Turning the “Terrible Twos” into the “Terrific Twos”

May 14, 2013

Many parents of two year-olds comment about the difficulty of having a two year-old.  The phrase the “Terrible Twos” is frequently used to qualify the feelings of parents about their frustration with their children’s temper tantrums and mood swings.  Whether or not a child has special needs, this period of time can be challenging.  I suggest that as we understand this unique period of growth in our children and have strategies to navigate challenging situations, we can turn this time period into the “Terrific Twos.”

Understanding: From the Perspective of a Two Year-Old

Being two years-old is hard. Children who are two are caught between having new self-help skills, leading to increased independence, and the reality that most tasks still cannot be done completely on their own.  They may have acquired a few new words and with language comes power.  Children quickly discover that the word “No!” is especially powerful.  But with this new-found power of communication, there is also realization that it is limited.  Two year-olds have limited verbal ability which leads to frustration. For children with delayed language, feelings of frustration can be even more intense.  Overall, children who are two have some ability, the taste of power, but, in the end, are relatively powerless in their situations.  That’s a very frustrating scenario.

Understanding: From the Perspective of a Professional

There is phenomenal growth and development occurring between 24 and 36 months across all areas of development.  In neuro-typical children, this is the time period of an explosion of vocabulary and language.  For children who are delayed in language, there is often significant change in language ability during this year.  With all of this growth and development, mood swing and temper tantrums are typical during this time period.

Strategies for Parents

  • Stay engaged with your child by talking with and playing with your child.  This is true in your home as well as when going out in public (to the grocery store, the doctor’s office, a restaurant).  Additionally, bring along a bag of engaging activities when going out in public.  Using a combination of engaging activities and staying engaged with your child’s interaction can go a long way to prevent a break down for your child.
  • When a child is having a temper tantrum, either offer comfort or ignore the behavior.  If you choose to ignore the behavior, ignore for a while, then offer comfort.
  • Distraction is a beautiful tool to use when a two year-old is upset.  Do something unexpected, be silly, or use humor.  Tickling sometimes works, if it is a generally desirable and engaging activity for your child.
  • When engaging in distraction, distract with interaction (tickling, being silly, etc.) rather than with another object (food or a toy). Giving a desirable food or a desirable toy can be seen as a reward and you can inadvertently reward an undesirable behavior.
  • Don’t be afraid of saying “No” to your child but reserve the firm use of “No!” for serious (i.e. dangerous) situations.  In other situations, redirect your child’s behavior to another activity instead.

By staying engaged, being prepared, and knowing ahead of time how to pull out of melt downs can turn this exciting period of development into a terrific time for you and your child!

Jennifer M. Adams, MA, CCC-SLP


Literacy Series Post #6: Supporting Your Child’s Reading At Home

April 10, 2013

“If you add a little to a little, and then do it again, soon that little shall be much.” -Hesiod

Listed below are some general suggestions for things that parents can do to help support the reading growth of their children. These are general suggestions, meant to be useful for almost any child, and there may be other things your child’s teacher will want you to do that are focused on the specific needs of your child. All of these suggestions come from research on the way children learn to read. If you do some of them regularly in a motivating and supportive way, they will help your child make faster progress in learning to read. Many of these activities, such as those that build vocabulary and teach children to think while they read, will also help your child ultimately be a much better reader than he or she might otherwise become.


1. Create a special workspace and schedule daily quiet time for your child to do his/her homework from school. Be sure this is a time you are available to help if needed.

2. Schedule 15 minutes of special time everyday to read to your child. Before you read each book, read the title and look at the cover and pictures inside. Ask your child what she thinks the book may be about (prediction). After reading the book, review her prediction. Was the prediction right? If not, what happened instead?

3. Plan to go to the school library, public library, or the local bookstore once each week and read a new book together. After reading each book, talk to him about what happened at the beginning, the middle, and the end of the story.

4. Play rhyming games. Say two words that rhyme (e.g. cat, sat) and ask your child to say a word that rhymes with your words. Take turns. Ask your child to say a word and then you respond with a rhyming word. For example, child says “cat”, parent says “hat”; child says “chair”, parent says “pair”.

5. Take turns thinking of two words that begin with the same sound. Examples: mom, moon; dog, door; fun, fast; paper, pet.

