What You Need to Know About CPSE (Committee on Preschool Special Education) Services

In New York State, every school district has a Committee on Preschool Special Education (CPSE), a program that provides services to children from 3-5 years of age who have or are at risk of having a developmental disability.

If your child received early intervention services as an infant or toddler up to age three and may still need special education, your Service Coordinator will assist you with transition planning and making a referral to the Committee on Preschool Special Education (CPSE) at your local school district. If your preschool-age child (3-5 years old) did not receive early intervention services, but has some delays or lags in development such as difficulty in talking, moving around, thinking or learning, or is facing physical or behavioral challenges, a parent or guardian may make a referral to the chairperson of your school district’s Committee on Preschool Special Education (CPSE) who will assist you in completing the referral process.

In either case, there will be new information and new people entering your life and the life of your child. To help you navigate this new stage, below you will find answers to some of the most common questions about Preschool Services.

What is Preschool Special Education?

The New York State Education Department (SED), Office of Special Education oversees a statewide preschool special education program with school districts, municipalities, approved providers and parents. Evaluations and specially planned individual or group instructional services or programs are provided to eligible children who have a disability that affects their learning. Funding for these special education programs and services is provided by municipalities and the State.

Why is an evaluation necessary?

Preschool evaluations are conducted to determine whether or not a child has a disability and is eligible for preschool special educational and/or related therapeutic services. If a child is found eligible for preschool services, the family acts as a member of the school district’s CPSE to determine appropriate services.

How does the evaluation process work?

When your child is referred to the CPSE (your local school district), you will be given a list of agencies approved by the State Education Department to provide preschool special education evaluations. You will be asked to select one of the approved evaluators, then sign a consent form for your child to be evaluated at no cost to you or your family. A copy of the evaluation report, including a summary of the evaluation, will be provided to you and to other CPSE members. You will be asked to meet with them to discuss the evaluation results.

How will my child receive special education programs and services?

If your child has a disability that may be affecting his or her learning, the CPSE will find your child to be an eligible “preschool student with a disability.” The CPSE will also recommend the program or services to meet your child’s individual needs and where they will be provided.

What is an Individualized Education Program (IEP)?

If your child is an eligible preschool student with a disability, you and the other CPSE members will write an Individualized Education Program (IEP) for your child that will list the recommended services to be provided, how often, and for how long. The CPSE must consider how to provide the services in the Least Restrictive Environment (LRE), where your child can learn close to your home with other children of the same age who do not have disabilities.

What programs or services will my child receive?

If approved by the school district, arrangements will be made for your eligible child to receive one or more special education programs and/or services recommended by the CPSE.

Preschool Related Services can include:
– Speech/Language Therapy (helps children with expressive (spoken) and/or receptive (understanding) language delays)
– Feeding Therapy (helps children who have motor difficulty with chewing or swallowing)
– PROMPT (helps a child develop motor control and proper oral muscular movements)
– Physical Therapy (works on gross motor skills such as running, jumping, skipping and hopping)
– Occupational Therapy (works on fine motor skills such as writing and cutting, eye-hand coordination, self-help skills, sensory and motor development)
– Parent Training (teaches parents and caregivers strategies for helping their child achieve success in daily activities)
– Social Work Services (provides information, emotional support and assistance for family members in accessing community resources)
– Counseling (works with a child or members of the family on issues surrounding or impacted by the child’s developmental delay)

Special Education Programs can include:
Special Education Itinerant Teacher (SEIT) – a special education teacher works with a child in a setting recommended by the CPSE.

Special Class in an Integrated Setting (SC/IS) – a class with preschool students with and without disabilities.

Special Class (SC) – a class with only children with disabilities.

How will my child get to special education programs and services?

