Customizing Language Therapy
A large percentage of all our programs over the years have been dedicated to improving Isaak’s language skills. Language involves the ability to understand language, to use language, and to make understandable sounds, and there are lots of complex, higher-level skills to gain. At first, language is concrete—nouns and simple sentences—which can be fairly simple to teach. As your child’s language skills increase, the teaching of higher-level skills will become more challenging.
Receptive language
Read and point
Purpose: To increase receptive vocabulary.
Prepare cards with pictures of common people, body parts, food, animals, etc. At first, write the words on the cards together with the pictures. Start with one card on the table at a time. “Point to ball.” If he does not respond, say it again, and then hand-over-hand help him point to the picture of the ball, and offer reinforcement. When he can do that, add another card to the table. When he understands the concept and is complying, and once he is consistently pointing to several pictures, take the words off the pictures, and continue the program.
Purpose: To follow simple instructions upon command.
From the most elementary one-step directions to complex, multi-task steps, instructions to your child can be modified to utilize his reading skills. Following the same ABA procedure (give command, wait, prompt if needed, reinforce), couple the request with a written prompt. Start with simple instructions such as “Give ball” or “Read book.” Gradually add more words to your instructions and then add additional steps such as “Give me the book and then sit down.” Fade the written prompts as soon as you can.
Differentiating verbal sounds
Purpose: To be able to differentiate different sounds in speech.
Present your child with two index cards with words that have similar sounds (e.g., bat and brat; thirteen and thirty). Pick words whose sounds your child struggles to hear the difference. Having him “see” the sounds should help him to learn to differentiate between them. Prompt him to point to the words on command.
Expressive language
Yes and no
Purpose: To use Yes and No appropriately.
The most effective way I found to run this program was to get a bucket of plastic letters and a card with Yes and a card with No. Put the two cards on the table. Put a plastic letter on the table. Ask, “Is this a ‘B’?” Prompt your child to point and say Yes or No appropriately, if needed. As always, end with praise and reinforcement. When he can answer Yes and No appropriately, give him a written prompt to increase the response length. For example, put a B on the table. “Is this a B?” Prompt him, “Yes, that is a B.” Put an M on the table. “Is this a P?” “No, that’s not a P, that’s an M!” Once he can do letters, add other objects. Fade the written cards.
Purpose: To improve articulation.
Present your child with written sentences to read. Start with short sentences (e.g., Dog runs.). Also start with words that have sounds that your child can already articulate well. Have him repeat the sentence after you. Make sure he is paying attention to your pronunciation and then looking at the words. It will help him to actually see the sounds. As he gets better, add more difficult sounds and longer sentences.
Labeling
Purpose: To increase expressive vocabulary.
Prepare cards with pictures of common people, body parts, food, animals, etc. At first, write the words on the cards together with the pictures. Start with one card on the table at a time. “What is it?” If he does not respond, say it again, and then give him the answer: “Say, ‘Ball.’” Ask him again. When he gives the answer, provide praise and reinforcement. When he understands the concept and is complying, and once he is consistently labeling several pictures, take the words off the pictures, and continue the program. Once he understands this program, he may enjoy it immensely. We had stacks of pictures and words that we would flip through with Isaak. There was no “drill and kill.” He loved this game! And he learned a tremendous amount of vocabulary.
Simple sentences
Purpose: To form simple sentences.
Prepare sentence strips and accompanying pictures. For example, get pictures of your family members doing different actions: eating, drinking, swinging, etc. Print out short sentences that describe those actions: Mom is eating, Chad is drinking. Cut the sentence strips so that each sentence is separate. Put a picture on the table. Hand your child the sentence strip that accompanies the picture. Prompt him to say the sentence and then match it to the picture. As he understands that concept, add an additional sentence or an additional picture from which to choose. Make it more complex.
Learning to ask and answer wh- questions will not only increase your child’s language abilities, but it may help him become more inquisitive about his environment. Knowledge spurs more interest in gaining more knowledge. The world may begin to open up for him.
Beginning
Purpose: To answer simple, concrete wh- questions.
Prepare common wh- questions that your child should know and their accompanying answers. At first, present one question and one correct answer, and prompt your child to match and read them. As time goes on, make it more complex, adding more answers from which to choose. Make sure you follow up by giving him a chance to answer the questions during the day. Fade the written cues as soon as you can.
Asking why and how
Purpose: To increase spontaneous use of Why and How questions.
Provide your child with an opportunity to ask a question by contriving an appropriate situation. For why, place a chair on top of a table, a toy in the bathtub, or a non-food item on a plate. When he notices that something is wrong, he should ask “Why is the toy in the tub?” If he doesn’t, give him a written prompt. For how, tell him to engage in an action with which he is unfamiliar. For example, tell him to “pretend to be an Alpaca,” for which he should ask, “How do I pretend to be an Alpaca?” If he doesn’t ask the question independently, give him a written prompt.
