Early Intervention for Toddlers: How to Include Siblings
Early Intervention for Toddlers: How to Include Siblings
Speech therapy with toddlers should be fun and engaging. Since it’s so enjoyable, sometimes this happens:
“Mommy, mommy, I wanna play. What about me? It’s my turn now!"
If you provide services to families with more than one child, I’m sure these comments sound pretty familiar. I’ve treated and currently work with several families who have multiple young children. When ALL children are present, things get pretty interesting.
Ronan and Kerrigan
Since we ideally want to focus in on the child with the language delay, parents usually try their best to eliminate distractions and interruptions from other siblings. While some older siblings may prefer to sit back, relax and enjoy the show, more often than not, the sibling of the child receiving the services feels left out. If the sibling insists on joining in, it may be wise to strategically include him or her into part of the session.
Why include the other child?
Besides trying to make everything copasetic, I believe it’s important to include the sibling for the following 2 reasons:
When a child has a language delay, it’s quite common for the other sibling(s) to speak for the child with the delay. I’ve witnessed this dozens of times. When this occurs, it impedes the language development of the child with the delay because he or she is missing out on excellent opportunities to communicate.
Secondly, in most cases the child you’re “treating” is used to playing with his sibling(s) at home. When families make time to play, they usually ALL play together. If one child dominates the play, we can show parents how to effectively include a sibling into the session or play routine so that each child is equally participating.
Including the sibling of a child who has autism is extremely important. The sibling who does not has autism (the neurotypical one) can be trained to facilitate play skills and social communication in his or her brother or sister.
Two Tips for Speech Language Pathologists
Develop a good rapport. First and foremost, establish a good rapport with the child you are treating. I strongly believe that for therapy to be effective, the toddler has to enjoy your company and be having a pleasant experience (Yes, I know, I mentioned this before). Before, including his or her sibling, take time to create a mutually respectable relationship with one another.
Set limits, have “talking” rules, or assign roles. Once you have a good rapport established and you understand what techniques work for the child, include the sibling. Make sure he or she knows what is expected of him or her. Tell the sibling, what will happen and how he or she can participate so that everyone has a turn. Modify how you set limits based on the child. Johnny (the child with the language delay) will push the car down the ramp and try to say “wee” and Cindy will select the next car for Johnny to push. All children regardless of age or ability level like to have boundaries because it helps them regulate their thoughts and emotions. Establish the rules or roles early on and coach parents to carry through with them at home. For instance, if the sibling is very chatty and tries to speak for Johnny we have to clearly explain to his sister, Cindy, to be quiet when it’s Johnny’s turn because that helps him think and gives him a chance to talk.
Three Tips for Parents
Have a heart-to-heart. Before the speech therapy session or play routine begins, talk to the sibling who is not receiving the therapy and explain why it’s really important to give Johnny a chance to think and talk. If the sibling is a little older and attends school, explain how this is similar to school (“You go to school to learn colors, shapes, and numbers. Jeffrey is learning how to talk. This is his school time. It’s important that we let him learn.”).
Play a listening or watching game. Assign a listening or watching role to the sibling. When the sibling hears or sees something that you have assigned, have them do something. For instance, you could tell Cindy, “Each time Johnny says the word help , draw a happy face with your brand new markers” or “Whenever you see Max sign for more, drop a penny into your piggy bank”. These suggestions are just ideas. Choose something that will be rewarding and or value to the sibling, but not distracting to the child receiving the treatment.
Encourage both children to engage and mutually respect one another. Associate Professor in Portland State University’s Department of Speech and Hearing Sciences, Amy Donaldson, developed a sibling mediation approach called Socialsibs. This approach seeks to be non-hierarchical and is mutually motivating for both siblings.
If you are a parent or therapist and have additional tips to share, please comment below.
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