BrainSTARS: Expressive Language Jeanne E. Dise-Lewis, PhD, Margaret Lohr Calvery, PhD, and Hal C. Lewis, PhD, BrainSTARS

A child with expressive language difficulties needs help participating in social and academic activities so that he does not become overlooked and isolated.

Use everyday activities:

• Praise your child when he does well in a conversational situation; be specific, "I like how you said ‘excuse me’ before interrupting."
• Your child is likely to fall back on one-word answers to questions. Help him to express himself more fully by asking open-ended questions, asking for elaboration, and inviting answers with more than one word.

Avoid: “How was school?” (Student is likely to reply, “OK.”)
Use: “What was the best thing that happened at school today?”

• Avoid holding important conversations when your child is already tired, when she is doing something else, or when time is short. For example, avoid conversations when rushing from one class to another or getting on the bus.
• Practice sticking with a topic and keeping a conversation going. Select topics for discussion such as a school field trip, a phone call to a family member, or a favorite sport.
• If your child struggles with words or stutters, provide adequate time for him to complete his thoughts. Do not pressure him to “hurry up.”
• Build vocabulary and skills with categorization by playing games in the car or on walks such as:
  • "Tell me al the animals you see in the park."
  • "Tell me all the different kinds of cars you see on the road."

Change the environment:

• Observe your child playing with peers. If your child is left out of conversation, practice, with siblings, joining in conversations during natural pauses. Teachers should use appropriate turn-taking with in-class discussions.
• When you don’t understand what your child has said:
  • Repeat back the parts that you do understand and ask her to tell you more about it.
  • Provide the word for your child if you can reasonably guess at it.
• If you see your child’s expressive language skills declining, that is your cue to reduce the stresses in the environment.  Anxiety causes expressive language difficulties to worsen.
• Waive foreign language requirements.

Teach new skills:

• Give your child the opportunity to develop fluency by practicing parts in plays, rehearse and read announcements, and teaching a prepared lesson to a younger student.
• For older children, role play real life conversations, such as attending a party, applying for a job, going out to dinner with family, or talking with a coach. Practice telephone conversations by having your child order a pizza or call a store for information.
• If your child is anxious about speaking in front of other people, don’t force it. Allow her to prepare in advance for in-class presentations and schedule her as the first presenter.
• Teach your child how to expand his verbal conversational abilities. Structure conversations with questions that allow the child to elaborate on details, for example, by using an interview technique. Discourage brief and vague answers by using open-ended questions.
• Provide opportunities for your student to develop expressive language skills through humorous or enjoyable activities, such as retelling stories and jokes and making up new stories based on videos and cartoons.
• Prepare for oral assignments, and increase comfort with oral expression, by practicing with a tape recorder.
• Teach your student how to organize his thoughts and express them in a meaningful sequence. For example, have the child ask himself, “what do I want to say to start, what should I say next, and what should I end with?”
• Encourage your student to use gestures, to move about when she speaks, and/or to refer to visual aids to help pace and increase comfort during speaking.
   

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From BrainSTARS, Brain Injury: Strategies for Teams And Re-education for Students, © 2002 Jeanne Dise-Lewis, PhD. Used with permission. The manual is available in English and Spanish. For more information or to order copies, call 720.777.5470 or chris.moores@childrenscolorado.org. A short video on how to use the BrainSTARS manual is available at www.youtube.com/BrainSTARSprogram.

Jeanne Dise-Lewis, PhD is a child clinical psychologist, director of the Psychology Program for the Department of Rehabilitation Medicine at The Children’s Hospital, and Professor of Psychiatry and Rehabilitation Medicine at the University of Colorado Anschutz Medical Campus. Dr. Dise-Lewis is a Magna cum Laude graduate of St. Joseph’s University in Philadelphia, the University of Pennsylvania (MS in Human Learning and Development), and the University of Denver (PhD in Child Clinical Psychology). A member of the faculty of the University of Colorado Health Sciences Center since 1984, Dr. Dise-Lewis has extensive experience in working with children and families of individuals who have acquired brain injuries. For the past 23 years, she has been the director of the Rehabilitation Psychology Services at The Children’s Hospital, creating several innovative programs of services for children who have medical needs and their families. She has developed workshops and presented papers nationwide in the area of pediatric traumatic brain injury.  She has been the principle investigator of three federal grants and has developed the BrainSTARS Manual, along with other innovative consultation programs regarding acquired brain injuries in children and adolescents. She is the PI of a grant funded by the Centers for Disease Control and Prevention titled “An Investigation of Outcomes associated with Pediatric Traumatic Brain Injury” and currently is the co-director of a Personnel Preparation grant funded by the US Department of Education, “Preparing School Psychologists to Meet the Needs of Students who have Acquired Brain Injury.” 

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