I need some ideas on how to get DS to start speaking using 2 words please

[TinySocks]

DS is 3.2yrs and has developmental delay due to brain injury.
He has been saying single words for about 8 months now. He has a very nice long list of words and understands plenty, but he refuses to put two words together.
For example:
DS says: Come
I say: Where
DS says: Up, kitchen, garden, etc

DS says: Want
I wait and wait, eventually I say: Want what?
DS says: Food, water, etc.

DS says: Watch
I wait and wait, and then I say, watch what?
Ds says: DVD

However, we often sing a HELLO song, and he can say "Hello Daddy" when we sing this song. I have tried using the same melody for other two word commands, but it is not working.

I am constantly saying two word phrases to him, everytime he picks something, or looks at something I speak to him using simple language: yellow car, big ball, soft bed, hard floor, want food, nice food, cold water, etc

What am I supposed to do to get him to speak in two words? Any ideas? I am supposed to wait until it just happens or can I help him a bit?
Thank you for any ideas!

Hmm.

Can't remember what we did with DS when we were trying to extend his language.

Think we just did what you are doing and it came along eventually.

How about concentrating on his requests rather than naming things with two words (like the 'yellow car', 'big ball' stuff).

So when he wants a drink of water:

DS: want

You: want what ?

DS: water

You: 'want water'

DS: (prob silence or repeats 'water')

You: 'want water'...(until he says it ?)

Obviously this is only worth trying if you think he can do the 2 words. Otherwise prob quite cruel.

DS was in a similar position at a similar age. I was advised to start introducing more verbs. I reckon that some of those adjectives you cite are probably more advanced concepts than verbs. So the way I built it up was with things like ball games/s being on the slide -

so we would have "ball"! "throw"! and then "throw ball".

or with the slide "steps", "climb steps", or "slide" "DS slide".

The Hanen course book "It takes two to talk" has lots of useful advice, including lists of of the order in which to "teach" language. I found it very useful.

I also found some use of PECs very useful to help build up sentence length - so that DS could point to I + want + juice (and say it as well).

With what you are doing so far - I would tend to offer choices, rather than just say "what" at this stage.

So convo could go -

DS says "want"

You say "want what"? "want food or water".

DS says "water"

You say "yes, DS want water, mummy get water, here's water, water in cup"

as TM says, there's a fine line between providing an incentive for them to communicate in longer phrases, and expecting them to do something they can't. if DS after a reasonable amount of time just wasn't able to say what I wanted, I would still let him have it.

A few more useful basic things to work on at the same time: stop, go, more and again.

do you have CAT, if so could you CAT me, as I can e-mail you some useful info.

Does he have any strong interests/obsessions ?

We often use DS's current obsession to 'encourage' him. Although this is usually to do with behaviour/compliance.

Have you tried using PECS?

So for when he says: Want
You can show him a PECS strip of common Want's and he can hand you the picture representing the thing he want's.
You can then say the appropriate phrase, such as: "I want an Apple" (or "I Want Apple")

Music: Try using a different melody to mean different things. "Time to go home, time to go home, everybody it's time to go home" can be a tune to sign when you need him to know that it's time to leave somewhere. Note: you must then go HOME, not to any other place. You can replace 'everybody' with his name, if it fits the tune.

Saying labels is a good idea... such as Yellow Car. That is different to Car. Car on it's own can be used to describe every thing that goes on the road. Adding a colour is a good step... so I'd keep doing that and see if he will copy that.

How is his comprehension ? Could you reply to his "want" as "What do you want, do you want water or juice?" so he gets to hear a proper sentence and might in time then attempt more himself.

TotalChaos, you are absolutely right, although I only mention adjectives in my examples, I do use verbs as well. DS understands a few verbs (last count was about 48). So from tomorrow I think I will concentrate more on two word phrases with verbs. Thank you so much for offering your notes, will CAT you.

The PECS idea is excellent. If he can actually visualise the phrase it might be easier for him to understand what he is meant to say. I haven't used PECS, I was using some signing but never tried PECS as I never really felt I needed it. Can I download the pictures from somewhere?

LIZS, his comprehension is very good. I have used longer phrases and given him choices, but his reply is always only one word.

www.do2learn.com for pecs

trainland.tripod.com/pecs.htm
This has lots of links to various resources.
PECS Page 54 contains a symbol for WANT

I'm not trained in using PECS... but I don't think you are meant to use words - at least not at first. But as your son is able to say some words, I think you could use the system to expand on those words and create sentences.
Nothing to stop you coming up with your own system in my view... do what works for him. If he goes to nursery / special school, then staff there may want to introduce PECS the way they do it at school.

You can use Velcro strips, to make sentence strips - laminate the pictures, sick Velcro hook part on back. Put Velcro loop part on cardboard, plastic ring binder etc.

