Infant and Toddler Language Development Series: Part 3

5:33PM Jan 15, 2025

Speakers:

Narrator

Priscilla W.

Cindy McInroy

Keywords:

language development

receptive language

eye contact

joint engagement

late talker

delayed talker

imitation

echolalia

scripting

autism signs

neurodiverse learners

developmental checklists

CDC guidelines

family support

independent living

Welcome to Inclusion Matters a podcast about children's development from the Center for Inclusive Child Care.

Welcome to Inclusion Matters the podcast from the Center for Inclusive Child Care, I'm Priscilla Weigel, the executive director, and I'm back again for part three of my conversation with friend and colleague, Cindy McInroy, speech and language therapist and early childhood language development expert. She has just really shed so much great light on the process of language and learning and communication in our youngest, youngest children. And today, in this episode, we're going to talk about when there's concerns and what we would notice that would tell us that there might be some concerns. And so, Cindy, welcome back.

Glad to be here.

All right. Well, let's jump right in. What are some of the things that you know, especially as a speech and language therapist, that's your day to day. I mean, that's what you're spending time determining in the lives of young children.

Yep. So we don't really get a whole lot concerned about language and language communication until they're right around that one year mark, so between 12 and 15 months. In earlier practice, I made reference, but it's still super important to know that the first part of language that grows is the understanding of language, or receptive language. So do I understand what a ball is. Long before I say ba for ball, or say the word ball. I understand and know what a dog is, and I know my family dog, really quite a long time before I point to a picture of a dog, when you say, show me dog in a book. So when the first things you get kind of concerned about, especially at around that one year old age, is, are they seeming to understand language? Are they doing things like anticipating highly routine things? When you say, let's go take a bath, do they start going to the bathroom, walking towards the bathroom to get ready for it, or, if you say, time to eat, do they get up and start heading towards the kitchen. So you don't say it in exact words, go get an apple. You're just like time to eat. And they know this is where I got to go for that. If at one year, or between 12 and 15 months, those kind of like understanding things seem not to be there, that when someone says, where's mommy?, do they turn and look for you and highly family names that are highly familiar, do they turn and look for that? Or when you say, when people mention things in conversation and you say something like, Oh, I'm you know, it'd be great if I could have an apple right now, and the next thing you know, they've got an apple or are going to get one because they're matching that in language. That's those early receptive things, and that's the part that you watch for in the early ages, am I understanding. We also talked about early on having eye contact and joint engagement. So do I look at you most of the time when you're talking to me? Do I turn to you when you say my name and I was like, even if it might take like, two or three times, because little brains, when they're focused on something, they're they literally can't hear us. They're like, so focused. But do you say it, and it's kind of quiet, and there's a pause, and you say their name, Noah, and they turn and they look. When you're looking in a book, or you're playing with a toy, or you're playing with something on the floor, and they look at the toy, they look to you, and they look back, and they wait for you to do that pop box, do that cause effect thing again, to make it keep going, that's joint engagement. Do they have that? So those are the early things that you want to look for. Then, as they get older, I start to get concerned about language. And true talking is around that like 15 to 18 month age, when I expect them to start having now at least one word for labeling something. So mama, book, ball, puppy. Are they making animal sounds for things? Kids the development of animal naming things seems to always start with sounds. So first it's a moo, then it's, then they call it a moo cow, yeah, and then it's a cow, okay. But the animal sound as a label is natural. That's the first thing that's so when you go to the doctor and they ask how many words they have, count those, count those words. As a speech therapist, I'm counting words that show me that it's a label for an object. So can they say cow? Because a place I'm calling