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Communication in Early Intervention

Original Editor - Dawn Willard

Top Contributors - Ewa Jaraczewska, Jess Bell and Kim Jackson  

Introduction

Infants start interacting with their environment from birth, responding to visual and auditory events and actively engaging in spontaneous movements of their limbs.[1] When working with children, it is important to recognise that motor problems frequently co-occur with communication difficulties.[2] [3] Where language and communication are reduced, a child's social development can also be affected.[4] This can impact their self-identity, self-esteem, self-control and interactions with others.[5] It can also affect caregivers,[6] who, as their child's primary communicators and advocates, play a pivotal role in helping children develop communication skills.[7] This page discusses how and why children communicate and offers basic communication strategies for caregivers to enhance communication with their children.

Methods of Communication in Children

Children adopt different communication strategies from infancy to when they become verbal.

Non-verbal Communication

"Infants as young as eight weeks of age actively engage in turn-taking in vocal interactions with their caregivers"[8]

Early non-verbal communication includes eye gaze, smiling, pointing, certain vocalisations, grabbing and crying.[9] If these non-verbal cues are absent or lack social intent, it may indicate developmental concerns and potential language acquisition challenges.[10]

A stimulus-response relation is usually learned by around 12 months of age.[11] This can be observed when an infant orients towards the caregiver to search for cues (e.g. in response to a new toy). Gazing towards the caregiver is critical for learning gestural communication. The absence of sustained infant eye contact with caregivers may indicate that the infant has a developmental delay,[12] with "associated delays in language and/or the absence of learning new stimulus–stimulus relations".[11]

Joint attention usually begins at 9-12 months of age and refers to an infant's "ability to make eye contact with another individual, shift her gaze to some stimuli and regain eye contact with the same caregiver".[11] It occurs when two or more people focus together on a shared point of interest, and it forms an important part of communication.[13] Joint attention supports the early learning of language skills, including naming, and provides a basis for cognitive development and social referencing.[11] Social reinforcers, such as a nod or a gestural expression, facilitate and maintain an infant's joint attention.

Social referencing is a behaviour chain involving an interaction between two people (e.g. a caregiver and child). It follows a sequence of eye contact, a gaze shift to a new stimulus, a return of gaze to each other, and altered facial cues.[14]

Verbal Communication

Infants begin to respond to symbolic language cues from around 6 months and may begin pointing to and naming objects by around 12 months.[11] Naming usually involves several steps: tracking the eye gaze of the person naming the object to ascertain what they are naming, repeating the name in the presence of the object, and looking back at the caregiver for confirmation. In some infants, receptive language can exceed 100 words by 12 months, although comprehension varies widely at this age. Expressive vocabulary usually catches up at around 18 months.[11]

Understanding Styles of Communication

The following strategies can enable caregivers to help their children learn language and start to use it expressively. Caregivers first need to understand how their child is already communicating (for example through gaze or smiles) and then consider how and why they are communicating that way. They should then identify how and why they communicate and recognise these same behaviours in their children. From there, caregivers can begin to understand and anticipate how to help their child communicate more.[9]

Understanding the Child's Style of Communication

To help caregivers understand their child's style of communication, ask the following questions:

  • Is your child very sociable?
  • Does your child have easy back-and-forth conversation and communication?
  • Is your child passive during conversation and communication?
  • Does your child have a reluctant style of communication?[9]
Understanding the Caregiver's Style of Communication

You can ask similar questions to help the caregiver understand their communication style:[9]

  • What kind of communication style does the caregiver have?
  • Do they have a passive style?
  • Do they have a sociable style?
Understanding how the Environment and Personal Feelings Affect Communication

It is important that caregivers understand that communication depends on our environment and how we are feeling. We cannot always expect our children to communicate in every environment and children may not want to communicate after a long day, just as adults may not.[9]

Four Stages of Early Communication

There are four identifiable stages of early communication: the discoverer stage, communicator stage, first-word user stage, and combiner stage.[15] The age ranges below are approximate and overlap, as each child is unique and may transition between stages at different times. One child may move more slowly through the stages than other children of the same age. This can be influenced by developmental delay or illness. Understanding where a child is in their development helps to set realistic expectations and goals.[9]

  • Discoverer stage (birth-8 months[16]): the infancy stage, with no back-and-forth reaction. Infants at this stage communicate through reflexive responses, such as crying, smiling and fussing, to get their needs met.
  • Communicator stage (8-13 months[16]): the child begins to understand meaningful conversation and starts to formulate or send messages with a specific purpose in mind, using pointing or grunting to send messages with intent. Communication remains non-verbal.
  • First word user stage (12-18 months[16]): the child uses words or signs regularly.
  • Combiner stage (18-24 months[16]): The child begins to combine words into two- and three-word phrases.

Communication Strategies for Parents

An excellent communicator usually listens, does not interrupt, and follows the other person's lead.[9] The following strategies can help caregivers communicate more effectively with their children.

1. Get Face-to-Face

Standing over a child can make them feel intimidated and uncomfortable, whereas getting down to the same level makes them feel more comfortable and allows communication to flow more freely. Being face-to-face helps the child understand what is being said and lets them model the caregiver's words by looking at their mouth. In some situations, it is not possible to be face-to-face, such as when walking or pushing a pushchair (if the child is facing away), while driving with the child in a car seat behind you, or when talking with your back turned, such as preparing dinner at the sink while the child plays on the floor behind you.[9]

2. Observe the Child

The clinician's role is to help the caregiver become a tuned-in listener, to understand the importance of getting face-to-face with a child, and to wait and observe how a child communicates.[9] Careful observation helps the caregiver determine what the child is trying to tell them, what messages they are sending, how they are communicating (pointing, grunting, smiling), and why they are choosing that style – for example, because they are happy or have enjoyed something.[9]

3. Respond to the Child's Communication

"When children learn to communicate, it's for a desire from within."[9] -- Dawn Willard, SLP

Rather than beginning a response by attempting to teach, control or show, help the child learn to verbalise and communicate from a desire to express what they want. As soon as the child sends a message, respond immediately; if a child is not listened to, they may leave the interaction quickly.

