Showing posts with label Development. Show all posts
Showing posts with label Development. Show all posts

Tuesday, May 28, 2013

Tip Tuesday! The Nonverbal Child Part 4: Techniques to Elicit Language!

This is the last installment of my Nonverbal child series!  Thanks so much to all of you who stuck with it this month and checked out my presentations.  I hope they helped in some way.

Please note that in this presentation a number of language facilitation techniques will be discussed.  I have written about each one as a culmination of things I have learned over the years via research and my own personal clinical experience.  I cannot pinpoint the exact places these pieces of information have come from since I created this series of PPTs using just my old brain.

Disclaimer:  These presentations are based on my clinical experience and should be used as a guide only.  I understand there are many ways to perform evaluations and therapy and I am just sharing how I do it.  These presentations are not comprehensive in nature and you may add or use different testing materials, strategies or techniques.  Feel free to share your experiences below.  However, when commenting please do so with respect and common courtesy.  Thank you.





This presentation has been removed from this post.  You can find Parts 1-4 of this series here!




Happy Talking!!!


Friday, May 24, 2013

FREEBIE Friday: Goals and Objectives for Nonverbal PK children!

This freebie goes along with my Tip Tuesday post this week (Part 3 of this series) on how to create a treatment plan for nonverbal PK children with typical hearing and vision.
Below I created a quick guide on how I write goals and objectives using the child's functional communication system.  I have a list of several skills I attempt to teach with regard to social skills (including play) as well as receptive and expressive language skills.  

This is by NO MEANS a comprehensive list, just a glimpse of some of the more common goals I write for the child while they are using their functional communication system (whatever that may be).  This information is meant as guide only!

When writing goals I use this equation:
Skill + Setting + Context + Cuing/Assistance + Measurement+ Data Collection + Duration = Measurable Goal


Grab a clear copy of this download here!



So a few completed examples of a short term objective I would write would be (using the format above):

Johnny will use total communication (i.e. picture exchange system, gestures, vocalizations, sign language, etc.) when responding to peers' greetings in the classroom setting with minimal or no cues (0-25% OTT) 1 time during arrival and departure of the school day as recorded by teacher data collection/report for 3 consecutive data collection days.

OR

Johnny will demonstrate an increase in receptive vocabulary by pointing/reaching/choosing the correct object/photograph/picture of objects and/or actions in response to directions given by the SLP in a one-on-one or small group therapy setting during structured therapy tasks with moderate cues (~25-50% OTT) with 80% accuracy across 3 consecutive data collection days.

So that's how I do it?  How about you?  What is your process or goal writing lingo?  Feel free to share below!
     

Enjoy and Happy Talking!

Tuesday, May 21, 2013

Tip Tuesday! The Nonverbal Child Part 3: Creating a Treatment Plan

Here is the 3rd installment in my Nonverbal Child series, discussing how to create a treatment plan.  Treatment plans in the academic environment versus private practice will undoubtedly be a different process.  However, this presentation includes the basic way in which I create a treatment plan.  Many times I find parents do not understand the process of IEPs or treatment plans and what goes into them.  So I hope this presentation will be able to shed some light on the complexity of the process.

On Friday I will share with you how I write goals and objects when creating treatment plans for these nonverbal kiddos using the functional communication system I determine at the time of assessment!

Disclaimer:  These presentations are based on my clinical experience and should be used as a guide only.  I understand there are many ways to perform evaluations and therapy and I am just sharing how I do it.  These presentations are not comprehensive in nature and you may add or use different testing materials, strategies or techniques.  Feel free to share your experiences below.  However, when commenting please do so with respect and common courtesy.  Thank you.






This presentation has been removed from this post!  You can find Parts 1-4 of this series here!


Looking for the Play ages and stages form I reference in the presentation?  If you've missed it when I posted it back in February, don't worry.  Go here and grab your copy!



Enjoy and happy talking!

