An update for the members and supporters of KIDCARECANADA Society..
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Dear <<First Name>>,

We are happy to announce that our 8th Annual Report (2017) has been published and can be viewed here:

"Currently British Columbia has one of the highest rates of childhood vulnerability in Canada. The consequences affect our whole society. With early childhood colleagues we are working to reduce childhood vulnerability by empowering parents and professionals to promote mental and emotional health in children, right from the start of life."

We are also excited to update you on our 2nd season of "Conversations with KIDCARECANADA". We have just wrapped up filming of 6 new episodes in the Victoria SHAW TV studio. The first episode features Registered Speech-Language Pathologist Caitlin Bittman in "The Gift of the Gab".
We believe the information she presented on air will be very helpful to parents and we will make her talking points available through our website.
As a sneak preview you can find the information at the end of this message.
Please feel free to share this message with anyone who might be interested - new parents, educators and anyone supporting children and families.

Yours sincerely,

From Caitlin Bitman:

Gift of the Gab Follow-Up
I was so excited to be included in the Shaw TV video series Conversations with KIDCARECANADA! Estelle and I talked about a lot of information regarding healthy language development of infants and children, and I thought an online summary would be a great opportunity to review our discussion and to add a few more details to the conversation.

Supporting Healthy Language Development—What can all parents do?
The first thing I recommend to all families who wish to support healthy language development in their children is ditch the technology!

I cannot stress enough the importance of putting down the phone or tablet, and turning off the TV. Both the Canadian Pediatric Society and the American Academy of Pediatrics recommend that children under the age of two have absolutely no screen time, and that children between the ages of two and five be exposed to under one hour of screen time per day (if any).

These recommendations are in response to the increasing amount of research that shows the link between screen time and language delays—specifically, more screen time = higher likelihood of an expressive language delay (i.e., a delay in a child’s ability to use words and sentences).
There’s no denying it is possible for technology to be an extremely effective learning tool for older children if it is used in the right way; however as it stands, I see the use of technology by both parents and children as one of the biggest barriers to supporting healthy early language development at this time. As technology becomes more readily available, and as we increasingly rely on our devices for entertainment and education, there is a risk of decreased interaction between parents and infants/children. We know that interaction and conversation is key to supporting healthy language development (more on this below!), and technology quickly and very easily becomes an obstacle for language-building interactions between parents/caregivers and children.

For parents scrolling through their phones, technology is a barrier to tuned-in interactions where we can match our child’s experiences and interests to language; for children playing games on tablets or watching TV, technology monopolizes attention so that they have difficulty attending to anything but the flashy lights and sounds. A parent could be providing an exceptional language model and good conversation, but if a child is glued to the TV or tablet they will likely not pay close attention to the parent’s words or respond in a way that they would if the screen were turned off. In either case, when technology is around, parents and children will most certainly miss opportunities for interactions that support optimal language development.

For more information about the effects of technology on language development, see:

**Note that all of the resources I am providing here are from The Hanen Centre, a Canadian not-for-profit organization dedicated to providing training and information to parents and professionals so that they can help young children develop the best possible language, social, and literacy skills. In addition to designing programs to help support parents and professionals, this organization takes information from the research and “translates” it into easy-to-read, parent-friendly articles that describe practical and easy-to-follow strategies for parents. I highly recommend parents explore the Hanen website in general!

Talk with your infants, talk with your toddlers—language quantity is important!

There was research done in the 90’s and early 2000’s that found there is a substantial vocabulary gap between children who were born to low-income families vs. those in the middle and upper class families. The researchers found that those in the lower income families heard 30 million fewer words over their first three years of life. These children were found to use fewer words overall, had a smaller overall vocabulary, and engaged in shorter conversations than their peers in the upper classes. Once these children entered grade 3, they were found to have lower performance on vocabulary, language development, and reading comprehension measures. The quantity of language a child hears, then, is important and has far-reaching effects on a child’s overall development and academic performance. All this to say, talk with your children of all ages as much as possible!

