Thursday, August 31, 2017

Therapy Tip: To Sign or Not to Sign

Welcome to Therapy Thursday! This is the day I share a tip based upon my experience as a pediatric speech-language pathologist and a mother of a child with special needs.

Today's tip is:

To Use Sign Language or Not To Use Sign Language

Sign language is sometimes brought up in my work with toddlers with language delays. Parents seem to have different points of view on the subject.

Some parents are interested in learning sign language to help their toddler who is not yet speaking. They see sign language as a temporary tool that can help their child communicate. These parents seem to understand that sign language allows a child to learn to express a word in sign and use it meaningfully. This is opposed to a child who merely grunts and points at random to mean a variety of things. The message becomes clearer when the child can sign "eat" or "drink" or "cookie" or "milk." They can start to build an expressive vocabulary that is taking a sign form rather than a spoken form.

Then I have other parents who have serious reservations. Some believe that signing may prevent the child from wanting to use words. They worry that successful signing may lead to the child not wanting to speak instead. Other parents see signing as an inefficient use of therapy time. They don't want me "wasting" time in sessions teaching the child signs when I should be teaching spoken language instead. Some families find learning signs overwhelming and confusing. The family may have a very busy life, and learning sign language may be too much for them.

As a speech-language pathologist, I do consider the parent's preference on signing. However, I do share the positives about signing. Plus, there is plenty of research on this subject. There is no need to fear if signing is appropriate. The research is clear. (Signing Time has a list of many research links.) Sign language does NOT hinder the acquisition or use of spoken language. In fact, it sometimes helps a child understand words or concepts. Here's another great article on this subject.

As a speech-language pathologist, I'm pro-signing. However, I don't necessarily teach sign language to EVERY child I see in speech therapy. A child with a language delay doesn't always need to learn sign language. Sometimes, picture communication is another alternative form that is more appropriate. Other times, the toddler has a good spoken base vocabulary of 20-30 words and doesn't necessarily need to learn sign since they have a good foundational vocabulary.

There is one particular type of child in therapy that I am reluctant to teach signing to in sessions. This child is very quiet but uses many gestures and pointing to get their message to others. In this case, I am reluctant to start signing right away because this child likes to gesture and NOT try to speak. I, personally, have seen these children flourish with sign language but make no effort to use their voice in any way. Therefore, I choose not to do sign language with these children or at least in the beginning. My first objective in therapy would be to get the child to start vocalizing in any way in an effort to teach him to use his mouth first.

Still, there are many children with delays that benefit from using sign language. Adding sign language to speech therapy routines requires minimal changes to the session and takes relatively no time if incorporated naturally.

Here's some important things I try to remember when using sign language with toddlers with language delays:
-This should be obvious, but maybe it isn't. Whenever you are signing with your child, you will say the word you are signing. Doing both ensures the child will see the sign and hear the actual word. We always want to sign a word and say it as they are learning signs.

-If a child begins saying a word, then I don't care if the sign is used. Spoken words are the goal, so that is the driving force. Once in a while a parent will insist that the child do the sign for the word they are saying. Nope, nope, nope! If they drop the sign once they say a word, that's what we are hoping for.

-If you have a child with a diagnosis known to have language delays, sign language is a good communication to use in additional to verbal speech. Sometimes, pairing a word with a sign helps a child "see" the word and thus have a new way to comprehend it. Children with Down syndrome, for example, have been known to do well with sign language acquisition before they are able to verbally communicate. This was the case for my daughter.

-I don't care if a child imitates the sign perfectly. Some signs are challenging because they require finger dexterity that a toddler does not yet have. My daughter could not replicate signs exactly because of her Down syndrome as a toddler, but I recognized her sign approximations and didn't correct her attempts. As her fine motor skills improved, her signs naturally got more accurate.

Sign language is one tool that is used in speech therapy as a temporary method of communication for children with language delays. Like any therapeutic method, sign language has its pros and cons, but it may prove to be a positive way for children to begin communicating with their families. If you feel like sign language could help your child, talk to your child's speech-language pathologist.

Therapy Thursday is for educational purposes only and not intended as therapeutic advice. 

1 comment:

  1. Thanks for sharing all of this, pros and cons. We did signs with both of our children who have Down Syndrome, but dropped off after drink and eat because it seemed the motor skills needed for the signs lagged behind the actual language! They didn't say the words perfectly, but they had a "word"


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