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New Information About Why Early Intervention is Key for Children with Autism Spectrum Disorder

This article in our series of short essays from Toronto's Hanen Centre is by Lauren Lowry, clinical staff writer and Hanen SLP.

If you have a child with autism spectrum disorder (ASD), or if you work with this population of children, you’ve likely heard the term early intervention. It’s almost impossible to read anything about ASD without hearing this catchphrase.

So what’s the big deal about early intervention? Why is it so important to start helping children with ASD as early as possible?

Now that children are receiving diagnoses earlier, we are able to follow their language development from a young age and track their progress.

Well, researchers have been working hard to find signs that let us identify children earlier and earlier. And now that children are receiving diagnoses earlier, we are able to follow their language development from a young age and track their progress. This means that we can see patterns in their development and notice time periods when children tend to make the most improvements in their language skills.

Two recent studies track young children’s language development

Two groups of researchers recently tracked the language skills of young children with ASD and compared them to their later abilities:

  • Jessica Mayo and her colleagues from the University of Connecticut looked at 119 children with ASD between the ages of 16 and 30 months [1]. They compared the timing of children’s first words with their abilities two years later. They considered a word to be a “first word” if it was a word other than “mama” or “dada” that was used in a meaningful, consistent way to send a message to someone (they did not include words that children could imitate but not say on their own).

    These researchers found that children who spoke their first words earlier tended to have better abilities later in childhood. And, in particular, children who acquired their first words by 24 months tended to have stronger language and cognitive skills later on than children who didn’t meet this milestone. However, even after 24 months, the earlier children acquired first words, the better their progress was.
  • Andrew Pickles and his colleagues followed 192 children with ASD from the time they were 2 years old up until they were 19 years old [2]. They looked for patterns in children’s language development and noticed several interesting things:

    • All of the children improved between ages 2 and 19, but their rate of improvement was quite varied before age 6 - some children started out with slow progress but made very good progress and surpassed other groups of children by age 6. Other groups of children had more stable progress over time.
    • After age 6, the children’s progress was not varied- children continued to make improvements after age 6, but they maintained their developmental path (did not surpass other groups’ progress but stayed on a stable track over time).
    What this means is that before age 6, children with ASD make the most changes in their language development. And if we want to have the biggest impact on a child’s language development path, we need to start doing so before age 6 [2].

The earlier, the better

The take-home message from these two studies is that the earlier children acquire language skills, the better their outcomes tend to be. Children who say their first words by 24 months tend to have better abilities later on, and children who show a lot of progress in their language development before age 6 tend to have better language skills as adults.

The earlier we start helping children with their language development, the better.

This does not mean that all progress stops as children get older. Children continue to grow and develop new skills. But this research shows that the key time frame for children to make the most gains in their language skills is when they are younger than 6. This means that the earlier we start helping children with their language development, the better.

Helping children early

In order to help a child as early as possible, it’s important to:

  • Seek help if you are concerned – Mayo and her colleagues discourage what has been called the “wait and see” approach to language delay. If a child’s language is behind, seek out an assessment by a speech language pathologist (SLP) as soon as possible to determine if help is needed.
  • Keep track of a child’s communication skills – SLPs rely on parents and other adults in a child’s life to provide valuable information about a child’s progress and skills at home. When a child starts to use words, notice if they are used to send a message to someone, or if the child is just playing with sounds or copying something he’s heard. And notice the other ways a child communicates – with his eyes, hands, and body. Any information you can provide will help the SLP determine whether your child needs intervention.
  • Communication is about more than just words – Mayo and her colleagues emphasize that while their study looked at children’s first words, words should not be the only focus in intervention. There are several skills which promote children’s outcomes that often develop well before words, and spoken words should only be the focus when a child is ready.

We need to give children the best kick-start we can so they have their best chance at good outcomes. In order to do this, we need to identify children early and provide them with help as soon as possible. Parents should to listen to their gut and seek help if they are concerned about their child. Because the earlier a child receives help, the better.


