Articulation Therapy is for Babies
Updated: Dec 11, 2019
As a speech-language pathologist who has worked with a lot of babies before they turn one, I often have people ask me--"what do you do with a baby? They're not talking."
But, in fact, babies are doing so much talking all the time, and that early pre-linguistic vocalization play is so important for their emerging vocabulary! Numerous studies have linked the early articulatory gestures and phonetic sound production that occurs in babies’ first babbling with later vocabulary development. Helping babies and toddlers with reduced consonant inventories expand the consonants they play and experiment with will give them more to work with for words.
Babbling, when babies begin to produce consonants in strings of consonants and vowels, is a huge milestone in speech and language development. Typically, we see this skill begin to emerge around 4 to 6 months of age. For babies at risk for speech or language impairment, teaching caregivers to engage in babbling play is a great approach to help baby master early sounds and add new ones as well, simply by babbling with them.
The best way to do this is to start by repeating baby's sounds. Pick a low distraction time, like after a meal when baby is sitting in his or her high chair, or after a diaper change. Many babies will naturally start cooing, making vowel sounds, or humming when they're happy and looking at caregivers. Start by doing exactly what baby is doing and see if you can get them to do this back and forth. Then, after a few turns, try something new. For example, if baby is saying "mamamama," you can do a few turns of repeating this string, then switch it up by saying "babababa." Often, baby will be shocked at the change and stare you down. "How did they do that?" they wonder. So do it again, and exaggerate your mouth movements to show them what you're doing. They may or may not try it themselves the first time. If they do, get super excited and praise them. If not, ask parents to keep it up for a few days and also listen in for them practicing when they think no one is listening--some babies like to give something a try on their own before performing.
Research has also suggested that babies, and later even toddlers, learn to distinguish phonemic sound contrasts by first experimenting with different articulatory movements at word level, to try and figure out how to say the word as a whole unit. We can help them try new words and give them opportunities for this practice when they’ve been a little slow to experiment on their own.
Let's start with helping them understand the goal of communicating a need to an adult. Often, we're so busy, we fall into the routine of anticipating what babies or toddlers may want or need before they have even asked. Or, we start a guessing game when they start fussing. Instead, pick a desired object, toy, food, etc, and place it out of reach but in sight. For example, take a small ball and put it in a clear plastic container with a lid. Wait until baby indicates that they want it by grabbing for it, pointing, etc. Ask them, "what do you want? Ball?" Many babies probably are not even looking at you at this point, they're looking at what they want. So, lesson number one is that they need to look at you and make eye contact before getting the object. The strategy here is to start with an easy enough task so baby experiences success that you can reinforce. If they don't look at you, you get in their line of vision, and when they have to look at you and make eye contact, you say, "good looking, thanks for asking" and you give them the ball. What you're teaching baby to recognize is that they have to communicate with you to reach the desired objective. In this way, what we’re doing in our early attempts at improving speech sound and phonological skills is exactly like what we do for increasing expressive language skills. This is because in the baby and toddler, these skills are so closely intertwined that we shouldn’t think about one without also thinking about the other.
From here, you can gradually increase the expectation of the task. If baby now knows to look at you, you have their attention on your face and can model the word "ball." Say, "what do you want, the ball? Tell me 'ball.'" You can point to your mouth, you can emphasize the "ba" and if you've already been working to establish /b/ as a goal in babbling play, this should be familiar enough to have baby imitate a "ba." As soon as they do, get super excited and say "you told me 'ball'!" and reward with the toy ball.
What if the baby is struggling with imitating consonant sounds? You can still encourage eye contact to facilitate that awareness of needing to request from you as a communication partner. Also, remember that sound development is a process of babies and toddlers trying out different articulation movements for different words until they’ve figured out what “works”—so praising the attempt helps to reinforce their learning, even when the production was far away from the adult target. We don’t start getting too picky about accuracy until after toddlers turn two, and even then we still expect a large learning curve for articulation development. Exceptions to this rule occur for certain errors that we know may lead to persistent speech sound difficulty, like growling or producing sounds in the throat for babies with cleft palate. In these cases, we don’t want to reinforce the attempt because we don’t want to encourage a pattern that can develop into a persistent error. Instead, wait a few seconds, then recast and model a desired behavior that baby is successful at in order to have something to reinforce—such as getting eye contact and joint attention, both you and baby looking at the same desired object, before giving it to them.
For some babies struggling with learning consonants, an important step in developing a symbolic system as a communication tool includes other categories in addition to words--things like producing environmental sounds. Environmental sounds refer to non-word speech sounds that we can make when playing with babies. Things like animal sounds (e.g. "cow says moo"), raspberries for car sounds (bbbbbbbbb), wooshing sounds for planes (pssshhhhh), or hushing sounds for baby sleeping (shhh) are all ways to encourage baby to play with their speech sound system and also start to connect these sounds they're making with their mouth to something it refers to. This can be less pressure on babies and toddlers and a whole lot of fun, so get silly with toys and make a lot of noise!
Another activity to encourage babies or toddlers to vocalize on demand is to use nursery rhymes, songs, or repetitive books. It's human nature to want to fill in the gap when you know what's coming next, so use a book like "Brown Bear, Brown Bear" and read it a bunch of times until baby knows it. Then read it and say "brown bear, brown bear, what do you see? I see a red bird looking at---" and look at baby. They're going to want so badly for the line to end, and you can encourage them to fill in the "me" each time the word comes around.
As with all things baby or toddler, we can help reassure parents to know that starting to see these skills develop in a baby with a speech and language development delay will take time and changes will happen on baby’s own schedule. It’s also important to remember that not saying words, or not knowing what words mean, doesn't mean that little ones are having problems thinking. All people have different strengths and for some babies and toddlers, they may need a bit more help in cracking this code of speech and language!
Ferguson, C. A., & Farwell, C. B. (1975). Words and sounds in early language acquisition. Language, 419-439.
McCune, L., & Vihman, M. M. (2001). Early phonetic and lexical development. Journal of Speech, Language, and Hearing Research.
Stoel-Gammon, C. (2011). Relationships between lexical and phonological development in young children. Journal of child language, 38(1), 1-34.