When the CPSE is planning programs and/or services for your child, they must also consider your child’s transportation needs, including the need for specialized transportation. If recommended by the CPSE, transportation will be provided by the county — once daily from the home or another child care location to the special service or program, and returning once daily from the special service or program to the home or other child care location — up to 50 miles from the child care location. Parents may be reimbursed for transporting their own child if the CPSE recommends transportation. Transportation will not be provided at public expense if the CPSE recommends special education itinerant teacher services or related services in the child’s home or another child care setting which the parent has arranged.

Where do I get more information?

Contact your local school district CPSE Chairperson or Director of Special Education.

For more information about preschool services and how MKSA can help you navigate the process, click here.


Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

The CPSE program is funded and regulated by the NYS Education Department, county and your local school district for children 3-5. Services are provided at no direct cost to families for children who meet eligibility guidelines.

Things to Look for When Choosing a Preschool

Choosing your child’s first school can be both exciting and overwhelming. If your child has special needs, it’s especially important to thoroughly explore different options. As space is sometimes limited, it’s best to start researching early and apply to several programs.

There are several things to look for as you begin to visit preschools. According to Harvard’s Graduate School of Education, look for the following:

Adults are talking to children in nurturing and encouraging ways. They address them by name, get down to their eye-level, listen and try to understand. A perfect example of this was a parent dropping off a recently potty-trained 3-year-old who wanted to wear his underwear backwards. The teacher understood that the little boy wanted to have the truck on the underwear in the front—where he could see it. And it wasn’t an issue.

Teachers focus on helping—not punishing—children who are behaving inappropriately. Good teachers help preschoolers develop social and emotional skills and self-regulation, with consistent routines, and strategies such as timers for turn-taking, and games for times a child needs to be physical.

Classrooms are joyful and fun. Teachers need to continually provide new activities and challenges in an environment focused on play.

Children are active. Artwork should cover walls, children should get lots of outdoor time, and they should not expected to sit for more than 20 minutes at a time.

Staff seem happy and are supported. It’s ok to ask about teacher turnover, and availability of regular professional development and planning time for teachers. Do they seem happy and excited—or bored? Teachers can make or break a child’s experience, so go with your instincts. If you feel good about the teachers, your child likely will as well.

Once you have arranged to visit a school, asking questions can further help you assess the program and decide. Call in advance to arrange a tour and try to schedule a follow-up visit with your child to see how he/she reacts to the school. Below are some suggested questions to ask and points to consider, from pbs.org’s pbsparents:

Ask yourself “What kind of school environment am I looking for?” Do you picture your child in a busy, active place with lots of other children, or are you looking for a small, nurturing environment with just a few kids? What specific needs does your child have: toilet training, napping, socializing?

Consider if this school is a good fit for your child—and you. How will he do socially in this environment? How does the school fit with your child’s disability, unique needs, strengths and personality?

Spend time observing. During tours, watch silently in the classroom and observe the interactions.

What is the educational philosophy? Some philosophies are play-based, some introduce reading and math earlier than others, and many schools incorporate multiple philosophies.

How large are the classes and what is the teacher-child ratio? The important thing to consider is how your child’s needs and your own will be met by this equation.

What is the look and feel of the school? Does it feel warm and inviting? Is it clean and organized, or messy and chaotic? Do they have a gym or play yard? How often do they use it? Is there a separate room for Speech, OT, PT and Psychologist services?

Is the atmosphere exciting? Do students seem happy? Do the teachers seem like they enjoy teaching here?

What kinds of activities are children doing? Are the projects controlled or open-ended, enabling children to do many different things with the same materials?

What is the focus on reading? Ask if it focuses on teaching early literacy skills and at what age. Does this approach seem right for you and your child?

Are children working all together or individually? Is everyone doing the same project or activity at the same time? Are individual interests being accommodated?

Organization. Are the classrooms organized? For children with Sensory Processing Disorder, are there visual and auditory organizers such as wall charts, schedules and timers to help minimize over- or under-stimulation?

How much do the children play? Both boys and girls need room to run around and time to do it, with plenty of opportunity for imaginative play.