  1. Mayo, J., Chlebowski, C., Fein, D. A., & Eigsti, I. (2013). Age of first words predicts cognitive ability and adaptive skills in children with ASD. Journal of Autism and Developmental Disorders, 43, 253–264.
  2. Pickles, A., Anderson, D. K., & Lord, C. (2014). Heterogeneity and plasticity in the development of language: A 17-year follow-up of children referred early for possible autism. Journal of Child Psychology and Psychiatry, 55(12), 1354–1362.

If you’re a professional working with young children, take a look at Hanen's Starting Early: Red Flags and Treatment Tips for Toddlers on the Autism Spectrum seminar for more information on how to identify red flags and select appropriate intervention goals for toddlers with autism spectrum disorder.


The Hanen Centre is a Canadian not-for-profit charitable organization with a global reach. Its mission is to provide parents, caregivers, early childhood educators and speech-language pathologists with the knowledge and training they need to help young children develop the best possible language, social and literacy skills. This includes children who have or are at risk for language delays, those with developmental challenges such as autism, and those who are developing typically.

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Shoot for the SSTaRS: A Strategy for Teaching Vocabulary to Promote Emergent Literacy

This article from the Hanen Centre was written by Elaine Weitzman, Executive Director, and Janice Greenberg, Program Director of the Hanen Learning Language and Loving It program.

If you like these strategies, you’re in luck. They all come from Hanen's guidebooks and trainings, which we at SNP think are hard to beat. This month, you can save 20% on all Hanen resources (except sets and members-only items).

Children learn new words every day. How many words they learn and how well they understand and use these words will have a significant impact on the kind of readers they eventually become. Reading involves understanding printed words, and having a large vocabulary makes it easier to gain meaning from what is being read. Vocabulary is also a tool for thinking and learning about the world. The more words children know, the more information they have. The more information they have, the better their understanding of the world and the easier it is for them to learn new words.
Children with rich vocabularies have an enormous educational advantage. Many studies show that vocabulary is the best predictor of reading comprehension at the end of grades 2 and 3, and that vocabulary growth is directly linked to overall school achievement. Not all children have the same opportunities to learn new words. As a result, children’s vocabularies can differ enormously in size by the end of their preschool years. Building children’s vocabulary in early childhood settings must therefore be a priority if children are to have the foundation they need to succeed at school.

When children first use new words, they usually have a limited idea of what they really mean. Helping children develop a deeper understanding of words is an important part of building their vocabulary. The adults in a child’s life play a significant role in helping children build a deeper understanding of words. They do this by giving children many opportunities to hear words in meaningful everyday conversations. In addition, they give children feedback on their use of words, leading to wonderful discussions about what the words mean.

A guidebook from The Hanen Centre, ABC and Beyond™: Building Emergent Literacy in Early Childhood Settings,outlines a powerful strategy for teaching vocabulary - Shoot for the SSTaRS. This  flexible, practical strategy can be naturally infused into shared book reading and other daily activities and routines in early childhood environments and at home.

Shoot for the SSTaRS is an acronym that represents:

The strategy is applicable to children who speak in sentences and already have a basic vocabulary. Early childhood teachers or parents can choose which words they want to help children learn, based on the following continuum:

Step 1 words — familiar everyday words like cat, table, funny, baby, dirty, eat and play. Children who are native language speakers rarely need explanations for these words since they are heard and used so often.

Step 2 words — more sophisticated words that are typically found in books and heard less frequently in conversations, especially in disadvantaged homes.

By sophisticated words we mean more precise words than the everyday words referred to in Step 1.

The goal is to:

A) replace familiar words (Step 1) with less commonly used words (Step 2) – for example, dash for run or exhausted for tired


B) introduce words that represent new concepts and build world knowledge, such as carnivore, technology and medication.

Once a new word is selected, then do the following:

Stress the new word:

Highlight the new word while introducing it. For example, “Look, that poor dog is exhausted. Do you know what exhausted means?