a car of voom, voom, or, you know, a train a choo choo? Yeah, that's normal, they make play sounds to label things, but I want them, as they're getting to that 18 month to two year old age, to have labels that show me it's the word as a symbol for a thing, and they know that. Two year olds too, that 18 month to two year old age is when they're starting to maybe they can't necessarily sing a song, and they probably can't do the gestures. It seems like finger play should be so easy, but it's hard to sing and do the motions to somehow, yeah, so that's like a two and three year old thing. But do they vocalize like singing? Because most, most 18 months ish to two year old kids do, and they'll, like, make up their own tune and they're just singing, or you'll start to recognize and some song they really like. I'm I am learning pretty much every day, a new Miss Rachel song, because she's now all the rage, and people, and because I'll be humming in tune and I'll be like, Oh, that's the Put It In song from Miss Rachel and so. But they do, they learn it, and they vocalize. And singing is is easier than talking. The song always stays the same. The words always stay the same. So being able to start to vocalize like singing and starting to fill in, I love kids when they first learn a song, too, that its just one word, twinkle, twinkle, twinkle, twinkle, twinkle, twinkle, twinkle, twinkle. You're like, yep, that is how we sing, twinkle, star, you are, right. So, yeah, those kinds of, those kinds of things. A lot of times people are concerned about, well, they're not talking and so then that's where I, as a speech therapist have to look and decide, is this a person who is a late talker, or are they a delayed talker? And the difference being that a late talker, it seems they understand everything. Their receptive skills are intact. They're right where they should be, and they have some of those early labeling things, or those early sounds, and the other big mark is when they can imitate after me, and pretty consistently imitate single words, just single words after me. So even though I might not have a whole lot of words when I'm playing with a toy, we're looking in a book I'm just talking to you, you're kind of parroting words after me. That shows me that you're trying to store that language in and make it words for you. So a two year old I want to have at two, they should have consistently about 20 to 25 words. You'll see on or I should probably drop that down, say 10 words or more so 10 labeling words as a base kind of a thing, because late talkers, that's what they'll have someone else, and a lot of times our developmental checklists, they'll say like 100 words. Know that when you're, this is important too, when you're reading developmental checklists on whatever site you're looking at, they're usually talking about the child who's at the 50th percentile. So the just like height and weight on that chart, their a kid at the middle of the normal curve, right there at the 50th percentile, but statistically and for someone who provides services in early childhood special education, a child down to the 16th percentile is still within normal, they will not qualify for kinds of services, and that's just the range of what is normal. So just like some kids are really early walkers, and that gross motor thing might be at the 60th percentile, well then the language might be at the 30th percentile, but it tends to all even out by the time they turn six. I always, I always joke, it's, it's maybe wasn't so arbitrary, we wouldn't we decided what age children should start kindergarten at in Minnesota, yeah, and that all of their developmental skills, they'll still have stronger gross motor skills, but they tend to fall within, like, a range that's much closer. You don't have this big gap where I'm a super good talker but I'm not walking, yeah, you know, or vice versa. So it does it all kind of comes together between four and six, where it all kind of evens out in a typically developing child. So being concerned, and then that two and a half, so the bar goes from basically 10 words at two years old and consistently imitating to a two and a half they should be using consistent two word phrases, yeah, so, my juice , more go, baby sleep.. And then at three, is pretty much three word little, simple sentences. So in that two to three year old year, language grows and grows fast. And then, and by four, I'm having conversations, so kind of watching for those and I think where people get really concerned is that 15, 18, month old, it doesn't have words. So watching, checking the receptive language first, and making sure they have intact hearing and make seeing if they're at least trying to imitate some of the sounds you're making.

