Expressive Language

A Guide to Expressive Language

What is expressive language? Are you concerned that your child is not verbally communicating effectively? If so, your child may be having difficulty with expressive language.  You might be able to guess that expressive language is the language that we verbally produce (sounds, words, sentences, etc.); however, it also includes the components of phonology, morphology, syntax, semantics, and pragmatics. Expressive language is important because it is the primary way that people communicate their wants, needs, thoughts, and ideas.

5 components of expressive language:Expressive Language

Phonology is the sound system of our language and the rules for combining sounds in words. For example, phonology governs that ‘ng’ does not come at the beginning of words but may be found in the middle or end of words like ‘finger’ and ‘wing’.

Morphology refers to the rules for creating words and word forms. This includes morphemes and linguistic units of language such as suffixes, prefixes, and roots. A morpheme is the smallest meaningful unit of speech and may include whole words or grammatical markers. For example, the word ‘cat’ is one morpheme but the word ‘cats’ has two morphemes. The ‘s’ morpheme results in ‘cats’ (plural) having a different meaning than the word ‘cat’ (singular).

Syntax refers to the rules of grammar and sentence structure. It is what governs the word order of sentences and structures within sentences. For example, it is because of syntax that we state “I see a big, brown dog” rather than “A big, brown dog I see”.

Semantics refers to the content of our language, or the meaning. Another term for this is vocabulary. In regards to expressive language, semantics is the variety of words one produces.

Pragmatics refers to the social and functional use of language. It is the difference between stating “Give me that pencil!” and “Can I please have that pencil?” Pragmatics is the ability to use the language components (phonology, morphology, syntax, and semantics) in a socially appropriate manner.

An expressive language delay or disorder may involve deficits in one or more of the components of language. You can help improve your child’s expressive language by providing clear, simple, and grammatically accurate models of language throughout daily activities.

North Shore Pediatric Therapy offers Speech and Language consultations at the Glenview, Highland Park, Bucktown, and Evanston locations.

American Speech-Language-Hearing Association. (1993). Definitions of communication disorders and variations [Relevant Paper]. Available from

a recipe for speech and language

A Holiday Cookie Recipe for Better Speech and Language

It is largely recognized that the holiday season is a lovely, yet chaotic time of year. During this busy time, being with family often takes precedent over the speech and language homework sent home by your child’s speech-language therapist. Why not combine a holiday tradition with speech-language homework?

Use this recipe for extra language and speech reinforcement while decorating cookies this holiday season:

  • 2 cups of basic concepts: While adding ingredients give directions emphasizing the understanding of a recipe for speech and languagequantitative concepts, such as all, some, one, both. For example, “Add both cups of flour” or “Put on some red sprinkles and some green sprinkles.” If this is too advanced, you can always get extra practice with counting. You can count the cups of ingredients or the number of cookies.
  • 1 teaspoon of adjectives: Adjectives or descriptive words can easily be targeted during baking. You can talk about ways to describe the cookies that you are making, e.g., “Look! You made a big cookie and your sister made a small cookie,” or you can give directions including adjectives, e.g., “Decorate the long tree cookie and I’ll decorate the short tree cookie.”
  • 2 tablespoons of vocabulary: Like with any activity throughout your day, it is good to try to introduce your children to new vocabulary or reinforce the vocabulary they are already using. Vocabulary categories that are easily targeted during cookie decorating are: colors, shapes and nouns. For example, “Do you want to make the tree, snowman or ornament?” or “What colors did you use on your cookie?”.
  • Mix in turn taking: Turn taking is a great social skill to practice at home with siblings or friends. Take turns putting in ingredients, mixing or putting on candies to decorate. Appropriate turn taking can be used by kids when playing games with peers and during conversations.
  • Stir in requesting: Have your child exercise his or her expressive language skills by requesting for items. Depending on their skill level a carrier phrase could be used, “I want ______” or the request could be in question form, “Can I have the _______, please?”. Once your child is successful at making simple requests, work towards expanding the utterance, making the request longer, (e.g, “I want the red frosting”).
  • Bake for following directions: Baking holiday cookies makes for the perfect set up for your child to practice following directions. First start with simple one step directions, “Put on white frosting”. To continue to improve your child’s receptive language you can advance to first/then directions, “First put on white frosting, then put on green sprinkles”.
  • Let it cool with articulation practice: Throughout the whole baking/decorating process, articulation (speech sounds) can also be targeted. As an adult model, you can provide the correct productions for your child emphasizing the target sound. (e.g., What cookie do you like?, Look at my cookie!”). If your child is at the stage in speech therapy where they can practice saying their target sounds, work on using them during the activity. For instance, if you were working on “s” or s-clusters you could practice using the sound to describe what you see “I see a reindeer” or when taking about the steps to baking “Stir in the flour”.

