Technique 1: Encouraging Interaction with young children

If you are looking for how to start in play-based therapy, here are my recommendations. Make sure that you are connected with a speech language pathologist who understands child development and who is playful.

Create a play space in your home that has the following:

• limited distractions
• Defined area with mats or carpet, so that the child doesn’t have free run of the whole house
• A small shelf or area to display toys
• 3-4 toy choices that are developmentally appropriate and that foster language development ( I can help you with this if needed)
• A nonbreakable wall mirror like I have in my play space is great to have also, since the child can see his whole body when imitating.

During the first play session the adult will be diligent to watch before responding, requesting little from the child, with the exception of staying in the interaction. Encourage the child to stay with the activity for a few minutes. It is important that the child makes the choice from the toys that you are provided. A good rule of thumb is the number of minutes that the child is old.

If the child initiates a word or nonverbal communicative behavior, then the adult will respond. For example, if the child says, “bubble” as you hold the bubble jar, then the adult “expands the phrase, by saying “blow bubble”. If the child uses a nonverbal, such as pointing, reaching, facial expression, then the adult keeps the meaning of the intent, but adds a word to fit the situation, as in “all done” as the child pushes away the bubble jar. If your child uses a word or phrase amidst jargon, then restate the word or phrase that was heard. The goal is not to get the child to talk as this puts undue pressure on both the adult and child. The goal is to be playful and keep the communication going. The goals will change as the adult becomes more accustomed to following the child’s lead.

The adult’s role is to keep the child in the interaction, both nonverbally and verbally. The adult should use language that matches or is a step above what the child. It is important that the adult not talk too much, and rely on the child to contribute. The adult should avoid questioning or asking the child to perform.

An example of a scenario.

The child points to the bubbles on the shelf. The adult says

“bubbles”, and waits with anticipation for the child to imitate. If the child imitates either signing or verbally, then the adult responds by saying ” you said, “bubbles”. Then the adult blows the bubbles. If the child does not imitate, or make an intentional gesture, then the adult restates, “bubbles?”. You can expect some refusal or even a tantrum because this is new. Up to this point the child did not have a way to communicate a phrase for this and probably does not yet truly understand the task. If your child already uses single words readily, then the adult should model phrases such as “want bubbles?”. Keep your sessions short and playful. If it seems like work, then we need to rethink what is going on.

Model these interactions in playful interactions, with frequency over the first week. A few playful and short sessions during the day are great.

Have fun playing.