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Pre-Speech Activities

Speech therapy is often thought of for children at the preschool or kindergarten level. Some families have found that requests for earlier speech therapy may initially be dismissed by early intervention programs. Families report being told that their child is too young for speech therapy or that the speech therapist would do the same exercises that the occupational therapist is already doing to increase mouth strength. We were fortunate to have a wonderful SLP (speech and language pathologist) named Maria Metzler come into our life when Nick was a toddler. She taught us about pre speech skills that we could encourage with Nicholas to make his speech more successful down the road. Below are some of the helpful ideas she shared with us.

Ethan

Diaphragm Play: Both the diaphragm and the lips affect sound production. A baby who babbles quietly may benefit from games that strengthen the diaphragm. 

*The earliest game we played was gently vibrating Nick's tummy with the palm of our hands while he babbled. The varied force behind his voice sounded funny and would encourage him to play again. This helps to introduce the feeling of controlling the force with which we can produce our sounds with.

*Lying over the exercise ball and bouncing gently while babbling can have the same effect as the first game. It can give the sensations of bearing down and making louder noises by forcing air out.

*Deep breaths and blowing. Our son's hypotonia led to very gently blowing. To encourage him to practice we found games that would respond to these gentle blows and slowly worked up to stronger blowing. A small 1" pinwheel from a party store, scraps of paper on the table and boats in bathwater all responded to his gentle blow and encouraged him to blow again. As he grew stronger, cotton balls and mounds of shaving cream challenged him to blow harder. A bubble blower made by Gymboree (much like a horn, you wrap your lips around a pipe to blow bubbles) was also good at this stage. Blow markers in the art section of stores provide an even bigger challenge. At 3.5 Nick is just learning to blow hard enough to be successful with these markers.

*Grunting games. Grunting encourages bearing down which increases tummy and diaphragm awareness. We would pretend that toys on the ground were *really heavy* and make grunting noises as we picked them up. We played tug-of-war with exaggerated grunting.

Encouraging those sounds and using them for two way communication: Games that encourage making more sounds as well as establishing the turn taking nature of communication can lay a good foundation for later speech.

*Mimicing the child's sounds with the same pitch and duration can lead to a fun back and forth exchange that encourages your child to not only make more sounds, but also to play around with varying the sounds.

*Begin to assign meaning to the sounds. If Nick said 'Ba' we would say 'Ba - Ball' and pick up the ball. He was begenning to learn that he could use his sounds to ask for different things. At the earliest stage his sounds were just a sound and not a word assigned to a meaning but this type of play began showing him that he could vary his sounds to give them meaning.

*Repeating our sounds. P and B sounds are more easily formed on our stomachs while G and K sounds are easier to form when on our backs. Getting into these positions while practicing sounds may aid in initial success. A therapy ball is a fun way to get on your tummy as is playing 'snake' on the floor.  Laying under the clouds or trees  is a good time to practice those G and K sounds.

*Simplified sound songs. While reading, singing and labeling are all excellent and essential tools in developing speech and communication, Maria taught us to sometimes simplify the game a bit to allow Nick to participate even before he had any words. Taking a favorite song like 'Row Row Your Boat' and singing the tune as 'Ba Ba Ba Ba' allowed Nick to be successful in 'singing' along with us.

*Language of toys: There is a book in our 'Book Nook' section that goes in depth on how to use toys to draw out language. We had great success with assigning language to a pop up toy. Long before Nick could physically turn the buttons and switches to make the animals pop up, Maria taught him to 'ask' the animals to come 'up'. He didn't have to produce the word 'up' (he couldn't at that point) but he did have to attempt a sound to bring about the desired effect of us flipping the switch and popping the animal up. We played this for several therapy sessions and by the time Nick could physically pop the animals up himself he had learned to also incorporate language into his play.

*Echo games: Buckets, microphones and bathrooms give a great echo effect that may encourage more sound play.

*Swinging: Vestibular input can increase sound play in some children. 

Waking up those lips, cheeks and tongue: Oral motor play can help increase awareness of the mouth area for a child with low tone and can help exercise those muscles to increase strength.

*Mouthing different textures and temperatures. There are tons of textured toys out there for babies in plastic, wood and cloth. Warming them or cooling them down in the fridge can provide new sensations.

*Pukering games. Silly games like giving kisses, making fish faces in the mirror and blowing raspberries are all exercises that can increase awareness and strength. We also played a game where we would close our lips around a piece of yarn and pull it out the other side of our lips. It tickled and encouraged bearing the lips down on one another so you wouldn't drop the yarn.

*Vibration games. Using a speech vibrator or vibrating toy (let batteries run down a little for younger children) in and around the mouth area increases awareness and vocalizations. If direct vibration is upsetting for a child you can use indirect vibration. To do this have the child chew on a favorite toy like a rubber gertie ball, and hold the vibrator on the ball while they chew. The vibrator will gently vibrate the ball and provide input without being overwhelming.

*Mousey Mousey run into the housey....a little game we played with a NUK where we would stroke the side of Nick's tongue with a Nuk and then pull it over into the side of his cheek while saying the rhyme. His goal was to bring his tongue over into the side of his cheek to 'find the mouse'. Encourages lateral tongue movements which may be more difficult in a lower toned mouth.

*For vertical tongue movements use a bit of applesauce or a cheerio. Sitting in front of a mirror place the cheerio or applesauce above or below the lips so that the child has to lick around their mouth.

This is an example of a wonderful session Maria had with us long before Nick was forming words and sentences.

When Maria arrived, Nick and I were looking through the mail. I began to clean it up and make space for the toys Maria had brought with her. She quickly told me not to bother cleaning the mail and left her toys in the kitchen.

1. We poked the cellophane out of the envelope windows and practiced sticking our tongues in and out of the windows.

2. We accordion folded some paper so it stood on end and Nick's gentle blows could knock it over.

3. We tore paper in half with Nick, all of us making exaggerated loud sounds as it ripped.

4. We twisted a newspaper ad into a rope and played tug of war with lots of grunting and laughing.

5. We crumpled paper into little balls and called them 'poppers'. Each time Nick made a sound we 'popped' one into the air. When he understood that his voice was making the papers pop he really got into making sounds.

6. We rolled around in the paper mess and laughed quietly and loudly. We encouraged Nick to vary his pitch and to try and mimic our laughs.