Speech Therapy for Pronoun Reversal

Pronoun reversal is one of those wildly frustrating things to work on in speech therapy, like a game of “Who’s on first?” In pronoun reversal, your child refers to themselves as “you” and refers to you as “me.”

It’s even more frustrating than that comedy sketch, because your communication partner isn’t joking and might actually cry after telling you, “You do it,” and then seeing you follow through on their request.

What’s happening and why is this so persistent?
Your child is a Gestalt learner, and is learning whole sentences at a time, without learning the meanings of each individual word.

Basically in order to fix pronoun reversal in speech therapy, you need to teach a whole lot of sentences containing your target words, in this case, you and I/me. Only once your child has command of lots of different sentences containing these target words can he start to break down the sentence into meaningful units that can start to be switched out.

  • Correct your child when they say something with the wrong pronoun that can be immediately reinforced. Example, my child says “Pick you up” when he wants to be picked up, because he’s only ever heard the sentence, “Do you want me to pick you up?” I’ve never once told him to “Pick me up.” Model the correct sentence and immediately reinforce it with whatever makes sense, in my case, picking my kid up.
  • If necessary, act confused when your child uses the wrong pronoun. This gives the critical feedback that what they have said does not make sense. When my kid asks to “pick you up,” I say “really? Ok, I’m pretty heavy, but you can try? —– OHHH you want ME to pick you up. Say ‘pick ME up.’”
  • Start teaching lots of different “I” and “me” sentences:
    • Give it to me
    • Throw it to me
    • Show it to me
    • Tell me how
    • Give me a turn
    • I want…
    • I need…
    • I hear…
    • I see…
    • I like…
    • Can I have…
    • I am… (in response to “where are you?” — right here, in the bath, sitting with Daddy)
    • I am… (in response to “how are you feeling?” – happy, sad, hungry, thirsty, tired)
    • I have to…
  • This will make an immediate difference in producing the right pronoun in context with your learned sentences, and with enough sentences, will teach your child the actual meanings of you and I.
tips for daily routines

Build language when you cook together


Speech Therapy at Home for Busy Families

I was inspired to create this video/post because of my own to-do list! Like everyone else, I’m pretty busy, but there are so many ways I can and do work in speech and language learning throughout our day. Often, when I talk to families, they have some misconceptions about speech therapy: it needs to be this super-structured adult-directed specially set aside time. And when people can’t make that happen, because… life!They feel guilty, and they think they can’t make a difference in their child’s abilities. But I’m here to tell you THAT’S NOT TRUE!

The best, best, best way to work on developing your child’s speech and language is to work it into your day. Research consistently shows that parents are the most important teacher for young children. Even the most perfect, most intensive therapy program is no match for you and your busy life. Therapy programs have to work on something called “generalization,” which is basically whether or not skills learned in therapy can carry over to new settings and new communication partners. So, if your child learns to say “bubbles please!” to your therapist in her office, that doesn’t mean your child will automatically ask you or use that skill at home. But if you practice all day long in different contexts, that skill is more likely to stick and to generalize.

When parents are really busy, they often have trouble with the “big picture” strategies, like “get face to face” because it’s vague, and they have A LOT on their minds. When that happens, people are sometimes much more successful with specific instructions, like “Say the names of the clothes while you’re folding laundry. You can work in words about colors, sizes, and numbers.”

So I’ll spend some time over the next few posts giving you some specific ideas to help encourage your child’s speech and language development while you’re still doing your day-to-day activities. Talk to you soon!


Face to Face Interactions

One of the first tools deployed in any good speech-language pathologist’s toolbox is getting face-to-face with a child. It is one of the first activities taught in many parent training programs, such as the Hanen Programme and DIR Floortime, and for good reason.

Verbal communication and learning to verbally communicate start with nonverbal communication. A child who regularly and effectively communicates via facial expressions, gestures, and eventually sounds will have a much easier time moving to words than a child who doesn’t employ those tools. To help our children learn to use those precursors to verbal language, we need to give them lots of opportunities to practice by coming face-to-face with them. This gives early learners a chance to read our expressions and learn about how we react when they use communication.

Getting face-to-face is exactly what it sounds like – move into your child’s line of sight. When children can see your face and your reactions, it helps add meaning to the interaction. For example, a child who drops a toy may not appear to notice, but if a parent makes an exaggerated facial expression and “Uh-Oh!”, the child is more likely to understand the meaning of “Uh-Oh,” to pay attention to the dropped toy, and to follow through on an interaction related to talking about the dropped toy or picking up the toy.

The more you get face-to-face with your child, the more opportunities he will have to learn to communicate with you.



Welcome to Joy Talks Speech

Who am I and why am I doing this?

Good question!

