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Preschool Social Language Therapy
Ages: 2-5   Grades: Toddler-K

Help your preschool child develop age-appropriate social language skills.  This book is chock-full of functional, goal-directed activities and practical "know-how" in ten key areas of social language development.


  • Establish developmentally-appropriate social language skills
  • Have successful interpersonal interactions
  • Make and keep friends
  • Accurately interpret and send nonverbal messages
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This is a systematic program of goal-directed activities for preschool children with developmental delays and older children with severe to profound pragmatic deficits.  These skill areas underpin social success:    

  • Social Referencing—eye referencing and joint attention
  • Reciprocity—turn-taking in play and in communication
  • Responding—following directions, reciprocating greetings, answering questions, and responding to comments
  • Initiation—gaining attention of the listener and beginning an interaction
  • Topicalization—topic maintenance, initiating a topic, and shifting topics
  • Communicative Functions/Speech Acts—protesting, requesting, answering and asking questions, and making statements/comments
  • Nonverbal Signaling—eye, voice, body, and space messages
  • Cohesion—presupposition, eliminating redundancy, and communicative reference
  • Comprehension Monitoring and Conversational Repair—inaccuracies in discourse, communication breakdowns, and conversational repair
  • Discourse Modalities—descriptive, narrative, persuasive, and humorous discourse

There is a hierarchy of instructional objectives and corresponding activities for each skill area.  The functional activities use:  

  • everyday objects and items
  • environmental prompts
  • reproducible therapy materials (cards, activities, social scripts, sequenced stories, visual organizers, etc.)

Each skill area has teaching helps:

  • detailed explanations of the skills
  • hallmarks and red flags in development
  • prerequisite skills
  • teaching and troubleshooting tips

Copyright © 2012

174-page book

  • Speech-language pathologists should play a central role in treatment of infants and toddlers with disabilities.  Children with identified disabilities should have access to a broad spectrum of care to address communication and other needs (ASHA, 2008a, 2008b, 2008c; Individuals with Disabilities Education Improvement Act, 2004).
  • Prelinguistic pragmatic functions are directly related to later expressive vocabulary in children with mild to moderate developmental delays.  Their rates of joint attention and communication were statistically significant predictors of later expressive vocabulary (McCathren, Yoder, & Warren, 1999).
  • Children with autism and those with other disabilities showed significant increases in cognitive, communication, and socio-emotional functioning following intervention that targeted attention, persistence, initiation, cooperation, joint attention, and affect.  Relationship-based therapy was conducted once weekly in hour-length sessions for one year (Mahoney & Perales, 2005).
  • Joint attention and social development in infants were positively related to the emergence of social behaviors in preschool children (Vaughan Van Hecke et al., 2007).
  • Social-communication intervention promoted increased initiations, responses, turn-taking, and peer interactions in young children.  Quantity and quality of interactions improved significantly (Stanton-Chapman & Snell, 2011).
  • The more that mothers and caretakers engaged children in joint attention via gesture use at age two, the greater the children's verbal language development at age three (Schmidt & Lawson, 2002).
  • Using child-centered strategies that promote interaction, such as talking about what the child is interested in and waiting for the child to participate in interactions, leads to more talkativeness in toddlers (Girolametto & Weitzman, 2002).
  • Shared event knowledge is important to scaffolding new language skills, particularly topicalization (Lucariello, 1990).
  • Book sharing activities provide adults with more opportunities for asking questions, making comments, and taking turns than many other conversational contexts with young children (Cole, Maddox, & Lim, 2006).
  • Book-sharing by teachers elicited more emotion words from preschool children, indicating more contemplation of emotional states (Thomas, 2010).
  • Two of four preschool children with autism increased initiation attempts through application of video self-modeling techniques (Buggey, Hoomes, Sherberger, & Williams, 2011).

Preschool Social Language Therapy incorporates these principles and is also based on expert professional practice.


American Speech-Language-Hearing Association (ASHA). (2008a). Roles and responsibilities of speech-language pathologists in early intervention: Guidelines [Guidelines]. Available from

American Speech-Language-Hearing Association (ASHA). (2008b). Roles and responsibilities of speech-language pathologists in early intervention: Position statement [Position statement]. Available from

American Speech-Language-Hearing Association (ASHA). (2008c). Roles and responsibilities of speech-language pathologists in early intervention: Technical report [Technical report]. Available from

Buggey, T., Hoomes, G., Sherberger, M., & Williams, S. (2011). Facilitating social initiations of preschoolers with autism spectrum disorders using video self-modeling. Focus on Autism and Other Developmental Disabilities, 26(1), 25-36.