Remember that infants are learning language long before they start using words. Since children first learn through experience, talking to your infants and toddlers about what is happening in the moment can really help support the development of their understanding of language. Try to really “tune-in” to your child and pay attention to what they are interested in, and then match words to their experience, highlighting key words as you speak. For a prelinguistic infant, this might mean talking about where they are looking (e.g., for the infant looking at a bird, “That’s a bird. The bird is eating. Oh! The bird flew away”). For a child who is not yet speaking but using gestures and sounds, this might mean talking to them about what you guess they are trying to say, or matching words to what they point out or show you (e.g., for the child who reaches to be picked up, “Up! You want up! Up into daddy’s arms”). For a child at any age, talking to them about their feelings or what is going on in their environment as it happens is always a good idea (e.g., “You’re sad! You fell down and hurt your knee!”). Just remember to use grammatically correct phrases and sentences, and don’t be afraid of sounding like a broken record! Infants love repetition, and repeating those important words will really help your child link meaning to words. You can even make up fun songs to familiar tunes about the things you are doing together! I once heard a mother in a grocery store narrating her actions for her child to the tune of ‘Frère Jacques’ and I thought it was the most wonderful idea! It went something like this:

We are walking (2x)
Now we’re stopped (2x)
Need to find the crackers
Look I found the crackers
In the cart (2x)

The child looked so happy to be sung to, and the repetition and matching of actions to words as they occurred was just perfect! I love sharing this idea with parents to encourage them to have fun, and to be silly and creative. That silliness and fun will keep children engaged longer, which will result in more opportunities for learning to occur. It’s also a lovely example to show parents that language learning happens any time, any place, and to encourage parents to take advantage of all 1:1 time, even while running errands.

For more information about how to support your child’s understanding, I love these articles: Conversation is a two-way street—quality interactions are important!

There is an increasing amount of research that shows that the quality of interactions between parent/caregiver and child is important for optimal language development. When children get to engage in back-and-fourth interactions, it is their opportunity to practice using what they’ve learned.  I’d like you to imagine learning to back a car up that has a trailer attached. Do you think that this is a skill that can be mastered simply by watching someone do it and/or having someone explain it to you? Likely not! Even once you have observed and listened to how it is done, you will need the opportunity to practice doing this many times before you can be expected to successfully back up, say, a 40-foot RV on your first try! The exact same idea applies to children and their language-learning process.  It is not simply a matter of hearing lots of words—children need the opportunity to practice using those words with their parents.  Research shows that the number of conversational turns between adults and children positively impacts a child’s overall verbal abilities.
To put it simply, conversation = practice = improved language skills.

Children naturally receive feedback on their language use when speaking with others, and this feedback is very important for the development of their expressive language (use of words and sentences), understanding, and social communication skills. For example, when children say a word incorrectly or use words in an incorrect way, parents can gently provide the correct model, thereby giving the child the information they need in a natural way to say/use the word correctly the next time. If a child says, “I falled down”, a parent might say, “You fell down? Oh no! You fell onto the grass”. Feedback may also involve building on the child’s sentences to make it longer or more grammatically correct. This “match + 1” strategy is for helping to expand the length of your child’s utterances. For example, if a toddler walks over to you and holds up their stuffed animal and says, “bunny”, a parent might say, “Yes, a bunny. It’s a soft bunny. Hi Bunny!”. Remember to repeat, repeat, repeat those key words to make the correct model more noticeable for your child. I like to challenge myself to model the correct form at least 2-3 times in a natural way when I respond to children, and I encourage all parents to do the same!

This kind of real-time practice using language with naturally occurring feedback simply cannot be achieved though passive input. Specifically I am thinking of the misconception that children can learn well through passively watching TV programs or playing games on tablets. We have already talked about the research that shows the link between screen time and language delays. The truth is that without the opportunity to practice using language, language will not develop to its maximum potential. Children do not have the ability to practice using language while they are watching TV, and in my experience, even the ‘educational’ programs on tablets can become passive entertainment when children are playing those games alone. This makes sense—most children are very quiet when they are absorbed in technology.