6. Play the “say it fast” game. Say a word, one sound at a time and have your child say the word at a normal rate. For example, you say each sound in the word cat, “/c/ /a/ /t/.” Then your child says the word at the normal speed, “cat.” Play this game with about five to ten short words (e.g. am, is, it, in, on, sit, pan, sun, top, net, fin) each day.

7. Take every opportunity you can to help increase your child’s vocabulary. You can do this by pointing to things and asking the child to tell you what they are, or you can stop and explain the meaning of any words in your reading that the child may not understand. The more you talk to your child, the faster their vocabulary will grow.

First Grade

1. Create a special workspace and schedule daily quiet time for your child to do his/her homework from school. Be sure this is a time you are available to help if needed.

2. Schedule 15 minutes of special time everyday to read with your child. Take turns reading a page at a time. Or, read a sentence and then have your child reread that same sentence until you read through the whole book.

3. Plan to go to the school library, public library, or the local bookstore once each week and read a new book together. After each story is read, ask her to retell the story to you. Go back to the story to reread sections if she needs help retelling the story in sequence.

4. Play the “say the word slowly” game. Say a word at normal rate and then have your child say that same word slowly, one sound at a time. For example, say the word, “mat.” Then your child will say that same word slowly, one sound at a time, “/m/ /a/ /t/.” Play this game using about five to ten short words each day.

5. Fold a piece of paper into three parts. Let your child draw a picture of something he did in sequence. Then help your child write one sentence under each picture explaining what he did first, next and last.

6. Take turns thinking of two words that end with the same sound. Examples: mom, some; dog, rug; fun, ran; paper, feather.

7. Take every opportunity you can to help increase your child’s vocabulary. You can do this by pointing to things and asking the child to tell you what they are, or you can stop and explain the meaning of any words in your reading that the child may not understand. The more you talk to your child, the faster their vocabulary will grow.

Second Grade

1. Create a special workspace and schedule daily quiet time for your child to do his/her homework from school. Be sure this is a time you are available to help if needed.

2. Schedule 15 minutes of special time everyday to listen to your child read.

3. Go to the school library, public library, or to the local bookstore once each week and read a new book together. Read the title then look at the cover and pictures inside. Ask your child to predict what the book is about. After reading the book, review prediction then ask about the characters, setting, problem and solution.

4. Fact or Opinion Game: The parent says a sentence to the child then asks whether it is a fact or opinion. Ex: The weather is nice. (Opinion) A dog can bark. (Fact)

5. Encourage reading fluency by having your child read and reread familiar books. It can also be helpful to have your child read a short passage over several times while you record the time it takes. Children often enjoy seeing if they can improve their time from one reading to the next, and the repeated reading helps to establish a habit of fluent reading.

6. Pick out a new vocabulary word from one of the books you are reading with your child. Talk about what it means then make up a sentence with the new word. Try to use the word again that week.

If your child is a struggling reader and you want professional support in helping your child read, please visit our website to make an appointment for an evaluation.

Social-Pragmatic Skills and Autism Spectrum Disorders

November 10, 2012

Social-Pragmatic skills help individuals engage in social interaction with others. Many of us grasped the unwritten rules that govern our behavior in the social environment early on in our lives. However, individuals with Autism Spectrum Disorder (ASD) have difficulties learning these rules. In fact, social-pragmatics is often considered a core challenge for these children. The “hidden” social expectations can make social interaction a confusing experience. Therefore, many professionals and parents may want to help children with ASD develop a variety of skills that fall within the social-pragmatic realm. Nonetheless, before we start, we need to first sort out important conversational skills and find ways to assess children’s performance.

Social-Pragmatic skills involve not only one’s ability to communicate intent, but also knowledge of discourse management, register variation, presupposition, and other social skills. Discourse Management involves managing the conversation to keep it flowing and effective. Conversation partners need to agree on turn allocation, which involves identifying turn-taking opportunities and limiting one’s talking to one’s turn. They stay on the topic unless there is a signal by a communication partner that he/she is going to change the topic. Knowledge of topic maintenance includes knowing how to smoothly switch to a new topic. When conversation breakdown occurs, one needs to recognize it and use subsequent repair strategies such as repeat, rephrase, or adding information to aid communication. Register variation includes politeness/social role recognition, as people change their word choices, sentence forms, vocal tone and gestures/body posture to adjust to social roles in various discourse patterns. Presupposition, or perspective-taking,involves making assumptions about what other people know. People learn to understand everyone has different thoughts, feelings, and experiences, and take this into account during the conversation. Paralinguistics refers to the use of prosody, gaze, gestures, and physical proximity to show interest in the interaction, convey different layers of meanings and monitor the nonverbal communication of the partner. Social behaviors involve use of facial expressions, conventional gestures, and social actions that are expected in one’s culture, such as dressing appropriately for an occasion, offering to share something, assisting someone who needs help, patiently waiting for a turn in a game, etc.