Tuesday, May 14, 2013

Tip Tuesday! The Nonverbal Child Part 2: Determining a Functional Communication System

This is the second installment in my Nonverbal Child series.  Remember this series focuses on the Nonverbal child under 5 years old with typical hearing and vision.  With that said I have used the same techniques for older children with age-appropriate toys and activities.  So some of these techniques can be generalized to other ages with appropriate modifications.

These presentations are based on my own clinical experience with evidence-based research I've read over the years and are meant as a guide.  The definitions in this presentation are my own and the process to determine a functional communication system is one I have trialed over the years and have come to conclude works best for my clients.  Again this is to be used as a guide!

Also take note of the additional information I add between a few slides below.  This is information I felt was important to explain but not necessarily within the presentation itself.

Disclaimer:  These presentations are based on my clinical experience and should be used as a guide only.  I understand there are many ways to perform evaluations and therapy and I am just sharing how I do it.  These presentations are not comprehensive in nature and you may add or use different testing materials, strategies or techniques.  Feel free to share your experiences below.  However, when commenting please do so with respect and common courtesy.  Thank you.



This presentation has been removed from this site! You can find Parts 1-4 of this series here!




Happy Talking!


Tuesday, May 7, 2013

Tip Tuesday! The Nonverbal Child Part 1: Assessment!

I have been performing early childhood assessments for the last decade and particularly over the last 5 years have encountered more nonverbal children between the ages of 3-5 than I have in my previous 5 years of therapy.  I wonder if there is a trend in the severity of disabilities we are able to diagnose at earlier ages or if parents are just being referred more often.  Maybe it is a little bit of both.

Since I've had quite a bit of experience with nonverbal children, I thought I'd put together some presentations and share some things that have worked in the past and continue to work for me and how I move that child from nonverbal to verbal communication.  

Disclaimer:  These presentations are based on my clinical experience and should be used as a guide only.  I understand there are many ways to perform evaluations and therapy and I am just sharing how I do it.  These presentations are not comprehensive in nature and you may add or use different testing materials, strategies or techniques.  Feel free to share your experiences below.  However, when commenting please do so with respect and common courtesy.  Thank you.

This presentation has been removed from this site.  You can find Parts 1-4 of this series here!

Happy talking :)

Wednesday, February 27, 2013

Guest Posting: Let's Get Physical! Keeping PK kiddos attention during therapy.

Today I am guest posting on [simply speech.]'s Welcome Home series today!  The topic?  Using movement to keep PK students attentive during therapy!

Here's a preview of all the goodies you will find over there...

So here is my biggest secret to success with preschoolers:  Movement!  It is NOT developmental to expect a PK age child to sit and attend to an activity for 30 or 50 minute sessions.  Children are constantly learning, exploring, and problem solving.  They, like us all, need proprioceptive feedback.  I provide that by adding movement to almost ALL of my therapy activities.  When I add movement to any activity, I have learned that my PK students attend longer to one single activity and will participate in more trials during the therapy session than if I would expect them to sit the entire time.  The movement does not have to be big or elaborate.

Want to know my simple tricks of the trade for some of our favorite activities as SLPs? Head on over to [simply speech.] TODAY to find out!

Do you use movement activities in your therapy sessions?  Feel free to share your great ideas below!

Happy Talking

Thursday, January 3, 2013

My Top 10 Favorite Songs for Early Language Learning!

As a Speech-Language Pathologist, I feel music, singing songs and finger plays are a very important part of communication as these activities improve auditory processing and comprehension skills while teaching language, prosody, turn taking and so much more!  So I thought I'd share with you my Top 10 favorite songs and explain why I love them.  Remember...let your child set the pace (go as fast or slow as he/she needs). (Note: this list is in no particular order)

1.  Old McDonald:  Who doesn't love this song?  It teaches children about animal identification, animal sounds, it's repetitive AND we can practice long vowels (E, I, O)...a great repetitive activity for children with Childhood Apraxia of Speech (CAS).


