Hesperian Health Guides

Activities for Communication and Speech

In this chapter:

A child’s ability to communicate typically develops through these stages:

expresses needs through body movements, looks on the face, and crying makes “happy sounds”— coos and gurgles babbles — listens to sounds and tries to imitate
a baby crying at less than 1 month old.
Wah! Wah!
a baby cooing at 1 to 2 months.
Goo! Goo!
a baby babbling at 4 to 8 months.
Ba-ba
Ga-ga
0-1 months 1-2 months 4-8 months
says a few words begins to put words (and ideas) together
a baby speaking at 8 to 12 months.
Mama
a child speaking at 1 to 3 years.
Look, Dad, a cow!
8-12 months 12 months-3 years

One of the early stages in a baby’s development of speech is noticing and responding to different sounds. A delayed child may need extra help and stimulation:

Make noises with bells, rattles, clickers, and drums, first directly in front of the baby, then to one side, so that she turns her head.
someone shaking a toy next to a child.
Tinkle tinkle
Hear the bells.
If she does not turn her head, bring the toy back so she can see it, and move it away again.

Or, gently turn her head so that she sees what makes the sound. Help her less and less—until she turns her head alone.
Repeat the babble of the child: have conversations with him in his language. But when he begins to say words, repeat and pronounce them clearly and correctly—do not use “baby talk.”
a baby and a girl speaking.
Ga-Ga Ga-Ga
Ga-Ga Ga-Ga
To get the child used to language, explain everything you do with him. Use clear, simple words—the same ones each time. Name toys, objects, body parts. Repeat often.
a girl speaking to a child as she washes his hands.
Now we wash hands.
Understanding language depends not only on hearing, but also on watching lips and looks. So speak to the child on her level. A child understands words before he can speak them. Play question games to help him listen and learn; he can answer your questions by pointing, nodding, or shaking his head.
a man sitting while speaking to a child; another man speaks to a child while standing above her.
Stand up straight. Good girl!
Stand up.
LIKE THIS
NOT LIKE THIS
Repeat words. Make small requests. Reward successes.
someone holding a different toy in each hand while a child points.
Now point to the rabbit.
That's right! Good girl!
Rhythm is important to language development. Sing songs, play music, and have the child imitate body movements: clap your hands, touch your toes, or beat a drum. Imitate the sounds that baby makes and have him copy the same sounds when you make them. Then say words similar to those sounds.

Also, imitate use of the mouth: open wide, close tight, stick out tongue, blow air, push lips in and out.
a man chanting and clapping while a child imitates him.
Hare ram, hare ram,
Clap clap. Clap clap.
a child and then a woman speaking.
Brrrrr
Brrrrr
That's right, "bird"! Where is the bird?
CAUTION! Encourage use of gestures, but not so much that the child does not feel the need to try to use words.


Challenges in Speech Development

CAUTION! If the child’s mouth hangs open and she drools, do not keep telling her to close it! This will not help and will only frustrate the child.
DVC Ch35 Page 314-3.png

A mouth that hangs open or drools is a passive (inactive) mouth. It makes development of language more difficult. Often children with Down syndrome or the floppy type of cerebral palsy have this challenge.

Here are some suggestions to help strengthen the mouth, lips, and tongue for eating and speaking ability.

Stroke or tap the upper lip, or gently press the lower lip several times.
DVC Ch35 Page 314-4.png
Or, gently stretch the lip muscles. This may help the child to close his mouth.
DVC Ch35 Page 314-5.png
To strengthen the tongue and lips, put honey or a sweet, sticky food on the upper and lower lips. Have the child lick it off.
someone speaking to a child as she licks her upper lip.
Now lick it off.
Good girl!
DVC Ch35 Page 314-7.png
You can also put sticky food on the inside of the front teeth and roof of the mouth. Licking this food helps prepare the tongue for saying the letters T, D, N,G, H,J,and L.
Also have the child lick sticky food from a spoon and lick or suck ‘suckers’ and other foods or candies. Put food into the side of the mouth and behind the teeth so that the child exercises the tongue. Also, have the child try to take food off a spoon with his lips.

Begin to give the child solid foods, and foods she needs to chew, as early as she can take them (after 4 months). This helps develop the jaw and mouth.
DVC Ch35 Page 314-8.png
CAUTION!
1. Do not do licking exercises in a child with cerebral palsy whose tongue pushes forward without control. This can make the tongue thrusting worse
2. After giving the child sweet or sticky food, take extra care to clean teeth well.


Play games in which you have the child:

suck and blow bubbles through a straw blow soap bubbles blow air blow whistles
DVC Ch35 Page 315-1-a.png
DVC Ch35 Page 315-1-b.png
DVC Ch35 Page 315-1-c.png
DVC Ch35 Page 315-1-d.png


CAUTION! For children with cerebral palsy, these blowing exercises may increase the uncontrolled tightening of muscles or twisting of the mouth. If so, DO NOT USE THEM.

Encourage mouthing and chewing on clean toys (but not thumb sucking).

Help the child discover how to make different sounds by flapping her lips up and down with your finger,
a child making a sound while someone flaps her lips.
Brrr
or by squeezing them together as she makes sounds.
a child making a sound while someone squeezes her lips together.
Mmmm

For a child with cerebral palsy, you can help him control his mouth for eating or speaking by stabilizing his body in a firm position. Choose the position in which he is most relaxed (has the least muscle tension). This usually means bending the head, shoulders, and hips forward. For this reason it is sometimes said:

“WE CAN CONTROL THE LIPS THROUGH THE HIPS.”
DVC Ch35 Page 315-4.png
You can help the child make different sounds by pushing on and jiggling his chest.

Imitate the sounds he makes and encourage him to make them by himself.
If the child has trouble with controlling his jaw when he tries to speak, try using “jaw control” with your fingers, like this. Have him repeat sounds that require jaw movement. When the child has difficulty pronouncing words, do not correct her. Instead, repeat the words correctly and clearly, showing that you understand.
a woman and then a child speaking.
Ababa,
Bababa
Ababa,
Bababa
a child and then an adult speaking.
Gim wawa.
Ok. I give you water.



REMEMBER: The child needs a lot of stimulation of all her senses to develop language. Play with her, speak to her, and sing to her often. Ask her questions and give her time to answer. Do not try to “make her learn,” but give her many learning opportunities. Ask questions that need words for answers, not just “yes” or “no.”

Does your child have hearing loss? If your child is taking longer to begin speaking, check his hearing. Even if he hears some noises, his hearing loss may prevent him from understanding speech.

Also, some children with no hearing loss may never be able to speak. For example, certain children with cerebral palsy cannot control their mouth, tongue, or voice muscles. For these children, as for young children with complete hearing loss, we must look for other ways to communicate (see Chapter 31).




This page was updated:04 Apr 2024