Describing how
Purpose: Describe how to complete an activity.
You should have the necessary materials for building, drawing, etc. and a specific object. Your child should be presented with a photo or visual representation of what the object should look like as well as a pre-made recipe, list, or description of the steps. There should be an emphasis on language such as, “First you get ______, next you need ______, then you ______ as well as ______ before you get the ______.” He should tell you how to make the object. Written prompts should be faded before the picture is faded.
Intraverbals
An intraverbal is more than answering wh- questions. It is responding to what someone else says with something relevant. Intraverbals are gathered from three main sources: features, functions, and class. Learning to identify and use feature, function, and class in your child’s language will increase his ability to communicate.
Introduction to feature, function, class
This program will continue for some time. You can introduce it first with simple concepts and targets, and as your child gains more language, you can increase the complexity of the program. Prepare pictures and word cards for the targets. Ask and prompt your child to answer questions related to the feature, function, and class of each target.
•Feature targets. Your child should be asked questions such as, “What do you find on a house?” and “Tell me something that has windows.”
•Function targets. Teach your child to answer a question such as, “What can you cut with?” and “Tell me something that cuts.”
•Class targets. Your child will be expected to answer a question such as, “What is a tiger?” and “Tell me a kind of animal.”
Describing objects (textual and pictorial cues)
Purpose: To accurately describe an object both in and out of view.
Prepare small cards that have description cues on them such as Color, Size, and Function for reference if your child needs help. Ask your child to tell you about an object. He should then be presented with several of those description cards (at least three but no more than five). Try not to ask him a question as you do not want him to depend on questions to talk about objects in his environment. Remember to rotate the description cards that are presented to him so that he does not learn to memorize specific language routines.
Thematic program
Purpose: To provide general intraverbal knowledge about specific themes.
Select a theme around which to organize all of your child’s language instruction, e.g., zoo animals. After a theme has been selected, specific targets within the theme should also be selected (specific animals, community helpers, buildings, vehicles, etc.). Remember that the focus of this program is to teach your child to be conversational about multiple topics. There is no pre-determined length for a thematic unit. Units can continue until your child has mastered the majority of the target components. Remember to return to mastered units as well as incorporate a previous unit’s targets in new units.
Grammar
Any grammar program can be modified for the child with hyperlexia. Present requests with written cues. Use plastic letters as illustrations. Write out the rules to a certain concept. Use worksheets taken from grammar workbooks. Write down sentences with correct/incorrect grammar and have him identify which is which. Some common grammar concepts to be taught are: possession (it’s mine, it’s their ball); adverbs (fast/slow, wet/dry); attributes (color, size, shape); prepositions (in/on/under); idioms (bear with me; it’s raining cats and dogs).
Verb agreement
Purpose: To understand and use appropriate verb agreement in speech.
Prepare a bunch of sentence strips and accompanying pictures. For example, get pictures of people doing different actions: eating, drinking, swinging, etc. Make sure you have pictures of both singular and plural subjects. Print out short sentences that describe those actions with the helping verb missing:
The girl _____ eating; The boys _____ drinking.
Print is and are separately. Present your child with the picture, then put the accompanying sentence on the table with the is/are choice. Prompt him to put the right helping verb in the space and read it. Once he can do that, put more than one sentence on the table to pick from. Use the same method with other verbs: jump/jumps, run/runs, etc.
Pronouns
Purpose: To understand and use appropriate pronouns.
Use pictures with both familiar people and strangers doing actions. Print out sentences with the full subject (Mom is drinking; The boy is swinging). Also print out pronouns (he, she, they). Present your child with the picture. Give him the full sentence, and have him read it. Prompt him to choose the appropriate pronoun and replace the subject with the pronoun. Have him read it again. Continue making it more complex with different pictures and sentences until he is using pronouns appropriately.
Expressive superlative identification
Purpose: To accurately use superlatives in an expressive manner.
Engage in a turn-taking game where your child is expected to fill in the blanks with the appropriate superlative. For example, if you both have balls and you say, “I have a big ball,” your child should reply, “My ball is bigger‘ or “I have the biggest ball.” Present him with visual prompts to begin with, and then fade those visual prompts until he is using superlatives independently.
Expressive identification of irregular plurals
Purpose: To learn to consistently use irregular plurals in everyday speech.
Target at least three specific plurals that will be the focus for a session or a day, e.g., mice, witch, and cat (note that one of these targets is a regular plural). The singular and plural forms of these nouns should be written for your child so that he clearly sees, for example, that one witch = witch, but two witches = witches. Provide your child with numerous opportunities per day to use the target plurals. Keep a running log of the plurals he is learning. This will be his “cheat sheet” to refer to if the need arises. It may be helpful to ask him first to identify how many of the specific noun he is talking about, and then teach him to match the number to either the singular or plural form of the noun.