2.  Apples and Bananas:  EVERY Speech-Language Pathologist LOVES this song!  It's repetitive and is so so so great to teach long vowel sounds, which is great for articulation deficits and children with CAS.  Plus, it's so fun to make up silly words!!!


3. Head, Shoulders, Knees and Toes:  A great song for introducing some body parts.  I like to sing it using all the words with younger children, but as they get older, I like to sing it all the way through with words than start to add "humming" for various body parts and have them fill in the body part name as we touch that body part.  Listen for word recall and use of a similar pitch.  Your child doesn't have to be on key, but if the song's pitch is going up, so should your child's.  This is an indicator that he/she is hearing the pitch change and able to imitate after you.

4. If You're Happy and You Know It:  I love this song because you can sing all the verses and talk about what it looks like to be happy, sad, tired, mad.  Great for teaching what emotions look like.

5.  5 Little Monkeys Jumping on the Bed (or any of the counting songs):  Fun song about those silly monkeys that never seem to learn that they can get hurt by jumping on the bed.  Great for counting and early math concepts; repetitive which is wonderful for recall and teaching vocabulary.

6.  The Wheels on the Bus:  who doesn't love wheels on the bus?  It so great for acting out verbs and describing parts of a whole (a.k.a. parts of the bus); its repetitive and keeps children engaged from the beginning to end.  

7. Hokey Pokey:  Great song for teaching body parts and introducing the very hard concept of "left vs. right".  Plus, its so much fun to "turn your self around" and really..."that's what its all about"!

8.  Goin' on a Bear Hunt:  I love this song because it lends itself to teaching children to follow directions, making sounds for objects, and attaching sounds to body movements.  It's a wonderful song for sequencing (forward and backward) the parts of the song.

9.  There's a Spider on the Floor:  this song is great for teaching location, following directions, body parts, and of course rhyming.  Its so much for kids to put a spider ring on their fingers and act out this song.  This song is one of my favorites to do just before Halloween!

10.  There's a Whole in My Bucket:  I like to use this song to teach problem solving skills.  I sing the "Henry" part and I ask my students what can I do to solve each problem in the song.  Once we come up with a solution (which may not be the exact words of the song but if its a logical solution I accept it) we sing it together.  I also like this song for teaching humor.

There's my list!  What songs do you love to use for early language learning?  Please share!

Happy talking, singing, and learning!

Friday, November 30, 2012

"Why kids should play with dolls!" featured blog post


baby dolls

Check out this GREAT blog post collaboratively created by an OT, SLP and child psychologoist on the importance of pretend play with baby dolls FOR ALL CHILDREN!!!!  It is so well written and what a great way to use pretend play to improve all areas of development!!!!  Check out  Why Kids Should Play With Baby Dolls

Enjoy, happy playing and happy talking!!!!

Friday, November 9, 2012

Pretend Play: Keeping Track of Progress!

This post has been relocated!  Click here to find it!

Wednesday, November 7, 2012

Pretend Play: Choosing Materials to Target Speech & Language Goals!

Pretend play is crucial for a child's cognitive, communication and social  development.  But how can we as SLPs and parents use this activity to target specific language goals?

There are a few rules to follow when using pretend play to target specific goals:

1.  Choose interesting materials:  If your child is not interested in the materials you are presenting for play than they will not want to participate in the play.  So simple to understand, yet sometimes we get caught up in our own ideas and what we think would be fun for our kids, that we miss their signs of disinterest.  So keep your child's likes and dislikes in mind and choose specific materials, dress up clothing and toys that are of interest to your child. (My rule of thumb:  If a child's eyes don't light up when I pull out my materials, I change it up!  I give the child/children a few choices and they tell me what they want to play with).