Children with ASD may be able to fluently express their intention, but they often face difficulties in their social interaction with lack of proficiency of more than one skill listed above.

Assessing pragmatic skills can be a challenge since conversations are dynamic, and there is no easy way to measure one’s performance via standard tests. Formal assessment which involves static, often pictured situations can be used to establish a starting point, but information collected through observation, interview, and check lists helps us to detect if the individual lacks the knowledge to manage such conversations or is merely experiencing a performance issue. If needed, specific situations can be created to probe particular skills. Information from more than one source is necessary to establish goals and priorities for intervention.

Several key components need to be considered as we develop an individualized treatment program for children with ASD. These include the child’s knowledge about social communication, his/her ability to apply social knowledge in various situations, the cognitive/emotional cost to the child, the need to find right strategies to specific challenges, the co-occurring elements in the planning/implementation stages of social interaction, plans to generalize learned skills, self-monitoring skills that promote independence and flexibility, etc. Interventionists should also consider what skills are easiest/most important to teach, which skills can be paired together, and which skills will make the biggest impact in terms of improving social interaction. Many tools and programs have been developed for improving social interaction in this population. For example, social groups and social stories help children with ASD to experience different social roles and social situations, expand their knowledge of social skills, give them examples of strategies they can use, and offer them opportunities to practice social-pragmatic skills in a low-stress environment. While the SLP may lead intervention, family members and school teachers can also provide additional learning opportunities throughout the day to help children monitor their newly learned skills.


Information taken from:



Chloe Chenjie Gu, MA., Speech-Language Pathology Intern

Kristina Elliott, MA, CCC-SLP

Joint Attention

June 6, 2012

Learning to communicate using speech and language is a primary developmental task for young children. Significant progress in research related to language intervention is available to improve the delivery of Early Intervention services. According to the most recent research, social attention and prelinguistic communicative behaviors are fundamental to language learning and use.  According to Adamson et al., 2009, “the process of joint engagement between children and their partners is foundational to emerging communication.” In CSLOT’s parent handout, Making a Joint Effort to Communicate, joint engagement is initiated by the child’s communication partner through observation. By becoming a thoughtful observer, one can learn what the child enjoys, desires, feels – even what they want to communicate. Yoder & Warren, 2004 indicated that “coordinated joint attention is an important early indicator of social communication abilities and predicts the onset of spoken language in typical children with disabilities.” How can a parent, caretaker or therapist initiate coordinated joint attention? According to Making a Joint Effort to Communicate, one way is to become more physically involved in the same activity as the child. This works best when it is an activity of the child’s choosing. During the joint action, try imitating the child’s play- then try adding or expanding on their play.

Adamson et al., 2009 also found that the use of symbols (gestures, words) within the context of joint attention marks the transition from prelinguistic to linguistic communication. One way of using language during a joint activity is by providing joint referencing for the child. According to the handout, once the communication partner (i.e., parent, caretaker, therapist) is engaged in joint action with the child and they have established joint attention (i.e., both attending to the same thing), the communication partner can introduce the language component by talking about the object/action that the child is attending to. For example, if the child is playing with a car, then the communication partner will guide their attention to the car, talk about what it is, what it looks like, what it is doing, etc. The car is important to him right now so one can make that a “teachable moment.” Additional methods for teaching joint attention and prelinguistic communication skills (point, show, give, turn taking) have included environmental arrangement, modeling, prompting, and reinforcing child responses in naturalistic and direct teaching paradigms. Please speak with a speech-language pathologist for additional information on these techniques.

-Sarah Peters, MS, CCC-SLP

Information gathered from www.cslot.com and “Advances in Early Communication and Language Intervention,” (Kaiser & Roberts, 2011).

How to Provide a Functional Home Environment for your Sensory Seeking Child

May 30, 2012

Have you ever asked yourself what type of environment can help your sensory seeking child pay attention and behave more appropriately? The following strategies can help increase your child’s attention, facilitate appropriate behavior, increase organization, and prevent over-stimulation.

