SPEECH AND LANGUAGE STIMULATION TECHNIQUES

All children have the innate desire to verbally communicate. As a Speech

language pathologist, it is our responsibility to provide the children with the right
environment and stimulation to encourage and enhance good speech and language
development. Language learning is a lifelong pursuit. However, the first five years
of life are the most important ones in which to establish a strong linguistic base to
build upon.

Language stimulation practices involve making a number of subtle changes

in interactions and behaviors with the child, which may serve to facilitate language
development.

A number of clinical techniques have been found to be useful in overcoming

deviant language and establishing appropriate language structures. These
techniques are intended to be applicable at many levels of language training. They
may be used individually or in conjunction with one another. Various speech and
language stimulation techniques are as follows:
1. Echoing
2. Verbal imitation
3. Modeling
4. Discriminative modeling
5. Demonstration actions
6. Commands
7. Binary choices
8. Expansions
9. Semantic cueing
10.Shaping
11.Fading
12.Sentence completion
13.Error identification
14.Questions
15.Sentence re-arrangement
16.Story telling
17.Categorizing
18.Self-talk
19.Parallel talk
20.Focused stimulation
21.Reauditorization
 22.Topic initiation
23.Topic maintenance
24.Turn taking
25.Request for repair
26.Milieu teaching
1) ECHOING:
In this technique, the adult echoes the child’s utterance back to him. The
adult may use “WH” such as what or where in place of an unintelligible word from
the child or he may echo the child’s utterance with a rising intonation, as if to
questions what the child said. This technique need not always require that the child
respond at all. It does, however, let the child knows some of what he says, is not
understood by an adult. Further, specifies to the child, which part of his comment
was not understood, thus enabling the child to focus on particular parts, rather than
having to reiterate his entire comment.

Illustration:
Child: I got 2 magos (unintelligible)
Clinician: You got 2 what?
Child: Magos
Clinician: Mangoes! Oh! U got 2 mangoes..
Child: Mangoes… chweath..
Clinician: Mangoes are what?
Child: Chweath.
Clinician: yes, mangoes are sweet.

2) VERBAL IMITATION:
In this technique, the child repeats after the clinician. But a child will not be
able to imitate those structures that are beyond his own level or linguistics
competence. Imitation also depends on the child’s memory span. While using this
technique, one should use the forms which are just slightly above the child’s own
present level of functioning. The length of sentence should not exceed the child’s
memory span. Imitation is useful in achieving the spontaneous production of
speech. It assists the child in becoming aware of the new structure to be learnt.
Imitation of this new structure will provide the child with an example of where and
how the new structure relates to other aspects of the sentence, which the child
already knows. It also plays a role in the child’s acquisition of the language rules,
as this tunes the child to parts of the sentence that he is currently not aware of.
 Illustration:
Clinician: Will u repeat after me? Today is Friday…
Child: Today…..today…
Clinician: No, no say today is Friday
Child: Mm…today is feeday..
Clinician: Friday…say Friday…

3) MODELING:
This technique can be used before and after the child makes a comment. The
clinician offers more information to the child. While her sentence structure is more
elaborate, this is not her primary intention to offer the child a more complex
sentence, but to offer meaningful utterance. It gives the child more things to think
about and thus to comment upon the listener.
This technique has 2 strong points:
 It draws from what the child says to extend the child‟s
comments.
 It does not correct or repeat the child‟s syntactic forms or
sentence structure. Thus, it does not require that a child produce a form that
that he may be unable to use correctly except as rate imitation, word by
word.
There are 2types of modeling:
a) Antecedent technique in modeling before the child says anything, the
clinician gives the model and then the child speaks.
b) Sub sequential technique in modeling: The child speaks 1st and then the
clinician comments on the child’s utterance without correcting or repeating.

4) DISCRIMINATIVE MODELING:
Correct and incorrect responses are modeled consecutively, asking the child
to imitate the correct form, as soon as it is modeled. Modeling of both correct and
incorrect responses encourages discrimination between correct and incorrect
responses. The correct form is strengthened and the incorrect form is weakened.