How do parents get involved in the school? Is there an active parent’s organization? Can parents volunteer in the classroom?

How is information communicated to parents? Is there a newsletter? Can you e-mail the teachers?

How does the school address social-emotional issues? How does the staff help children resolve conflicts? How are issues like hitting, throwing, and biting addressed?

Food and mealtime. Where do students eat? In a classroom or lunchroom? How does the school handle special dietary requirements and how are food allergies handled?

What are the discipline policies? Are children punished for inappropriate behaviors? Ask for details about their discipline policies.

Is this school accredited? Public schools need to meet state and district requirements. Private schools get additional accreditation from organizations like the National Association for the Education of Young Children (NAEYC)and the National Association of Independent Schools. Accreditation standards vary, and some schools may meet standards without being accredited by outside organizations.

Specialists and therapies. What therapists visit the school and how often? Does the school have regular access to Speech Therapists, OTs, PTs and Psychologists? Does the school offer adaptive physical education? If your child has difficulties with speech and language, ask what method the school will use for communication. Do they have access to assistive technology? Are any extracurricular activities open to special needs students?

Paraprofessionals. If your child is going to need a para, ask what training is given to him/her. Will your child get the same para each day? Will the para be with your child at recess and lunch?

Request a copy of the class schedule. How is the day structured? Is it the right fit for your child’s intellectual, emotional and physical needs?

What are the medical policies? Is there a nurse on site full time? How are medications handled? How does the school handle injuries or illnesses? Can kids come to school with a cold but not a fever?

Is the space safe? Is it up to code? What evacuation plans are in place?

Can you get references from other parents whose children go to the school? If you haven’t been personally recommended, ask for some numbers of other parents who might answer more specific questions.

While there are many factors to consider when selecting a preschool, with some diligent exploration you’ll be able to find the right setting for your child—a nurturing yet stimulating environment that will positively shape his/her orientation toward learning for many years ahead. If you have any questions about your child’s development, reach out to us! You can call 516-731-5588 or contact us by email.

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

pbs.org’s pbsparents
Child Mind Institute, childmind.org

Are You and Your Children Washing Your Hands Properly?

Kids are back to school, cold weather is coming and we’ll be spending more time indoors. It seems like a perfect time to review handwashing practices to keep everyone clean and healthy. Did you know that frequent handwashing is one of the best ways to protect yourself, your family and others from getting sick?

While it seems simple enough, there are some dos and donts for washing your hands, including how and how often. If you’re not washing properly, you’re missing out on its benefits. Did you know the Centers for Disease Control and Prevention calls handwashing a “do-it-yourself” vaccine?  Studies show that frequent handwashing helps prevent the spread of certain illnesses, including stomach bugs, strep and the flu. With most children picking up 6-10 colds each year, handwashing is an easy preventive measure.

Some handwashing facts:
-For every 15 seconds of handwashing, 10 times more bacteria are removed.
-A research study showed that school children who washed their hands had 51% fewer sick days due to stomach bugs and 24% fewer sick days due to colds.
-Compared to dry hands, damp hands are 1,000 times more likely to spread bacteria.
-Hands spread approximately 80% of common infectious diseases.
-Only 1 out of 5 people wash their hands before preparing food.
-95% of people either don’t wash their hands, or don’t wash properly after using a public restroom.

It’s also worth noting that antibacterial soaps, such as those containing triclosan, are no more effective at killing germs than is regular soap, and they may lead to antimicrobial-resistant bacteria. As of 2016, liquid, foam and gel hand soaps, bar soaps and body washes containing antibacterial ingredients can no longer be marketed to consumers. If you or your child are not near running water, hand sanitizer can be used in a pinch. Be sure the sanitizer contains at least 60% alcohol and is used properly: apply gel to the palm of one hand, rub your hands together, covering all surfaces, until hands are dry. Be sure to supervise young children using sanitizer; swallowing these products can cause alcohol poisoning.

