Turn on the chat by knocking off the TV
BABIES ARE pre-programmed to start learning to communicate from the day they are born. If they could talk, they would say “speak to me” – they are fascinated by people’s faces and more interested in human voices than anything else
That “goo-goo, ga-ga” routine which otherwise sane adults embark on at the sight of a baby is only half daft. It is instinctive behaviour because the high-pitched, sing-song delivery helps capture babies’ attention – it is just the silly words they could do without. Far better to call a spade a spade, rather than a “lickle spadie”.
“How parents interact with children from day one determines how they are going to do in terms of speech and language,” says Dr Ciara O’Toole of the Department of Speech and Hearing Sciences in University College Cork.
When you consider that by the age of two, 70 per cent of a baby’s brain has formed and, by the age of three, it’s 80 per cent, there is clearly no time to waste.
A new parent may feel foolish chattering away to a tiny baby who is never going to answer back – at least not in as many words – but it is a good idea to get into the habit of giving a running commentary on what you are doing, what the baby is doing, what is going on around you both.
And you shouldn’t make it a one-sided conversation. Your baby needs time to respond, whether it is with a gurgle, a squeal, a kick or a roll of the eyes.
Prams and buggies in which the baby faces the pusher are recommended because this encourages and enables more visual and vocal interaction when out and about.
The one big conversation killer in many a home is the television – or, indeed, any screen. And that is why, even if you don’t plonk your toddler in front of it for hours on end, just having it on in the room can be detrimental.
There may be a lot of talk on TV, but it does not improve a small child’s vocabulary or communication skills, rather it impairs them. (Although one US study found among children aged 30 months that watching certain programmes, such as Dora the Explorerand Arthur, resulted in higher scores for vocabulary and expressive language, whereas watching Teletubbieshad the opposite effect.)
What children need is interactive experiences and TV does not talk back. What’s more, wherever a television is switched on, talking in the vicinity stops. One study carried out by the Seattle Children’s Research Institute found that, on average, parents say more than 900 words an hour, but when a TV is on this drops to under 200.
As we head into school holidays, in what is shaping up to be a typical Irish “summer”, the last thing parents want to be reminded of is the necessity to limit television watching. But the Irish Association of Speech and Language Therapists (IASLT) recently published guidelines explaining why we need to – particularly when there are pre-school children around.
For children under two years, the association advises no more than half an hour’s television a day. That is half an hour more than the American Academy of Pediatrics, whose stance on the issue for the past decade has been “zero tolerance”, calling on doctors to urge parents to avoid all television viewing by children under two.
Although, it acknowledges, television programmes are promoted to this age group, “research on early brain development shows that babies and toddlers have a critical need for direct interactions with parents and other significant caregivers for healthy brain growth and the development of appropriate social, emotional, and cognitive skills”.
For children aged three to five, the daily dose of television can be increased to an hour, according to the IASLT.
“We all love TV,” says O’Toole, a council member of the IASLT, “and it is a reality of life, but try to minimise it and, when you do watch it, try to make it interactive.”
You should, if possible, sit with your child when he or she is watching a programme and take every opportunity to sing along or join in the actions. It is also a good idea, if watching a DVD or a recording, to stop it after 10 minutes and talk to your child about what you’ve seen before resuming.
Don’t be fooled by the so-called “educational” DVDs either. Parents are doing their best by buying these, says O’Toole, but there is no research to back up the claimed benefits – in fact, there is evidence that children’s learning slows down.
Buying a book or an interactive toy would be much better, she suggests, even ones produced in association with popular children’s TV programmes.
“You can turn off the TV and read the story or act out with the toys what happened in the episode they watched,” she points out. “Playing with toys imaginatively is so much more valuable than time with the television.”
It is a “worrying trend” that TV is becoming more and more a part of children’s lives, says O’Toole, because by the time children start school, they need a sufficient level of language to enable them to learn reading, writing and spelling in the classroom.
About 10 per cent of children will have some sort of speech or language difficulty. But how do you know if your child is speaking “enough” and sufficiently well for his or her age – and if you have concerns, where do you go?
The association gives guidelines for speech milestones (see panel) but also stresses that the rate of development in children varies greatly.
“It is hard to compare one child with another because there is such a vast range of ability, particularly at that young age,” says O’Toole. “But the child should be making steady progress, whether it is fast or slow, it should be steady.”
If your child has not spoken a recognisable word by 18 months, try to make sure you have at least half an hour of one-on-one interaction a day, playing games and reading books. That can help give the child a boost in developing speech.
However, if they reach the age of two and can’t say 50 words or can’t join two words together, then parents should look for professional help. Other reasons parents refer their children to speech and language therapists include when a child:
* Has more difficulty understanding instructions than their peers;
* Has a stammer or stutter;
* Is not interested in interacting with others;
* Can’t be understood by a parent at the age of three;
* Has a hoarse voice, which has persisted for more than 10 days.
Parents can go straight to their local health centre to look for a free speech and language assessment for a child and do not need a GP to refer them.
