How Many Words Does Your Child Say?

April 9, 2015

When you take your toddler to a well-child check-up at the pediatrician s/he will certainly ask you how many words your child says. The developmental milestone that they are looking at is your child’s spontaneous use of words. These are words your child says not in imitation. If your child points to a dog and says “dog,” that is spontaneous. If you ask your child, “What’s that?” and he says “ball,” that is spontaneous. If your child repeats a word s/he overhears or says a word when you tell him or her to say it, then it’s imitated.

The most accurate way to keep a count of your child’s spontaneous words is to maintain a written list and add to it every time you hear a new word. The chart below can be printed and used to track your child’s early word acquisition. If your child reaches 50 words that s/he uses spontaneously before his or her second birthday, you can stop counting. Children should have a minimum of 50 words in their vocabulary by their second birthday. If your child does not have 50 words by age 2, you should seek a speech-language evaluation from a speech-language pathologist or a developmental evaluation through your state’s early intervention program.

Toddler Word Chart


Simple, but Effective, Communication Strategy

March 24, 2015

This simple strategy is easy to implement at home. At snack time, get down on your child’s level and offer two choices. Hold them about shoulder-width apart and far enough away so that your child cannot grab. Once s/he points to or reaches for the desired object, hold that one up by your face and say the name of it. Pause expectantly, giving your child the opportunity to imitate. After about 5 seconds (you can count in your head), say the name again and pause. Do this once more and then hand the item over whether or not your child has imitated. If your child does imitate (or attempt to imitate) the word, be sure to praise the effort.


Benefits of using this strategy:

  1. By offering a choice, your child has to intentionally communicate a want or need. This is an early step on the way to talking.
  2. By getting down on your child’s level, you get his/her attention and make it easier to watch your face.
  3. Children tend to look at the object they want, so bringing it up by your face while you say its name encourages eye contact and allows your child to watch your mouth as you form the word, so s/he can see how it is said.
  4. By pausing expectantly and waiting, rather than saying, “Say ___,” you are giving your child the opportunity to imitate without any pressure. This is important because many children with delayed language will shut down when pressure is put on them to speak. Please be sure not to tell your child to say the desired word.
  5. By saying the word 3 times, you ensure that s/he has heard the word 3 times in the immediate context of the item, which helps with understanding the meaning of the word.
  6. By giving the item to your child after the third time you have said it, you reduce everyone’s frustration. You, as the parent, do not have all day to wait for your child to say a word before giving a snack. By limiting yourself to saying the word 3 times, you get to move on. Your child also gets to practice being patient.
  7. When this strategy is used consistently, many children get tired of waiting for you to say the word three times, and learn to imitate after the first or second time.


  1. If your child points specifically to what s/he wants, you can skip the step about offering a choice, as your child has already used intentional communication to indicate a want/need. Go straight to holding the desired item up by your face.
  2. Once you’re comfortable with this strategy at snack time, try it out during other routines. (Green shirt or red shirt; play trains or blocks; milk or water)


Let’s Pretend!

November 30, 2014

It’s that time of year again when parents, grandparents, aunts, and uncles go out in search of new toys for their youngest relatives. I’ve written before about tips for choosing toys, always at this time of year it seems. (Top Toys for Toddlers and How To Choose Toys That Encourage Development Through Play). And here I go again.

This year, I’m focusing on toys that encourage symbolic and/or pretend play. Language and play develop along similar paths, so as children’s play becomes more complex, so does their language. The toys below lend themselves to children narrating what they are doing. For some little ones, this will be in complete sentences, while for others, they may just use single words or two-word phrases. Regardless of the complexity, it’s important that children be able to use language to comment about what they are doing, rather than just for labeling pictures and requesting desired items.

Parents and caregivers can support language development by reflecting back what the child says and expanding on it. For example, if your child is playing with a farm set, puts the horse in the barn, and says “Horsie night-night,” you could respond by saying “The horse is going night-night,” or “The horse is going to sleep.”

So here are a few toys that encourage symbolic and/or pretend play. None of them require batteries, which saves you money, saves you from listening to annoying toy sounds, and allows your child to use his or her imagination.