When should you wash your hands?

Always wash:
Before, during and after preparing food, especially raw meat, poultry or fish
Before eating food
Before treating wounds or caring for a sick person
Before inserting or removing contact lenses
After using the bathroom
After changing diapers or helping a child use the bathroom
After contact with bodily fluids
After treating a cut or wound
After touching an animal, animal food or treats, animal cages or animal feces
After touching garbage or outdoor garbage pails
After blowing your nose, coughing or sneezing (try to cough or sneeze into your elbow or shoulder)

It’s also a good habit to teach children to wash hands when they come home from school. This is especially important if they are going to eat a snack as soon as they come home. You can teach children to Wet-Lather-Scrub-Rinse-and-Dry. Those five simple steps are all it takes.

How to wash your hands properly:
-Turn on water and wet your hands, preferably with warm water.
-Apply soap and lather well.
-Rub hands together, palm to palm; clean all surfaces including fronts and backs of hands, wrists, fingers, between fingers and under fingernails.
-Scrub your hands for at least 20 seconds. You can hum the “Happy Birthday” song from beginning to end twice, and that about covers it.
-Rinse your hands well under clean, running water.
-Dry your hands with a clean towel or paper towel and use the towel to turn off the faucet.
-If you’re in a public place, use the paper towel to open the (dirty!) bathroom door as well.

It’s important to teach children how to wash their hands, and to encourage them to wash frequently. If a child can’t reach the sink, explore keeping a step stool handy. Make handwashing an important and fun part of your day to keep you and your family as healthy as possible! For more resources, including handwashing videos, and some additional hygiene tips, read more here.

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.


Centers for Disease Control and Prevention Handwashing
Mayo Clinic Handwashing Dos and Donts
Duquesne University School of Nursing Proper Handwashing Techniques and Hygiene Tips: Guide for Teachers and Parents
Fastmed Back to School Checklist: A Handwashing Lesson



Back to School Tips for Families of Special Needs Children

As families and their children get ready for the back-to-school transition, there’s a lot to be done to get into a new schedule. The new school year means a new grade, new teachers, and even a new school. Back to school can be an anxiety-provoking time for parents under the best of circumstances. Making sure your kids have the right clothes and the right supplies can be overwhelming, but when you’re the parent of a child with special needs, you have to make sure they have the right program in place, too. Getting organized—both physically and mentally— before the year begins will go a long way toward creating and maintaining peace and success in the year ahead.

We’ve listed below some areas to address in preparing for the school year, along with 50 Tips for School Year Success:

Schedule a special back-to-school meet-and-greet/tour for your child prior to the first day of school
Many children with special needs need prior exposure to new experiences to help ease their anxiety. If this sounds like your child, we recommend reaching out to the school to request a special meeting and/or tour with your child’s teacher. For elementary students, try meeting with teachers, the principal and the school nurse. For middle and high school students, you’ll want to meet with the guidance counselor as well. For many children this is necessary even if they are just moving up a grade into a new classroom, but it is especially important if s/he is undergoing a significant transition. As with the back-to school IEP meeting, it is recommended that you include this special meeting/tour in your child’s IEP accommodations in their IEP every year.

Review your child’s IEP
For children with IEPs, it is important to refamiliarize yourself with the services and accommodations your child will receive in the upcoming school year. The IEP is the cornerstone of your child’s educational program, so it’s important that you have a clear understanding of it. Note when it expires and if your child is up for reevaluation this year. Most importantly, check to make sure that the IEP still reflects your child’s needs.

Meet your child’s new teachers
Special Education Advisor points out that many kids with special needs have some quirks that teachers ought to know about. But your child also has wonderful things about him that the teacher should know as well. Make an appointment to sit down with or schedule a conference call with your child’s new teachers to tell them the good things and the not-so-good things they need to know about your child. Reading a child’s file isn’t the same as learning about him from someone who knows him.

