1. Early Intervention Approaches for Young Children with MR
…An ounce of prevention is better than a pound of cure…
Main Speech and Language Concerns of Young Children with MR
Language/
Learning
Domain
General
Language
Skills
Pre Requisite
Skills
Strategies
PLAY PLAY PLAY!!!!! With
manipulatives and with other
children and adults too
(For stimulation, sensory
integration, to induce, facilitate,
and maintain language-related
behaviors)
Free Play
Structured Play
Dyad Play
Group Play
Action Songs and Rhymes
Indirect Language Stimulation
(ILS)
o Child-centered approaches
o No specific objective but
generally aims to facilitate
language learning
o No specific form as target
but aims for a general level
Guidelines
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Incidental teaching (teach anywhere,
anytime. Make every moment a teaching
moment)
Self talk (talk about your own actions as
you play beside the child: “ilalagay ko ito
sa taas…dadagdagan ko pa ng isa…ayan
mataas na ang tower ko, isa pang kahon…”
parallel talk/ information talk (talk about
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2. o
o
of communication
efficiency
Follows the child’s lead
Makes use of what is
available at the moment of
intervention
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what the child is doing as she plays
beside you: “tinutulak mo yung aso. Ay
kinuha mo yung pusa. Binibigyan mo sila ng
pagkain…” : talk about what the child is
doing/seeing/feeling…)
imitation (imitate what the child is
saying/vocalizing)
expansions (affirm what the child said
and then add up to what the child said:
“Dog. Yes, it’s a big dog.”)
extensions (add up to the thought of
what the child said, not necessarily using
the same words)
Recast (use the child’s own words in
another sentence form)
Peer-mediated learning (let the child
learn with other kids who may serve as
models for him to imitate)
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3. Pre-requisites
in Language
Content
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Searching for
objects
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Peek-a-boo
Hide and seek
Tunnel games
Where’s the ____ games
Toys which allow for dropping
something at one end and
expecting the same thing to
come out on the other end
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Hiding
objects
(as above)
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Performing
action on
objects
Use of manipulative table-top toys
which allow for as many movements
and manipulation as possible
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Exhibiting
object to
object
relations
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Use manipulatives that allow for
connecting, dismantling, cueing…
Knots and bolts
Screw tops
Pounding toys
Stacking
Chaining /Clip-ons
Puzzles and Beads
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Ask “where”
Point “There”
Play with your voice
Speak slow and clear
Use short, adult-form sentences with simple
words
Use familiar/favorite toys of the child
Repeat procedures in as many situations as
possible
Be creative
Reward positive behaviors – even the smallest
efforts
Let the child be the one to hide the object/
self
Gesture and say “No more”, “Its’ gone”, “wala
na”…
(as above)
Do ILS as the child plays and as you play with
the child
Highlight the action done and the result of
the action
Use songs and rhymes to enhance the activity
Consider age-appropriate toys
Scaffold
Couple with ILS and songs
Use hand-over-hand as needed
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4. Pre-requisite
In Language
Form
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Imitating
gross motor
behavior
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Action songs and rhymes
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Imitating
fine motor
behavior
Imitating
vocalizations
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Action songs and rhymes
Action songs and rhymes
story telling
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Approximati
ng adult
linguistic
form
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Action songs and rhymes
Story telling
Phone play
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Consider songs with big movements
Modify movements for younger kids
Use hand over hand
Sing with other kids
Do live singing or sing along with CDs and
Tapes
Reward/praise every effort
Use pop hits if it is more familiar with
the child
Improvise actions but be consistent
(as above but focus on fine movements)
Let the children fill in the missing lyrics
of a familiar songs
Reward/praise every effort
As above; give time and space for the
child to answer)
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5. Pre-requisite
skills in
Language
Use
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Gazing
interpersonal
ly
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(Incorporate goal with other
play activities)
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Focusing
using joint
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Point to the ____ games
Where is the ____ games
(Incorporate goal with other
play activities)
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attention
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(Incorporate goal with other
play activities)
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Taking turns
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(Incorporate goal with other
play activities)
Peek-a-boo
Ball games
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Sit at eye-level of the child
Call the child’s name whenever there is
something you want to say to him directly
Place favorite objects beside your face
to draw the child’s gaze to you
SMILE and do ILS
Say, “Look at that” and point towards the
direction
Lead the child to look at the same object
gently (try inclining the child’s body
towards the direction first. If the child
does not look gently lead his head to look
towards the direction)
Let the child follow the movement of the
object from one place to another before
pointing it out to him: “there it is!”
Call the child’s name and wait for a
response before presenting him with the
favored toy
Use colorful manipulatives which engage
the child
Use Audio-visual-kinesthetic-tactile
materials
Prompt the child: “____ turn first, Now
____/your turn”, “wait for your turn”,
“good waiting”,
May give auditory signals to help the child
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6. 
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Making
reference
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regulating
 Point
 Pull
 Push
 Tap
 Vocalize for
help
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Group games
(Incorporate goal with other
play activities)
Pointing games
(Incorporate goal with other
play activities)
Model the behavior
Use manipulatives
Incidental teaching
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“wait” like counting 1-5 before next turn…
Use hand over hand
Scaffold
reward
Use ILS
You may need to be a bit Over-Acting
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7. Pre Speech
Skills
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Sucking
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Swallowing
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Chewing
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Smiling
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Blowing
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Lip closure
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Sensory
Integration
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Hyposensitiv
e
(hyperactive
behaviors)
Hypersensiti
ve
(hypoactive
behaviors)
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OPM Exercises
Use of Cross-cut nipples
Use of flavored pacifiers
Use of straws with varying
length and diameter
OPM exercises
Use of varying food textures
OPM exercises
Use of varying food textures
OPM exercises
Incorporate in other
activities
OPM Exercises
Use of various blowing
materials
OPM Exercises
Verbal reminders
Visual reminders
Swinging
Spinning
SI Massage
Trampoline
Desensitization
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Consider the level; and preference of the
child
Consider proper sitting/positioning of the
child
Consult with SPLs
(as above)
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(as above)
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Consider the level; and preference of the
child
Consider safe/non toxic materials
Consult with SPLs
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Consult with OTs
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Consult with OTs
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8. My Personal Tools
My Language Parameters
Content/ Semantics
Form
Use/ Pragmatics/context/function
My Speech Parameters
Pitch
Volume
Voice Quality
Rate
Fluency
What to do?
Use Simple, age-appropriate terms
Modify, adapt, bend your style
Speak with a clear diction
Use the syntax/grammatical level similar to or at least one
step ahead of the child you are helping (for imitations and
expansions)
Use short but correct grammar and syntax as often as
possible when interacting with children
Talk about what is here and now rather than there and then
Supply speech teaching with experience
Use terms, materials, and concepts familiar to the child
Use pictures or real objects related to previous experience
when talking about past events
Make every moment a learning experience
Be conscious of the child’s focus of attention
What to do?
Moderate to slightly low pitch generally relaxes
High pitch generally excites
Do not shout!!
Modulated rather than throaty and shrill
Slow rate to give accent to important words and allow each
sound to be heard. Also facilitates processing for the child.
Let your speech naturally flow while considering appropriate
rate.
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