Recently, I have had a couple of people ask me, “How do you do therapy with a toddler? Isn’t it just glorified play?” In response, I did a lot of thinking. Now I would like to share some of those thoughts so that those of you who may have had this same question (it certainly is a legitimate one), might gain some new insight into the process of speech and language therapy.
Everything begins with play. Play is the way that children learn about and begin to understand the world around them. Play begins with simple sensory exploration, moves on to early cause and effect manipulation, and continues through early representational play to symbolic play. Throughout each of these stages, speech and language skills begin to map onto that play.
As a child’s play and speech-language skills develop we begin to see social communication and reciprocity develop symbiotically. Social reciprocity begins through eye gaze and/or shared attention with an object that is being explored. Eventually it develops into a social experience of shared pretend play (or conversation) in which each individual’s action (utterance) is predicated upon the last action of the other.
As you can see, engaging with a child through the medium of child-directed play provides the SLP with a window into the child’s understanding of the world around them. It is through this window, that a picture of an individual child’s strengths and weaknesses begins to emerge. And all of this is happening between the ages of 4 months and about 3 years! Therefore, this is a critical time for intervention to have its most profound effect on challenges faced by a child.
So what happens in that therapy room? Through a deep understanding of the typical sequence of development, the SLP can engage in child-directed play in a manner that meets the child where they are, and then gently nudges them toward the next stage of development. At any given time, during any given activity, the therapist is analyzing the child’s current abilities while facilitating development, in many areas at once. These areas include social interactions, comprehension of language (both verbal and nonverbal), expression of thoughts and ideas, and production of specific speech sounds (at levels ranging from sounds in isolation, in simple words and ultimately in sentences/stories). Throughout each and every therapy session, the therapist “plays” with the child while determining the most effective and efficient means to facilitate that next level of development. So…while we enjoy each and every moment engaged with a child (and hopefully make it look effortless and spontaneous), we are thinking critically and responding dynamically all the while. We are definately doing therapy with toddlers!
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