Show the children what the word means:   
  • Use facial expressions (e.g., to dramatize being exhausted)
  • Use dramatic gestures, pantomime or play-acting when possible (e.g., pretend you are exhausted and slump into a chair, assuming an exhausted posture)
  • Change the way you say the word - e.g., use a tired voice for “exhausted”
Tell the children what the word means:
  • Describe the word’s meaning - e.g., “He’s exhausted. That means that he is very, very tired. He’s so tired, he can hardly move. That’s what exhausted means.”
  • Give specific details about the word – e.g., “Look. The dog’s tongue is hanging out of his mouth and he’s panting because he’s been running so much. That has made him exhausted. If someone has been running for a long time that can make him feel exhausted. Staying up all night and not sleeping can also make you feel exhausted the next day.”
  • Describe what the word is and what it is not – e.g., “Exhausted doesn’t mean you are just a little tired. It means that you are very, very tired - so tired that your whole body feels like it can’t move and you just want to lie down and rest.”


Relate the word to the children’s experience, background knowledge and other situations.

New information makes more sense to children when they can relate it to something they already know. Help children develop a deeper understanding of new words by “hooking” new words onto their existing knowledge and experiences as well as onto words they already know.

For example, “Remember when your grandma came to visit? When she flew from England on a plane, she didn’t sleep the whole night. She was exhausted when she arrived, so she went to sleep early that night and slept until lunch time the next day. Then, when she woke up, she wasn’t exhausted anymore because she had a very good sleep.”

Relate the new word to other known words

Help the children recognize how the new word relates to other words. In relation to the word exhausted, introduce the children to familiar related words like sleepy and tired, as well as to new words like weary. It is also helpful to discuss words with the opposite meaning, like refreshed and energized. These kinds of discussions help children develop a clearer understanding of what exhausted means, as well as helping them understand other related words.

Relate the new words to other contexts/situations

You can build even greater depth of understanding of a word by relating it to other situations in which it can be used. For example, when discussing the word exhausted, you can talk about what else might make someone exhausted or about whether the same thing would exhaust different people. For example, a person who runs every day won’t be exhausted by running a mile, whereas a person not used to exercise might be exhausted after running much less than a mile.

Say it again

The more times children hear a word and the more contexts in which they hear it, the better they will understand it, and the more likely they are to use it.

It takes years before children truly understand the full meaning of a word. It is only through repeated exposure to the word and through participation in many conversations in which the word is used in varied contexts that they will fully understand it, even after they begin to use it themselves.

Note: There is no need to insist that children say the word. The goal is for children to understand it. Once they do, they will start to use it as part of their expressive vocabulary. In addition, while the examples provided appear to demonstrate the adult taking very long turns, a typical interaction would involve the children actively. It is important for adults to wait after telling children something about the word so they can then respond to the children's comments and questions.

Let’s take the word, passenger.

Here’s an example of how to Show, Tell and Relate for the word, passenger.

Note: ABC and Beyond™: Building Emergent Literacy in Early Childhood Settings (Weitzman & Greenberg, 2010), outlines practical strategies for infusing literacy into early childhood classrooms in ways that are playful, motivating and developmentally appropriate. This practical guidebook describes how early childhood teachers can make literacy instruction explicit and purposeful, yet still informal and enjoyable, as they interact with children during shared book reading and other daily routines and activities. In so doing, educators can help children develop the early literacy skills they need to learn to read and write successfully when they get to school.


Special Needs Project, the US and Latin American distributor, carries all Hanen Publications.

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More Than ABCs: Building the Critical Thinking Skills Your Child Needs for Literacy Success

The Hanen Centre is a Canadian not-for-profit charitable organization with a global reach. Its mission is to provide parents, caregivers, early childhood educators and speech-language pathologists with the knowledge and training they need to help young children develop the best possible language, social and literacy skills. This includes children who have or are at risk for language delays, those with developmental challenges such as autism, and those who are developing typically. SNP is glad to offer readers this article by Hanen staff writer Andrea Lynn Koohi.