Throughout your cooking baking experience keep in mind that the activity should remain fun, keeping the speech-language practice with in your child’s abilities in order to keep frustration low. Enjoy this recipe for ideas of ways to target speech and language! Happy Holidays!

Hearing Loss

How Hearing Loss Impacts Communication

Hearing loss impacts nearly 20% of Americans to some degree. This may manifest in a variety of different manners, including adultsHearing Loss watching TV just a little too loud (Hi, Dad!), children sitting closer to the teacher in class, or even lip reading. Some individuals will use hearing aids, cochlear implants, or even Bone Anchored Hearing Aids (BAHA).

All children in Illinois are given a newborn hearing screening prior to leaving the hospital at birth. This helps to identify children early who may be at risk. Babies with hearing loss are at greater risk for delayed speech and language development, and early identification and intervention are best to reduce any negative effects.


Degree of Hearing Loss Effect on Communication
Minimal Hearing Loss (16-25 dB) Child may miss 10% of a message when teacher is more than 3 feet away. Effect is greater in a noisy environment.
Mild Hearing Loss (26-40 dB) Child may miss 25-50% of a message without using any amplification.
Moderate Hearing Loss (41-55 dB) Child will understand speech only when standing face-to-face, a few feet away. When novel words or ideas are presented, child will likely miss most. Without amplification, child may miss 50-100% of message.
Moderate to Severe Hearing Loss (56-70 dB) Child may miss 100% of message unless amplification is used. Speaker must use slow, loud speech.
Severe Hearing Loss (71-90 dB) Child may hear sounds approximately 1 foot away, when not using amplification.
Profound Hearing Loss (>90 dB) Child may be aware of speech vibrations, but will likely not detect sounds. Oftentimes, child will rely on vision to compensate for hearing inability.


Intervention depends on an individual’s age, degree of severity, and type of hearing loss. Difficulties with hearing may impact a child’s language and school success. Should you have concerns about your child’s hearing abilities, consult with an audiologist!


 Click here to find out more about how hearing affects speech and language.


Plante, E., & Beeson, P. (2004). Communication and Communication Disorders: A Clinical Introduction (2nd ed.). Boston: Pearson/Allyn and Bacon.


Shipley, K. G., & McAfee, J. G. (2009). Hearing Considerations. In Assessment in Speech

Language Pathology: A Resource Manual (4th ed., pp. 580-581). Clifton Park, NY: Delmar

Cengage Learning.

everyday items for language play

How to Use Everyday Items for Language Play




When you walk into your child’s therapy clinic, you see toys, games, slides, swings, bubbles, scooters….I could go on forever. There’s always an endless supply of things to keep children entertained, motivated, and mostly, to make sure they’re having fun while working towards their therapy goals. However, you don’t need fancy toys or equipment to work on speech and language! Purchasing and using toys as therapy tools can be costly, overwhelming, and even intimidating for many families. However, there are a multitude of items you can find in your own home that will work great for speech and language home practice. And the best part, these are things you most likely already have so the cost is minimal or even nonexistent!

Home Tools for Speech and Language Practice:


What can I do with them?
Make them into a sock puppet or even a snake.
How can I use them for therapy?

  • Identify body parts
  • Pretend play
  • Feed the puppet; label food items you feed the puppet and verbs such as “eat” and “chew”
  • Conversational turn-taking skills

Bubble Wrap

What can I do with it?
Pop it!
How can I use it for therapy?

  • Verbalize “Pop!”
  • Have your child request “more”.  Allow him to pop a few and then hold the bubble wrap; either say or sign “more”.
  • Focus on size concepts; “These are big bubbles! This one is small.”

Toilet Paper/Paper Towel Roll

What can I do with it?
Leave it as is or decorate it!
How can I use it for therapy?

  • Play “I spy” to label common objects around the house.
  • Use it as a microphone for imitation. For example, say a word or phrase into the “microphone”, then have your child try it!
  • Make binoculars and use them to follow simple directions with location concepts. For example, “Find the ball under the table.”