Tinysocks - we are having the same problem though it sounds as if your DS's expressive vocab is better than DS2's. We tried for ages prompting 'want...' but he would just say 'biscuit'. So it would go like this
DS2: Biscuit!
Me: W...
DS2: Want (long long pause)
Me: B...
DS2: Biscuit!
Me: Want biscuit
DS2: Please

We also tried with 'please' (ie: drink/biscuit please) but he started using please for everything including yes. So we've stopped trying for the moment - and lo and behold he's started using 'X please' just in the last couple of days. Think I might try 'want' again now - as well as TCs verbs idea.

You do use words with PECS.

It often does increase sentence length (even in non verbal ds1- he'll intonate a sentence with PECS).

Do you have a SALT or teacher who can give you a quick crash course in PECS.

Thanks everyone for your replies.
He used to get SALT (up until 2 weeks ago) for 20 minutes every couple of weeks. Unfortunately it has now stopped until september (don't get me started!!!).
She had some nice ideas but to be honest I do much more at home.

sphil, I am not even trying to teach "please" and "thank you", good on your DS to be saying please already!

Will let you know progress!

We're not doing it from a politeness point of view TS (although it does help to charm old ladies ). Our programme supervisor suggested it as a way of getting DS2 used to saying 2 words together, when we had no luck with 'I want'.

We had the same pattern with SALT - after a while they just left us to get on with it, with reviews every 6 months .

NannyNick, thanks for that link, the range of pictures available is really impressive. I hadn't realised PECS was so complete.
I will have to print and laminate for the next few days I think!!

Just want to say I have a 2yr old son who I think has problems with apraxia & am hopeful that some of the advice here will help me, too. Thanks ever so much!

TClanger - thanks for linking to your blog. I really related to some of it, especially about the gulf between what you see at nursery and at home. At nursery the SALT saw no pretend play, just S lining up dinosaurs - the same night at home S was playing doctors with a doll and toy stethoscope.

Kel - google Nancy Kaufman and speechteach for info and practical exercises. also there is a good book by a lady called Debbie Feit called the Parent's guide to speech and language problems by a mum of 2 kids with apraxia.

I need help!!

TotalChaos, when you used PECS to help S move to 2 word sentences did you strictly use the PECS methodology? Or did you just show him the pictures so that he can get a visual cue of what he is meant to be doing.

I have searched for videos to see how PECS should work. DS is not on the spectrum, and from what I have seen on the videos PECS is used to help children who are not keen communicators. DS is very keen to communicate. I am not sure now if PECS is the way to go.

I know DS should be capable of saying two words now. Yesterday he said "wake up".
He can say more, again, stop, go. I have been working with him on WHERE, WHO, and that has gone well. I have now started on WHICH questions. His comprehension has improved so much. But expresively he really struggles.

He seems to struggle expressively, if I ask him to say PEEPO, he will say POPO. But he can say MANGO.

I feel like I have no support, I don't know how to move on and help DS. Do you think that a visit to a centre or a private SALT could help me move forward?

PS: I ordered the it takes two to talk book and it is really good! Thanks.

Definitely get advice from private SALT- make sure it's one who has experience of kids with your DS's sort of problem. Private SALT has been well well worth the cost. SALT can also look into if there are any phonological problems (i.e. if he has difficulties pronouncing certain sounds) as of course that can help expressive speech.

I didn't use pecs at the 2 word stage - (at that point I was still recoiling a bit from using anything that wasn't speech, as it felt like a backward step to me). When I used pecs at the 3 word stage, I would get him if he wanted juice to point at the picture for "I", the picture for "want" and the picture for "juice", with me saying the words at the same time, and encouraging him to say them.

I wouldn't say that PECs is only for not keen communicators - I would say that PECs is good for kids who have difficulty retrieving words but are good visually.

I will dig out your e-mail addy again and will e-mail you the explanatory notes my private SALT sent me for using PECs with DS, and see if that helps give you some idea.

Thanks TC. What you describe makes sense to me, but DS is just getting frustrated. I only found the "I want" picture (both words in one picture), I didn't find two seperate pictures. Will have to search a bit more.

We are planning a trip to Enland, so I will try to organise a consultation with a private SALT. Tclanger also mentioned the ICAN org, I wonder if it would be best to visit them or someone else.

If anyone can recommend a good private SALT preferably in Bristol or in London, I will be really really greatful.

no personal experience of ICAN but TClanger seemed to rate them. Or you might want to consider BIBIC (other MNetters have found them useful, for sensory stuff and developmental stuff in addition to speech). think their web site is www.bibic.com. I found my excellent private salt via helpwithtalking website (that's the website of members of the association of speech and language practitioners). Advantage of going private is you can interrogate prospective SALTs as to their experience in kids with your DS's type of problem, rather than just getting what you are given. At some point today I will scan in a page of DS's communication book and e-mail it over to you, so you can see the individual piccies. If you look at other threads on here, not all kids seem to like PECs, for whatever reason. SO this is the sort of issue where an experienced SALT in things like PECs would be very helpful, so could advise whether you just need to tweak things, or whether PECs is not suiting your boy.

Great, I will look into the website to find a SALT.
I did visit BIBIC a couple of times, they are very nice people, but I don't really think they have help DS further.