Using focused stimulation to help speech and language development in young children

Focused stimulation is a technique used by speech therapists to help stimulate child language acquisition. Like so much of what we SLPs do, it is relatively easy, costs nothing, and is wonderfully effective.

The video below shows a nice example of a speech-language pathologist using the book If You Give a Mouse a Cookie by Laura Joffe Numeroff for focused stimulation. Note how she is not reading the book, but talking about the pictures and then summarizing each page with "The mouse wants ..."

The idea with focused stimulation is to target a particular word, phrase, or grammatical form, and to use it repeatedly while interacting with the child. It sounds easy, and it is, mostly. It does take a little bit of planning and thinking ahead while you are interacting with your child, but if you use it often enough, it starts to become habitual.

Here's an example of focused stimulation targeting the use of is as a copula, or linking verb, with a child who frequently omits it, producing sentences like This mine or Where my hat? Please note that I have put is in italics to make it more visible and to emphasize how often it appears. You don't need to put a lot of stress on it in speech, although it should be good and audible.

"Where is my hat?

"Where is it?

"Oh, here it is.

"Here is my hat.

"Here it is.

"It is in the drawer.

"That is where it is."

When you say this, the child hears is eight times in various positions within sentences. In the second sentence (Where is it?), is appears in a naturally stressed position; in the third and fifth ((Oh), here it is), is is the last word of the sentence. Stressed and final positions are highly salient, so it's always a good idea to include a number of sentences with the target in a position such as this.

Focused stimulation does not usually produce instant results, but it has been shown in the research to be effective when used on a regular basis.

A number of children's books and songs lend themselves well to FS, due to their simple, repetitive text. For example, Eric Carle's Brown Bear contains multiple repetitions of What do you see? and I see ... . Since a lot of preschoolers have difficulty with questions beginning with WH- words (what, why, where, etc.), and with nominative pronouns (I, he, she, we, they), this book can be found in a lot of speech therapists' libraries.

Here are some more books that work well for focused stimulation, and features that get repeated a lot in each. This is not an exhaustive list, but it should be enough to get you started.

• The Very Hungry Caterpillar by Eric Carle: He ate ... (nominative pronoun he & irregular past ate); He was still hungry (nominative pronoun he & copula was).
• The Foot Book by Dr. Seuss: irregular plural feet.
• Are You My Mother? by P.D. Eastman: Copula are, possessive pronoun my, question formation using subject-verb inversion (Are you ... ?), negation (The __ was not his mother; You are not a __).
• I can say that and I can do that by Susan Hendler Lederer: early vocabulary, two-word combinations. Written by a professor of speech-language pathology.
• Five Little Ducks by Raffi (Songs to Read series): counting; number + adjective + noun; duck/s, quack.
• The Doorbell Rang by Pat Hutchins: irregular verb rang; idiomatic expression: No one makes cookies like Grandma.
• Goodnight Moon by Margaret Wise Brown and Clement Hurd: goodnight plus noun or noun phrase.
• The Runaway Bunny by Margaret Wise Brown and Clement Hurd: this book is full of if-then statements. Actually, the text does not use the word then, but I put it in anyway, to emphasize the relationship of the first part of the statement (dependent clause) to the main clause (If you become a rock on the mountain, [then] I will become a mountain climber and climb up to you). Additional value comes from the fact that the dependent clause of each if-then statement echoes the main clause of the previous one (e.g., If you become a mountain climber and climb up to me, [then] I will ...).
• Caps For Sale by Esphyr Slobodkina(Reading Rainbow Book): in addition to the familiar cry of "Caps! Caps for sale! Fifty cents a cap!", this book is full of bite-size stock phrases that get repeated over and over, sometimes with a slight variation, e.g. ...then a bunch of gray caps, then a bunch of brown caps, then a bunch of blue caps, ... .
• Squares are Not Bad by Violet Salazar: This book is unfortunately out of print, but if you are lucky enough to own a copy, you can use it for stimulating a variety of early vocabulary and grammatical structures. The opening pages (in which the various shapes are expressing their very politically incorrect contempt for diversity) contain multiple repetitions of the phrases If you want to be smart and beautiful and good, you must have ... and If you do not have ... then you are stupid and ugly and bad, bad, bad. These phrases can stimulate three adjective antonym pairs, plus the use of and to conjoin a list of adjectives; in addition, they model an if-then relationship, an important logical/linguistic concept that is difficult for some children. By the way, the shapes do discover, in the end, that the other shapes are also smart and beautiful and good.
• Quick as a Cricket by Audrey Wood and Don Wood: as-as comparison statements (similes), e.g. I'm as small as an ant. Rhymes and great illustrations make this an exceptionally engaging book.

In addition to these, many books and songs can be easily adapted for focused stimulation if you allow yourself to break free of the printed text and "talk" the book instead of reading it, or tweak the lyrics of songs to fit your need.

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