Play-Based Therapy for Preverbal and Nonspeaking Children: A Speech Therapist’s Insights

As clinicians, we know that play is the work of the child. This concept is particularly crucial when working with preverbal kids. Play-based therapy not only engages these young ones but also fosters essential communication and developmental skills. Today, I want to share some insights and tips on how to effectively use play-based therapy with preverbal children, drawing from a recent discussion I had with Joanne Cazeau, a multilingual speech and language pathologist.

Understanding Preverbal Kids and Play

Preverbal children, those under 12 months who haven’t started using words, are still actively communicating. Joanne emphasizes that “just because a child is preverbal, that doesn’t mean that they’re not communicating or working on some early communication skills.” These skills, often referred to as pre-talking or mini milestones, are foundational for language development.

The Importance of Naturalistic Play

One of the key takeaways from Joanne’s approach is the emphasis on naturalistic, child-led play. Unlike traditional clinic-based interventions, home-based therapy allows children to engage in their natural environment. Joanne describes this as a setting where “if they’re up walking, I’m up walking. If they’re on the floor, I’m on the floor. If we’re rolling around, everybody’s rolling around.” This adaptability helps create a more engaging and effective therapy session.

Overcoming Barriers to Play

Preverbal children may face various barriers to play, including:

1. Lack of Access: Joanne highlights that “a lack of access to play and social play” is a significant barrier. This can be due to factors like time poverty, where parents have multiple responsibilities that limit their ability to engage in play with their children.
2. Physical Limitations: Physical or medical conditions can also restrict a child’s ability to participate in play activities.
3. Social Interaction Difficulties: Some children may struggle with pragmatic skills, affecting their ability to engage socially with others.
4. Communication Barriers: Without words, children might find it challenging to interact and play with peers or adults who are not familiar with their non-verbal communication methods.

Strategies for Clinicians

Here are some strategies to support preverbal and nonspeaking children in play-based therapy:

1. Use the Child’s Interests: Engage with whatever the child is naturally drawn to in their environment. As Joanne suggests, “if they’re up walking, I’m up walking. If they’re on the floor, I’m on the floor.”
2. Emphasize Joint Engagement: While joint attention (shared focus on an object) is important, joint engagement, which involves shared participation in an activity, is crucial. Joanne mentions, “I’m trying to say joint engagement because a child doesn’t necessarily have to be looking at something or looking at you to be able to engage in activity.”
3. Incorporate Everyday Routines: Children’s vocabulary and communication skills often reflect their daily routines. Integrate these routines into play to make learning more relevant and effective.
4. Utilize Non-Toy Play: Remember, “your child’s best toy is you.” Engage in people games and activities that don’t necessarily involve toys to foster interaction and communication.
5. Adapt to Physical Limitations: Find creative ways to include children with physical limitations in play. This might involve modifying activities or using adaptive equipment.

Final Thoughts

Incorporating play-based therapy into your practice with preverbal kids can significantly enhance their communication and developmental outcomes. As Joanne eloquently puts it, “play is the work of the child,” and through play, we can help these young learners reach their full potential.

By understanding the unique needs and barriers faced by preverbal children, and by employing flexible, child-centered strategies, we can create a more inclusive and effective therapeutic environment. Remember, the key is to meet children where they are and let their natural curiosity and interests guide the way.