Proprioceptive: Make tools available for heavy work activities such as a climbing a rope or riding a bicycle.

Tactile: For tactile sensory seekers, organize your environment so that items the child uses routinely provide tactile stimulation such as textured bath mats.

Vestibular: Make equipment available that provides purposeful movement requiring an organized response such as a swing. Have your child swing and aim for a target.

Visual: Maintain organization by labeling drawers, placing toys in containers to minimize clutter, and using muted colors. .

Auditory: Provide a steady background of quiet sounds such as classical music.

Oral: Provide foods with intense tastes.

If you have any questions, please contact an occupational therapist at CSLOT who can assist you with making environmental changes in your home to support your child.

-Anna Lisa Matudio, M.S., OTR/L


Miller, L.J. (2007). Sensational Kids. New York, N.Y.: Penguin Group, Inc.

What is Early Literacy Development and How Does it Tie to Language Acquisition?

May 22, 2012

Children start to learn language from the day they are born. As they grow and develop so do their speech and language skills. They learn to understand and use language to express their thoughts, ideas, and feelings to communicate with others. During this stage of early speech and language development, children also learn skills that are important to the development of literacy skills (reading and writing). This is known as Emergent Literacy or Early Literacy. This begins at birth and continues through the preschool years.

Children are exposed to print (e.g. books, writings on the grocery list) in everyday situations (e.g. home, daycare) well before they enter elementary school. Parents can see their child’s appreciation for print grow as they begin to recognize words that rhyme, scribble with crayons, name some letters in the alphabet, and eventually combine what they know about speaking and listening with what they know about print indicating their readiness to read and write.

The Development of Print Knowledge

Children start by making guesses:

  1. Understanding what symbols mean
  2. Making inferences based on the size and length of the print
  3. Making inferences based on their unique design
  4. Directionality
  5. Oral/Written Language Correspondence
  6. Understanding how letters relate to sound

Warning Signs

The experiences with talking and listening learned during the preschool years prepare children to learn to read and write during early elementary school years. This means that children who enter school with weaker verbal abilities are much more likely to experience difficulties in learning literacy skills than those who don’t. Children who are at risk may exhibit these warning signs:

  • Persistent “baby” talk
  • Absence or lack of interest for nursery rhymes
  • Absence or lack of interest in joint book readings
  • Difficulty understanding simple directions
  • Difficulty learning or remembering names of letters
  • Failure to recognize or identify own name

What can you do?

Children need to engage in learning about learning literacy through meaningful experiences. You, as a parent, can help your child develop literacy skills during regular activities without adding extra time to your day. Show them reading and writing is part of everyday life and can be fun and enjoyable. Activities for children include:

  • Talk to your child and name objects, people, and events in their everyday environment
  • Repeat what your child is saying, including babbling (e.g. “dadada, bababa”) and add to them
  • Talk to your child during routine activities (e.g. bathtime) and respond to their questions
  • Draw your child’s attention to print in everyday settings such as traffic signs, store logos, and food containers
  • Introduce new vocabulary word during holidays and special activities such as outings to the zoo, park, etc.
  • Engage with your child in singing, rhyming games, and nursery rhymes
  • Read picture and story books that focus on sounds, rhymes, and alliteration (words that start with the same sound, as found in Dr. Seuss books).
  • Reread your child’s favorite book(s).
  • Focus your child’s attention on books by pointing to words and pictures as you read.
  • Provide a variety of materials to encourage drawing and scribbling (e.g., crayons, paper, markers, finger paints).
  • Encourage your child to describe or tell a story about his/her drawing and write down the words.

-Michelle Smith, M.S. CCC-SLP & Chary Liz Macasero, B.S. – Student Intern


Roth, F., Paul, D., & Pierotti, A., (2006). Emergent Literacy: Early Reading and Writing  Development. American Speech-Language-Hearing Association (ASHA).  Retrieved May 14, 2012, from http://www.asha.org/public/speech/emergent-          literacy.htm.

Dobbels, D. (2003). Using what we know to enhance early literacy programming: An  SLP’s guide to early literacy development & practices [PowerPoint Slides].  Retrieved May 14, 2012, from  http://www.asha.org/Events/convention/handouts/2007/1500_Dobbels_Deidre/

Early Intervention: Speech & Language

May 1, 2012

Early intervention (EI) refers to services, education and support provided to families with children, birth to three, with disabilities, delays or at risk of developing a disability that can affect their development or impede their education. The goal of early intervention is to provide support to families to help their children grow to their greatest potential.  The services are designed to identify and meet a child’s needs in five developmental domains, including: physical development, cognitive development, communication, social or emotional development, and adaptive development.  Although services vary by state, they can include speech and language therapy, occupational therapy, physical therapy, educational services and family counseling.