For more information about how conversations help support language development, you can read the following: Speak in a way that helps your child understand

Help support your child’s understanding of words and concepts by speaking at a pace that is slow but natural, and by using simple but grammatically correct sentences. Make sure to stress key words by making them louder and longer, and use real objects, gestures, or pictures whenever possible—you can literally help your child see what you mean! Then repeat, repeat, repeat—use new words often, and in as many different contexts as possible, and try and have your child experience the words as you talk about them as well. For example, If I am teaching my child the word ‘cut’ while we are playing play-doh, I may first tell them, “I’m going to cut the play-doh [stressing the word ‘cut’ and using a gesture with my hands when I say it]. I might then take the plastic knife and show them ‘cut’ while I say, “cut, cut, cut. Cut the play-doh”. I could then offer them a turn to cut, giving them the opportunity to experience the word, and me to label their actions—“Your turn to cut. [offer the knife and/or help them use it]. Cut, Cut, Cut. Good job! You are cutting the play-doh! (**Did you notice all of my repetition?!). All of these things will go a long way in supporting their comprehension and use of new words.

There are more than just nouns, colours, and numbers—providing vocabulary-rich language models!

Parents love talking about colours, numbers and object names, and I often see parents providing beautiful language models using many of the above strategies but lacking word variety. Talking about object names, colours, and numbers is an easy fall-back, and I, too, need to sometimes remind myself that there are so many more interesting things to talk about. Making sure to provide vocabulary-rich language models is important—just think of how limited your child’s words and early sentences would be if all they used were nouns, colours and numbers! For example, we can also use describing words (e.g., soft/pretty/yucky/fast), actions (e.g., run, jump, splash), feelings (e.g., sad/happy/tired), locations (e.g., on/in/under), social words (e.g., hi/bye/cool!), belonging words (e.g., mine/my/your/his/her), and question words (e.g., who/what/where). Modeling these other types of words will help your child say a larger variety of things once they start to combine words together as well.

Just as it is important to model a variety of word categories, it is also good to model a variety of ideas. I have stressed the importance of linking experience to word meaning by talking about the here-and-now, but parents can additionally talk about things that are beyond the here-and-now in a way that is accessible to young children by linking it to a their experiences. To use an example, if we think about baking a cake with your child, you could talk about the past (e.g., “last time we make a cake for daddy’s birthday!”); the future (e.g., “soon, we get to put candles on the cake and sing ‘happy birthday.’”); feelings (e.g., “You’re sad because there’s no more batter left on the spoon”); and we can explain things (e.g., “We have to put the cake in the oven so it will bake”). Using your child’s experiences to talk about things other than the here-and-now can help them understand and one day use language in the same way.

For more detailed information and more ideas about how to help support your child’s vocabulary, I love these articles: When To seek out a referral to a speech-language pathologist

There can be a variety of reasons why a parent might want to speak to a professional about their child’s communication development. My broad referral recommendations are as follows:
1) If your child is not nearing 18 words by 18 months (“18 by 18”) or not speaking at all by 18 months, a referral is recommended.

It can sometimes be difficult for parents to count their child’s words off the top of their head, so I typically have parents keep a running ‘refrigerator list’ where they can keep track of all the words their child uses over the course of the week. We think of a word as anything the child uses to consistently refer to the same thing. Things that count as words include: names (mama, dada), animal noises (moo, baa, woof), noises that children use to refer to object names (‘choochoo’ for train; ‘moomoo’ for cow), Note that verbalizations that sound the same but that are clearly used to label different things count as separate words (‘da’ used for dad, that, and dog = 3 separate words). Finally, things your child says that don't sound close to words at all but are used by your child consistently to refer to the same thing (e.g., “oo-ee” for milk) count as words as well.