2.  Choose materials that lend itself to targeting your goals:  For example, if your goal is to increase a child's vocabulary or understanding of categories and you have noticed that he/she does not know the names of many pictured foods or the differences between fruits and vegetables, then playing with fake food would be a great way to target those skills. 
  • If your goal is to improve social skills by taking turns, joining in play, sharing, etc. than you want to make sure you DON'T have enough materials for everyone.  This way you create an artificial environment where a child will have to request objects, wait for his turn, take turns with others and learn how to share. 
  • If your goal is to improve articulation skills, and your child is working on specific sounds, try to pick several (if not all) toys and materials that have the child's particular sounds in them.  Its a GREAT way to model these sounds in play and possibly encourage generalization of speech production to play (if you child is at that stage). 
  • If your child has sensory issues, try to incorporate some of the materials he/she has trouble processing on a TOLERABLE level (low music-if noise is an issue, tactile issues-how about shaving cream, rice, flower, various homemade play doughs, etc. in the sensory table, play with REAL food-if textures are an issue). 
  • If your child is working on specific grammatical structures (complete sentences, understanding prepositions, etc.) make sure you create an environment where he/she has the opportunity to use those skills or if he/she cannot do that yet, provide several opportunities where you will model these skills.  E.g.  Your child is working on understanding concept of "where".  You bring out a few play materials and then after some time, misplace one, then "remember" where you misplaced it by giving your child simple directions to "get the (toy) under, in, behind, the...".  E.g. Your child uses only names of objects and you want him/her to create phrases and sentences.  You can put down a few toys and have a clear box/bin out of reach but visual so your child can ask for the toys he/she wants in a sentence (I want the ___) or question (Can I have the ___?) format. 
  • If you want different types of sentences using self-talk and parallel talk (see this blog for more details on these skills) is a GREAT way to give your child stimulation and modeling of these skills. 
Just keep your child's strengths and weaknesses in mind and you'll be able to provide just the right about of assistance to make play fun while he/she learns.

3.  Keep track of progress:  This is the MOST difficult thing sometimes for parents and therapists to do.  How do you keep track of all the things a child is saying and doing while playing?  We are going to learn that in the next blog.  Stay tuned!!!

In the meantime...keep playing...and happy talking!!!!

Monday, November 5, 2012

Pretend Play: Why it's Important!

 I was at the Dollar Tree in early September and look at what I found?!!  Some great Halloween/ dress up goodies for...well you guessed it, $1 a piece!
 
Look at the wonderful pretend play outfits I found for a total of $6 (plus tax)!  Pretend play is sometimes overlooked in the Speech Pathology world because we are trained to "make the most" out of every speech session, have the most possible trials, teach the skill, practice the skill, and ABOVE ALL take LOTS and LOTS of data!!!! 


So one can imagine how hard it is for SLPs to have evidenced-based therapy sessions with tons of data IF we do not have control over the context the entire time!  The truth is, I struggled with this for a long time and it wasn't until I worked with some amazing early childhood teachers that I realized how important pretend play is for language development, social skills, and cognitive development. 

According to the article titled. Pretend Play: The Magical Benefits of Role Play, by One Step Ahead  the benefits of pretend play are numerous as it faciliates:
  • Imaginative thinking and exploration
  • Abstract thinking
  • Problem Solving
  • Life skills
  • Leadership skills
  • Communication development
  • Social Skills development
  • Use of "Theory of Mind" (understanding/taking another's perspective)
  • Understanding of safety
  • Self-confidence and a high self-esteem
**There is a theory some researchers believe that pretend play actually creates synaptic connections!  This has yet to be proven but if so, participation in pretend play could positively impact IQ!**

