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Behaviors in a Child With a Communication Disorder

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Mom's Question: "My little one is 23 months old and has a very limited vocabulary, so he screams at the top of his lungs constantly. We tried to take away the pacifier with no success. Any advice on how I could help him with this behavior?"

First of all, I can totally empathize with you from a mother’s perspective. My son, Nicholas, is almost 8 months old and when he doesn’t get what he wants, boy does he scream.

Not just any scream – it’s a loud, shrieking, indescribable scream. The kid that makes you want to wear ear plugs all day. I’m going to break up this blog into different sections so I can, hopefully, answer all your questions!

Screaming Because of Limited Vocabulary

Any time a child cannot communicate their wants and needs, they WILL act out in a variety of ways. This can be behavioral, such as screaming, kicking, or hitting OR it could be emotional, such as crying to socially isolating. If it seems like your child is attempting to communicate, but can’t, here are some things you can do to help:

  • Create picture cards to make communication easier. This can be a simple board with everyday objects and activities. Make sure you have the staples, like food and drink. The usage of this board will heavily depend on your child’s age and their ability to understand the board. It may take a few weeks for them to get the hang of it, but don’t give up. Start with only a couple words and gradually increase when your child gets the hang of it. 
  • Give your child options. If they want something to drink, model the words “milk” and “water” (or whatever choices you want to give). This demonstrates proper vocabulary usage, but also eliminates too many options. 
  • Encourage pointing, gesturing and having your child take you to what they want. Once you understand what they need/want, make sure you tell them the words. For example, if they are pulling you to the bathroom, ask your child, “go to the bathroom?” Expose them to the language you want them to use. 
  • Keep your sentences, directions and explanations short. Children can only handle so many words in one sentence and giving them more overloads the auditory processing center of the brain. This can lead to frustration and misunderstanding. 
  • Say the key words 3 times and then move on. For example, ask your child to say “more.” If they don’t repeat it after you, model it two more times and then switch to the next topic. Studies have shown repeating stimulus items three times is more successful than hearing it once or more than three times. 

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Bottles Versus Sippy Cups and Pacifier Usage

This information is not to alarm or make anyone upset, but instead should be used for knowledge and information purposes.

Bottles should be taken away at 12 months of age. The longer a child has a bottle, the harder it is to give up AND it can lead to articulation and speech delays. In addition, the use of pacifiers past three years of age, can also lead to speech development issues. 

As a mom, I can tell you what I have done with my 3 year old daughter and what is currently happening with my son (8 months). 

Nora and Nicholas were breastfed until 6 months, but did receive bottles of formula to supplement. I started giving Nora a 360 cup and sippy cup/straw cup when she was about 9 months old and let her play with it any time she wanted. Every once in a while, she would use it appropriately and get water out of it. When she turned 12 months, switching to the straw cup was no big deal. At bedtime, we’d still put milk in it so it wasn’t that big of a change. I just started giving Nicholas the same cups and he is totally interested, as well!

They both used/are using pacifiers when napping or sleeping. With both kids, they only get the pacifier when sleeping; no other time is that in their mouths. I suggest you try and do the same. Eliminate the pacifier during the day, first. Then take away during 1 nap, then 2 naps, and then at bed time. 

At 23 months, we took Nora’s pacifier away. It was right before Christmas, so we told her that Santa had to take the pacifiers back to the North Pole to give to other children who didn’t have any. She cried/whined for three nights and then never looked back. Nicholas still has his pacifier because he is only 8 months old. I plan on taking his pacifiers away before 2 years of age OR sooner, if he’s ready. I won’t be able to use the Santa excuse, but I’m hoping the Easter Bunny will do the trick!

Take Away Points about Behavior of Child with Limited Vocabulary

Children will fight you on changes, initially. The important thing to remember is that YOU are the parent. YOU are the adult. You are stronger and wiser than a toddler.

It’s very hard to hear them scream, but you need to stay strong and not give in. By giving in, you are only rewarding the behavior that you are trying to eliminate. 

If they do something positive (e.g., drink from the straw), reward them with praise and high fives. Kids love to know they are being good and will keep doing the behavior that you acknowledge positively. 

We are working hard to answer all of your questions, so keep asking away!

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