This post is for a group of children so dear to my heart: toddlers with Down Syndrome and/or speech delays.
Experts say the the first three years of life is the most important period for the development of speech and language. Unfortunately, because of COVID-19, our Junior and toddlers like him won’t be getting speech therapy for who knows how long. This is a real setback, unless parents take a proactive role in providing their little ones with therapy at home. Of course, getting therapy from an experienced and qualified speech therapist would be best, but there are many resources to help parents out.
So I’d like to share with you a list of speech therapy resources that we have found most helpful. Many of them have been recommended by Junior’s therapists and by a dear friend who is a speech language pathologist.
Learning Sign Language
What’s great about these books are the pictures. Junior and I can look at the pictures together and learn the signs. However, because this series uses ASL, some of the signs are too complicated for him learn.
Baby Sign Language made Easy uses signs that are more appropriate for toddlers. Although it has cute pictures of toddlers making the signs, it does not have pictures of the words themselves. So, it is more geared toward the parent. Nonetheless, I found it to be very useful, and Junior ended up learning to sign most of the words. This prevented a lot of frustration as he was able to communicate his needs long before he was able to speak them.
Toys to Develop Oral Motor Skills
We use these to strenghten the muscles in and around Junior’s mouth, particularly his lips:
Junior still has a hard time using the bubble wand, but he sure loves the bubbles. He had more success with the bubble pipes you find in bubble party packs. The toy trumpet is so much fun: you can blow into the trumpet from the back or the side, and whether you blow in or out, you get a sound. We also bought a variety of cheap whistles at Party City. You can also get packs of donut blowers at Party City. To make them last longer, I wrap scotch tape around the mouthpiece.
Many toddlers with T21 need to be taught how to produce the vowels and consonants. That was the case with our Junior.
Some sounds are easier to produce than others, so it helps to know which ones you should teach first. Mommy Speech Therapy has a great Speech Sound Development Chart which gives you an idea of the normal progression of consonant mastery. The vowel diagram shows you where in the mouth each vowel and dipthong is produced.
Which vowels should you teach first? Pam Marshalla has some excellent resources for teaching sounds. Here is her advice on the proper sequence of teaching vowel sounds, based on her 40 years of experience.
Visual cues are very effective tools for helping children remember how to produce the sounds. You can watch Pams videos on how to give children visual cues for vowels and consonants.
I was quite surprised to learn that there is not a standard set of visual cues for consonants. It seems each speech therapist has her own preferred set of visual cues. You might prefer this video showing visual cues for consonants called Speech Sound Hand Signals. Here is a print out of visual cues with pictures and descriptions that you might find helpful: Phonetic Placement and Visual Cues. It probably doesn’t matter which set you use as long as you are consistent.
Laura Mize, a speech therapist who specializes in treating toddlers with language delays, has a series of videos for speech therapists and parents. Podcast #376: How to Cue Speech Sounds with Toddlers is very informative. She teaches parents how to use verbal, visual, and tactile cues. I highly recommend taking the time to listen/watch.
Talk with Me! The Big Book of Exclamations is a wonderful book for practicing early sounds and words. All the pictures depict the natural routines and familiar environments of toddlers so they can learn how to use the exclamations and words in context.
One of the *best tools* we use to practice and improve articulation are Nancy Kaufman’s Speech to Langauge Treatment Kit.
What I love about this set of flash cards is the way the words are organized. I knew there had to be a very systematic way to teach sounds, and here it is! The down side (and it’s a very big down side) is the cost: $199 for the first set! Thankfully, I was able to borrow some from a friend. This set of cards is mainly used to treat children with Childhood Apraxia of Speech. However, many children with T21 need to work on intelligibility, and these cards are still helpful for improving the clarity of their speech. We use these almost on a daily basis. Junior loves pulling out his cards and naming the pictures.
Of course, two hundred dollars is a really hefty price to pay for flash cards. Thankfully, you can print out articulation flash cards for free at Testy Yet Trying, a blog about Apraxia. These cards are smaller, and the pictures are not as attractive. However, the author choses her words very carefully so as to use only the easiest sound combinations (ie. no consonant blends or multi-syllabic words etc). Since they are free, I printed them out and we use these as well to give Junior some variety and more vocabulary.
One little tip: Toddlers with T21 enjoy container play. So I cut a slit into the lid of a yogurt container, large enough for the cards to fit into. Whenever Junior practices a flashcard, I let him put the card into the container. It keeps him very motivated.