There are SEVERAL different kinds of pretend play:
  • Dress Up:  probably the one most of us think of when we talk about pretend play.  Do you remember the box of mom and dad's old clothes and shoes you used to play dress up?  Dress up teaches children about jobs and roles within the community as well as creates social situations they can work on using language to successfully navigate. 
  • Imitation of Adults:  If you have a child, you will surely remember the phase where they wanted to help you with the housework and vaccuum, dust, dry the dishes, etc.  They wanted to imitate mom and dad.  What you might not have known was that they were learning while having fun.  Even if they don't "do it right" or "take too long", let your child participate in these activites!  You can always have a clean house AFTER they've grown! :)
  • Imitate Real-life:  this includes when your kids play "grocery store", "library", "doctor", "restaurant", etc.  They learn social skills and appropriate language for these situations simply by playing.
  • Acting out Stories:  children love to become their favorite characters, which is another reason reading to your child is so important.  When acting as a character, your child is learning "theory of mind" (how to take on that character's perspective), which is one of the most important social skills a child can learn!
  • Perform "On-Stage":  Your child or children will eventually begin to want to take center stage and perform for you (the audience).  In performances there are characters, with various feelings, a setting (various situations), sometimes a problem and resolution, the characters have "lines" (scripting), and there is a beginning, middle and end (a true narrative) to the story.  Your child will learn how to navigate these situations cooperatively with his/her peers to put on a successful performance!
  • Create pretend play space:  This occurs when your child turns a box into a rocket, or hands you a "cup of coffee" (which is really a piece of tupperware with blocks in it), or puts his shoe to his ear and talks into it as if on the telephone.  Your child is pretending that objects are actually other objects.  This is not the time to say "NO, you don't drink blocks!".  This is the time to encourage this type of imagination.  Maybe your child has NOTHING in his hands but he will swear that he "hit that monster with his frisbee".  No your child hasn't lost his mind, in fact, he/she is using his/her mind more than ever before!  So what you do say?  "Wow, thanks for getting that monster and keeping me safe!" 
As an SLP, we can rationally understand the benefits of pretend play but still struggle to incorporate it into our therapy sessions.  But here are a few lessons I have learned that will hopefully make you want to put on a mask and cape and play superheros with your students/clients:

1.  I learned that IT REALLY IS OK to let go and follow the child's lead, then use our wonderful evidence-based techniques (modeling, echoing, expanding, feigning confusion, etc., click here for a complete list) to achieve these goals. 
2.  And IT IS OK to use qualitative data for these things as well (the key is really knowing what qualitative data you are looking for; once you figure that out you'll be just fine).  
3.  IT IS OK to encourage a healthy self-esteem and cooperative play with a group of students/clients!  
4.  When a parent comes to you and ask why you just play in speech therapy, IT IS OK to educate parents on the positive effects pretend play has on cognitive development and future academic skills!  
5.  IT IS OK, ethical, and clinicially appropriate to provide age-appropriate therapy activties (and this does include pretend play)! 

So what does this mean for parents and SLPs out there?!! When working with the little guys...we need to play with our kids!  We need to follow their lead!  We need to present amazing, interesting materials (whether it be dress up clothes, a doll house, sensory table full of goodies, etc.) that will target the child's goals (vocabulary, expressive and receptive language skills, and yes...even articulation).  And then...we need to sit back, and be quiet for a bit (hard for us SLPs).  See what they do!  Watch how they problem solve, how they use and play with these new materials.  THEN...we give them the language for it!  You won't get a ton of pluses or minuses on your data sheets, but by the end of the session, you'll know if little Johnny was able to ask his friend for a toy he wanted using appropriate language, and you'll know if Susie was able to use socially appropriate language to "order" lunch from the "restaurant" in your room!

Later this week we will discuss specifics on how to choose appropriate materials, effectively target goals, and collect data during pretend play sessions!

Enjoy playing...and as always...Happy Talking!!!!

Tuesday, July 31, 2012

Sensory Processing Disorder: What you should know!


When parents are new to the diagnosis of ASD (Autism Spectrum Disorders) or other medical diagnosis that have sensory processing deficits as a characteristic, it can be overwhelming to hear so many professional terms and understand what it all means.  As a Speech-Language-Pathologist, I have worked with several children with sensory processing difficulties and wonderful OTs (Occupational Therapists) and COTAs (Certified Occupational Therapy Assistants) that aided in my understanding of the complexities of sensory processing.  I will attempt to impart their knowledge as clear and concisely as I can.