Set up transportation
Special transportation is frequently a service on an IEP, meaning the school will provide transportation other than the regular bus to get your child to her school or special education program. If you haven’t heard yet, check in with the bus company or special education office to get the details about where and when your child will be picked up. Then you can do a “run-through” to make sure your child understands the routine.

Organize all that paperwork
In the world of special education, there are lots of meetings, paperwork, and documentation to keep track of. Try to keep a family calendar of school events, special education meetings, conferences, etc. Setting up a binder or folder to keep your child’s special education documentation, meeting notices, and IEPs in sequential order can also help you stay organized.

Start a communication log
Keeping track of all phone calls, e-mails, notes home, meetings, and conferences is important. Create a “communication log” for yourself in a notebook that is easily accessible. Be sure to note the person you spoke with, dates, times, and nature of the communications you have. It might be useful to send a communication notebook to and from school with your child to help him/her and the teachers keep on top of what’s happening. It’s also a great way to stop playing phone tag with the school and let them know if your child is having a rough day.

Talk and prepare
Just talking about the upcoming year and changes can help reduce some of that back-to-school anxiety! Talk to your child about exciting new classes, activities, and events that they can participate in during the new school year. Children pick up on your mood, expectations, frustrations, and disappointments. Of course, they also pick up on your excitement, pleasure, anticipation, and gratitude. Be sure you are starting the year off in a positive manner. If attending a new school, try to schedule a visit before the first day. With older students, it is sometimes helpful to explain the services and accommodations in their IEP so that they know what to expect when school begins.

Attend school events
Take advantage of Open Houses, Back-to-School Nights, and parent-teacher conferences to help you and your child get a feel for the school and meet the teachers, other staff, students, and families. Share the positives about working with your child, and let the teacher know about changes, events, or IEP concerns that should be considered for your child.

Clothing and weight/compression
Is your child a sensory seeker, or in need of special clothing? Be sure clothing is soft, comfortable, and provides pressure if needed to calm and comfort. Tagless shirts, compression vests, and other sensory-savvy clothing items can help kids adjust and perform at their best. By applying compression to the joints, a compression shirt or garment can provide an all-day hug to calm, engage, and help with focus. If your child has a hard time sitting still, try a wiggle seat, weighted vest, or lap pad. Your student might also like a wiggle cushion or ball chair for school or during homework at home. Sensory filters such as weight and movement can really help children transition well to school and not lose touch with their physical needs.

Behavior and Rules
Talk to your child about school expectations—and yours as well. Be sure your kids know the rules. Have them repeat those rules back to you, so you are clear that they are aware and understand. Give them space to voice any concerns as well. If your child needs assistance with emotional intelligence, regulation, or social communication, be sure to discuss this with the teacher and to give your child ample opportunity to express himself or herself.

Eat Well
Providing a healthy breakfast, lunch, and snack can have a huge impact on how kids perform, as well as on how they feel as they manage their day. Be sure to stock up on easy-to-access fruits and vegetables. In addition to edibles, some students can benefit from a chewy or fidget to have throughout the day to help ease stress.

50 Tips for School Year Success
For some specific strategies to help you and your children get, and stay organized, take a look at these tips:

  1. Set your kids’ sleep schedules back to “School Time” two weeks before the first day.
  2. Get your kids involved in programs that they can do after school to keep them active.
  3. Reacquaint your kids with the calendar schedule they’ll use to manage their activities.
  4. Set up weekly meetings to review your kids’ schedules for the week(s) ahead.
  5. Create a family calendarthat tracks everyone’s activities and commitments.
  6. Refresh your rules about screen time for the school year. What’s allowed and when?
  7. Establish a set “Family Time,” whether it’s during dinner or before bed.
  8. Use an egg timer to get your kids used to focusing for specific periods of time.
  9. Teach your kids to prioritize their assignments by making to-do lists with deadlines.
  10. Set a regular alarm each day that signals the start of homework time.
  11. Discuss what your kids can expect on the first day so they feel more prepared.
  12. Visit the school with your kids so they can get familiar with their new environments.
  13. Include your kids in back-to-school shopping by letting them pick out their items.
  14. Create a dedicated space for your kids to store their school supplies and technology.
  15. Establish a specific space like the family office as the official “homework area.”
  16. Remove distractions like TVs and video game consoles from homework areas.
  17. Repurpose and relabel plastic tubs to organize all school supplies.
  18. Help your kids develop a filing system for organizing their documents for each class.
  19. Set–and enforce–regular weekday and weekend
  20. Set–and enforce–regular weekdayand weekend wake-up alarms.
  21. Keep track of existing extracurricular activities to prevent over-scheduling.
  22. Create a list of fun after-school activities and gamesto keep your kids entertained.
  23. Touch base with teachers early on to troubleshoot any issues your kids may be having.
  24. Create an after-school schedule that allows time for snack, relaxation, play and study.
  25. Establish regular bedtime routines for elementary school kids and preschoolers.
  26. Carve out blocks of fun time for your kids, whether it’s through sports or playdates.
  27. Encourage your kids to lay out their school clothes the night before.
  28. Have your kids pack their school bags before they go to sleep that night.
  29. Have your kids also pack their gym bags the night before and leave them by the door.
  30. If your kids bring their own lunch, pack their lunch boxes before going to bed.
  31. Establish rules for where they should put lunchboxes, etc. when they come home.
  32. Go through your kids’ schoolwork once a month to toss the things you don’t want.
  33. Create an inbox for kids to leave things that need your attention, like permission slips.
  34. Get copies of school menus in advance to discuss lunch choices.
  35. Get your kids involved in creating and preparing their daily lunch menus.
  36. Buy reusable sports bottles to increase their water consumption during the day.
  37. Keep a small emergency allowance in your kids’ bags, just in case.
  38. Use sticky notes to flag important items in kids’ folders that they should pay attention to.
  39. Set your clocks forward 10 minutes. This makes it easier to be on time.
  40. Use positive phrasing, such as “You can go outside after your homework is done,” rather than “You’re not going outside until this is finished.”
  41. Make sure your kids (and you!) have an effective wake-up alarm that works for them.
  42. Set an alarm or notification 30 minutes before bedtime.
  43. Remove mobile devices from kids’ bedrooms to focus them on sleeping.
  44. Set up the breakfast table before you go to bed.
  45. Set up a hanging organizer with five boxes for clothes for each day of the week.
  46. Dedicate a rack in the garage, basement or entry way for sports equipment.
  47. Schedule study blocks on the weekends before big tests, mid-terms and finals.
  48. Talk openly with your kids about their feelings about returning to school.
  49. Do something fun to diffuse this stressful time of year for all of you.
  50. Take a breath!

Your child’s well-being is the most important back-to-school preparation. Addressing sensory, physical, and psychological needs as kids head back to school can help ensure that everyone has a great back-to-school experience. Be sure to address your own as well!


Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. If you have any specific questions regarding your child and his/her needs at school, consult your primary care physician.


Ilana Danneman at Friendshipcircle.org
LizAlton at care.com    
Lara Cleary at Npnparents.org 
Amanda Morin at Popsugar.com



Answers to 5 Common Speech and Language Concerns in Children

One of the most common concerns among parents and caregivers of young children is speech and language development. This post’s contributing author is Betty Aboff, an MKSA Speech-Language Pathologist with 25 years’ experience in evaluating and providing therapy for children.

Is your child developing speech and language skills like other children? Is your child at age level? Children develop these skills at different ages, and there is a wide range of normal development. Let’s learn more about children’s speech milestones and when one should be concerned.