Fisher Price Little People Mini Farm – This one has no batteries. If you choose the Fun Sounds Farm, do yourself a favor and never put the batteries in. If you put the batteries in, your child may learn that a cow says oink or a sheep says moo because the toy does not know which animal figure your child is playing with as s/he puts it on a spot that activates the sound.

little people farm


Tea Set – There are lots of tea sets out there with batteries, but this one doesn’t use any. It’s simple, which will encourage your child’s creativity. Pair this with some dolls or stuffed animals, and your child can host a tea party.

tea set


Doctor Kit – This is a great toy for acting out adult roles, as well as playing with others. Children can take turns being the doctor or the patient. Playing with the doctor’s tools can help desensitize children to them, so they are more comfortable in the doctor’s office.

doctor kit


Cooking Set – Children can play restaurant or house with this set of cookware and food. They don’t even need a play kitchen to make believe they’re cooking like mom or dad.

cooking set


Baby Doll Set – Both feeding and clothing the baby are great for pretend play. Additionally, dressing and undressing the baby require the use of fine motor skills. All kids, not just girls, are likely to enjoy taking care of a pretend baby.

baby doll set


I have intentionally left out toolbox sets. While some children engage in pretend play with hammers and screwdrivers, many children only use them for banging. Since we are looking for higher level play than just banging, I recommend choosing a different play set.

I receive no financial benefit from promoting these toys. I just think they are great toys for young children. All of these toys can be found on Amazon, which is where the links will take you, but the same or similar toys can be found in any toy store. Happy shopping!


Top Ten Uses for Plastic Drink Bottles

July 15, 2014

Many communities have recycling programs for used plastic bottles, but whether yours does or not, you can upcycle your used plastic drink bottles for some fun activities with your kids. Here are my top ten uses for plastic bottles and some skills you can address while you play.

1. Once you have a collection of at least three bottles, you can set them up like bowling pins and have your child roll a ball to knock them down. One or two-liter soda bottles work best for this, but you could use water bottles instead.

  • Talk about the concepts of up and down as you set up and knock down the pins.
  • Work on sequencing: first we put up the pins and then we knocked them down.
  • Practice taking turns.

2. You can fill bottles with a variety of different small objects and then super glue them shut to create sensory bottles. A quick search on Pinterest will reveal hundreds of ideas for what to put in the bottles. Here are a couple of ideas that I like for working on basic concepts. Small Gatorade bottles work well for this because they are sturdy and have a wide openings, but you could use any clear plastic bottle you have.

  • Fill each of several water bottles with items of a different color. Then talk to your toddler about each color and the items that are in the bottles. You can add water to the bottle to make the items float freely.
  • Fill several bottles with items that make different sounds (jingle bells, dry rice, cotton balls). You can talk about loud and quiet.

Orange Sensory Bottle

3. Create a tornado in a bottle by filling it with water and adding a little bit of dish soap. Seal the bottle closed with super glue. Then shake it up to see a tornado.

4. Use a collection of empty and cleaned plastic and cardboard food containers to create a play supermarket.

  • You can name the items for your toddler as he puts them in the basket.
  • Talk about the sizes of the containers. (The soda bottle is bigger than the water bottle.)
  • Engage in pretend play with your child. One of you can be the customer while the other is the cashier, and then switch roles.

5. Put colorful items inside a two-liter bottle, seal it with super glue, and let your crawling baby roll it across the floor.

6. Save the caps from a variety of bottles and let your child sort them by size or color. Not only can you work on the concepts of color and size, but as you sort, you can work on same and different.

7. Your empty plastic bottles can become bath toys as you allow your child to practice pouring water from one bottle into another.

8. Have your child work on his fine motor skills and hand-eye coordination by picking up raisins, Goldfish crackers, or Cheerios one at a time and putting them in an empty and dry water bottle or soda bottle with a small opening. Then let him dump them out and do it again.

9. Use toothpicks or  uncooked rice or beans inside a plastic bottle to make a shaker toy for your toddler. For preschoolers, see if they can copy a rhythm pattern after you.

