He s combining words now what??! Helping children develop early sentences

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1 He s combining words now what??! Helping children develop early sentences By Lauren Lowry Hanen SLP and Clinical Staff Writer It s a major milestone when a child moves from single word production to combining words. In It Takes Two to Talk, we refer to this stage as the Combiner Stage. While this milestone is exciting, it also brings with it questions about how we can keep the child moving forward onto sentence production, such as: Should I focus on increasing the length of the child s utterances, so that he can string more words together? Should I target some early grammatical markers such as plural s or present progressive ( he is swimming )? Should I expand his repertoire of verbs? Is there something else I should be working on? If you ve ever felt unsure about what direction to take when presented with a child who is combining words, you re probably not alone. We don t have a lot of information about early sentence milestones in our clinical literature (Hadley, McKenna, & Rispoli, 2018). Instead, we have information about the onset of first words and word combinations, and the expected developmental timeline for early grammatical markers (known as Brown s stages of grammatical development, which were first published in 1973). This is likely why many clinicians target children s mean length of utterance (MLU) and grammatical morphemes once a child is combining words (Kamhi, 2014). But there s more to it than that, according to Pamela Hadley and her colleagues at University of Illinois at Urbana- Champaign, in their recent article Sentence Diversity in Early Language Development: Recommendations for Target Selection and Progress Monitoring (2018). Sentence Development 101 Children s first sentences, which usually emerge between 24 and 26 months, consist of a subject + a verb (SV) (e.g. baby sit ), or a subject + verb + object (SVO) (e.g. baby eat cookie ). Subjects and verbs are the essential building blocks for sentences in all languages of the world (Hadley et al., 2018, p.554). In order to produce both SV and SVO sentences, children s vocabulary needs to include both intransitive and transitive verbs (Hadley, 2014): intransitive verbs like sit or fall do not require an object and are used to form SV sentences. Children might produce SV sentences like Mommy sit or Tower fall. transitive verbs like build or take require a subject and an object and are used to generate SVO sentences. Children might produce SVO sentences like Mommy build tower or He take cookie.

2 By months, most children can produce two or more SV and SVO sentences during a 30 minute sample of parent-child interaction (Hadley et al., 2018). During this time children also produce word combinations, but unless these combinations contain a subject and a verb, they are not considered sentences. Hadley et al. (2018) explain that when evaluating a child s utterances, you have to determine whether the child is producing SV and SVO sentences, or whether his utterances are just word combinations. Hadley et al. (2018) provide the following example to highlight this point. Think about the following three utterances: Mommy, more juice, please car go I did it! At first glance, it s tempting to think that the first utterance is the most complex because it s the longest. However, while it has a subject, it lacks a verb. Therefore it is not an early sentence. The third utterance I did it! contains a subject ( I ) and a verb ( did ), so it s technically a sentence. However, unless the child uses I in combination with other verbs and did with other subjects, this may not be evidence of sentence development. Rather, this may be an utterance the child has memorized as a whole. These rote types of utterances, like I don t know, I want or I see you, are heard frequently within the target language (Hadley et al., 2018). It can be easy to overestimate a child s sentence development if these utterances are counted as true sentences (Hadley et al., 2018). Despite the fact that the second utterance is telegraphic (missing words and grammatical markings), it contains a subject ( car ) and a verb ( go ). This utterance is an example of an early sentence, and was likely constructed by retrieving words from the child s lexicon and assembling them together. Hadley and her colleagues refer to these early sentences that may be missing adult-like grammatical markings as childlike sentences. These are different from word combinations because childlike sentences have a subject and verb, whereas word combinations do not. The following example illustrates the difference between word combinations, childlike sentences, and adult sentences (Hadley, 2014): Word combination go home (contains a verb but no subject) Childlike sentence I go home (contains a subject and verb, but there are grammatical errors) Adult sentence I m going home Hadley et al. (2018) explain that...it is crucial for speech-language pathologists to differentiate word combinations from sentences in order to recognize early difficulty with the acquisition of sentence structure, a core diagnostic feature of language disorders (Hadley et al., 2018, p. 554). Sentence diversity Once you have figured out if a child is producing SV and/or SVO sentences, you need to determine the child s sentence diversity. Sentence diversity is calculated by counting the number of unique SV combinations in a 30-minute parent-child language sample, including different verbs with the same subject, and different subjects with the same verb. (Hadley et al., 2018)