(NOTE:  Often, sensory integration and sensory processing as well as sensory integration dysfunction and sensory processing disorder are used interchangeably.  Therefore, I have used them interchangeably as well.  In addition, I do NOT specialize in sensory integration and am writing this blog for educational purposes only.  I recommend that you speak to an OT that specializes in sensory integration if you have additional questions and concerns.)

What is Sensory Processing?
Simply put, sensory processing is a complex process in which our brains understand what is going on inside our bodies as well as in our external environment through the use of our senses. 
Sensory processing is affected by two things: 
1.       The way our brain responds to sensory input
2.      Our self-regulation strategies (how we use strategies to manage this sensory input).
Keep in mind that sensory processing is a continuum and that we all require proprioceptive (physical, external) feedback to regulate our sensory system.  What we are really concerned about is one’s extreme responses to sensory input and the negative affect these responses have on a person’s ability to communication and participate in daily living activities.
The blow powerpoint presentation will further explain sensory processing vs. sensory processing disorder.


















How do I know if my child has difficulty processing sensory information?
Below is a link to a checklist also adapted from Carol Stock Kranowitz’s book, Out-of-Sync Child.  This checklist is very detailed and examines several areas of processing including tactile, vestibular, proprioceptive, auditory, oral input, olfactory, visual input, auditory-language processing, and social-emotional play and self-regulation.  You place a checkmark next to the characteristics your child exhibits. 
IF you feel your child exhibits numerous characteristics in one or more areas, please follow up on your concerns by contacting an OT that has experience in sensory integration.  They can perform a complete evaluation and make recommendations.

Check out Sensory Processing Disorder website for a complete checklist on sensory processing disorder.

Is it important for my child to receive OT for sensory processing disorder?
ABSOLUTELY!  Sensory processing disorder CAN and WILL affect all areas of growth for your child (cognitive, academic, executive functions, social skills, communication, etc.).  If you have concerns about your child’s sensory processing skills, it is imperative that you contact an OT with experience in sensory integration dysfunction in order to determine your child’s needs as well as an appropriate plan of treatment.


Happy Talking!!!

Sunday, July 22, 2012

Teaching Your Child How to Answer Questions

Often, parents express their concerns with the fact that their child is struggling with answering questions.  There are so many steps to actually learning and understanding questions of which we, as adults, are not aware, as we naturally learned this skill when we were younger. This skill is such a difficult one for typically developing children to learn (let alone children with various diagnoses), we first need to talk about the process of understanding what questions actually are before we learn how to teach the skill.

Process of Understanding and Answering Questions:
1.   A Question Requires a Response:
For every child (no matter what diagnosis), the first thing we need to teach a child is that when they hear this question word (Who, What, Where, When, Why, How, Do, Does, Can, etc.) at the beginning of a sentence which ends with a raised pitch, it is a question and does require a response. 
·    The most basic way to do this is to say “I asked you a question.  You need to try and answer me.” (then repeat the question again). 
·    With Y/N questions you can prompt your child to answer with one of those words.  Ex. “I asked you a question and you need to tell me ‘Yes or NO’” (and ask the question again).  
·    All we are looking for is a response (doesn’t have to be a correct response).  If your child responds with echolalia (as children with receptive language deficits, developmental delays, ASD, and many, many other diagnoses will respond to questions this way), repeating the last word/few words you just said, your child has already mastered this concept.  Great!  Move on to step 2.

2.  Every question word means something different: 
The next step is to teach a child what each question word means. We don’t do this all at once but rather systematically by targeting one question word at a time.  (This will be further explained in Step 3.)
So what does each question word mean?  (Taking a trip back to Grammar 101)
·     “What”: means a person, place, or thing (for younger children (PK age) I explain that “what means a person, an animal, or an object”, place is something I introduce later with “where”).
·    “Where”:  means a place.
·     “Who”:  means a person (or an animal).
·     “Why”:  is a cause to an effect.  (even for typically developing children, this cause and effect concept is extremely difficult to express so I don’t expect children to begin to answer this question until approximately 4 years of age)
·     “When”: is a time. (Time concepts are very, very hard for younger children.  In my experience some children don’t understand concepts of time (yesterday, today, tomorrow) until Kindergarten.)
·    “How”: is a process. (Answering this kind of question is typically the last skill to develop as children need to understand ALL the above question concepts to answer “how” something happened.  Children in Kindergarten can struggle with this skill as well.)