1. Why can’t my 2-1/2-year-old child say “s” and “th” sounds?
A child at age 2½ is only expected to be approximately 65-70% intelligible when speaking. We are not concerned with difficulties in articulation (the production of certain sounds) until a child is at least 3 years old unless it’s severe. Even at age 3, it depends upon which sounds the child is having difficulty with. At age 3, a child should be able to say sounds produced using his lips, including “b,” “p,” “m,” and the tongue, including “t,” “d,” and “n.” At age 4, a child should say the “r” sound and “back sounds” such as “k,” and “g”. At age 4 ½, the “s,” “sh,” and “ch” sounds should be produced. At age 6-7 a child should say “later sounds” including: “v,” “th,” “j,” “z” and blends (2 consonants together).

2. Why does my 3-1/2-year-old child stutter a lot?
Stuttering among children ages 2½-5, when they are still learning how to speak, is very common and is not a cause for concern. This is called “developmental dysfluency,” which appears in about 25% of all children at that stage and will usually disappear if left alone over time. As therapists we don’t address it and we discourage parents from telling their child to “slow down” or “think about what you want to say.” We don’t want to call attention to the dysfluencies. Never finish a child’s sentences for him. Act as if you have plenty of time to hear what your child has to say. Model slower speech for your child. When at home, insert extra pauses, simplify your own language and maintain normal eye contact with your child. Reassure your child that talking can sometimes be hard for everyone. If your child develops what are called “secondary characteristics” such as eye-blinking, foot stamping or facial grimaces, or if the stuttering gets worse, the dysfluencies should be addressed by a speech therapist.

3. Why does my 2-year-old child only say a few words?
Normal speech and language development in children can proceed at very different rates. It is common for many 2-year-olds to have a 40-50 word vocabulary and to be just starting to put 2 words together. Other children develop language skills faster, and can manage to conduct a conversation at that age. However, if a 2-year-old child only has a few words, isn’t imitating words, and is having trouble understanding language and commands addressed to him I would suggest having the child’s hearing tested, and a speech and language evaluation is recommended.

4. Why must my 4-year-old child be told something multiple times before he follows directions? He also has trouble with answering questions and repeats what you ask rather than giving you a response.
If he has not been already, your child should be tested for auditory processing (the ability to understand spoken language) difficulties as part of a complete audiological evaluation, to discover if the source of the difficulty is behavioral, processing or a combination of both. In the meantime, before giving your child directions, make sure you have gained his complete attention. Speak slowly and clearly, but don’t over-exaggerate your speech. Your directions should be simple and brief. Try to use visual aids such as pictures or actual objects and written instructions to supplement your spoken words. While speaking to your child, emphasize key words, and ask him to repeat your instructions back to you to make sure that he understood what you told him. Next year in Kindergarten he will be expected to follow directions and answer questions. If he has auditory processing difficulties, it will become more apparent in the classroom setting. This is the time to work try to give him compensatory strategies in order to function better in the classroom setting.

5. I have three children under the age of 5. Can you give me tips for helping them develop their language skills?
Below are some recommended techniques:
Expansion: Expand what your child says. If your child says “mommy,” you say, “Where is mommy’s car?”
Modeling: Provide a good model for the child to follow. If your child says, “baby hurt,” you say, “put a band-aid on it.”
Parallel talk: Comment on the actions of yourself or your child, with the hope that your child will begin to do the same.
Imitation: Have your child imitate your words after you, to hopefully begin to use them spontaneously.
Association: When a child comes across a new experience or word, supply additional vocabulary words. If your child says “car,” you say, “It is a car and it has wheels like daddy’s car.”
Repetition: Repeat the same new words over again in front of your child in many different contexts; eventually your child will begin to use the words himself.

Try these techniques at home and keep praising your child each time he tries to use a new word. Encourage him to want to learn new words and use them.

As with any concerns, speak with your child’s pediatrician first. MKSA is always available to answer questions and make appropriate referrals. For more information about MKSA’s services including speech-language therapy, click here.