While a child should be assessed within two to three months, and parents then advised on what is needed, waiting lists for therapy under the HSE vary from region to region. There are also therapists working in private practice.
Boys tend to be slower to develop language for a number of reasons, says O’Toole. It is partly to do with the way the brain organises language and that boys tend to focus more on physical activity and girls on language.
“It is also a cultural thing: a girl is given a tea set and a dolly and imaginative play starts and that is really good for developing language. A boy is maybe given construction work, which is not necessarily conversation-inducing.” However, by about the age of three, in normal circumstances, this all evens out.
Between the ages of two and a half and five, many children go through a temporary phase of what is called “dysfluency”, when they have difficulty getting words out and start stammering. At this age children have so much in their heads they want to say, it can be hard for them to form their thoughts into sentences.
If there is a family history of stammering or the child is anxious, the problem may persist. When children are referred at this age, a therapist works more with the parent than the child on how to handle the issue while waiting to see if it passes.
“A parent can’t cause stuttering but at the same time how they react to it can influence whether the child will grow out of it or if it becomes more of a difficulty,” explains O’Toole. “We do tell parents not to tell the child to slow down or to draw any attention to it, because it is a totally normal thing for them to be doing.”
In busy lives, where work and several children compete for a parent’s attention, it may be difficult to find a half hour for one-on-one time with a pre-school child every day. Slight changes to your routine may be more achievable.
We all have less time for conversation but try to build it into what you do every day: sit down for breakfast and dinner with your child; talk in the car and keep the radio off; explore a picture book together at bedtime.
But this summer, when you are at your wits’ end with children rampaging around the house while it pours rain outside and you want nothing more than a dumb-struck toddler for half an hour, don’t feel too guilty about occasionally putting on that television!
Useful websites: iaslt.ie, iasltpp.com and talktoyourbaby.org.uk
Jonathan had low self-confidence because he was aware he could not say things properly and was shy as a result
Hilary Warren-Perry suspected something was wrong when, from the age of two, her son Jonathan seemed slower to speak than his older sisters.
“I felt he wasn’t hearing properly,” she says. His hearing was checked and she was told he had fluid in his ear, but that it could fluctuate.
He had a second hearing test and was fine, but it later became clear that inconsistent hearing was hindering his ability to learn to talk.
At a pre-school assessment, it was advised that he join a mainstream school with a language class attached, designed to support children with a specific speech and language impairment (SSLI).
Although they were lucky that there was such a school, Shanbally National School near Ringaskiddy, Co Cork, just two miles from their home, Warren-Perry admits that initially she was very apprehensive about the idea of him in a “special class”.
But his speech therapist reassured her and said it would really benefit Jonathan, who also had grommets fitted the summer before he started school. At the time, he had low self-confidence because he was aware he could not say things properly and was shy as a result.
An estimated five per cent of children aged between five and six have an SSLI and 65 of these language classes are run in mainstream schools around the country by the Department of Education and Skills, with speech and language therapy provided by the HSE. There is a maximum of seven children in a language class.
A speech therapist came in three mornings a week, says Warren-Perry, and she worked with each child individually and in group sessions. The class teacher worked on areas the children had difficulty with and there was “lots of homework”.
Jonathan had a “tricky word copy” into which went words he found problematic. He would practise them, writing them down and clapping out the syllables. “Cinema” was one he had a real problem with, she recalls.
Warren-Perry cannot praise the school too highly. By Christmas, they were delighted with Jonathan’s progress and it was clear he would not need to avail of an optional second year in the language class.
The extra attention allowed him to overcome his early disadvantage, catch up with his peers and Jonathan, who is now aged eight, then slotted easily into a mainstream class at his sisters’ national school the following year.
The speech therapist has closed his file.
Support for teens with stammers
Teenagers who have a problem with stammering can benefit greatly from group work, says speech and language therapist Jonathon Linklater.
“It gives them a chance to see other people with similar challenges and difficulties, and can reduce the isolation.”
Working with peers and discussing what strategies help them cope in certain situations, such as oral exams, boosts their confidence.
There is no cure for stammering, he explains, but there are specific therapy techniques which help people to be an effective communicator.
“You can’t stop it happening to some extent, so it is just trying to make it more okay and make people more comfortable with stammering,” adds Linklater, who stammers himself.
“If you are not struggling against stammering, it makes it easier.”
Parents looking for group support for a teenager should contact the local health centre.
The Irish Stammering Association has a parents’ network. For more information, see stammeringireland.ie
At the following ages a child should be able to:
Two years: Say between 50 and 200 words and join two words together in a sentence.
Three years:Say about 500 words, make simple sentences and have basic conversations.
Four years: Say about 1,000 words and tell you about things that happened during the day.
Five years:Say well over 2,000 words and understand many more. They can also make up and recall stories, and strangers should be able to understand them.
NB:At any age, there are large individual differences
Source:The Irish Association of Speech and Language Therapists