There’s a beautiful little girl I work with named Dinah*. Small and delicate as a flower, she is hesitant in everything she does. Dinah is the youngest child and is “babied” by her older siblings. When I first began working with the family, Dinah wasn’t saying any words. Mom reported frequent tantrums and crying fits, as Dinah found it difficult to express what she wanted or accept “no” for an answer.
As I spent week after week providing early intervention therapy, I learned that Dinah was capable of more than she demonstrated on a regular basis. She responded beautifully to praise, playfulness, and gentle encouragement.
I was gratified to hear laugher and soft words begin to emerge from this quiet-as-a mouse toddler. Now, like a flower beginning to blossom, Dinah can imitate words and phrases on request, and some spontaneous language is emerging as well. She is using one or two words to communicate a complete thought, which is a significant milestone. For example, Dinah will point to the stairs and say “Mommy-book” to indicate “I want to show Mommy this book”.
Although I acknowledge Dinah’s significant strides in expressive language skills, I am still concerned about her overall language development. The reason for this is that although she is finally talking, Dinah continues to struggle in many areas. I have identified the following tasks as areas of challenge for Dinah:
- Following simple verbal instructions (“Give me the book”)
- Transitioning attention from a visual stimuli (book, picture, object held in hand) to an auditory stimuli (adult calling her name)
- Verbal recall
- Receptive identification (“point to the butterfly”)
These challenge areas indicate a pattern. It seems that Dinah struggles with auditory processing. Many school-aged children with similar problems receive a diagnosis of auditory processing disorder. I explained this to her mother, Sharon. I also assured Sharon that Dinah is too young for any kind of diagnosis. In fact, it is possible that Dinah will overcome these challenges long before she reaches school age. As I confided to Sharon, I hope we can help her overcome these challenges so that one day, they will be but a hiccup in the history of her childhood. Our intervention, together with a developmental growth spurt, may be enough get Dinah across the finish line.
In order to address the auditory weakness, it hers important to help Dinah learn through her other senses whenever possible. Here are some tips and strategies I am offering the family.
- Pair physical stimuli with auditory stimuli whenever possible
- tap her shoulder when calling her name
- pair gestures with words to aid recall (i.e. flap hands for “butterfly”)
- pair verbal instructions with physical cues (“Give me the book”, while guiding hand to the book)
- Minimize other stimuli before presenting auditory stimuli
- Clean up excess toys before engaging in reciprocal play
- use simple picture books- only 1-3 pictures on a page
- picture cards with one picture per card are great
- Chose the right environment for your child: chose a day care that is quiet and predictable, with a consistent routine. Noise and chaos are attention-killers for kids with auditory processing challenges.