2) If your child has difficulty following simple directions without the use of gestures by 18 months, a referral is recommended (e.g., “give me the ball”, “put the book on the table” without using your hands to signal more information).

3) If you have a significantly difficult time understanding your child’s words, a referral is recommended.
Note that certain speech sound errors are considered typical depending on the age of the child. Generally speaking, parents should be able to understand approximately. 25-50% by 19-24 months, 50-75% by 2-3 years, 75-90% by 4-5 years, and 90-100% by 5 years+.

4) If you feel your child does not frequently make eye contact, or does not generally direct their communication towards you by 18 months, a referral is recommended.
An example of communication not directed to a partner may be a child who, when wanting to leave, stands in front of a door crying instead of asking for help to open the door (e.g., by bringing you to the door, or my looking between you and the door, or by using words), or a child who looks at cookies on the counter and makes a sound and reaches but does not look at or bring their communication partner to the cookies to ask for help getting them.
5) If your child was previously speaking but ‘lost’ all their words, a referral is recommended.
6) If your child has difficulty responding to their name, or if you have ever wondered whether your child may have difficulties hearing, a referral is recommended.
7) If you have any concerns about whether your child may be on the autism spectrum, a referral is recommended.
8) If your child (who is speaking in sentences) appears to be s
Note that some ‘normal nonfluencies’ (i.e., short repetitions of sounds, words, or phrases; e.g., “I-I-I want that one”) may be a part of typical language development, particularly if the stuttering coincides with a language burst. However, if there is a family history of stuttering, if the stuttering moments occur very frequently or last for long periods of time, or if your child appears to be ‘’getting stuck’ or ‘pushing out’ words, it is best to see a speech-language pathologist to rule out a true stutter.

9) If your child (who is speaking in sentences) has difficulty with correct grammatical markers and word order, or if you feel they are having difficulties expressing their ideas, a referral is recommended.

10) If parents have genuine concerns about their child’s ability to communicate in any way, a referral is recommended.

Research shows that parents are around 90% accurate in their referrals for speech and language evaluation. This makes sense! Parents are generally very intuitive and they know their children best. If you are truly concerned about your child’s communication, you should always speak to a speech-language pathologist.
Take-home messages
  • Mindful communication with children of all ages is important. Children are learning the foundations of communication long before they learn their first words, so tuning into your child and speaking to them about their interests and environment right from infancy is important. The best way to start to do this is to ! We cannot truly ‘tune-in’ when we are distracted by our devices!
  • We need to focus on both language quantity AND quality! Talk to your children often, but also focus on quality interactions/conversations and quality language models with rich vocabulary exposure.
  • Responsive and language-rich interactions that are necessary for language development can happen anytime, anywhere!
  • If you have genuine concerns about your child’s language development, seek out a referral to a speech-language pathologist.
  • Be present, not perfect. A friend once told me (while I was being distracted by my phone and social media at a restaurant), “Being present these days is 95% putting down your phone”. These words have really stuck with me! Technology is around us all day, distracting us, and luring our focus away from quality face-to-face conversation interactions.Frequent, quality parent-child interactions are critical to developing good communicators that are ready to learn at school.Step Away From The Screen :) and help children connect with people and learn about the world.
Hart, B. & Risley, T.R. (2003, Spring). The early catastrophe: The 30-million word gap by age 3. American Educator, 4-9. www.aft. org//sites/default/files/periodicals/TheEarlyCatastrophe.pdf
Wasik, B. A., & Hindman, A. H. (2015). Talk alone won’t close the 30-million word gap. Phi Delta Kappan, 96(6), 50-54.
Diamond, A. (2018). Faculty of 1000 evaluation for Beyond the 30-Million-Word Gap: Childrens Conversational Exposure Is Associated With Language-Related Brain Function. F1000 - Post-publication Peer Review of the Biomedical Literature.


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