Alongside improving articulation, we constantly work on building Junior’s vocabulary.
One of Junior’s favorite games is Seek-a-Boo! It’s meant to be a memory game, but we use it as a matching game. Start by having your child match only two or three cards. (For each large card, there is a matching smaller one.) Little by little you can increase the number of cards for your child to match. It’s a fun way for him to learn basic vocabulary.
First 100 Words Sticker Book is a fun way to teach some basic vocabulary. To help Junior learn multi-syllabic words, I place these dot stickers under each picture that has more than one syllable. We then point to the sticker as we say the syllables. For example, I place two stickers under the “apple” picture. We then point to the first sticker for the “ah” and to the second sticker for “ple”.
Of course, reading lots and lots of books is a great way to build receptive and expressive language. At this age, predicatable books with repetitive text is the way to go. Here is list of 50 Repetitive Books for Children with Apraxia of Speech. Once Junior is familiar with a book, I start dropping out words, usually at the ends of phrases. He then fills them in as we read. But there’s so much more you can do besides just reading the book to your child.
Facilitating Early Pragmatic Functions through Shared Picture Book Reading is a very scholarly paper about reading picture books. It’s quite technical, but it has some great strategies for reading books to and with young children.
Another way we’re building vocabulary is by labelling everything in and around the house. Last week, we went around the house finding all the doors and door knobs. We opened and closed all the doors and talked about open and close. Another day, we found all the windows, then all the chairs. This week, I’ve been labeling all the clothes as Junior watches me fold the laundry.
We are also working on saying 2-3 word phrases such as “more _______ please”, “help me”, “thank you”, and “my turn/your turn”. To help with that, Junior’s speech therapist gave him a pacing board. Similar to the idea of putting dots under pictures, a pacing board is a small strip with two dots on one side and three on the other. For each word in a phrase, Junior points to a dot. It’s a visual reminder of how many words he needs to say. He’s gotten used to saying “more chips please” while pointing to the dots on his pacing board.
Here are two papers that give information on pacing boards:
First Words to Phrases for Parents of Young Children with Down Syndrome. This article also explains how to use one word expansion to help children make the transition from one word “sentences” to two-three word phrases.
You have probably figured out that toddlers with Down Syndrome love music. Junior’s favorite activity is sitting on my lap while I play nursery songs and lullabys for him at the piano. He also loves to dance. Songs that have words or phrases that are repeated over and over are a fun way for our children to practice speech. See this paper for more information on the effectiveness of music and singing in helping children with T21 develop language.
Check out these great sources of music for toddlers with T21:
The King of Kings is a collection of bible songs sung by a choir of children and the highly entertaining Donut Man. Much of the music by the Donut Man is highly repetitive, making it easy for children to learn the lyrics. A lot of his music is availiable on Amazon Prime for streaming. Junior loves dancing and singing along to the Donut Man. You can also order CDs at the Donut Man’s website.
Lullabies is a collection of simple piano music and beautiful artwork from the Metropolitan Museum of Art. If you can play the piano, this will be a wonderful addition to your home. All of my children have enjoyed looking at the pictures while I played for them, but Junior especially so. The nice thing about playing these songs live for Junior is that I can slow down the music enough for him to learn the lyrics.
Time to Sing is a collection of traditional children’s songs, such as Wheels on the Bus. What makes this CD unique is that the songs are slowed down, so children with speech delays can sing along, too. Don’t try to buy this at Amazon; last time I checked, it costed a whooping $400!!! Apraxia Kids sells it for $15.
Books for Parents
Finally, I’d like to recommend three books which I have found very helpful:
Early Communication Skills in Children with Down Syndrome – This is like the speech therapy bible for parents and therapists. It might be a little overwhelming at first. I read it bit by bit as my son progresses and in this way find it very informative. Lots of practical tips and ideas, too!
It Takes Two to Talk – I really appreciate this book. It shows parents how to follow their children’s lead, how to encourage kids to initiate speech, how to make play purposeful, and so much more.
Supporting Positive Behaviour in Children and Teens with Down Syndrome – This is not a book about speech. However, it has a lot of practical advice on how to motivate children with Down Syndrome.
One year ago, Junior could only say “ba” and “ca”. Now he says words like “elephant” and “butterfly”. The other day, imitating his older brother, he said “Sewiously, Dad!” (attitude and all!) We all cracked up. It’s really so fun and exciting to watch his progress.
I hope you find these resources helpful! Please pass this post along to any parents who might benefit from it. 🙂