What can I do with it?
Get creative! Make it into a play house, mailbox, oven, etc!
How can I use it for therapy?

  • Work on basic concepts such as “in, out, on, off”
  • Hide objects under or in it; “Where did the ball go? Find the ball!”
  • Place item in the box, don’t let your child see it, and have them guess what it is by feeling and describing the item.

Milk Jug

What can I do with it?

  • Cut it to make it into a scoop
  • Make it into a shaker

How can I use it for therapy?

  • Scoop up/pour out various items; label verbs like “scoop, pour, fall” and concepts such as “full, empty”
  • Sing nursery rhymes and use the milk jug as an instrument; stop at various point throughout the song and have your child fill in the words. For example, “Row, row, row, your ____”
  • Fill it up with water, pour it out or water plants in the garden. Work on concepts like “in/out”, “full/empty”, “heavy/light”.

Markers/Crayons and Paper

What can I do with it?
How can I use it for therapy?

  • Identification of body parts; draw a head and have your child label all the body parts you need.
  • Practice speech sounds; make dots ( “dot, dot, dot”), squiggles (“sssss”), dashes, etc. Pair any mark you make with a sound.
  • Make cards for family members. Talk about concepts/location of items. “Put the heart at the top of the page!”

This is just a tiny sample of items you can find in your home that can be used for therapy. There are endless possibilities. Remember all those old bridesmaid dresses you’ll absolutely never wear again? Hello, dress-up and pretend play! Get creative and have fun!

Click here for 5 fun and easy ways to promotes speech language in the warm weather!

speech and language activities for bedtime

Speech and Language Activities for Bedtime

Bedtime can be a great time to enhance your child’s speech and language skills! Utilizing this parent-child time to build skills and incorporate speech and language can be useful for a variety of purposes. See below for some fun tips to incorporate into your everyday routines!

5 tips to enhance speech and language skills:

  1. Follow directions: Use the bedtime routine to practice direction following. Tell children one or two steps to follow while getting ready for bed, and help when needed. Examples may include, “put your dirty clothes in the basket,” or “get under the covers.” Incorporating directions into the routine will target your child’s ability to understand location concepts as well as his auditory comprehension.
  2. Sequence steps: Similar to follow directions, giving your child a sequence to follow will target his ability to sequence steps. This skill is important during the school day, to ensure that your child is listening to his teacher and keeping up with his peers. Examples may include, “first, brush your teeth, and then pick out a book.” For older children a more complex sequence could include, “before you brush your teeth, put on your pajamas and pick out a book.”
  3. Story retell: It is very important to read to children, targeting increasing vocabulary, pre-literacy skills, auditory comprehension, as well as sentence construction. While reading to your children, periodically pose questions, such as, “who did brown bear see?” or ask, “why did the caterpillar eat so much?” After finishing a book, ask your child to retell you the story. If needed, he can use the pictures to help with the story construction.
  4. Build vocabulary: Reading aloud to your child is extremely beneficial for language development. When reading stories, emphasizing and reinforcing new words will enhance vocabulary skills, and explaining night time words will encourage usage. Use bedtime words like pajamas, moon, night, and stars in context, and encourage children to use new words, too!
  5. Narrate: Explaining what you’re doing can help expose your child to the correct production of language concepts and verb tenses. Narration can also help to increase your child’s vocabulary size. Examples may include describing activities and increasing use of adjectives (e.g., color, texture, size, etc.).

Click here to see our Speech and Language Milestone infographic!

School Readiness: What Does it Take for Your Child to Succeed in School?

In today’s world, expectations for your child’s academic performance are higher than ever. Occasionally, the requirements for school are actually above the developmental norms, causing even typically developing children to have trouble in school. Luckily, we know more than ever before about how to best support early development.

Speech and Language Skills Come First:

Good speech and language skills are the foundation for learning to read. Difficulty in this area will lead to further difficulty down the road. If children cannot say the sounds correctly, they have more trouble associating them with the correct sound. If children have difficulty with the content and grammatical aspects of language, they will have trouble comprehending the concept of how to read and how sentences are constructed. Read more

Hearing Impairment and Language

The earlier your child is diagnosed with a hearing impairment, the earlier he can receive services to assist in the development of speech and language skills during the critical 0-3 year-old period. Children with a hearing impairment are at a disadvantage during this time frame because much of language develops from exposure to the sounds and voices around them.

