When I was but a young and inexperienced speech therapist, parents sometimes gave me the side eye during our sessions. I would come into their homes, pull out a bunch of toys and start playing. I could hear their gears turning: Why am I investing my time and resources into this therapy when she is just playing?
Now that I am old and gray(ing), I know that I need to be more explicit. I haven’t stopped playing – young children learn through play – but I am better at explaining the why and how. A good speech therapist plays sneakily and teaches parents to do the same.
I’ve said it before, and I’ll say it again: a speech therapist that works with toddlers can turn any toy and any interaction into an opportunity for communication. One way to do this is to carefully construct a play environment that tempts a child to communicate. In grad school, we called this milieu teaching.
Milieu teaching is filled with “temptation tasks.” The play may look unstructured, but nothing that happens is accidental. To illustrate this, I will give you two examples. The first example shows how to control the play environment in order to engage a child in communication right off the bat. The second example explains how to tempt a child to talk using one of childhood’s most beloved toys.
Example One: The Closed Bag
I have a bag. It is an enormous black-and-white monstrosity with a sturdy zipper. Although it may look uninspiring, toddlers across the San Francisco Bay Area know that inside that bag lies a treasure trove of colorful toys: Mr. Potato Heads, blocks, crayons, play dough, shape sorters, and all kinds of incredible things. It is basically the Little Engine That Could of bags. But the darn bag is perpetually zipped. How is a toddler, with his emerging fine motor skills, supposed to access the enticing cornucopia inside?
Would it surprise you to learn that for many of the children I see, “open” is one of their first words? Well…surprise!
Every Single Time I come to their house, I bring my big, bland yet promising bag, and Every Single Time the first thing they have to do in order to access its splendor is to ask for it. Depending on where the child is in his language development, I might “accept” different types of communication: reaching, pointing, the sign for ”open,” the syllable “oh,” or the word itself. The key is to tempt them to try something just a little harder than what they are able to do on their own. For example, if I have a little boy who points but doesn’t say any words yet, once I’ve engaged his interest and attention with the bag, I tempt him and help him to use a sign or word approximation instead of just a gesture.
There are many other temptation tasks that look a lot like this one, and you can try them at home. Clear bags and clear bins are some easy standbys. Put favorite toys in a clear storage bin so that your child can communicate to request a toy. Perhaps they request “blocks.” Take out a clear bag full of blocks. Perhaps they request “open,” and you can give them one block and shut the bag. This gives them the opportunity to request “more,” or “open,” or “block” again. All of this language is possible in a short period of time, and even children who are having difficulty learning to talk can be tempted to do so when they are given adequate help and opportunities. Compare this to what would happen if a child interested in blocks walked into the room and the blocks were lying all over the floor. THAT would be unstructured play, and while unstructured play has enormous benefits in its own right, it does not create the same opportunities for increasing expressive language skills as does milieu teaching.
Example Two: Bubbles
If you work with kids or have kids or are a kid at heart, you probably already know that bubbles are the most exciting things in the whole wide world. Children will do almost ANYTHING for bubbles, and talking is no exception.
Again, we start with the bag. The toys are always in the magic bag. At home, you can use your own magic bag, or you can put the bubbles in the aforementioned clear plastic bag or bin, or just place them on a high shelf. The child might request the bubbles by saying or signing “bubbles” or “want,” or if they are more advanced, they might use a variation of “I want the bubbles please”.
At this point, I often just give them the bubbles. But fear not – the interaction is not over! Giving them the bubbles is actually a dirty trick because most of my toddlers (and I know the exceptions, believe me) cannot open the bubbles on their own. At this point, a child has the opportunity to request that I “open” the bubbles, or take the top “off,” or “help” them. Some children will communicate their intention by just giving me the bubbles and looking at me expectantly. This is communication, too, although I am going to start asking them to do something a little more complex pretty soon.
However, some of my children do this instead: they try to pry the top off by themselves, they shake the bottle up and down, and they do anything in their power to get to the bubbles WITHOUT my help. They don’t look at me, they don’t hand me the bubbles. They just drop the bubbles on the floor and go try another toy. These children do not use any kind of communication to let me know what they want because they have no idea that they can influence their environment by doing so. They do not know that if they indicate their desire to an adult, the adult will probably help them.
I hesitate to write this because I try to keep things professional, but I have to level with you. When I see two and three-year-olds respond to a favorite toy this way – without any looking, pointing, giving, or speaking – it really makes me sad. If you teach your child one thing, please teach them that their communication is powerful and that they are able to influence their environment. When I have a child who does not know that he can communicate to make a request, I work on cause and effect (he does something, and I immediately respond to it) over and over and over again until he understands that there is something he can do (or hopefully say) to get something.
As with the clear plastic bags and bins, you can keep going and going with bubbles. If the child says “off” and I take the top off, they have the opportunity to say “out” so that I will take the wand out. Then I hold it to my lips, they might say, “blow.” I put the top back on, they might say “open” or “more” or “off” or “please” or “bubbles.” I think you get the picture.
Do you see how much language is possible with just a bag and some bubbles? Can you imagine how many other opportunities there are for communication, given the enormous variety of toys out there? If you want to work on body parts, play with Mr. Potato Head. If you want to work on colors, play with crayons. You can even work on verbs like “eating,” adjectives like “thirsty,” and nouns like “crackers” each time you have a snack. I maintain that every time we interact with toddlers, we have the opportunity to support their language development, but to do so, we need to give them opportunities; we need to give them a reason. And so we play, and we structure our play to teach them the power of their communication.
Play on, friends, play on.