Cole, K., Maddox, M., & Lim, Y. (2006). Language is the key. In R. McCauley & M. Fey (Eds.), Treatment of language disorders in children (pp. 149-174). Baltimore, MD: Paul H. Brookes.

Girolametto, L., & Weitzman, E. (2002). Responsiveness of child care providers in interactions with toddlers and preschoolers. Language, Speech, and Hearing Services in Schools, 33, 268-281.

Lucariello, J., (1990). Freeing talk from the here-and-now: The role of event knowledge and maternal scaffolds. Topics in Language Disorders, 10(3), 14-29.

Mahoney, G., & Perales, F. (2005). Relationship-focused early intervention with children with pervasive developmental disorders and other disabilities: A comparative study. Developmental and Behavioral Pediatrics, 26, 77-85.

McCathren, R.B., Yoder, P.J., & Warren, S.F. (1999). Prelinguistic pragmatic functions as predictors of later expressive vocabulary. Journal of Early Intervention, 22(3), 205-216.

Schmidt, C.L., & Lawson, K.R. (2002). Caregiver attention-focusing and children's attention-sharing behaviors as predictors of later verbal IQ in very low birth weight children. Journal of Child Language, 23, 279-305.

Stanton-Chapman, T.L., & Snell, M.E. (2011). Promoting turn-taking skills in preschool children with disabilities: The effects of a peer-based social communication intervention. Early Childhood Research Quarterly, 26(3), 303-319.

Thomas, D.V. (2010, January 1). The nature of teacher-child interactions in emotion discourse. (Doctoral dissertation). ProQuest LLC. (AAT 34.30902)

Vaughan Van Hecke, A., Mundy, P.C., Acra, C.E., Block, J.J., Delgado, C.F., Parlade, M.V., & Pomares, Y.B. (2007). Infant joint attention, temperament, and social competence in preschool children. Child Development, 78(1), 53-69.



Tina K. Veale


Tina K. Veale, Ph.D., CCC-SLP, is professor and program director of the Speech-Language Pathology Program at Midwestern University in Downers Grove, Illinois.  She teaches courses in child and adolescent language disorders, autism spectrum disorders, neurological aspects of communication, and research methods.  Tina has held previous university appointments at Eastern Illinois University, Western Illinois University, Miami University (Ohio), and the University of Cincinnati.  Her research has included studies to evaluate learning styles of children with autism, patterns of language acquisition in early emergent language users with autism, the impact of routine upon language therapy for children with autism, the effectiveness of auditory integration training for children with autism, early indicators of Asperger syndrome, and ways to differentially diagnose autism spectrum and related disorders.

For 28 years, Tina owned and operated Comprehensive Concepts in Speech and Hearing, Inc. (CCSH), a private practice in Cincinnati, Ohio.  Tina also developed Wee Talk, a preschool for children with developmental disabilities.  Other professional experiences include ongoing consultations with schools across Ohio and Illinois as an autism consultant and serving families as a private speech-language pathologist.

Tina has conducted workshops and professional presentations at local, state, national, and international venues for nearly three decades.  She has served both the Ohio Speech-Language-Hearing Association as the director of educational and scientific affairs and the Illinois Speech-Language-Hearing Association as vice president for the division of educational development.  Service to the American Speech-Language-Hearing Association has included committee work to prepare position statements and technical reports, assistance with program selection for the annual convention, and numerous conference presentations.


The preschool years of child development are magical.  Children emerge into walking, talking little people who surprise and delight us with the things they say and do.  During these years, children grow physically, cognitively, linguistically, and socially.  In fact, developmental changes occur faster during this period than at all others in the human life cycle.  For the neurotypical child, these are years of metamorphosis.  From ages 2 to 5 years, children begin to run and climb, think and learn, talk and converse, and interact with others around them.

By the time most children go to kindergarten, they talk in complex sentences and enjoy socializing with other children.  They understand when their teacher speaks in strings of complex utterances.  They crave novel information and absorb it readily.  No longer do they require individual lessons, but they can learn via group instruction.  They play with a variety of construction and imaginative toys and are cooperative with other children in play settings.  They are ready to take on the new frontier of elementary school and all that it requires.

