All About Words: Developing first words in Children with Language Delay

You have just assessed 2 year old “Tommy” at your clinic. He presents with severe expressive and receptive delays and has little to no single words.

Does this scenario sound familiar?  If you’re a practicing paediatric speech therapist/pathologist you most likely have met this child at some point during your profession.  If not, be prepared; he/she is coming.  The question is where do you go from that point? What type of intervention approach do you use? What words do you teach him to use first? Many of us immediately start banging our knuckles together saying “moooore.”  However do we have a basis for choosing this word as part of our “first faithfuls”?  Some therapists have argued that “more” actually isn’t a very functional word to learn, whereas others believe it is the most functional for children’s everyday interactions. Our next #slpchat, therefore, will discuss some of the considerations in choosing the first words to teach to children with expressive language delay.

Owens(2004), notes that an important consideration in choosing words for a first lexicon  is that words are functional and fulfill a broad range of communicative purposes. We want to teach children words that they can use often to accomplish their social goals. Lederer (2002) expands this to include not only functionality, but also developmental norms, motivation, lexical variety and phonological information.

Many researchers have compiled their lists of vocab targets for children with language delay. Some contain familiar items within a child’s environment such as names of family members, body parts, preferred foods or toys, while others expand to substantive and relational words as is shown in the table below by Bloom & Lahey (1977).

A good list of early words can also be found in Banajee, Dicarlo, & Stricklin, (2003). Core vocabulary determination for toddlers. Augmentative and Alternative Communication, 19, 67-73. Accessed:

We’d like to hear from you! What are you using in therapy? Are you following any particular research/ hierarchy?

Join us for the #slpchat on April 10th, 2011 at 2pm ET, where we will be discussing these vocab choices, as well as your own considerations for early vocabulary, whether it be through verbalization, sign language or any form of AAC. We also wish to look at the types of intervention techniques you use to target this vocabulary.

It would be useful to read the following articles in preparation for our discussion:

Lederer, S.H. (2002). Selecting and facilitating the first vocabulary for children with developmental language delays: A focused stimulation approach. Young Exceptional Children, 6(1), 10-17.

First Words: From Theory to Intervention
Susan Hendler Lederer, Ph.D., Adelphi University, Garden City, NY

First Words, First Books, & Focused Language Stimulation
Susan Hendler Lederer, Ph.D.

We look forward to hearing from you!

Other References:

Lahey, M., & Bloom, L. (1977). Planning a first lexicon: Which words to teach first. Journal of Speech and Hearing Disorders, 42, 340-350.

Owens, R. (2004).  Language Disorders, (4th ed.).  Boston, MA: Allyn & Bacon.

Paul, R. (2006). Language disorders from infancy to adolescence (pp. 301-305). St. Louis, MO: Mosby.


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