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Waiting for the Diagnosis: How to Help a Speech-Delayed Toddler Communicate Now

The period between suspecting a diagnosis and actually getting the appointment is often the most difficult time for parents. It is easy to feel defeated when a child has a limited vocabulary and traditional methods like "saying the word more often" aren't working.

If a child is in therapy but communication is still a struggle, it is often because we are trying to build the roof (words) before we have built the foundation (pre-verbal skills). Here are three actionable strategies to try while waiting for an evaluation.

1. Stop "Testing" and Start Narrating

When a child is delayed, our instinct is to quiz them: "What is this? Say cow. Can you say cow?"

  • The Problem: For a neurodivergent child, this feels like pressure. It often causes them to shut down or avoid interaction.

  • The Fix: Switch to Descriptive Commenting. Act like a sportscaster. Instead of asking questions, just narrate what they are doing. "Oh, you have the red block. Up, up, up! Crash!"

  • Why it Works: It takes the pressure off. When the demand to "speak" is removed, children are often more likely to vocalize voluntarily.

2. Communication Temptations (The "Sabotage" Method)

If a child can get everything they need without speaking (e.g., the cup is always on the low table, the toys are always open), they have no reason to communicate.

  • The Strategy: Sabotage the environment lovingly.

    • Put their favorite toy in a clear, tightly closed jar. They can see it, but they need you to open it.

    • Give them a juice box but don't put the straw in.

  • The Goal: The moment they hand you the jar or the juice, they have communicated. Even if they don't say a word, that interaction is the building block of language.

3. Sign Language: Motivation vs. Manners

Many parents struggle to teach sign language because they start with "polite" signs like Please or Thank you.

  • The Shift: A toddler does not care about manners; they care about getting what they want. Focus on High-Motivation Signs only.

    • Open (to get a toy)

    • Help (to fix a problem)

    • More (for snacks/tickles)

  • Hand-Over-Hand: If they won't mimic the sign, gently guide their hands to do the motion while saying the word, then immediately give the reward. This helps their body learn the motor plan.

4. Focus on Joint Attention First

Before a child can speak, they must have Joint Attention—the ability to share a moment with another person.

  • The Activity: Forget the toys. Focus on "People Games" like Peek-a-Boo, Chase, or Tickles. These games build anticipation and eye contact, which are the prerequisites for speech.