10. Give your child age-appropriate art materials to create an animal or a vehicle out of a bottle. Again, you can find plenty of such projects on Pinterest. Or you can let your child’s imagination run wild. Your child can work on sequencing by telling the steps to complete the project in the correct order.

Before you throw away your next plastic drink bottle, think about how you could use it instead to play with your child. You’ll be keeping some trash out of the landfill and some money in your wallet as you create some free toys.

Do you have any other ideas for using plastic bottles for play? If so, leave a comment to tell us.

Sneaking Some Learning into a Board Game

June 9, 2014

My 5-year-old loves to play the classic board game Chutes and Ladders. The numbered squares on the board make it an obvious way to work on math skills. However, it seems like every time I play it with her, I find another skill that can be addressed using this game.

chutes and ladders

Math Skills:

  • For preschool and early elementary age children, following the numbers in sequence on the board can be a challenge because of the way they zig-zag across the board. You can show your child how, after the number 10, the numbers start to repeat again, only this time with a 1 in the front. After 10 comes 11, 12, and so on.
  • For older elementary age children (about 2nd grade and up), you could challenge your child to use addition to figure out what square to go to next, rather than counting the squares. For example, if your child is on square 47 and spins a 5, she would need to add 47+ 5 to find what square to go to next.
  • Also for older elementary children, when they go down the slides, they could use subtraction to figure out how many spaces they had to go back. For example, if your child lands on square 87 and has to go down the slide to square 24, she would need to subtract 87 – 24 to find how many squares she went back.

Language Skills:

At the bottom of every ladder is a child doing something good, and at the top is the child earning some sort of reward. The top of each slide shows a child misbehaving, and the bottom shows the child earning a negative consequence. Here are a few language skills that can be targeted with these pictures when your child either has to go up the ladders or down the slides. The first one would be appropriate for children as young as three or four, while the rest are appropriate for older elementary age children.

  • Ask your child a “why” question corresponding to the picture at the end of the slide or ladder. Your child should be able to answer with the help of the picture at the beginning of the slide or ladder. (Why did the girl feel sick? Because she ate too many cookies.)
  • Have your child use the past tense to talk about the pictures. (She helped the dog.)
  • Have your child form a complex sentence by telling what happened to one of the children. (He mowed the lawn, so he got to go to the circus.)
  • Ask your child which picture is the cause and which picture is the effect. Cause and effect is a skill that frequently shows up on standardized tests. (Cause: He broke the window. Effect: He had to use the money from his piggy bank to pay for it.)

Social Skills:

As with any board game, your child will naturally practice these skills by playing with others:

  • Turn taking
  • Waiting patiently
  • Being a good sport (whether as the winner or the loser)

Board games are a great way to interact with your kids. Try out some of these ideas the next time you sit down for a family game night.

My Favorite App: PicCollage

March 12, 2014

Despite the plethora of speech and language apps available for phones and tablets, I actually don’t use them that much in therapy. This is mainly because I find that most of my little clients are so proficient at using touchscreens that they tune me out as soon as they get their hands on a phone or tablet and all meaningful interaction ceases. However, there are times when I find that a specific app either makes my job a little easier or keeps the child engaged a little longer, and that’s when I pull out my tablet.

PicCollage truly is my favorite app to use in speech and language therapy sessions. I initially downloaded this free app (available for iOS and Android devices) just to make collages of pictures that my own kids could bring to school for show and tell. Then one day I had an epiphany; I could use PicCollage to create a picture schedule. Prior to that, when I needed to create a picture schedule for a session, I had been taking pictures of the activities for the day, printing them out, cutting them out, and attaching them to a board with two-sided tape. With PicCollage, I can either use pictures that I’ve taken or search the web (through the app) for a suitable picture. Then I just add them to the collage, line them up, add a heading, and I’m done. At the beginning of each session, my 4-year-old client looks at the schedule and tells me everything we’re going to do for the day. After each activity, he gets to swipe the picture into the trash to show that the activity is finished. (This is definitely his favorite part.) When all of the activities have made it into the trash, the session is over. This method is much more efficient and saves some paper too.

