Two-word stage

Also called Two-word combinations, Telegraphic speech, Word combinations

"More juice", "daddy gone", "no bed": the point where words start to combine, and the right first target for AAC as well.

What it is

The two-word stage is when a child starts putting two words together to make a meaning neither word has alone. "Mummy sock" might mean mummy's sock, or mummy put my sock on, or mummy look at the sock. Context tells you which. It's the first grammar: word order is already usually right, and the child is expressing relationships (who did what, where, what's gone), not just labels.

It typically arrives around two years, once a child has something like fifty words to combine. The words are mostly content words with the grammar missing, which is why it's sometimes called telegraphic.

Who it can help

Parents of toddlers, and anyone working with a person who has single words but isn't combining them: a child with developmental language disorder or Down's syndrome, or an AAC user of any age who's been left at one symbol per turn.

For AAC it's the right target, and it's usually the neglected one. A single-word board can only ever be used for single words. Combining needs a board with the right words on it (core words like more, go, not, big, that) and partners who model two-symbol messages rather than one.

How it works

Children combine words that express a small set of relationships: agent and action ("daddy go"), action and object ("eat biscuit"), possession ("my cup"), location ("teddy bed"), recurrence ("more juice"), disappearance ("juice gone"), negation ("no bath"), description ("big dog"). Nearly all early two-word utterances fit one of these, in any language.

From two to three, combinations lengthen to three and four words and grammar starts arriving (grammar and syntax). Mean length of utterance tracks it.

In AAC the same relationships are the target. A core board with "more", "go", "stop", "not", "big", "mine", "there" lets a person make nearly every early combination with a handful of symbols. The Talk board has 308 cards across fourteen sets including sentence starters and actions, and the cards build into a spoken sentence rather than being spoken one at a time.

Getting started

Take what the child says and add one word. "Juice" becomes "more juice" or "juice gone". Say it, don't demand it back (expanding and recasting). Do it twenty times a day for a fortnight and count.

On a device, model two symbols at a time. "Go" plus "car". "More" plus "bubbles". "Not" plus "that". Press them yourself while you talk (aided language stimulation). Make sure the words you're modelling exist on the board; if "more" and "gone" aren't there, add them before anything else.

Set up situations that need two words. Give a little, so "more" is needed. Put something out of reach, so "want ball" beats "ball". Stop the swing, so "go" or "more push" has a job to do (communication temptations).

Where to get help

The NHS page for 1 to 2 years and for 2 to 3 years. Speech and Language UK for advice and a helpline. Communication Matters and ACE Centre for AAC vocabularies built for combining.