Quantifying verbal responses
Purpose: To use words or phrases to quantify a statement.
This program should be taught in an Expressive Statement-Statement format (you make a statement then have your child make a statement) so that your child hears a quantitative model before he is expected to produce a quantifier on his own. Begin by providing him with the exact language model you expect him to imitate, and, as he progresses, prompt him to generate his own statements.
For example, you may start by taking all the cookies and saying, “I have all the cookies,” then give all the cookies to your child and prompt him to say, “I have all the cookies.” After he can do that well, you take all the cookies, and give him all the books. You say, “I have all the cookies” and prompt him to say, “I have all the books.”
Sets: all, some, none, a, the, always, sometimes, never
Adverb game
Purpose: To receptively discriminate between adverbs and the verbs they modify.
This skill should be taught to your child in a game format, either during therapy sessions with an adult or during group sessions with his peers. Adverbs modify verbs and usually end in “ly.” Game cards should be prepared from which the players can draw. Cards would initially have a verb such as “run” written on one side and on the other side there should be two adverbs from which your child could choose, e.g., quickly and slowly. When your child draws a card from the pile, he can read the verb and then select one of the adverbs. He will then be asked to demonstrate the verb and adverb, e.g., running quickly.
Expressive identification of “before” and “after”
Purpose: To identify the events of “before” and “after” as related to familiar sequenced events and familiar descriptions of competing specific tasks or projects.
This program should be used only after your child understands and uses the basic concepts of “before” and “after.”
Prepare a verbal as well as a textual or pictorial sequence with which your child is familiar, e.g., going to McDonald’s, getting dressed, taking a bath. This program is not designed to be a pure sequencing exercise for him but rather to help him identify “before” or “after.” You should tell him the story and simultaneously provide him with the textual or pictorial supplementary materials so that he gets a clear visual and auditory understanding of what is being described. When the story is complete, ask him to identify both what happened before and after specific components. Begin with a simple story; “You go to the store. You buy candy. You come home. What happened before you came home?” Use written before and after cards if he needs them. As your child becomes fluent with this skill, begin fading the extra stimulus cues and make the stories more complex.
Dictionary
Purpose: To expand receptive and expressive vocabulary words.3
Prepare worksheets that have the sections Word of the day, Part of speech, Different forms, Definition, and Example on them with blank lines after each. As you come across a word that your child does not know, get out a blank worksheet and fill in the appropriate lines for that word. When you have completed worksheets, you can either keep them in a binder for him to read over, or you can post them on a wall to refer to. It is important to refer back to words that he mastered to keep them fresh in his mind.
Your child can be taught to use social language from the beginning. Teaching him to interact and converse with people will help improve his language skills as well as his social awareness and abilities.
Greetings
Purpose: To receptively and expressively make appropriate greetings.
Prepare “greeting cards” with common greetings written on them such as “Hi!” and “How are you today?” and “See you later.” Some cards should have the greeting and then a line for your child to fill in the appropriate name, e.g., “Hi, _____.” Set up a situation where he will enter a room and be greeted by you or a peer. Prompt him with the written prompt, if needed, to respond appropriately. Work on appropriate eye contact with this program. Fade the written prompt as soon as possible to help him be independent.
Making contingent statements
Purpose: To make a statement contingent on a previous statement as a means of increasing commenting skills during conversations.
Present your child with a conversation board complete with symbols for various statements that could be made and/or questions that could be asked about a specific topic. Initially, you will introduce a topic of interest, e.g., a new toy in which he is interested. After your comment or question, he should be prompted to refer to his symbol board in order to either answer the question or make a reciprocal comment that is on topic.
If he does not attend to his symbol board, prompt him to point to an appropriate symbol and provide a verbal model, if necessary. If he responds to a comment or question in a non-contingent manner, restate your original comment or question and refer him to at least two symbols from which he could choose that would logically follow. Remember that the goal of this program is to teach him to have conversational exchanges with his partners based on their comments and questions.
Using a computer program called Boardmaker from Mayer-Johnson is a good place to start. These symbols are simple, and most people teaching Picture Exchange Communication System (PECS) use this program. If it is too simple for your child’s language level, simply create your own word-, question-, and statement-banks for him to choose from.
Interview
Purpose: To learn to spontaneously ask social questions.
