We know that you need thousands of hours of practice to become an expert at any skill, and many, many repetitions for something to stick. The same is true for children learning new speech, language, or listening skills. But how can we get in the practice they need without boring them (and ourselves!) to tears?
Traditional repetition is often done in a “drill and kill” manner. Say this speech sound five times in a row to make sure you have it right, imitate my sentence with this language structure until you can use it correctly, etc. This isn’t fun, and, because it’s not fun, it’s not motivating or effective, either. But we can’t throw the baby out with the bathwater. Repeated practice is crucial. So how can we achieve it?
Create games where repetition has a purpose. For example, if you’re working on a child’s auditory list memory and you want to see if she can recall four items, you could just give her random lists of four that she’s expected to spit back out at you… but how boring is that? Instead, play a game like “restaurant” where she, as the waitress, has to remember that the customer wanted milk, toast, tomatoes, and scrambled eggs. Multiple customers equal multiple chances to remember different lists of four. You’ve accomplished the same goal, but this time, the child had a why. Why am I remembering these items and repeating them back to you? I’m the waitress, you’re the cook — I have to give you the orders or we’ll have some unhappy customers!
Work smarter, not harder: use the target throughout the day. If a little listener needs to learn to use pronouns like “mine” and “yours,” why limit yourself to a formal lesson? Once you start to look for it, you’ll find opportunities to use this goal (or any other goals) in many situations in the course of your normal daily routines. Not only does this give you tons of opportunities for repetition, but it also encourages generalization (helping the child use the skill in many different contexts). If you can talk about “mine” and “yours” while getting dressed, setting the table, putting on your shoes, cleaning up toys, playing outside, and going to the grocery store, you could probably sneak in one hundred trials a day, at least! Consider this when compared to how many boring repetitions you could squeeze out of a child with a short attention span during a sit-down lesson.
Multiple opportunities + small changes = spontaneous use. Repetition and imitation are the first step, but our end goal is really to have the child start to use language on his own, to express his own spontaneous thoughts. After all, I know what I said. I want to know what he thinks about the world! We can use repetition in a clever way to facilitate this, too. Here’s where family participation in Auditory Verbal Therapy really comes in handy — more bodies in the room for having conversations! Playing games or doing activities where each person takes a turn (repetitions) but alters the form slightly (small changes), can be a good middle ground for the child when helping him to move to using a language structure on his own (spontaneous use).
How might this look? For example, if we want the child to start using the sentence structure Subject + Verb + Object, we can all sit down to have a snack of pretend (or real!) fruit. Mom says, “I eat the grapes.” Sister says, “I eat the apples.” Dad says, “I eat the bananas.” Then it’s the child with hearing loss’s turn. He can choose his favorite fruit and say, “I eat the bananas.” He gets multiple repetitions of the target, yet when the time comes for his turn, he’s not just imitating. He has a chance to “choose his own ending” as it were, helping him transition the SVO structure from imitated to spontaneous use little by little. At a more advanced level, we can change up not only the object, but the verb in this sentence. Mom might “cut the apples,” sister “mashes the bananas,” Dad, “chews the grapes,” and the child, “squeezes the orange.” Tada! More repetition of the target, more onus on the child to produce his own version.
Create repetitions that work toward a goal. Some parents and therapists try to make traditional (boring) repetition more “fun” or “rewarding” by offering the child a reinforcer for every trial — a token, chip, sticker, or some kind of treat. I have issues with that. However, there is a way to craft activities that include natural reinforcers that facilitate lots of repetition. One activity that I love is building a tinfoil “boat,” putting it in a bowl of water, and then slowly adding pennies (or beans, or pebbles, whatever you have around the house) until it sinks. Old school repetition would say that the child could earn a penny to put in the boat for each attempt at the target, with a totally unrelated goal (for example: each time you say an /s/ word from this flashcard, I’ll give you a penny). We can do better than that! Why not structure the game so that the child is using the target in a functional way to ear the pennies? For example:
Using plural -s/-es (I want five pennies, I want three pebbles, I want two beans)
Requesting “another” (another penny, please)
Quantity words: some, a few, a little, a lot
Subject + Verb + Object + Prepositional Phrase sentences (Mommy puts the penny in the boat, I put the penny in the boat)
Future tense (I will drop it in, I think it will sink)
More advanced language: predicting, reasoning, science terminology, estimating, etc.
And what if you need to work on an articulation (speech sound) goal? You can still make this activity phoneme-loaded without resorting to a traditional stimulus-response-reward structure. Why stick with just pennies? For blends, you could load the boat with sticks (/st/), stones (/st), quarters (/kw/), blocks (/bl/), or more. Will it float (/fl/)?