3.  Teach the skill:
·    Unless a child is showing me that they understand one question word as compared to another, I follow the sequence of most simple/concrete questions to most abstract:
o    Beginning with: WhatàWhereàWhoàWhyàWhenàHow

·    Begin with ONLY one type of question
o   As previously stated I usually begin with “what” questions because they are the most concrete questions to teach and understand

·    Use visual cues and concrete questions:
o   Pointing/showing:  is the most basic concrete cue. 
§  Object Labels (names):  Ex.  “What are you playing with?” (pointing to the object in a child’s hand),  “What am I playing with?” (showing object in your hand).  By using these cues you are teaching your child that the answer to this simple question is to use the object label (name).
§  Action Labels (verbs):  Once a child has mastered the “what” questions that refer to object labels with concrete objects, I introduce questions that refer to the actions of objects.  Ex. “What are you doing with your car?” (driving), “What is mommy doing with these dishes?” (washing), etc. 
§  Accept the most basic single word answers then echo/expand on them:  As a technique introduced in a previous blog the “echo/expansion” technique is a great way to encourage correct answers your child gives you while expanding upon their answers.  Don’t necessarily expect them to repeat your expanded answer.  You are just modeling more language for them.  Don’t forget to encourage their answer. 
·  Adult: “What are you doing with your car?”
·  Child: “Driving.” 
·  Adult: “Yes, you are driving!  Driving up the ramp.”
§  If their answer is incorrect, no attention is brought to the incorrect answer but you do model the correct answer for them.
·   Adult: “What are you doing with your car?”
·   Child: “car.” 
·   Adult: “You are driving.  Driving the car.”

o   Looking/gesturing:  once a child can answer questions about the concrete objects and actions they are doing, you can move to asking these same questions about pictures (which is still a concrete question but more abstract than if you had the objects directly in front of you).  As your child understands questions about object and actions labels you can alternate these types of questions when looking at book.
§  Adult:  “What does the girl have?”
§  Child:  “Ball.”
§  Adult:  “Yes she does have a ball. What is she doing with the ball?”
§  Child:  “Kick,”
§  Adult:  “You are right!  The girl is kicking the ball.  Nice talking!”

o   Picture paired with question word:
§  Sometimes children do a great job answering concrete questions but once you take away the object/picture they struggle with answering a question because their “visual cue” is gone. 
§  One way I attempt to encourage generalization is to use a picture cue during the above two steps in order to provide a visual cue once the object is removed.
§  Use the visual cues that work for your child (here are some examples):
·  ASL signs of “what, where, when, why, how” (can find on internet)

·   The words “what, where, when, why, how” printed out separately on different colored pieces of paper

·   Other pictures: you can find great pictures on the internet to represent each question word. 

·         Moving to more abstract questions:
o   When it is time to move from concrete questions about objects and pictures in books to more abstract questions, I continue to the use the picture cues I have paired with the question word to facilitate carryover.
o   Asking questions immediately after:
§  Immediately after playing with an object or looking at a book, take away the object/book and ask the SAME questions.
§  Ex. Adult:  “What were you just playing with?”
      Child:  “Car”
      Adult:  “Yes, you were playing with the car!” (now showing the object).  If question is answered incorrectly show the object and state “You were playing with the ball.”
§  Ex. Adult:  “What was the girl doing in the picture?”
      Child:  “Play with ball.”
      Adult:  “Yes the girl was kicking the ball!”

o   Asking questions after a delay:
§  The next step is to remove the objects/book you were looking at and wait about 30 seconds, and ask the same questions.  This duration may be too long initially for children, so you can begin with a 5, 10, 15, 20 second delay.  Begin where the child is successful and add a few more seconds over time during your activities.

