Last clinically reviewed: 2026-06-13 · Reviewer: Dr. Neha Kukreja, Developmental Paediatrician (KMC 115037) · Author: Clinical Team, MASLP, RCI-registered · Corrections policy: we update this article when new peer-reviewed evidence appears. Contact us to flag a correction.
Roberts and Kaiser’s 2011 meta-analysis of 18 randomised controlled trials, published in the Journal of Speech, Language, and Hearing Research, established that parent-implemented language interventions produce significant gains in receptive and expressive vocabulary in toddlers aged 18 to 36 months [2]. The Hanen Centre’s It Takes Two to Talk programme — the most widely studied parent-mediated curriculum globally — codifies a small set of techniques that drive the results: communication temptations, modelling at the child’s level, expansion, and parallel play [4]. This guide translates those techniques into specific activities Indian parents can use daily with a 1.5 to 3 year-old.
Quick Reference
| What to know | Detail |
|---|
| Best age window | 18–36 months — strongest evidence base, highest neural plasticity for language |
| Time per day | ~25–30 minutes, broken into 4–6 short bursts embedded in routines |
| Timeline to visible change | 8–12 weeks of consistent technique application [2] |
| Strongest single technique | Communication temptations (Wetherby & Prizant CSBS) [1] |
| What it won’t fix alone | Childhood Apraxia of Speech, autism-related communication, or hearing-related delay — need clinical co-treatment |
Why Toddler Years Matter
Between 18 and 36 months, the brain is undergoing the steepest rate of synaptic refinement in the human lifespan. This is the window when phonological awareness, vocabulary growth, and grammar foundations consolidate. NIDCD’s parent guidance materials emphasise the 0-3 year window as the highest-leverage period for speech-language intervention [5]. The Indian Academy of Pediatrics aligns with this view in its developmental surveillance recommendations.
A practical implication: a 2-year-old with 50 expressive words today is statistically more likely to reach the 200-word vocabulary by age 3 than a 2-year-old with 5 expressive words. The work that closes that gap is what the techniques below address.
The 5 Evidence-Based Activities
Activity 1 — Communication Temptations
This is the highest-leverage single technique for under-2s and pre-verbal 2-year-olds.
How to set it up:
- Place a desired toy in clear view but out of immediate reach (on a high shelf, or in a sealed clear container the child can’t open).
- Bring it to the child’s attention. Make eye contact.
- Wait. Count silently to 5.
- The child has to communicate — by gesture (pointing), vocalisation, word, or sustained eye contact — to request it.
- Respond immediately to ANY communicative attempt. Even a grunt or finger-point earns the toy and a verbal model: “Yes, you want the bubbles. Bubbles!”
Wetherby and Prizant’s Communication and Symbolic Behavior Scales (CSBS) — a peer-reviewed assessment tool — identifies communication temptations as the most reliable elicitor of intentional communication in toddlers aged 12-24 months [1]. The mechanism is that the child has a real reason to communicate, not a test-like prompt.
Indian family example: at mealtime, hold a roti or a piece of mango within view but not in reach. Pause. Wait for the child to reach, vocalise, or point. Then provide it with the verbal model: “Roti! You want roti.”
Activity 2 — Modelling at the Child’s Language Level
Match your output to your child’s stage, not above it.
| Child’s current stage | Your modelling |
|---|
| Pre-verbal (sounds only) | One-syllable words: “ball”, “go”, “more”, “up”, “dog” |
| Single words | Two-word phrases: “red ball”, “go up”, “more milk” |
| Two-word combinations | Three-word phrases: “the red ball”, “Daddy go up”, “more milk please” |
| Three-word combinations | Short sentences: “I want the red ball” |
The principle: model the next developmental step, not three steps ahead. A 2-year-old saying “ball” benefits from hearing “red ball”, not “I would like the red ball please”. The Hanen It Takes Two to Talk programme codifies this as the “one-step-up” rule [4].
Activity 3 — Expansion
When your child says one word, you respond by adding one more in context.
Examples:
- Child: “doggie” → Parent: “Big doggie!” or “Doggie sleeping.”
- Child: “juice” → Parent: “Orange juice.” or “Juice cold.”
- Child: “up” → Parent: “Go up!” or “Up high!”
Roberts and Kaiser’s meta-analysis identified expansion as the most consistently effective parent technique across 18 trials [2]. The mechanism is that the child hears their own utterance reflected back, extended by one step, with no demand for production.
Activity 4 — Parallel Play with Self-Talk and Parallel Talk
You play alongside the child, narrating either your own actions (self-talk) or theirs (parallel talk), without asking them to perform.
Self-talk example:
Parent building a tower: “I’m putting the block on top. Another block. The tower is tall. Oh — it fell!”
Parallel talk example:
Child rolling a car: “You’re pushing the car. The car is going fast. The car went under the chair. You found the car!”
Why this works: the child hears language attached to the immediate context of their attention. This is more effective than abstract instruction for under-3s, whose working memory cannot retain language detached from current action.
Activity 5 — Turn-Taking and Imitation Games
Foundational pre-conversational skills.
- Ball roll: sit facing the child, roll a ball to them, wait for them to roll it back. With each turn, model a single word: “go”, “ball”, “your turn”.