The ideas in this article are from I’m Ready! How to Prepare Your Child for Reading Success. Based on the latest research in early literacy development, this guidebook gives parents easy-to-use interaction strategies for building the critical skills that prepare young children for school.


When sharing a book with your preschooler, one of the most important things to do is encourage her story understanding. The better your child understands the stories she hears now, the easier it will be for her to read and write stories on her own later.  

The words and pictures in a book can only tell us so much. To truly understand a story, your child needs to go beyond what’s written on the page or shown in the pictures. She needs to use her critical thinking skills to fully grasp the story’s meaning.

What Is Critical Thinking?

Critical thinking happens when a child draws on her existing knowledge and experience, as well as on her problem-solving skills, to do things like:

  • Compare and contrast
  • Explain why things happen
  • Evaluate ideas and form opinions
  • Understand the perspectives of others
  • Predict what will happen in the future
  • Think of creative solutions

During book reading, you can help your child develop all of these skills to help her understand the story at hand, and to prepare her for literacy success.

Story Understanding – It’s All Talk!

If your child just listens to a story and says very little, she won’t have much opportunity to build and use the critical thinking skills she needs to understand stories. That’s because this kind of thinking happens during back-and-forth conversations in which your child can draw upon her own experiences and problem-solving skills to talk about the story.

So remember to add a little conversation to every book you share with your child. Pause several times during the story to talk about what interests your child, and take a few minutes after the reading to keep the conversation going.


E’s and P’s – How to Get Your Child Thinking Critically             

As you and your child talk about the story, keep “E’s and P’s” at the back of your mind. These are the things your child needs to think about to exercise her critical thinking skills and deepen her understanding of the story:


Experiences — Connect the story with your child's knowledge and experiences

When you relate what you’re reading to something your child already knows or has already experienced, you help her better understand the characters’ perspectives and why they think and act the way they do.

Tip to promote this skill...

Choose a book about a familiar experience – Choose a book in which the main character does something your child has experience with – for example, a book about going to the dentist or making a new friend. Start a little conversation during the reading by saying something like, “Remember your first day at school? How did you feel when you didn’t know anybody?”


Explain — Why things happen

It’s important for your child to understand not only what is happening in a story, but why it’s happening. This builds her understanding of cause-and-effect, as well as her understanding of what motivates the characters in the book.

Tip to promote this skill...

Act out the story – After you’ve read a story a few times, gather a few props and have fun acting out the story with your child. For example, collect a few bowls, spoons, a chair and a blanket to act out Goldilocks and the Three Bears. Plan who will take on each role and if there are other children around, invite them to join in. Acting out the story will help your child think about how one event leads to another and why characters act and react the way they do.


Problem-solve — How to solve the problem in the book

To understand a story, your child needs to understand the problem that must be solved. Recognizing the problem and thinking of possible solutions builds the problem-solving skills she’ll need later when analyzing texts on her own.

Tip to promote this skill...

Use a thinking-out-loud comment – Thinking-out-loud comments start with words like, “I’m thinking that...” or “I’m wondering about...” These kinds of comments show your child how you are thinking about the book and encourage her to think along the same lines.

To encourage your child to problem-solve, make a comment like, “I’m trying to figure out what the pig could do to frighten away the wolf”. This kind of comment doesn’t require your child to respond, although there's a good chance that she will.


Predict — What will happen in the future

A good reader uses her knowledge and experience to predict what will happen in a story. Children who are encouraged to predict what will happen next get into the habit of searching for meaning, which is really what reading is all about.

Tip to promote this skill...

Ask a question about what might happen next – During book reading, ask a question like, “What do you think Franklin will do to make it easier for him to ride his bike?” Or, when finished reading a book, ask your child to predict what could happen in the future with a question like, “Do you think the first two little pigs will build new houses now?”

By helping your child think critically now, you’re laying the foundation for her to make judgements, solve problems, think creatively, empathize with others and communicate effectively – skills she’ll need not only for literacy, but for lifelong success.



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