3 Diverse combinations of subjects and verbs are essential for learning the specific grammatical patterns of a language (Hadley et al., 2018). Sentence diversity, therefore, serves as an indicator of a child s progression towards mastering the rules of the language. A sampling of the child s language during 30 minutes of parent-child play allows the child to have many opportunities to talk about a variety of topics and provides the child s optimal performance as he s conversing with the people he knows best (Hadley et al., 2018). How to calculate sentence diversity When calculating sentence diversity, clinicians must identify sentences within the child s language sample. Telegraphic utterances are considered sentences as long as they have a subject and a verb (e.g. baby eat, me go home ) (Hadley et al., 2018). Furthermore, the subject has to be explicit, not inferred. For example, if a child says pour juice, there is an understanding that someone is there with the child, ready to pour the juice for him (the subject). However, because the utterance doesn t explicitly specify the subject before the verb (e.g. Daddy pour juice ), this does not count as a sentence because we can t know for sure that the child understands that this statement implies a subject (Hadley et al., 2018). The authors illustrate the calculation of sentence diversity with the following examples: Child s Utterance Is it a sentence? Is it a unique subject-verb combination? Points I want that Yes Yes, I want 1 I need more Yes Yes, I need (same subject I, but with a different verb) 1 I want drink Yes No ( I want was already used above) 0 Help me please No (no subject) N/A 0 It fall Yes Yes, it fall 1 (Hadley et al., 2018, p. 556) Notice that utterances with the same subject and verb, but different objects are only counted once (such as I want that and I want drink ). There are 3 unique subject/verb combinations in this sample; therefore this child s sentence diversity score is 3. There are additional, detailed instructions for calculating a child s sentence diversity which are beyond the scope of this article. Interested readers are encouraged to consult Hadley et al. (2018) for the sentence diversity metric and scoring instructions (available online in Supplemental Material S1). Sentence diversity at 30 months To establish criteria for determining whether a child s sentence diversity is developing as expected, Hadley and her colleagues collected data about 40 typically developing children at age 30 months and noted the following: All 40 children produced more than 10 childlike sentences with at least two SV combinations Children who produced more words and longer utterances had more diverse sentences First-person (e.g. I ) and third-person singular (e.g. it ) subjects were common, followed by secondperson subjects (e.g. you ). Plural subjects (e.g. dogs ) were less common. Nouns were rarely used as subjects, with the exception of baby and Teddy (there were two dolls and a teddy bear in the playroom during data collection) The authors conclude: By 30 months, a child should be able to produce at least two SV combinations from both first- and third-person singular subject categories in 30 minutes of parent-child interaction (Hadley et al., 2018)

4 It s a red flag if a child s length of utterance increases but sentence diversity does not (e.g. the child produces longer sentences but most of them start with I want or I see, etc.). This may indicate that the child is having difficulty acquiring expressive syntax (Hadley et al., 2018). Setting goals according to sentence diversity When children are combining words and using over 100 words (including at least 20 verbs), Hadley and her colleagues suggest working on sentence diversity in the following order: First- and third- person subjects The first goals are for the child to combine verbs with different subjects, and to expand the child s use of first- (e.g. I ) and third-person (e.g. it ) subjects. Noun subjects (e.g. The bubble, That ball, My pizza ) can also be modeled at this stage. Increase nouns as subjects When children are combining words more regularly, using between words (including a variety of verbs), and using first- and third-person subjects, the goal is for the child to produce more diverse nouns as subjects. Adults can expand and recast children s utterances to include noun subjects (e.g. sleeping -> the baby is sleeping ; he running -> the horse is running ), and use children s nouns as the subjects of the next sentence (e.g. drink juice -> my juice tastes delicious ). Expand categories of subjects, including plural nouns and pronouns By this stage, children have a longer MLU (>2.50), are using some third-person sentences, and some plural nouns or pronouns as objects (e.g. I see the birds or I like them ). For these children, it s time to expand their subjects further by working on plural nouns and pronouns as subjects (e.g. The birds or They ). Sentence diversity and the Hanen approach Hadley et al. (2018) propose targeting sentence diversity by expanding and recasting children s utterances during child-centred play, and by talking about the actions, states, and properties of the toys with which children are engaged. This fits very well with the Hanen approach, in which parents are encouraged to use responsive interactions to build their child s vocabulary and model grammatically correct sentences while following their child s lead. In the Hanen approach, parents of children at the Combiner stage can start to think about sentence diversity as a goal. Children at this stage have more than 50 words and they communicate primarily by combining 2 or more words. Initially, goals for children that promote sentence diversity could include: Expand vocabulary According to Hadley (2014), To produce diverse sentences, children must have a diverse vocabulary to draw on. Descriptive words (i.e., adjectives) and action words (i.e., verbs) should be increasing steadily for children with vocabulary sizes between 50 and 400 words (p. 112). Having parents complete the MacArthur CDI (Fenson, Marchman, Thal, Dale, Reznick, & Bates, 2007) can provide good information about gaps in children s emerging vocabulary. Increase lexical verbs Without a good number of verbs in their vocabulary, children don t have the building blocks to begin forming sentences. As Hadley explains, verb acquisition entails the learning of sentence frames, and therefore, a child s verb lexicon forms a core interface between semantic and grammatical acquisition (Hadley, 2006, p. 175). Specifically, children need to acquire both transitive and intransitive verbs in order to produce both SV and SVO sentences (Hadley, 2014). Therefore, consider both verb types when selecting target vocabulary, but always ensure that they relate to the child s interests. Eventually, once children are producing over 100 words, including 20 verbs, a goal could include: Expand types of subjects these children are ready to produce some first- and third-person subjects, including I, me, it, he, etc., and some noun subjects like My ball or The baby... When parents follow their child s lead and talk about their child s interests, they can expand their child s utterances to include these types of subjects. Books and pretend play provide many opportunities to model diverse