4. Follow the Child's Lead

"Silence is the sound of someone thinking."[9] -- Questlove

"Playing the way the child wants to play is the most important part of following their lead."[9] -- Dawn Willard, SLP

Allow the child to initiate conversation, as this is the first step towards using expressive language to communicate with others. There should be pauses and give-and-take during a conversation, so the caregiver should not talk the entire time. Waiting five to ten seconds for the child to send a message gives them time to process what is happening and decide what they want to communicate next.[9]

Summary of Strategies for Parents and Caregivers

Caregivers can use the following strategies to help their children develop language and start using it expressively: get face-to-face, observe, listen, and follow the child's lead by staying on topic.[9]


The short video below describes back-and-forth interactions and considers how to help children develop communication skills:

[17]

ICF-CY Resources

The International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY) can be used to define the impact of communication problems on a child's functional skills. The cognitive functions of language include "recognising and using signs, symbols, and other components of a language", as described in the ICF-CY. You can learn more about the ICF-CY in the Plus course, Using the ICF with Cerebral Palsy.

Resources

References

  1. ↑ Versfeld P. The Newborn Infant – Setting the Scene Course. Plus, 2023.
  2. ↑ Vaillant E, Geytenbeek JJM, Jansma EP, Oostrom KJ, Vermeulen RJ, Buizer AI. Factors associated with spoken language comprehension in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2020 Dec;62(12):1363-1373.
  3. ↑ Valla L, Slinning K, Kalleson R, Wentzel‐Larsen T, Riiser K. Motor skills and later communication development in early childhood: Results from a population‐based study. Child: Care, Health and Development. 2020 Jul;46(4):407-13.
  4. ↑ van Barreveld M, Scheper A, Vissers C, Duinmeijer I, Hakvoort B. Social-emotional functioning and quality of life in language disorders: a systematic review of development from childhood to adolescence. Int J Lang Commun Disord. 2025 May-Jun;60(3):e70039.
  5. ↑ Sainain NS, Omar R, Ismail H, Mamat N, Abdullah R. Parental knowledge and development of languages and literacy, communication and socializations in the early childhood education. International Journal of Psychosocial Rehabilitation. 2020;24(9):2070-80.
  6. ↑ Leitão S, St Clair MC, Botting N, Gibson J, Jackson E. "They don't realise how hard he has to try every day": The rewards and challenges of parenting a child with developmental language disorder. Int J Lang Commun Disord. 2025 Mar-Apr;60(2):e70003.
  7. ↑ Dinkel D, Rasmussen M, Rech JP, Snyder K, Dev DA. A qualitative comparison of parent and childcare provider perceptions of communication and family engagement in children's healthy eating and physical activity. Child Care Health Dev. 2022 Jan;48(1):99-109.
  8. ↑ Nguyen T, Zimmer L, Hoehl S. Your turn, my turn. Neural synchrony in mother–infant proto-conversation. Philosophical Transactions of the Royal Society B. 2023 Apr 24;378(1875):20210488.
  9. ↑ 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 9.11 9.12 9.13 9.14 Willard D. Communication in Early Intervention Course. Plus, 2024.
  10. ↑ Palomero-Sierra B, Sánchez-Gómez V, Magán-Maganto M, Bejarano-Martín Á, Ruiz-Ayúcar I, de Vena-Díez VB, et al. Early social communication and language development in moderate-to-late preterm infants: a longitudinal study. Front Psychol. 2025 Apr 3;16:1556416.
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 Pelaez M, Monlux K. Development of Communication in Infants: Implications for Stimulus Relations Research. Perspect Behav Sci. 2018 Apr 17;41(1):175-188.
  12. ↑ Araújo LA. Warning signs for identifying neurodevelopmental disorders: a systematic literature review. J Pediatr (Rio J). 2026 Mar-Apr;102 Suppl 1(Suppl 1):101478.
  13. ↑ Voniati L, Papadopoulos A, Ziavra N, Tafiadis D. Communication abilities, assessment procedures, and intervention approaches in Rett syndrome: a narrative review. Brain Sci. 2025 Jul 15;15(7):753.
  14. ↑ Pelaez M, Monlux K. Development of Communication in Infants: Implications for Stimulus Relations Research. Perspect Behav Sci. 2018 Apr 17;41(1):175-188.
  15. ↑ Hanen's Four Stages of Early Communication: A Short Guide for Parents. Available from https://www.hanen.org/About-Us/Who-We-Help/Academia/Hanen-Insider/Hanen-s-Four-Stages-of-Early-Communication--A-Shor.aspx [last access 17.12.2023]
  16. ↑ 16.0 16.1 16.2 16.3 Weitzman E, Greenberg J. The Six Stages of Communication and Language Development. Learning Language and Loving It. Hanen Publication 2002.
  17. ↑ Speech in a Sec. Developing a child’s communication skills. Available from:https://www.youtube.com/watch?2JG9AC0ZxuY [last accessed 12/12/2023]
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