PicCollage Picture Schedule

Parents can use PicCollage in a similar way for difficult daily routines. For example, if your child has trouble remembering to complete all of the steps needed to get ready for bed, you can take pictures of the things he needs to do and put them in order in the collage (shower, pajamas, toothbrush, book, bathroom). Then, as he completes each item, he moves it to the trash. Once all the tasks are complete, it’s time for bed. Picture schedules are particularly helpful for children on the autism spectrum who need routine and predictability built into their day. This app provides a portable way to take picture schedules with you out of the house.

PicCollage Bedtime Picture Schedule

Another use I’ve found for PicCollage is creating interactive “worksheets.” I was working on possessive nouns with one child, and rather than using a traditional worksheet in which she would draw a line to match each object to its owner, she manipulated them on the screen and formulated a sentence like, “It is the dog’s bone.” The use of the touchscreen seemed less like work to her than a worksheet would have, but I still got her to practice the grammatical structure we were targeting. (And she got to put the pictures in the trash when she was done with them.)

PicCollage Interactive Worksheet

Here are a few other ideas for using PicCollage to support language development:

  • After a vacation, put a few pictures from your trip in sequence. Then, have your child use the pictures to help tell someone about the trip. (Skills addressed: formulating sentences, creating narratives)
  • Take pictures of the steps in a process (e.g. making a sandwich) and put them in random order on the screen. Then, have your child put the pictures in the correct order and tell how to do the task. (Skills addressed: sequencing, formulating sentences)
  • Use the web to find a collection of seemingly random pictures (shoes, car, airplane, carrot, giraffe, bird, apple, stop sign…), and then have your child find things that are alike in some way and tell how they are alike. (An airplane and a bird both fly. An apple and a stop sign are both red.) (Skills addressed: comparing, formulating sentences, identifying features of nouns)

The possibilities for using PicCollage to support speech and language development are really limitless. If you have another idea, please share it in a comment.

Bubbles Aren’t Just for Blowing Anymore

February 10, 2014

In one of my previous posts, “Bubbles, bubbles, bubbles!” I listed several speech and language skills that could be targeted while blowing bubbles with a young child. In this post, I have a few more skills that can be addressed while blowing bubbles.

Encourage your child to pop the bubbles in different ways:

  • Poking the bubbles with the index finger will encourage an isolated point, a fine motor skill. Once the skill is achieved, the child can more effectively point to indicate wants and needs and engage in joint attention.
  • Pinching the bubbles between the thumb and index fingers will encourage the use of a neat pincer grasp, another fine motor skill. Young children need this skill in order to efficiently pick up small objects and will one day use it to hold a pencil correctly for writing.
  • Stomping the bubbles while standing up encourages use of the gross motor muscles.
  • Clapping the bubbles between the two hands encourages the child to bring his hands together at the midline of the body, which requires the two sides of the brain to work together.

You can use these motor activities when playing with bubbles and integrate some additional cognitive and language skills.

  • Motor imitation – Have your child copy your action: poking like a bumblebee, pinching like a crab, stomping like an elephant, or clapping like a seal.
  • Following directions – Give your child a verbal direction without modeling the action to be done.
  • Imitating 2-word phrases – As you and your child pop the bubbles in a variety of ways, use 2-word phrases to describe what you are doing, and encourage your child to repeat them. “Pinch bubble,” or “Clap bubbles.”
  • Using verbs – You perform the action and have your child narrate what you are doing. “You poked the bubble,” or “You stomped on the bubble.”
  • Engaging in pretend play – Your child can act out how one of the animals listed above would pop the bubbles or he can think of an original one to act out.


In my previous bubbles post, I discouraged the use of a bubble machine because the key to the activity was the interaction between the adult and the child in requesting bubbles. However, for this set of activities, I think the use of a bubble machine is fine, since the goal is not requesting. The adult and child still need to be interacting for it to be effective, but a bubble machine could free up the adult’s hands for some good clean bubble popping fun.


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