November is… Time for Thanksgiving!

This November, we are focusing on the use of carrier phrases to help children state their wants/needs using phrases or sentences and on modifications that can be made during Thanksgiving gatherings for the sensory-sensitive child. Time for your child to say, “I want turkey!” or “I need a sensory break!”

The Use of Carrier Phrases for Expanding Children’s Utterances

In a previous article, Ways to Increase Your Child’s Verbal Skills, the focus was on increasing a child’s verbal communication when their speech is absent or limited. This article focuses on children who demonstrate the ability to label objects, people and even actions around them, but primarily produce one-word utterances. This may include a two year-old who has a number of words in their repertoire, but consistently uses only one word to comment on their environment or request preferred items. 

This brings us to a term that should be in every parent’s vocabulary: carrier phrase. 

Carrier phrases are essentially “starter” phrases in which the first 2-3 words are constant and the last word changes. They are used often in speech-language therapy sessions as a way to help children expand their single word utterances to a phrase or sentence level by using a format that becomes highly familiar to them through repetition. 

Examples of carrier phrases include:

• I want
• I see
• I need
• I found
• I feel
• I have

“I see” is a great carrier phrase to start working on expanding speech of children who often label nouns in their environment as their primary way of communicating (i.e., pointing at a dog and stating, “Dog”). The “I want” carrier phrase can also be paired with nouns, although it’s recommended that its use is limited to the child’s expression of their functional needs, such as requesting food, drink, toys, colors, etc. (e.g., “I want milk” during lunch; “I want green” when coloring). You can also pair an “I want” phrase with actions, such as “I want up” if the child wants to be picked up or “I want open” if they want you to open something for them that they can’t.

Think of ways to manipulate everyday situations or feign ignorance so that your child has to use expanded utterances to get what they want. As cruel as it may sound, these can be very effective methods that help motivate children to use their words and to help them realize the power of their own communication. Whether they intend to or not, parents and caregivers often anticipate a child’s needs since they know the child’s natural preferences and/or can usually understand their speech/communication even if less familiar listeners can’t. 

Manipulation and ignorance techniques are popular for young children not yet speaking. If a young child is grunting and reaching for the fridge and their parent knows they want a snack, it’s recommended that the parent refrain from immediately getting the child’s snack without making them “work” for it, communication-wise. They might say, “I don’t know what you want. Do you want a snack?” to get them to answer yes or no via talking or body language. They might also prompt them with picture card choices of a snack, milk, or toy so the child can choose. Manipulating situations might mean taking items that the child can normally access on their own and putting them in out-of-reach places or boxes that are difficult to open so the child must request help.

In a similar way, parents can manipulate situations or pretend that they don’t know what the child needs when they are only using single words to communicate what they want. If a child says, “Cookie” while reaching for a cookie, a parent can say, “Cookie? Yes, that’s a cookie. What about the cookie?” If the child continues using single words, the parent can initially help out by saying, “Do you want the cookie? Ohhh, now I understand. You can say, ‘I want cookie.’ Can you try?” You may have to start off my modeling each word and prompting your child to repeat you, such as:

Parent: “I…”

Child: “I…”

Parent: “Want…”

Child: “Want…”

Parent: “Cookie.”

Child: “Cookie.”

Make sure to give lots of praise for any verbal attempts, and BE CONSISTENT throughout the day with this approach. Eventually, cues for each single word should fade and the child will communicate “I want ____” on their own. 

For children whom this is difficult for or for children who benefit from additional visual cues, the use of a sentence strip can be a helpful tool in the journey toward expanded speech. A sentence strip contains written word and/or picture cues to help increase a child’s understanding of the utterance and their ability to segment, or break up, all the words required to make the request. An example of a sentence strip below depicts sign language for the target words:

For children that rely heavily on picture cues, it may be helpful to have picture cues of a variety of things that they like, including pictures of preferred foods, drinks, toys, etc. You can take your own pictures and print them or search the internet for pictures of common items. 

For additional ideas and suggestions about getting your child to expand their speech to phrases and sentences, ask your child’s speech-language pathologist, or seek out one if you think your child may be behind in their speech skills for their age. 

Reminder:      

The clinic will be closed on Thursday, November 28 in recognition of the Thanksgiving holiday. We wish all of our families a joyful day filled with warmth, loving family and friends, and delicious food to share. We are very thankful for each and every one of our children and families that walk through our door. 

Thanksgiving Day Modifications for the Sensory-Sensitive Child

Large family/friend gatherings can be extremely anxiety-ridden for many children, particularly those that are highly sensitive to sensory input in their environment. This Thanksgiving holiday, consider making the following modifications to reduce your child’s anxiety and help promote peaceful and trusting participation:

• Don’t insist that your child hug family members, especially those they are unfamiliar with. 
• Read a social story in the days leading up to Thanksgiving to increase your child’s understanding of what to expect.
• Before the big event, let family members know about any issues your child may have with noise, food, lights, etc. so they understand that your child gets overstimulated and can be considerate of their needs.
• For children that seek proprioceptive input, incorporate some heavy work before the event and/or provide some deep pressure during the event when they become dysregulated. 
• Allow your child to dress in comfortable clothes.
• Prepare a dish that you know your child likes and will eat- even if it’s non-traditional Thanksgiving fare- in order to provide some familiarity and enjoyment for your child during the meal.
• Consider preparing traditional Thanksgiving items at home in the days/weeks leading up to the event to increase your child’s familiarity with them. If your child is in feeding therapy, send these foods with them to therapy so their feeding therapist can work on desensitization to the tastes and textures.
• Offer small portions of food to encourage new tastes, but maintain positivity and don’t “push” foods, especially in a setting that may already be placing stress on them. 
• Request or provide a quiet space where your child can retreat to for a sensory break when they become overwhelmed by excess sensory stimuli.
• Choose to forgo large family gatherings and have a small, quiet meal at home, if that works best for you and your family.

November- a time of gratitude and family- seems a perfect time to be thankful for all the wonderful parents out there who have opened their hearts and homes to children who desperately need both. To these parents and the children they love and cherish as their own, we wish you warm family gatherings this year and always. 

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megan@ctctherapy.com

Children Therapy Connections is committed to providing effective intervention to children diagnosed with Autism Spectrum Disorder. If your child does not have diagnosis but you suspect delays with development, do not wait, call today for a free screening. 708-226-9200.   

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