Illustration:
Clinician: see the picture. Tell me, which is correct- ‘the boy is running’ or
‘the boy is hoping’
Child: the boy is running.
Clinician: Good, here’s a star for you.
5) DEMONSTRATION ACTIONS:
This technique involves the physical acting out of what is said. The child
and the instructor physically go through the action as it has being discussed. This
technique is intended to the language form to the event itself. The real physical
action paired to the language provides the child, a more detailed comprehension or
understanding than does a picture. It involves the child more directly as a
participant. This technique is quite useful with a very young child who may
become bored, unless he is physically active and involved in the situation. It works
well for the child, whose language skills are at a very basic level.

Illustration:
Clinician: Open the door, child. See how I am opening it.
Child: Open door (does the action)
Clinician: That’s good, you have opened the door. Now, try to close it along
with it.

6) COMMANDS:
Commands are the sentences, which direct the person to carry out certain
actions. The use of commands can be employed for both understanding and
production skills. Commands can be used with the children, at all levels of
language learning & they should be from simple to complex. After a command is
given, the child is expected to understand the instruction and then demonstrate his
comprehension by accurately doing, as told. When the child is taught to command,
he is said to develop some degree of control over his environment, by using
language as a tool.

Illustration:
Clinician: Give me any one square from the table.
Child: Here, square.
Clinician: Now give me a blue and red square from the table.
Child: Here, 2 square.
Clinician: Thank you, can you keep the white square on the blue square and
bring it to me.
Child: (does the action)
Clinician: Yes. Good! Thank you.

7) BINARY CHOICE:
Often, the parent or the clinician does not understand what the child is trying
to say, whether because the child is unintelligible or does not make sense with his
choice of word combination. The adult can often establish some limits on the
child’s possible range of answers and can, in this way, have a better means of
understanding the child’s response. By presenting the child with two or more
possible acceptable choice, the adult is narrowing the range of responses that he
will have to figure out. It may be used effectively to help the child compare and
contrast language concepts and to stabilize new language forms. The binary choice
technique also helps in developing the syntactic and semantic skills.

Illustration:
(Picture of a child eating ice-cream is shown)
Clinician: What is this child eating? An ice-cream or a lollipop?
Child: Ice-cream
Clinician: Yes, the child is eating ice-cream. Do you want a toffee or candy?
Child: Candy…. Candy…

8) EXPANSION:
Expansion is the technique of expanding or re-formulating the child’s
utterance into an adult like form, either in terms of sentence structure
(grammatically) or with request to the meaning. This technique provides the child
greater accuracy either grammatically or meaning wise. In this way, the listener
more readily understands child. By expanding the child’s utterances to an adult like
form the clinician shows the child how to get this specific message across more
effectively and the clinician/adult can also determine what the child intended to
say. Through this technique, clinicians verbally interact with their children.

Expansion is of two types: 1) Grammatical (syntactical)

2) Meaning related (semantically)

Illustration:
Semantic expansion:
Child: Ma’am, bus go.
Clinician: That is not a bus. That is a lorry.
Child: Ma’am, Red, ball.
Clinician: No, see the color. It’s a yellow ball

Syntactic Expansion:
Child: Ma’am, water
Clinician: Say, I want water
Child: Ma’am, I wan…. water.
Child: Ma’am, water…..dress
Clinician: Oh! No! The water has split over your dress
 Child: Dress…. Wet…
Clinician: Yes. Dress has become wet. Come on; let me change the dress for
you.

9) SEMANTIC CUEING:
In this technique, the clinician or the adult gives meaningful cues to the
child, so that he can easily come out with the target or the required responses. This
technique is useful when the child has responded inappropriately or is at a loss to
respond at all. It provides the child the required stimulus that may elicit the target
responses, it helps the child to recall or retrieve a label, which he is made to
express independently. It can also be used to establish new words or concepts. The
new information can be paired through the cues to what the child already knows. It
encourages the child to do some processing to derive a response than merely telling
him the specific response required.

Illustration
(A picture is shown)
Clinician: What is this picture about?
Child: quietly sees the picture
Clinician: A child is doing something with the ball
Child: He is playing
Clinician: Yes, the child is playing with the ball. What are you doing?
Child: See pictures
Clinician: Yes. You are seeing the pictures

10) SHAPING:
Complex target behaviors need to be simplified, so that the child is able to
learn them easily step by step. In sequential steps, the components are put together
to achieve the final complex, integrated behavior.