Implications of a hearing impairment during early childhood can include the following:

  • A smaller base vocabulary
  • Slower acquisition of words and sentence structures
  • Some American English sounds are produced with a very high frequency which is harder for children with hearing impairments to hear.  As a result, children with hearing impairments don’t learn these sounds.
  • Difficulty hearing and/or producing the /s/, /z/, /sh/, /ch/, /f/, and /v/ sounds. Read more

Red Flags for Feeding & Swallowing Disorders in Children

Most of us taking eating and swallowing for granted.  These actions come naturally and allow us to eat our mealsfeeding and swallowing disorders peacefully.  However, for some children, feeding and swallowing disorders make these natural reflexes and muscle actions difficult.  Read on to understand more about feeding and swallowing disorders and for red flags that your child may have a problem in this area.

What are feeding & swallowing disorders?

Feeding Disorders include difficulties gathering food to suck, chew, or swallow. According to ASHA:“…a child who cannot pick up food and get it to her mouth or cannot completely close her lips to keep food from falling out of her mouth may have a feeding disorder.”

Swallowing Disorders, also known as Dysphagia, include difficulty in one of the following stages of swallowing: Read more

3 Tips for Promoting Speech and Language Development in Children: Ages 0-3

Ages 0-3 are critical for learning and mastering speech and language. Some babies and toddlers initiate talking earlier speech and language developmentthan others.  If you are looking to encourage speech and language in your little one, read on for easy guidelines to help promote speech and language for young children.

3 Tips for promoting Speech and Language Development in children 0-3 years of age:

1. Use Simple Language:

  • Short sentences are easier to understand and allow your child to pick up the important pieces of the message.
  • Talk about what you are doing as you go about your day. It is easier for a child to pick up new language if he can see or hear the object or action as he is exposed to the vocabulary. Read more

Helping Your Child Produce the /K/ Sound at Home

As toddlers are developing their speech and language skills, there are a number of articulation errors that are typical. A common articulation error that speech therapya 2-year old may make is substituting the /t/ sound for /k/. For example, the child may say “tat” for “cat,” “tar” for “car” or “bite” for “bike.” By the age of 3, however, accurate production of the /k/ sound should be emerging in a typically developing child.

The /k/ sound is called a “velar consonant,” meaning it is produced in the back of the mouth, with the back of the tongue elevating to touch the velum (soft palate). When a child replaces this sound with a /t/, she is “fronting” the sound, which means she is instead lifting the front of her tongue (the tip) to the ridge behind her teeth.

If your child is unable to imitate the /k/ sound, try these tricks at home:

  • Use a mirror. Having the visual support of actually seeing what’s going on in the mouth will help your child.  Explain to your child you will be practicing the “/k/ sound” which is made “in the back of your mouth.”
  • Keep your child’s mouth open, and have her practice a coughing sound. She will feel the back of her tongue naturally elevate. You may need to provide tactile support by gently holding her lower jaw as a reminder to keep her mouth open. Provide positive verbal feedback like, “Great! I heard that sound in the back of your mouth.”
  • Use a popsicle stick to gently hold the front of your child’s tongue down while she tries the /k/ sound in isolation. Prompt her by saying, “Good job! I saw your tongue go up in the back.” Try it again without the stick.
  • Have your child lie on her back on the ground. Her tongue will naturally pull to the back of her mouth in this position. Try the /k/ sound in isolation. Make it fun by lying under a table with the lights off and a flashlight. Stick pictures of objects that have the /k/ sound (e.g. bike, cat, car) on the underside of the table, and practice the /k/ sound by itself every time the flashlight finds a new picture.
  • Once your child is able to imitate /k/ in isolation, practice in syllables (e.g. “key, “coo,” “kah”) and then the initial position of words (e.g. “can,” “cow,” “cat,” “carrot”). The /k/ sound may need to be separated from the rest of the word at first (e.g. “k – ey”) to maintain an accurate /k/ sound, however with continued practice, your child should be able to blend the sounds together.

With a little practice, your child should be producing the /k/ sound in no time!

For ideas on eliciting the /m/ sound in your child’s speech, click here.  If you have concerns regarding your child’s speech production, please consult a licensed speech-language pathologist to complete a full evaluation of skills.