Early intervention programs and services can be received in a variety of settings.  However, these settings must be considered a natural environment, such as in the home or in the community, where children without disabilities or delays can participate and are embraced.

In order to be considered for early intervention services, which are provided to families at no cost, a child must first be evaluated prior to age 3.  After their third birthday, they are no longer eligible for early intervention services.  If services are still needed after three years, a transition in services will occur and it is then the school district’s (special education team) responsibility to determine eligibility and appropriate services.

Often times, parental concerns initially rise due to their child “not talking” or having a limited expressive vocabulary.  If there is any concern regarding your child’s development or meeting developmental milestones, it important to talk to professionals such as your pediatrician.  Talking to your child’s pediatrician and requesting a referral for an assessment is the first step!  Research shows the learning takes place at a faster rate between birth and 5 years of age.  Unfortunately, parents who take the “wait and see” approach, 75% of their children with communication difficulties go undetected until they enter kindergarten and are 5 years old.


Research Findings

Studies examining the effectiveness of early intervention found that

  • Early childhood programs can benefit children on intelligence quotient (IQ) and demonstrate sizable long-term effects on school achievement, grade retention, placement in special education, and social adjustment.
  • Late talkers have demonstrated gains in expressive vocabulary size and use, utterance length and socialization skills.
  • Between 25 and 50% of children receiving intensive EI will move into general education by Kindergarten and many others will need significantly less service provision in future years service provision in future years.

How do I support my child’s communication development?

Birth to One Year:

  • Check your child’s hearing ability pay attention to ear problems and infections, especially when they are reoccurring.
  • Reward and reinforce your baby’s communication attempts by looking, listening and imitating their vocalizations.
  • Teach your baby to imitate facial expressions, actions such as peek-a-boo, clapping, blowing kisses and waving.  These games teach turn-taking which facilitates later developing skills to engage in conversation.
  • Talk about what you and your baby are doing, such as bathing, feeding (e.g., “Mommy is putting on Marie’s socks”; “Marie is eating a banana”).
  • Teach animal sounds (e.g., A sheep says ‘ba ba’”).

One to Two Years:

  • Talk while doing things and going places.  For example, point out and label familiar objects like a cat.  Provide language that is simple and concrete.  “I see a cat.” “A cat says meow.”
  • Use simple speech, phrases and sentences that can be understood and imitated by your child.
  • Expand on words.  If you child say’s “baby,” respond by saying, “Yes!. The baby is crying.”
  • READ, READ, READ!!!  Find books with large print and pictures.  Name the objects and describe the pictures. Use simple phrases on sentences on each page.  You don’t have to read the actually text (It may be to long or use abstract language).
  • Ask your child to point to named pictures.
  • Ask your child to name the picture. If they don’t, name it for them!

Two to Three Years:

  • Model clear and simple speech and easy enough for your child to imitate.
  • Attend to your child and show that you are interested in what he or she has said and expand on it.
  • Repair communication breakdowns.  Let your child know that what have said is important and ask them to repeat information you could not understand.
  • Expand your child’s receptive vocabulary by labeling objects and pictures in books and providing synonyms for familiar words.
  • Sing songs, tell nursery rhymes and play finger games.  These activities introduce rhythm and the sounds of language as well as promote literacy development.
  • Look at family photos and describe what is happening. Write simple and appropriate phrases under the pictures.  This helps your child understand that reading is spoken language print.
  • Give the child choices and use open ended questions rather than asking yes/no questions.  For example, ask “Do you want juice or water?” or “What do you want?” rather then “Do you want juice? Do you want water?”

Barnett, W. S. (1995). Long-term effects of early childhood programs on cognitive and school outcomes. The Future of Children, 5(3), 25-50. Retrieved April 25, 2012, from


Eichten, P.  (2000).  Help me talk: A parents guide to speech and language stimulation techniques for children 1 to 3 years (2nd ed).  Richmond, VA: PI Communication Materials, Inc.

Chelsea Collins, M.A., CCC-SLP

Speech Language Pathologist