Illustration
(Clinician has a chocolate. The child sees it and stretches out his hand)
Child: Ch…..ch….. um….
Clinician: You want toffee?
Child: Ch….ch…..tof….
Clinician: Yes, say toffee
Child: T….top….topee
Clinician: No say toffee dear
Child: Top…..fee…
Clinician: Hm, once more say toffee
 Child: Toffee
Clinician: That‟s correct, say - I want toffee
Child: Me wan…. Top…fee….
Clinician: Say, I want toffee
Child: I wan toffee
Clinician: WANT say it once again dear
Child: I want toffee
Clinician: Very good. Here take this toffee

11) FADING:
It is defined as a technique in which special stimulus control of target
behavior, created by clinician is reduced in gradual steps. While the same
responses are consistently evoked, the special stimuli are gradually withdrawn.
Modeled stimulus is faded step by step, till the response is strengthened. Initially
the clinician models the response with an appropriate level of vocal reliably; the
clinician reduces the vocal intensity. As the child begins to imitate the response
reliably, the clinician reduces the vocal intensity of modeling with softer and softer
voice on successive trials until the voice is completely faded. Manual guidance as
well as pictures used can be faded similarly.

Illustration
Clinician: What is this dear? It is something which you eat and green in
color
Child: (pause)…. Um…. apple
Clinician: See this picture. It is green in color and tastes sweet. You can see
this in bunches
Child: Guava…. No…. gapes
Clinician: Hm… it is grapes. Say GRAPES
Child: gapes… gapes…..sweet
Clinician: very good. Now you can have this bunch of grapes for yourself

12) SENTENCE COMPLETION:

In this technique, an incomplete sentence is presented to the child and he has
to complete the sentence with an appropriate word. It provides as much or as little
assistance to the child as needed. It can be inflectional ending or a phrase. As the
child advances, this technique enable the clinician to reduce the amount of stimuli
needed to elicit a response can allow for the variety of responses to be acceptable.
A variation of this technique is to have the child begin a sentence with the
structures which he is learning and then allow the clinician to finish the sentence.
This presents information in a structured way to the child. It can be used across all
levels of language complexity, from the one word response level through more
elaborate or advanced multiword response levels.

Illustration
(The child is shown a picture of a play-ground)
Clinician: The boys are playing….
Child: Foot-ball
Clinician: the girls are playing….
Child: Kho-kho
Clinician: What are these old people doing? Sitting on a…..
Child: The…… bench. Me sit ……mmm……I sit
Clinician: Say, I will sit on the……
Child: Chair!
Clinician: O.K. let’s sit on the chair.

13) ERROR IDENTIFICATION:

The child has to identify the error in the sentence and based on his
knowledge, he has to put forth more a correct form. Scientific and syntactic errors
are introduced in the sentences and the child has to correct the sentences. Semantic
correction deal with the meaningfulness of the sentence and syntactic correction
deals with In this technique, the child is presented two sentences of any language
structure. grammatical structure of the sentence. While the child may not always be
able to correct or accurately form a sentence, he may have some knowledge of
what makes the sentence the acceptable or unacceptable. Even though, the child
may not be totally adequate they do tell the clinician something about what the
child knows about the language, how much he is yet to know. This technique is
useful as a means of stabilizing a new language behavior that has been acquired.
Once the child knows what the language form is, and when to use it, this technique
provides the child to a means of sharpening his knowledge of how the newly
acquired form may be adopted. The child would be expected to identify where the
form was used correctly and incorrectly, thus improving his knowledge of the
rules.

Illustration
Clinician: Is this sentence right? – “I go to the shop everyday”
Child: No
Clinician: O.K. that’s fine. Try to correct the sentence.
Child: I went to the shop.
Clinician: Yes. Good
14) QUESTIONS:
It’s one of the best methods to obtain a response from an individual.
Questions can be of 3 types.
1. Questions requiring yes-no response Ex: Did you eat in the morning?
2. Questions requiring a naming response Ex: What is that?
3. Questions requiring an open ended response Ex: Where did you go
yesterday evening?
In eliciting a language sample from the child, the open ended question tends
to be most effective type, as it requires more language usage than yes-no questions,
requiring a one-word naming response. The open ended question allows the child
several possible answers, whereas the yes-no or naming type of question requires
that the child respond with one specific word which of course, helps the child who
is limited in his expressive skills. The open ended question not only gives the child
the opportunity of responding with a variety of appropriate answers, but further, it
makes for a higher likelihood of successful responses.

