Q: At what age should a child be able to blow bubbles or a horn? My two-year-old client, who I suspect has apraxia, cannot blow and he is very hard to understand.

We have no data on when children should be able to blow bubbles or a horn.  However, I have been observing the blowing skills of young children for 40 years.  I have observed scores of children trying to blow out their birthday candles and my experiences can be summarized as follows––

The average child cannot blow out the candle on his first birthday cake.  The average child can however be taught to blow out the two candles on his second birthday cake. The average child has no problem blowing out the three candles on his third birthday cake.

These informal observations suggest that blowing comes in around two years of age and matures by three years of age. (I wish some enthusiastic student would do a master’s thesis on this.)

What does this mean? It means that blowing per se has nothing to do with speech. Think about it… By the time a child can blow out a candle, he already is producing most of the phonemes in the English language, and he is putting them into words to form 3-5 word utterances.  Thus, the ability to blow like this is a more advanced skill than first words or first phonemes.

From this we learn that blowing has nothing to do with speech.

However, inhaling and exhaling have everything to do with speech.  Speech is the modification of controlled exhalation–– “It is upon the prolonged, controlled exhalation that speech sounds are produced” (Van Hattum, 1980).

In therapy this means that we do not use blow toys to teach blowing.  However, we do use blow toys to teach children about inhaling and exhaling so they then can breathe better for speech.

A client like yours, who is only two-years-old, should not be able to blow well. However, your client also could have a basic problem with breath support that you are just coming to an awareness of. You said he might have apraxia. If so––if he truly has a motor speech disorder––he should have problems with breath support for speech.

My suggestion is that you use blow toys to teach your client about INHALING. Most kids who do not blow well do not know how to bring in enough air. Purposeful inhalation is the real problem, and without enough air coming in, there will not be enough exhalation strength to blow, and there may not be enough air upon which to produce good speech. Your client’s entire problem with expressive speech could stem from his lack of breath control related to inhalation. Use blow toys that work on both inhalation and exhalation, and teach him ho to draw in more air.

Best toys for working on inhalation–– Kazoos, sirens (lip sirens and tube sirens), toy harmonicas, whistle straws, and inspiration spirometers.

I will have a whole chapter on breath support in my next book to be called “The Marshalla Guide to 21^st Century Articulation Therapy.”

Reference

• Van Hattum, R. J. (1980). Communication Disorders: An Introduction. NY: Macmillan.