Some children, however, don't develop all of these skills during the preschool years.  For them and their parents, these years can be challenging and concerning.  When a child fails to meet motor, cognitive, language, or social milestones, it's a sign of a developmental disorder.  We know that early detection and treatment of developmental deficits yields positive results, and this knowledge has produced institutional mechanisms for ensuring early identification and intervention.  If you're reading this book, you may well be part of a team of professionals who address the developmental needs of preschool children.

In order to target communication concerns, speech-language pathologists (SLPs) consider numerous linguistic abilities.  These include syntax, morphology, phonology, semantics, and pragmatics.  There are clear milestones for skill emergence in each of these domains and numerous therapy techniques designed to address deficits.  Of all the domains, it's fair to say that pragmatics remains the most elusive.  Perhaps this is because pragmatic disorders occur less commonly than other language problems.  Perhaps it's because pragmatic elements are relative and depend on the communicative context.

This can be illustrated quite simply.  Consider the sentence, "It's really hot in here."  The syntactic, morphological, phonological, and semantic elements of the utterance remain the same no matter when or where the speaker says this sentence.  The pragmatics, however, can vary greatly.  This social relevance of the utterance, including its perceived meaning, shifts based on a number of elements.  These include who the speaker is talking to, who else is in the room, where the speaker delivers the message, and how the speaker delivers the message (facial expression, tone of voice, body language, proximity).  As the pragmatic elements of the communicative exchange shift, so does the interpretation of the message.  Because pragmatic elements are ever-changing, and there are so many possible pragmatic influences on a given message, addressing pragmatic deficits in individuals is extremely challenging.

Pragmatic language problems are the underpinnings of most social disorders.  When children don't know what to say and when to say it, their communication can appear awkward, rude, and insensitive.  This quickly translates into social isolation by peers and fewer opportunities to develop social skills.  We witness the impact of social-pragmatic deficits very early in a child's development.  While family members often accept a child's social differences as personality traits, as soon as the child interacts with people outside of his immediate family circle, social problems can result.  This often occurs in preschool when most children come face-to-face with an extended peer group for the first time.

Traditionally, SLPs have addressed social-pragmatic deficits in school-age and adolescent clients.  By mid-elementary to junior high school, the social fallout from pragmatic communication deficits has compounded into significant issues for the child and his peers. This is often when we are called to assess and treat social-pragmatic problems.  In recent years, our focus has begun to shift to pragmatic problems of younger children.  This is due in part to our focus on early intervention, but it's also secondary to the dramatic increase in the incidence of autism.  Social-pragmatic disorder is part of all autism spectrum disorders.  We now have an ever-growing number of preschoolers with pragmatic deficits, many of whom are in the autism spectrum.  In addition to these clients, other preschoolers exhibit pragmatic problems, including those with severe hearing impairment, traumatic brain injury, psychiatric disturbances, or nonverbal learning disorder.

Preschool Social Language Therapy addresses the social-pragmatic issues of the preschool child; however, you may extend its use to older children or others who exhibit severe to profound pragmatic issues.  The philosophy for the content of the book is that social deficits are the result of underlying communication issues and they have a pragmatic basis.  As such, the book follows a hierarchy of pragmatic skill development.  You will note the developmental linguistic framework and recognize the skills addressed in the book as ones we expect a child to develop within the preschool years.

Teaching social-pragmatic skills requires us to devise ways to teach skills that most children develop naturally.  Sometimes the method of instruction may feel awkward or forced because we must break dynamic skills into a concrete teaching sequence in order to be successful.  This requires perseverance, and I encourage you to be patient.  These clients often don't understand the fundamental ways that communication occurs, and teaching them how to use verbal and nonverbal language as a social tool can take time.  It can also be extremely rewarding.  Teaching children to talk is satisfying, no doubt, but showing them how to use language to interact with others and meet social goals is amazing!  When your young clients begin to use communication to their advantage, their language development and their social success accelerates.  Few things are as gratifying as seeing this process unfold.

I wish you every success as you tackle social-pragmatic goals and hope you find Preschool Social Language Therapy useful as you address pragmatic deficits in preschoolers.  It's important, perhaps critical, that we identify and remediate core elements of a social-pragmatic disorder early, before they grow into complex social impairments.  By assessing and addressing core pragmatic skills, you'll help children build the social skills they need to be more successful in interpersonal interactions.  This will affect not only their ability to make and keep friends, but it will also positively influence their sense of self and others' opinions of them and their abilities.  It will promote success in school, at home, and later in the workplace.  These skills lay the foundation for a more satisfying and successful life.