Therapy Tip: Pace Cards for Phrase Development

It's therapy Thursday! This is the day that I share a therapy tip based upon my job as a pediatric speech-language pathologist and a mom of a child with special needs.

Today, my therapy tip is:

Pace Cards for Promoting Phrases

What is a pace card? Great question!

A pace card is a visual representation of a phrase or sentence. Since I work with toddlers, my pace cards are made for two and three word phrases. Here are two examples. The pace card on the left is a visual for a two word phrase and the right is a three word phrase. Pace cards are very simple, easy to make, and can be a great technique for some children.

I first read about pace cards in a book titled, Early Communication Skills for Children with Down syndrome.  This book is written by Libby Kumin, a speech-language pathologist who is well known within the Down syndrome community. I was able to listen to her speak at a Down syndrome conference once and learned so much from her.

When I read about pace cards in Libby's book, it was new information to me. I thought it was a great idea. Many children with Down syndrome are visual learners, so the pace card is a great tool for children who learn best visually.

After I read about this technique in her book, I started using it in my speech therapy sessions with a variety of children none of whom had Down syndrome who were struggling to talk in phrases. That was almost 10 years ago! Since then, I have used pace cards many times. Sometimes, the child will connect with it on the first exposure to it. Other children seem confused by the pace card. I have had a variety of responses. It isn't a magic fix. Like any technique used in speech therapy, not everything works for everyone.

How do you use a pace card?

Here's how I introduce a pace card with a toddler:

1. First, I model some two word phrases using the pace card. I point to each dot as I model each word. ("My turn.") Usually, I follow that with, "Did you see that?" Then I repeat the pointing at each dot and the words. Depending on the child, I may do this for a complete session before moving on to the next step. Other children move to step two on the same day.

2. The next step is to try to get the child to repeat both words of the phrase using the pace card with a pause between the words. After I use the modeling as described in step one, I then say, "Your turn. Say my (pause for child to say), turn. Great! My turn!" Again, I point to the dot that corresponds to each word as I am saying it. Some children will get stuck here for quite awhile as they will not combine words without the short pause.

3. Finally, the child will progress into repeating the phrase with no pause while I continue to model the phrase while pointing to each dot.

4. When I start to hear some spontaneous phrases, I usually discontinue the pace card. Some children use the pace card several weeks and some just need it a session or two.

Who should you try it with?
I have tried the pace card with a variety of children. I tend to try the pace card for children when I am not getting phrases from the usual methods. Again, some children click with it right away while others do not. I give it a few sessions before deciding if it's a method worth continuing with.

My recommendation would be to try pace cards if you are unsuccessfully trying to get phrases or longer sentences with a child.  

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