My name is Joy, and I am a speech-language pathologist working in early intervention, the population from birth to 3 years old. I have a bachelor’s degree in psychology from Penn State received my Master’s degree from Marywood University in speech-language pathology in 2010. I worked with adults for 2 years, and then was given an opportunity to try early intervention. There I found my passion. Over the last 5 years, I have treated hundreds of children and helped them to talk, and have found it to be incredibly rewarding. As I grew in the field, I found myself asking the same clinical questions over and over and decided to return to school for my clinical doctorate.

What is a clinical doctorate? So, in the field of speech-language pathology, the Master’s degree is the entry level degree. The PhD is a separate career path which terminates in academia and the lab, and never the twain shall meet. Or sort of. The clinical doctorate is for people like me, who work with people, who have questions that are born out of their day-to-day work. It helps them learn to do real-world clinical research to answer those questions.

I am the kind of person who, when she gets interested in something, needs to know everything there is to know about it. Over the last few years, my caseload has transitioned to predominantly children with autism, and I found I had more questions than answers. When I proposed my research project, I was SO EXCITED. I thought the research question would change the face of treatment today.

Then, I had a baby, and spent some of my time on maternity leave catching up on reading (and trying to map out my post-baby career plans) while he napped. I read a book by Temple Grandin (because I have to know everything there is about autism) and was dumbstruck: Temple had done some groundbreaking research about humane treatment for animals, and she found that decades later, it wasn’t well known or implemented. She realized that MOST RESEARCH DOESN’T MAKE IT TO THE REAL WORLD. But what research consistently shows us is that parents are the MOST important and influential teachers for this age group.

With all this in mind, I thought and thought about how to bring a message to the people who need it. I realized that we have such a rich information distribution medium in the ever-changing face of technology, and that if I wanted to make a real change, I’d have to consider the unconventional.

Thus was born Joy Talks Speech. I truly hope it helps, entertains, and brings joy to a potentially difficult process.

There is SO MUCH information out there, and as a parent hungry for answers, it is hard to sort through. Not only that, but you know just from searching for answers about, say, your sore throat, you’ll get answers like: Common cold! Cancer! Your thyroid! Dehydration! Acid reflux!

And you’ll get ideas like this for your sore throat: drink expensive all-natural Miracle TeaTM! Write your will! Only speak in a whisper! You’ll need surgery! It will get better on its own! Medication! – don’t even get started on which kind – that’s its own rabbit hole.

So, my goal is to bring you information. Real, research-backed information. To show you how to use it in your own home, and to help you recognize and avoid bad information. To help you understand your child and how you can help and how you can get help.

Also, with any “therapy,” whether it be speech, physical, or psychological, there is work that you need to put in to make a change. Early in my career, I am ashamed to admit, I would be frustrated when I would show a family the same technique week after week and every week, they’d admit they didn’t use it, maybe didn’t understand it, and I’d show them again.

There were two things I didn’t understand here, and the first one is, um, entertaining.

To set the stage, once, I went to circus school. For real.


No seriously, what happened is I found an aerial arts class, which is static trapeze and aerial silks, and it happened to be put on by a real-deal circus school. I LOVED the idea of it, and I loved doing it. Kindof. It was HARD. When we were learning basic skills, I would watch the demonstration, listen to the discussion, and get onto the apparatus with no idea how I was supposed to be moving my body. It was a totally foreign set of skills combined with an incredible amount of physical difficulty, either one of which would have been challenging on its own. Put together, it was very frustrating, and my progress was slow. When I finally could climb a decent distance up the silks, one day we were supposed to learn a new and prettier technique to come back down.

I painstakingly climb, concentrating on my technique and using all my strength, to get about twenty feet into the air, bit by bit. I look down to discover “OH MY GOD I did it!” Already tired, and elated by my success, I start the dismount. I take my feet off the silks and then realize, twenty feet in the air and tired, that “Holy moly I don’t remember how to get safely down!”

My instructor was FURIOUS, and shouted at me as I dangled there, “You have to listen! And you have to get stronger!”

And a lightbulb came on. People need to be showed new speech therapy techniques over and over because it’s not the same to watch me and hear me. When they do it themselves, they are feeling it in a new way and might get stuck halfway through and not remember what to do. And as they learn, they’ll get stuck in new places while they make progress.

Secondly, when people, particularly parents who have just gotten a game-changing diagnosis of autism come to see me, I’m one of a string of people they have seen, each one of whom has delivered information to them rapid-fire… AND they are in no shape to process it all.

So, by putting this stuff out there for you when you can watch it or read about it whenever you need to, I’m hoping it helps you get unstuck and helps you learn at your own pace.

In no way is this meant to be a substitute for real-live honest-to-God evaluation or intervention by a professional, but to help you choose that person and remember and use that information at home. Please reach out when you have questions, and enjoy the journey!