o   Expand the delay:
§  Continue to expand the delays, 5 minutes, 10 minutes, and 15 minutes and so on, while playing with other toys.
§  Ex.  Adult: “What were we playing with before the guitar?”
       Child:  “Car”
       Adult:  “Yes we were playing with the car before we started playing with the guitar!”

o   Introduce sequencing words:
§  Now you can introduce sequencing words, such as “this morning, afternoon, yesterday” etc.  These are very difficult concepts for ANY child!  This will take a lot of practice to understand concepts of time.

o   Using a calendar/picture schedule to aid in recall and sequencing:
§  Many times children cannot recall what they did (yesterday, today, this morning, etc.), but if we give them a visual cue they can be successful answering these questions.
§  You will see preschool teachers using these types of picture calendars to remind their students what they did in school so parents will know the events of the day.
§  Some parents use pictures on a calendar or color code days on a calendar.  Maybe you went to the story time at the library yesterday, so you have a picture of a book on the calendar and you point to it when you ask “What did we do yesterday?” or “Where did we go yesterday?”
§  If you want a child to recall events they participated in during one day, I recommended some type of visual/picture calendar for that day. 
·         You can begin with the most simple type (what you did this morning, this afternoon) and have two pictures “book” for story time in the AM and “store” picture for trip to the grocery store in the PM.
·         Or you can put a picture for various activities throughout the day. 
·         Either way you create your visual calendar/schedule, you want to refer to it when asking your child these questions of time so they are successful.
·         Eventually you will be able to ask them what they did this morning/afternoon, etc. and they will independently look to their calendars for the answer.   
·         Then one day, you will realize they just answered your question without needing to look at the calendar!!!!
·         When that happens your child will be able to begin to tell you things/events that happened to them during the times you were NOT with them.

Things to remember when you are working with your child: 
As one can see, teaching the skill of answering questions is involved and extensive and it is truly amazing that any of us actually learn such a difficult skill at such a young age. Although examples are based on “What” questions, one would follow the same sequence when teaching each question word.  Just a few things to remember:
1.       Meet your child where they are.  Your child needs to be able to answer concrete questions before he can answer abstract ones; he needs to be able to label objects and actions before he can answer questions about them.
2.       Goal:  Success regardless of use of scaffolding.  This means, provide as many cues as your child needs to be successful.  You can always fade out cues later on.
3.      Mastery at concrete level is indication that next question word can be introduced:  You don’t have to wait until your child can answer “what” questions about things that happened “yesterday” before you introduce “where” questions.  If a child can answer “what” questions about real objects and pictures in books, you can begin to introduce the next question word at the most concrete level. 
4.      Stick to age norms:  Keep in mind that if the skill is not age-appropriate, you can introduce it with the goal of modeling but don’t expect your child to answer these questions correctly.  Example, a three year old is NOT going to be able to answer “when, how” questions b/c they don’t have a concept of time.
5.   "Which" question not included:  As you may have noticed I did not include the question word "which" in the above model.  This question word tends to develop outside of the typical model above.  Once children understand how to make choices between objects you can introduce "which" immediately ("Which one do you want?").  Most of the time children develop understanding of this question word very quickly.  However, if your child is struggling with this concept, feel free to use the above techniques to facilitate understanding and language growth.
6.      Praise and Reinforcement:  Don’t forget to praise your child’s ATTEMPTS.  It doesn’t matter if the responses are correct, it matters that your child is participating in the process.  The more excited you are, the more willing your child will be to participate.
7.      Give yourselves the credit you deserve and have realistic expectations.  Learning how to answer questions is SO difficult that it takes typically developing children years to do it.  If you have been working with your child and he/she can answer ANY question (no matter how concrete), give yourself a pat on the back!  You have just “moved a mountain” and you need to celebrate your success along with your child’s.  Remember it is a long process and won’t happen overnight.  When your child is an adult, no one will care that it took him a year to answer the question “What are you doing?”.  They will only care that he can answer it!

Happy Talking!

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