Prepare a worksheet with a variety of social questions such as: what’s your name, how old are you, where do you live, what’s your favorite food, and what do you like to play? Put the worksheet on a clipboard. Prompt him to ask these questions of different people (whom you have prepared for this). If he can write, have him write down the answers. That will help him pay attention to the answers. If he cannot, you can write the answers for him. After the “interview” is over, go back and ask him, “What did Sally like to play with?” If he cannot remember, take him back to that person to ask again. Mix up the order of the questions each time so that he does not memorize them. Work on eye contact and appropriate body language during this program.
Labeling emotional states associated with verbal responses
Purpose: To use words or phrases to describe emotional states related to a contextual statement.
This program should be done with peers or with props such as puppets. You should provide your child (and his peer if applicable) with a picture or story that targets a specific emotional phrase such as, “I’m sorry” or “I’m happy.” Keep the stories brief and the pictures explicit. A sample story would be “Maggie is sad because she cannot have another piece of candy.” You should then ask your child what he could say to Maggie. Give him the exact written prompt at first, and as he progresses, encourage more novel responses and fade the written prompts.
Topics
Purpose: To identify what statements are considered on-topic in conversation.
Prepare worksheets with a topic at the top and a list of statements beneath, some of which follow that topic and some of which do not. Have your child read the worksheet and check off which statements pertain to the topic. You will need to change the order of the statements and add new statements regularly so that he does not memorize the answers.
At the beach |
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Labeling the strength of responses
Purpose: To use words such as “I think, I guess, I know, etc.” to describe the certainty of his responses.
Choose a target such as “I think, I guess, I know, I believe, Maybe, etc.” and be prepared to provide your child with not only multiple verbal models throughout the day, but also textual cues in situations where it is appropriate for him to make such statements.
You can create opportunities for this program by setting up real life situations, especially in small peer group situations. Engage in an activity such as an art project or taking a walk. You or a peer make statements such as, “I think my bike is really cool” or “I think the sun is really bright today.” If your child does not immediately reciprocate with a similar statement (including the target strengthener), then ask him, “What do you think?” Remember that he needs to follow your target model. Provide him with a textual cue for his strengthener.
Non-verbal social cues
Purpose: To increase receptive and expressive non-verbal social cues.
Demonstrate the target non-verbal social cue and ask your child to label it. Next, ask him to identify and use appropriate behaviors in response to that social cue. Also have him demonstrate the target non-verbal cue. Use scripts, verbal explanations, or create worksheets in order to prompt him through this task.
•Shaking head (yes and no)
•Lifting arms (I don’t know)
•Shrugging shoulders (oh well)
•Waving hand (come here)
•Pointing (over there/over here)
•Waving hand (no/I don’t like that)
•Appropriate facial expression and body language (willing)
•Appropriate facial expression and body language (unwilling)
•Appropriate facial expression and body language (annoyed)
Story telling
Purpose: To tell creative short stories.
Present your child with the opportunity and materials to tell a short story on his own. Initially, model a short story for him. Use a felt board or props when modeling your story. Your child should use the same props when he tells his story. He will be expected to model a story of the same length as yours. It may also be helpful to create a corresponding textual cue to which he can refer while telling the story. Write down his story as he tells it, as it will be reinforcing to him to see it. If he does not begin to tell his story or begins to talk off-topic, refer him back to the felt board or props and provide him with one “jump start” for the next component of the story. This program can be made as simple (1 sentence + The End) or as complex (full story with plot and conclusion) as your child needs to learn.
Chat Bag
Purpose: To make a statement contingent on a previous statement as a means of increasing commenting skills during conversations.
Prepare a special “Chat Bag.” The Chat Bag should contain either photos or written topics about which he and another person can have a conversation. Take turns drawing a topic from the bag and initiating the conversation. The goal of this program is to teach your child to engage in conversational exchanges based on his partner’s statements. It may be helpful, at least in the original stages of this program, to write or draw each partner’s sentences after they are spoken. After the words or pictures are available to him, it will be much easier to direct his attention to specific words and/or concepts in his partner’s statements about which he could make a contingent statement or ask a relevant question. This program can be made as simple (an apple or a dog) or as complex (talk about your day at school; talk about your favorite sport) as your child needs to learn. Below is an example of a teaching interaction:
•You pick a picture of a slide out of the Chat Bag.
•You then say, “Some slides are big.”
•You write out the sentence.
•If your child does not immediately begin to make a contingent statement, review the written words and verbally model a contingent statement based on one of the words in the statement, e.g. “Yes, the slide at the park is very big.”
•Write down his statement.
•After the contingent statement is made, you make another contingent statement based on your child’s previous statement.
Purpose: To paraphrase a story.
Read or tell your child a story. Immediately after he has heard the story, he should be asked to re-tell it in his own words. He needs to repeat all of the salient details of the story. If you decide that he has missed a detail, he should be re-told or re-read the target amount of story. This program can be made as simple (one sentence) or as complex (three-minute story) as your child needs to learn.
