases, what people mean when they say “talking,” usually at 18-24 months. Linda and Jeff’s little boy Curtis was developing very typically in all areas except speech, where he was lagging behind. At 26 months he had just two single words and got most of his needs met by pointing. There was no evidence of a hearing loss or of childhood apraxia of speech.

In three half hour visits, we taught Linda and Jeff to use several techniques of indirect language stimulation. We taught them to observe what Curtis was doing as he played, then use a short descriptive sentence to describe that (“You’ve got the ball” or “That’s a red car”). We strongly encouraged them to reduce the number of questions they asked Curtis (unless they were essential ones like “Are you wet?”). We had them first spend a day counting the non-essential questions they asked Curtis. We taught them three techniques of indirect language stimulation: description (making a short sentence about objects that Curtis had or saw); parallel talk (describing an action that Curtis was doing); and expansion, where the parent hears an utterance from the child and repeats and expands it without asking a question.

Following the three training sessions, we sent the family home to use indirect language stimulation in daily activities (playtime, bath time, meals, dressing) and we requested a total of at least thirty minutes of stimulation each day. After two weeks of getting used to the methods, Linda and Jeff actually wound up using the new techniques about 45 minutes to one hour each day. Three months after the first visit, at 29 months, Curtis was re evaluated and found to be using 2 and three word phrases. His average utterance length was close to three words, which is within age appropriate limits.

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