Illustration:
Clinician: When did u go to your uncle’s house?
Child: Yesterday
Clinician: How did you go?
Child: By bus
Clinician: Why did u go to your uncle‟s house?
Child: See uncle
Clinician: What did u do there?
Child: Play games and ate biscuits
Clinician: Who all are there in your uncle‟s house?
Child: Uncle, aunty, rohit…….

15) SENTENCE RE-ARRANGEMENT:

This technique facilitates the child’s activity to organize his words into a
meaningful utterance. It’s useful for the child who has the ability for using one,
two word utterances to label persons, things and activities. This technique can
facilitate the child to see the order and relationship of these words in a sentence.
The language training program must aim, not only at encouraging children to link
linguistic forms and devices with categories of experience, but also helping them to
improve on their initial guesses about those categories when they are incorrect.
This technique provides the word from which the child can create his own
sentence, by analyzing relationships between these words and categories of
experiences. This technique can be used to develop many levels of language skill
and is applicable to the development of early 2-3 word sentence.

Illustration:
Clinician: What do you see in the picture, dear?
Child: Dog, boy
Clinician: Read the following words. Can you arrange them to describe this
picture? (Dog, pet, boy)
Child: The dog pet the boy
Clinician: No, No! The dog does not pet the boy. What does the boy do?
Child: The boy is petting the dog
Clinician: Yes that’s good

16) STORY TELLING:

It can help the child to sequence ideas, to retrain information and to use
particular words, inflectional endings and sentence types. It serves as a type of
structured conversational speech. A story is told to the child and later on questions
are asked. These questions should require yes/no, naming, or open ended
responses, depending on the child‟s skills. The child is expected to make up a story
himself, using a set of pictures, arranged in sequential order. The child might ask
questions to the clinician about the story. This technique is effective one for
developing both production and comprehension skills and it can be used to find out
the child‟s syntactic and semantic level. It is also used in stabilizing new language
forms.

Illustration:
(The story of “The thirsty crow is narrated to the child)
Clinician: Did you understand the story dear?
Child: yes mama
Clinician: What did the crow see?
Child: water!
Clinician: Where was the water?
Child: In the jug
Clinician: Why could the crow reach the water?
Child: Water …. Mmm….below…..
Clinician: What did the crow do then?
Child: Put pebbles
Clinician: what happened to the water then?
Child: Water… mmm…. Up….
Clinician: Yes. Then the crow drank water
 Child: The crow was happy mummy
Clinician: Yes, the crow was happy after drinking water. Where did the crow
go to?
Child: On tree
Clinician: Yes, the crow flew away and sat on the tree

17) CATEGORIZING:
It is useful in showing the child relationship between words. The child
should know the concept of each word and this technique helps the child to see the
way words go together, to make sense. It also facilitates the child‟s ability to
identify the words in ways, which makes sense conceptually. By categorizing
words as „doers‟, ‟ receivers‟ or actions‟ for a sentence, the child has a better
chance of grasping the meaning. This technique is also useful in learning the
syntax of a language. The grammatical forms, like indirect and direct sentences,
active and passive sentences, can be learnt. If the child is able to categorize words
by their function, she is more likely to comprehend and produce meaningful
sentences.
This technique focuses on the child‟s attention towards the function of
different words and word classes. Thus, it prepares the child to combine words into
meaningful relationship in a structural complex level of language development.

Illustration:
(Clinician shows the pictures of apple, biscuit, toffees, plate, spoon, rubber,
chalk piece and pencil)
Clinician: Can you see these pictures? Now can you name the things that
you cannot eat?
Child: Plate, spoon, rubber…..
Clinician: Those that you can eat?
Child: Toffee, biscuits, apple….
Clinician: Yes. Fine. You know these words like eating, drinking,
sleeping….tell you about actions. Can you tell me a few more?
Child: Ah!...bathing, jumping, hopping, running…..
Clinician: Very good.