Yeah, really important stuff. And I do think and the reminder about the eye contact and engagement, I do think that that's something that is a really big concern or flag and but I do I appreciate all the things you're sharing for us to really be watching for and listening for, because sometimes I think you said you've said it so many times throughout this series, have a pause. Allow that little brain to take some time to be able to answer you and follow through. Because I do think sometimes with young children, when we're getting them to move through things, we're push we're saying things quickly and expecting immediate response, and they need, especially the younger the child, they need some time to process that that's coming in receptively.

Yeah, and it gets in where I talked about imitating after you, that gets really, really, gets to be a really fine line between what someone trying to imitate after me and what's called echolalia or scripting. So in children who are showing signs of autism, echolalia or scripting is really, really common. It's one of the prime indicators that were like, hmmm, I wonder. Echolalia is they imitate words after you, but the words never generalize into their vocabulary as spontaneous words. Most kids that are going through as they're learning language and they're saying words after you and imitating after you, imitating words within a couple of days, they should have that word in their general conversation. If you, you know, practiced it and they've heard it more than just a handful of times, they generalize it. They're like, oh, that's the word. that's a word for this thing and I'm going to put it into my, into my, my vocabulary, yeah. Whereas echolalia, it's just a short loop. It's just, I hear it and it just, it just comes back out. So it's literally an echo. It has no context tied to it. There's no meaning tied to it. So therefore I don't store it as a word. It's just something that was fun to say, just like going, you know, bibbity bop, you know, saying some silly word too. There's no context dependency to it. That's the difference between echolalia and imitation. Echolalia is something we want to be concerned about, because that means I'm not storing language to make it into functional, usable language. Yeah. As kids get older, or sometimes very young, and this is oftentimes favorite songs, lines from movies, I'm trying to think it's pretty much their lines from lots of lines from moviesand their cartoons, are what we call scripting and and that is, is this is it, they're repeating back a script. The words stay the same. They stay all the time. And then oftentimes, what they'll do is they'll say it, not necessarily watching that movie, but they say it. They just script and say it whenever. That is very much an indicator of autism spectrum disorder. There is now we call those children a special thing. They're called Gestalt Language Processors, and they are learning language in a way different from that typical development we've talked about here, where it's bottom up, where I take single words, I turn them to phrases, terms that make it complex. Gestalt language processors learn language as a chunk. So they learn that phrase and they assign a feeling to it. So oftentimes, they will script things when they're happy that are fun and exciting, active moments in the show, the movie, the song that they like. They will say more negative things or no statements, or what one character might have said to someone at that that's like a sadder time or more difficult time, or an anxious time. So they assigned a feeling to it, and it's stuck, and those words stuck. So what we do is we work with them to start to learn and to do what we call is to mitigate it. So, like a really common one, sometimes kids is like, Swiper, stop swiping. And they'll say that. And so when you're playing with them and they want you Swiper, stop swiping, and they say, they're like, this is making me and I'm like, Oh, I think your voice is telling me you want, you want to stop playing this game. Swiper stop game now, or Swiper stop. So we take it just slowly, moderate it into their own vocabulary and give them their own words. We don't tell them to stop because it is we used to try and give them a completely different phrases, but they don't learn language that way. It doesn't connect to them, and that's and that's just really new in our profession. It is also our our neurodiverse counterparts, people who they themselves, are neurodiverse and became speech therapists. Were like, this is how I learned to talk and look at now, I'm this profession. I do this and I'm doing a webinar, but this is what would have helped me when I was younger, because when I was told not to use those words, I had no other words, right? I had nothing. So that's kind of like looking those are all concerns, especially when you go to the CDC website or anything. I think what's really important for me as a therapist is for for families and caregivers, not to rely on anecdotal evidence. Don't, don't go to Tiktok, don't go to Facebook, go to the CDC, go to the Minnesota Autism Society, go to your pediatrician and ask about those things. And because we do know, that's why the CDC site is called, Know the Signs, Act Early. It very clearly defines what it is to be concerned about what to do, because we know, and I have two neurodivergent nephews, and that we know that doing things early to help them have their internal picture of the world, be able to match and interface a little better with the external picture of the world, it helps. We just know it helps. And there are different kind of learners, and we need to learn how to help be flexible with them, but help them be flexible in this world that wants to be very neurotypical. Yes, and it's scary. It is scary. It is a scary thing to talk with a family, and I've done it through my entire career, ever since working in Fraser with families on that journey of having a member in their family and this child that they have to be told that they're autistic. You know, no one, no one sees that coming, but, but we know, if we look for, you know, signs, and people call them, red flags. I always think that's just so scary. Red flags. Red flags are when the sharks out in the water, yeah. But I think, you know indicators, signs, you know that that that we there's people out there that can coach and can team and can and can help you along that. And they are still, they're amazing, amazing little people. They're just learning interaction and social interaction and language in a different way, yes than what we see,

Yes, and meeting them there and starting from that point.

Totally yeah.

You're gonna see the you're gonna see the success. And we can speak to that firsthand. You see it every day. And I mean, we could, we could sit here and talk about past students that we supported at Frazier, and the success stories that really and the partnership with families that, I think, as you say, walking along that journey, it's a scary, it's a scary path to be on by yourself, and so to partner and to say, You know what, we're going to figure out this together, because every child is unique. Every child totally comes to us with something different that tells us who that child is and how they need to best fit into the world. And we just need to start there.

They all take and I always, and I mean, we're starting, I'm with them at their early stages. But I used to work with young adults on job sites and people who were working on working and living in independent living. And so across the the life frame of it, is it, yeah, they can have they can have their own apartment. They can have their own job. And I'm talking about people at all different cognitive skill levels and levels, because they each found their joy. They it was not the life that was my life or the life I would think they would have, but it was their life, and it was their life, but was their choices. They were choosing their furniture for their apartment, to go to their job at whatever restaurant or hotel or whatever, even if it was an opportunity workshop, a supported workshop, living kind of place, it was their independent living. It was their choice, their place, their thing, they wanted, and they worked for their paycheck and paid for it. And like, yeah, is that the perspective I had when I gave birth to my children, no, but had it been one of my children that ended up there I could have seen that. But I always give families, tell them to give them permission, to give themselves grace, because it does not matter. We can do everything we can as external people helping support, but that family, I get to meet you, and when your child gets older, moves on to the next phase in life, I'm gone. I'm out of your life. I don't have to go and be in your house overnight. And so give yourself grace, because you are going to have to be their advocate for a very long time, and that takes power and strength. So find support where you can and give yourself grace, because no one expects you to be perfect.

Exactly what a great point to end this episode on. Cindy McInroy, thank you very much. We have another episode in the waiting in the wings to continue this conversation, and we're going to talk strategies in our next episode, which is super exciting for all of our listeners. So thank you, Cindy McInroy, speech and language therapist, and we will be back with another episode of Inclusion Matters. See you soon.

Thanks for listening. For more resources, visit us at inclusive childcare.org.