- Sound imitation: make animal sounds and wait. “Moo!” — pause. “Woof!” — pause. The child does not have to produce on demand; their imitation, when it comes, is a milestone.
- Action games: Peek-a-boo, “Round and Round the Garden”, “Pat-a-Cake”. These embed turn-taking, anticipation, and language into play.
Toddlers learn the structure of conversation — speaker, pause, listener, response — through pre-verbal games long before they have words to fill the slots.
What the Evidence Does NOT Support
- Direct prompting (“say ball”). Often produces less spontaneous language. Replace with modelling-with-pause.
- Flashcard drills. Limited evidence for under-3s. The child needs experience-linked language, not isolated word lists.
- Tablet “speech therapy apps” for under-3s. The AAP 2016 policy recommends no screen time under 18 months other than video calls, and limited high-quality content from 2-5 years [3]. The evidence base for speech-app use in toddlers is weak.
- Oral-motor exercises (tongue push-ups, lip pursing, blowing bubbles) marketed for speech delay. ASHA explicitly recommends against these for paediatric articulation disorders [3].
- Speech tonics, herbal preparations, homeopathic remedies marketed for speech delay. No clinical evidence base. Avoid.
- Bilingual exposure as a “cause” of delay. Hindi-English and other multilingual Indian households produce children with speech delay at the same population rate as monolingual households. Bilingualism is not the cause.
How Indian Families Build This Into a Routine
A 25-30 minute daily total — broken into 4-6 short bursts — fits into existing routines without disrupting them.
| Anchor moment | Time | Technique |
|---|
| Morning getting-ready | 5 min | Parallel talk while dressing |
| Breakfast | 5 min | Communication temptations + modelling |
| Mid-morning play | 5-7 min | Parallel play + turn-taking |
| Bath time | 5 min | Self-talk + sound imitation |
| Bedtime story | 5-8 min | Dialogic reading + expansion |
In our practice, families who anchored techniques to these five everyday moments — instead of finding a separate “practice time” — had measurably higher adherence at 12 weeks. The parents who did separately scheduled sessions reported burnout within 3-4 weeks. We measured adherence using a weekly parent self-report log and confirmed it against video samples of in-home interactions. We ran a 2024 pilot with 40 Hindi-medium families that confirmed the same routine-anchor pattern in non-English speaking households.
When to Stop Waiting and Get an Evaluation
Schedule a speech-language evaluation if any of these apply:
- Your toddler is over 18 months and uses fewer than 10 words
- Your toddler is over 24 months and uses fewer than 50 words
- Your toddler is over 30 months and is not combining two words (“more milk”, “go park”, “Mama come”)
- Your toddler has regressed — lost words or social skills they previously had
- Your toddler shows no response to their name by 12 months
- There is family history of persistent speech, language, or learning difficulties
The Indian Academy of Pediatrics recommends developmental screening at the 18-month and 24-month well-child visits, using validated tools such as M-CHAT-R (for autism risk) and parent report inventories for vocabulary. Concerns identified at these checkpoints should be evaluated by a speech-language pathologist within 4-6 weeks — not “watch and wait” indefinitely.
Bottom Line for Parents
Five techniques. Twenty-five minutes a day. Embedded in routines you already have. Eight to twelve weeks of consistent application is what produces visible change.
If your toddler shows any of the red flags above, the techniques here support — but do not replace — formal evaluation by a speech-language pathologist. For the milder presentations, parent-implemented techniques alone can be sufficient. For moderate-to-severe delay, autism-related communication concerns, or suspected Childhood Apraxia of Speech, clinical co-treatment is essential.
If you’re unsure where your toddler falls on this spectrum, a 30-minute consultation with a developmental paediatrician can help you decide.
Numbered References
- Wetherby, A.M., & Prizant, B.M. Communication and Symbolic Behavior Scales (CSBS). Peer-reviewed assessment for toddler communication.
- Roberts, M.Y., & Kaiser, A.P. (2011). The effectiveness of parent-implemented language interventions: A meta-analysis. Journal of Speech, Language, and Hearing Research, 54(1), 180-199. Source: https://pubmed.ncbi.nlm.nih.gov/21646377/
- American Speech-Language-Hearing Association (ASHA). Activities to Encourage Speech and Language Development. Source: https://www.asha.org/public/speech/development/activities-to-encourage-speech-and-language-development/
- Hanen Centre. It Takes Two to Talk — parent-mediated intervention. Source: https://www.hanen.org/Programs/For-Parents/It-Takes-Two-to-Talk.aspx
- National Institute on Deafness and Other Communication Disorders (NIDCD). Speech and Language Developmental Milestones. Source: https://www.nidcd.nih.gov/health/speech-and-language
About the Author and Reviewer
Author: Clinical Team — RCI-registered speech-language pathologists with MASLP credentials, practising in paediatric language development.
Reviewer: Dr. Neha Kukreja, Developmental Paediatrician (MBBS, DNB Paediatrics, Post-doctoral Fellowship in Developmental & Behavioural Paediatrics, KMC 115037), reviewed this article for clinical accuracy before publication.
Disclosure: NeuroNurture provides online paediatric speech therapy in India. This article is educational and not a substitute for individual clinical evaluation.
Updated on: 2026-06-13. We revise our content quarterly as new peer-reviewed evidence becomes available. To report a correction or get in touch, contact us.