18) SELF-TALK:
When the child is nearby or where they can overhear you, talk out loud
about what you see, hear, are doing or feeling. The child doesn’t have to be
involved in what you are doing; they just need to be able to hear you. Speak
slowly, clearly and use short simple words.
 Examples:
• When you are making a bed you might say, “sheet,” “spread sheet on the
bed,” “pull,” “pull cover on.”
• When preparing a meal or snack you can say, “apple,” “wash the apple
“cut, cut, cut the apple” etc.

19) PARALLEL TALK:

When you are within the child’s range of hearing, talk out loud about what is
happening to them. Use words to describe what the child is doing, seeing, hearing
or feeling. The child doesn’t have to be close to you or paying attention. It is very
important to use clear, slow, simple words and short phrases.

Examples:
• When you are both outside and the child is playing in the sand or dirt, you
might say “pour sand,” “Eli pours sand,” “patting sand.”
• When the child is playing with a toy and mommy comes home, you could
say, “Roll ball – get ball-pick up ball-run to mommy-hi mommy.”

20) FOCUSED-STIMULATION:
A technique of language intervention in which the clinician repeatedly
models a target structure to stimulate the child to use that structure; usually a part
of play activity.

Examples:
 Design a play activity to focus on particular language structure (e.g., the
plural morpheme s).
 Collect various stimulus materials (books, cups, hats)
 Talk about the materials and repeatedly model the plural constructions.
 Do not correct the child’s wrong productions.
 Respond to the child’s non target responses without insisting on the correct
response. If the child says the book is nice; clinician may say yes, the books
are nice.
 Continue until the child begins to produce the target structure.

21) REAUDITORIZATION:
Reauditorization is clinician’s repetition of what a child says during
language stimulation. It is often combined with such other techniques as
modeling.
 Repeatedly model a target language feature in varied language contexts.
 e.g., clinician will say, “the book is on the table; the cat is on the tree; the
dog is on the house)
 Point to a target stimulus or ask a question (where is bird?)
 Repeat the child’s production of “on tree” or “bird is on the tree”

22) TOPIC INITIATION:

 Arrange a variety of stimuli that could trigger a new topic
 Introduce one of the stimulus items or situations and draw the child’s
attention to it.
 Wait for the child to initiate conversation about the picture and topic.
 If the child doesn’t initiate a topic, instruct the child to say something
about the picture.
 If the child does not initiate, prompt by beginning the story.
 Praise the child for saying anything related to the topic.
 Accept statements that are remotely connected to the topic at hand;
gradually demand more relevant responses.
 Do not interrupt the child to use the topic cards to initiate new topics.
 Ask the child to think of new topics about.
 Prompt new topics.
 Withdraw or fade such prompts, cues, cards, pictures, and other special
stimuli to make topic initiation more spontaneous.

23) TOPIC MAINTENANCE:

 Target topic maintenance when training has moved to the conversational
speech stage.
 Let the child selects topic of interest for talking.
 Set a realistic duration for which you want the child to talk on a single
topic; or set a target number of words to be produced on a topic.
 Increase the duration or number of target words in gradual steps.
 Use questions to stimulate more speech on same topic.
 Reinforce the child for maintaining the topic.
 Stop the child when he/she changes the topic.
 Move the child back to target topic.
 Train on a few topics and then probe with untrained topic to see whether
the skills have generalized.
 Turn on additional topic exemplars if the skills have not generalized.
24) TURN-TAKING:
It is the appropriate exchange of speaker and listener roles during
conversation. It is a pragmatic language skill. It is an advanced treatment
target.

25) REQUEST FOR REPAIR:

In this technique, clinician use various devices to let know that child’s
expression was not clear and message need to be altered. It can done by
 Asking the child to repeat.
 Asking a question.
 Using negations to prompt the child to clarify the statement.
 Turning the child’s utterance into a question with a rising intonation.

26) MILIEU TEACHING:

It emphasizes natural, functional and conversational communicative
contexts for teaching language. It uses typical, everyday verbal interactions to
teach functional communication skills. Here, the child often initiates an
interactional episode and the clinician turns such episodes into opportunities to
teach language. It is the incidental teaching method and uses natural
consequences as reinforcers.

References:
 Hegde’s pocket guide to treatment in speech-language pathology,
M.N.Hegde
 Speech and language stimulation techniques for children,
Kunnampalil Gejo John, MASLP