2. Saturday 12th May 2007 Presented to TAMBA Study Day 1 Language Development in Multiples Michelle Field Speech and Language Therapist Janet O’Keefe Independent Speech and Language Therapist

3. Saturday 12th May 2007 Presented to TAMBA Study Day 2 Introduction Why are multiples more at risk of language delay ? How can you encourage early language development ? Developmental progress – hearing and speech Referral criteria References

4. Saturday 12th May 2007 Presented to TAMBA Study Day 3 Overview In non-selective studies, irrespective of the measures used and aspects of language studied, a significant language delay is found in multiples (on average) Why?

5. Saturday 12th May 2007 Presented to TAMBA Study Day 4 Risk Factors for Language Delay (in all children) Male Premature Birth Trauma Low Birth Weight Quiet or irritable baby Delayed motor milestones Feeding problems Family History

6. Saturday 12th May 2007 Presented to TAMBA Study Day 5 More Risk Factors! Siblings close in age Large family Hearing problems Bilingual home Poor stimulation Frequent hospitalisation Poor concentration Poor coordination

7. Saturday 12th May 2007 Presented to TAMBA Study Day 6 Multiple Specific Factors Late diagnosis Identical Also consider: Who is babies’ main model for language? Shared attention

8. Saturday 12th May 2007 Presented to TAMBA Study Day 7 Background History Do remember that these are risk factors. ‘Children with one or more of these characteristics are more likely to have difficulties, most will not.’ La Trobe Twin Study, 1987

9. Saturday 12th May 2007 Presented to TAMBA Study Day 8 What can you do to encourage early language development Encourage babies to attend to their environment Turn everything off for 30 minutes a day Look at books with each child individually Give individual time and attention Address comments to the children individually

10. Saturday 12th May 2007 Presented to TAMBA Study Day 9 More ideas … Encourage outside social contacts and individual friends Each parent to spend time with each multiple Help others to tell the multiples apart Find strategies to help you to have time as parents without the children to re-charge your batteries!

11. Saturday 12th May 2007 Presented to TAMBA Study Day 10 0-12 months Cooing Babbling Laughing Waving Showing affection to parents Understands ‘no’ and ‘bye’ Recognises object names and simple requests Begins to use specific sounds May acquire first true words

12. Saturday 12th May 2007 Presented to TAMBA Study Day 11 12 – 24 months Jargon Recognisable words Copies new words Pointing Wants to communicate Gives familiar objects on request Understands verbs and attributes Echolalia

13. Saturday 12th May 2007 Presented to TAMBA Study Day 12 2-3 years Uses 50-200 recognisable words and understands many more Can concentrate for 5 minutes Combines 2-3 words in simple sentences Refers to self by name Enjoys stories, nursery rhymes and songs Knows body parts Names objects and pictures Enjoys miniature doll play Talks during play Asks questions

14. Saturday 12th May 2007 Presented to TAMBA Study Day 13 3-4 years Most speech sounds correct Fluency increases Tenses may be confused Understands concepts of colour and size Can pretend an object is something else 80% intelligible Large vocabulary Can count to 10

15. Saturday 12th May 2007 Presented to TAMBA Study Day 14 4 – 5 years Fluent, grammatically correct and intelligible 4-6 word sentences Asks ‘Why ?’ and other questions Constructs own stories Understands abstract words Plays pretend games with other children Understands numbers Can concentrate for 10 minutes Enjoys jokes

16. Saturday 12th May 2007 Presented to TAMBA Study Day 15 Referral Criteria Hearing Interest in people Single words by 2 years Sentences by 2.5 years Intelligible by 4 years Correct grammar by 5 years

17. Saturday 12th May 2007 Presented to TAMBA Study Day 16 Summary 2-3 years – hearing, understanding and play 3-4 years – listening, attention and cooperation 4-5 years – speech, language and fluency 5-10 years ‘AFASIC language checklists’ available from Winslow Press

18. Saturday 12th May 2007 Presented to TAMBA Study Day 17 Reading Early Communication Skills by Charlotte Lynch and Julia Cooper Working With Children’s Language by Jackie Cooke and Diana Williams Talking Together by Rachel Hall Baby Talk by Dr Sally Ward Help Me Speak – A Parent’s Guide to Speech and Language Therapy by Jenny Barrett