5 noun subjects as parents describe the characters and toys (e.g. The boy looks very sad, My baby wants some milk, or That car is so dirty ). Thinking about goals for parents that promote sentence diversity is also important: Increase variety in parents language models Children need to hear a variety of SV and SVO combinations in order to learn about sentence diversity. Hadley et al. (2018) explain: In several longitudinal studies both subject and verb diversity in parent input and sentence diversity in children s spontaneous speech promote the acquisition of later developing grammatical structures (p. 538). The information about Adding Language in the It Takes Two to Talk guidebook (Weitzman, 2017, Ch. 6) is important for these parents as it encourages them to use a variety of words, highlight their language, and expand their child s messages, strategies which promote diversified language models. Create opportunities for sending messages Hadley et al. (2018) explain that children s attempts to translate diverse messages into sentences stimulate grammatical development (p. 538). This means that parents should be encouraged to provide their child with many reasons and opportunities to send messages. Sharing books together is a great way to encourage children to send messages for a variety of reasons as they attempt to describe, compare, explain, and make predictions. Thinking about sentence diversity with children who are combining words may not be on our radar, but it can easily be worked into the goals and strategies we are already using with children at this stage of development. Those of you who work with children at this stage of development will find the work of Hadley and her colleagues very practical and useful. They continue to research ways to move children across the bridge from single word production to early sentence formation. Some of their articles are listed in the references below. Parent-friendly articles about early sentence development are available on our website.

6 References Brown, R. (1973). A first language. Cambridge, MA: Harvard University Press. Earle, C., & Lowry, L. (2015). Target Word Parent Handbook (4th ed.). Toronto, Ontario, Canada: The Hanen Centre. Fenson, L., Marchman, V., Thal, D., Dale, P., Reznick, J. & Bates, E. (2007). MacArthur-Bates Communicative Development Inventories (2nd edition). Baltimore: Paul H. Brookes Publishing Co. Hadley, P. A. (2006). Assessing the emergence of grammar in toddlers at risk for specific language impairment. Seminars in Speech and Language, 27(3), Hadley, P. A. (2014). Approaching early grammatical intervention from a sentence-focused framework. Language, Speech, and Hearing Services in Schools, 45, Hadley, P. A., McKenna, M. M. & Rispoli, M. (2018). Sentence Diversity in Early Language Development: Recommendations for Target Selection and Progress Monitoring. American Journal of Speech-Language Pathology, 27, Hadley, P. A., Rispoli, M., & Hsu, N. (2016). Toddlers verb lexicon diversity and grammatical outcomes. Language, Speech, and Hearing Services in Schools, 47, Kamhi, Alan. (2014). Improving Clinical Practices for Children with Language and Learning Disorders. Language, Speech, and Hearing Services in Schools, 45, Weitzman, E. (2017). It Takes Two to Talk (5th ed.). Toronto, Ontario, Canada: The Hanen Centre. About The Hanen Centre Founded in 1975, The Hanen Centre is a Canadian not-for-profit charitable organization with a global reach. Its mission is to provide parents, caregivers, early childhood educators and speech-language pathologists with the knowledge and training they need to help young children develop the best possible language, social and literacy skills. This includes children who have or are at risk for language delays, those with developmental challenges such as autism, and those who are developing typically. For more information, please visit The Hanen Centre is a Registered Charitable Organization (# RR0001)